基于Logistic回归模型的针刺蝶腭神经节治疗变应性鼻炎疗效影响因素研究  

Study on infuence factors of acupuncture sphenopalatine ganglion in treating allergic rhinitis based on Logistic regression model

作　　者：张鹏[1] 商晓娟[1] 谭翊[1] 杨静[1] 王奎吉[1] 许世闻 汪芗 孙三峰 於堃[5] 赵新雨[6] 舒凝 杨威[1] 陈陆泉[1] ZHANG Peng;SHANG Xiaojuan;TAN Yi;YANG Jing;WANG Kuiji;XU Shiwen;WANG Xiang;SUN Sanfeng;YU Kun;ZHAO Xinyu;SHU Ning;YANG Wei;CHEN Luquan(Department of Acupuncture,Bejing Tongren Hospital,Capital Medical University,Bejing 100010,China;Department of Acupuncture Beijing Pinggu District Chinese Medicine Hospital,Beijing 101200,China;Department of Acupuncture,Beijing Tongzhou District Integrated Chinese and Western Medicine Hospital,Beijing 101149,China;Department of Rehabilitation,Huairou District Hospital of Traditional Chinese Medicine,Beijing 101400,China;Yuetan Community Health Service Centre,Fu Xing Hospital,Capital Medical University,Beijing 100032,China;Department of Acupuncture,Chaoyang District of Traditional Chinese Medicine Hospital,Beijing 100020,China;Beijing Fengtai District Yangqiao Outpaitient Department,Beijing 100068,China)

机构地区：[1]首都医科大学附属北京同仁医院,北京100010 [2]北京市平谷区中医医院针灸科,北京101200 [3]北京市通州区中西医结合医院针灸科,北京101149 [4]北京市怀柔区中医医院康复科,北京101400 [5]首都医科大学附属复兴医院月坛社区卫生服务中心,北京100032 [6]北京市朝阳区中医医院针灸科,北京100020 [7]北京市丰台区洋桥门诊部,北京100068

出　　处：《中华中医药杂志》2024年第1期429-434,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家重点研发计划(No.2022YFC2504100);国家自然科学基金项目(No.82205202);北京市自然科学基金项目(No.7212166);高层次公共卫生技术人才建设项目(No.学科骨干-02-46);首都卫生发展基金自主创新课题(No.2020-2-2055);北京市中医药科技发展资金项目(No.JJ-2020-18);北京中医药“薪火传承3+3工程”李新吾名老中医工作室;首都医科大学附属北京同仁医院院基金项目(No.2021-YJJ-PY-015)。

摘　　要：目的:探讨影响针刺蝶腭神经节治疗变应性鼻炎(AR)疗效的医患因素。方法:回顾2017年4月至2018年6月北京地区7个分中心收集的222例AR患者针刺蝶腭神经节治疗的病例报告,提取可能影响疗效的医患因素,计算患者针刺前后症状改善率,采用χ2检验对提取因素进行筛选,再采用非条件Logistic回归模型分析筛选因素,并评估该模型的预测价值。结果:患者体质,医师年龄、年门诊量、学历是可能影响针刺疗效的因素,相比阳虚质,气虚质患者获得满意疗效的概率降低了79.489%,而平和质患者该概率增加了198.937%;相比30岁以下医师,40~49岁医师的患者获得满意疗效的概率降低了76.018%,50~59岁医师的该概率降低了97.472%;相比本科学历医师,研究生学历医师的患者获得满意疗效的概率疗降低了85.925%,该模型ROC曲线的AUC值为0.751。结论:平和质患者针刺治疗效果最佳,规范培训可以帮助针灸医师掌握该项技术,针刺蝶腭神经节治疗AR遵循中医针灸学理论指导。Objective:To investigate the doctor-patient factors affecting the therapeutic effect of allergic rhinitis(AR)by acupuncturing sphenopalatine ganglion.Methods:From April 2017 to June 2018,222 cases of AR patients receiving sphenopalatine ganglion acupuncture treatment from 7 sub-centers in Beijing area were reviewed.The docter-patient factors that might affect the curative effect were extracted,and the symptom improvement rate of patients before and after acupuncture treatment was calculated.The extraction factors were screened by x test.Then,the selection factors were analyzed by unconditioned Logistic regression model,and the predictive value of the model was evaluated.Results:The patient's physique,the physician's age,the number of outpatient visits and the educational background were the factors that may affect the curative effect of acupuncture.Compared with yang deficiency,the probability of obtaining satisfactory curative effect was reduced by 79.489%in patients with qi deficiency,and increased by 198.937%in patients with mild deficiency.Compared with under 30 years old physicians,the probability of satisfactory efficacy was reduced by 76.018%for physicians aged 40~49 years and 97.472%for physicians aged 50-59 years.Compared with doctors with undergraduate degrees,the probability of patients with postgraduates obtaining satisfactory curative effect was reduced by 85.925%,and the AUC value of ROC curve of the Logistic regression model was 0.751.Conclusion:The best effect of acupuncture treatment is achieved in patients with mild condition.Standard training can help acupuncturists master this technique.The treatment of sphenopalatine ganglion follows the theoretical guidance of traditional Chinese medicine acupuncture.

关 键 词：蝶腭神经节 变应性鼻炎 多中心研究 针刺疗效影响因素 LOGISTIC回归模型 

分 类 号：R246.81[医药卫生—针灸推拿学]