基于多水平统计模型评价针灸治疗原发性抑郁症的疗效及干预层次  

Evaluation of Therapeutic Effect and Intervention Level of Acupuncture and Moxibustion in Treatment of Primary Depression: Based on a Multilevel Statistical Model

作　　者：黎波[1] 杜元灏[1] 骆雄飞[1] 

机构地区：[1]天津中医药大学第一附属医院

出　　处：《中医杂志》2016年第7期570-573,共4页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81403454)

摘　　要：目的建立多水平统计模型,定量评价针灸治疗原发性抑郁症的疗效及干预层次,并探讨其与Meta分析结果的异同。方法检索数据库,纳入针灸治疗原发性抑郁症文献,首先构建评价针灸疗效的拟合对数事件发生率线性模型,运用MLwi N 2.26软件拟合结果,建立不同干预方式为指示变量的组合模型,以评价不同针灸干预方式对整体疗效影响程度。并对上述数据采用Rev Man 5.3软件进行Meta分析,比较两模型结果。结果最终纳入13项研究,多水平统计模型结果表明,单用针灸及针灸联合药物改善原发性抑郁症患者临床控制率优于药物[RR=1.54,95%CI（1.02,2.32）;RR=2.14,95%CI（1.63,2.81）];Meta分析结果显示,针灸联合药物改善原发性抑郁症患者临床控制率及总有效率优于药物[RR=2.24,95%CI（1.68,2.98）;RR=1.12,95%CI（1.05,1.19）]。干预方式指示变量数据模型分析结果表明,单用针灸与针灸联合药物在临床控制率、显效率及总有效率比较,差异均无统计学意义（P〉0.05）。综合多水平统计模型结果,单用针灸干预临床控制率为27.97%~28.14%,临床显效率为30.36%~35.79%,临床总有效率为90.85%~91.82%;针灸联合药物干预临床控制率为36.42%~36.64%,临床显效率为38.52%~38.84%,临床总有效率为90.91%~93.58%。结论多水平统计模型方法可评价针灸疗效及干预层次,支持针灸疗效的高质量证据充分,较Meta分析结果更为准确。Objective To establish a multilevel statistical model,quantitatively evaluate therapeutic effect and intervention level of acupuncture and moxibustion treating primary depression and study the similarities and differences between above results and the results of Meta analysis. Methods The researchers retrieved database to collect literatures acupuncture and moxibustion treating primary depression. First of all,the researchers constructed linear model with incidence rate of fitting logarithmic event that evaluated therapeutic effect of acupuncture and moxibustion. They used software MLwi N 2. 26 to fit results for establishing combined model with different interventions as indicator variable. The researchers established the model to evaluate incidence to curative effect of different intervention with acupuncture and moxibustion. Then they used Rev Man 5. 3 software to make Meta analysis to above data and compared the results between the two models. Results Eventually 13 studies were brought into this research. Results of multilevel statistical model showed acupuncture and moxibustion or the two combined with medicine can better improve clinical control rate of patients with primary depression compared with only medicine [RR = 1. 54,95% CI（ 1. 02,2. 32）; RR = 2. 14,95% CI（ 1. 63,2. 81） ]. Results of Meta analysis showed acupuncture and moxibustion combined with medicine can better improve clinical control rate and total effective rate of patients with primary depression compared with only medicine [RR = 2. 24,95% CI（ 1. 68,2. 98）; RR = 1. 12,95% CI（ 1. 05,1. 19） ]. Results of data model with interventions as indicator variable showed that there were no statistically significant difference in clinical control rate,effective rate and total effective rate between only acupuncture and moxibustion and acupuncture and moxibustion combined with medicine（ P 〉 0. 05）. Collecting results of multilevel statistical model,clinical control rate that intervened with acupuncture and moxibustion was 27. 97%- 2

关 键 词：针灸 多水平统计模型 原发性抑郁症 疗效评价 干预层次 

分 类 号：R246.6[医药卫生—针灸推拿学]