基于倾向评分法的中西医结合方案治疗艾滋病的生存评价研究  

Evaluation of Survival After the Treatment of AIDS by TCM- WM Therapy Based on Propensity Score Method

作　　者：崔伟锋[1] 李星锐[1] 郭建中[1] 杨小平[1] 徐立然[2] 

机构地区：[1] 河南省中医药研究院, 河南省郑州市450004 [2] 河南中医学院第一附属医院

出　　处：《中国全科医学》2016年第13期1594-1597,共4页Chinese General Practice

基　　金：国家十二五科技重大专项课题(2013ZX10005001);国家自然科学基金资助项目(81273877);河南省中医药科学研究专项课题(2014ZY01007)

摘　　要：目的评价中西医结合治疗方案对艾滋病患者生存时间的影响。方法于2011年1月—2013年12月,对河南省汝南县接受治疗的艾滋病患者741例进行为期3年的观察。根据治疗方案不同分为治疗组(n=219)和对照组(n=522)。治疗组采用益艾康胶囊联合高效抗反转录病毒(HARRT)治疗,对照组采用HARRT治疗。以是否参加益艾康胶囊治疗为因变量,利用Logistic回归模型计算艾滋病患者的倾向指数,并用贪心法按照倾向指数进行组间1∶1匹配,得到128例匹配后数据(64∶64),对匹配后的数据进行生存分析。结果经过倾向指数匹配法处理的数据,组间混杂因素的均衡性得到明显改善,治疗组中位生存时间为10.0年〔95%CI(9.5,10.8)〕,对照组为9.7年〔95%CI(9.6,10.2)〕;两组Kaplan-Meier生存曲线间差异有统计学意义(χ2=11.15,P=0.001)。结论益艾康胶囊联合HAART治疗效果优于单纯采用HAART治疗;在艾滋病的临床疗效评价中,倾向评分法可有效均衡组间的混杂因素。Objective To evaluate the influence of TCM- WM therapy on the survival time of AIDS patients. Methods From January 2011 to December 2013,we enrolled 741 AIDS patients who received treatment in Runan County of Henan Province to conduct 3- year observation. According to different therapies,the patients were assigned into treatment group（ n= 219） and control group（ n = 522）. The treatment group was treated by Yiaikang capsules combined with HARRT,and the control group was treated by HARRT. With taking Yiaikang capsules or not as the dependent variable,Logistic regression model was used to calculate the propensity score of the patients. The greedy method was used to make 1∶ 1 match between the two groups based on propensity scores. After 128 patients were matched（ 64∶ 64）,survival analysis was made based on their data. Results After matching, balance of confounding factors between the two groups was significantly improved. The median survival of treatment group was 10. 0 years 〔95% CI（ 9. 5,10. 8） 〕,and that of control group was 9. 7 years 〔95% CI（ 9. 6,10. 2） 〕.The two groups were significantly different in Kaplan- Meier survival curve（ χ^2= 11. 15, P = 0. 001）. Conclusion The efficacy of Yiaikang capsules combined with HAART is superior to HAART alone. In the evaluation of the clinical efficacy of AIDS,propensity score method can effectively balance the confounding factors between the two groups.

关 键 词：获得性免疫缺陷综合征 中西医结合疗法 治疗结果 倾向评分 

分 类 号：R24[医药卫生—中医临床基础] R512.62[医药卫生—中医学]