针刺对慢性自发性荨麻疹患者应急使用抗组胺药的影响:基于随机对照试验结果的二次分析  

Impact of Acupuncture on Emergency Use of Antihistamines in Patients with Chronic Spontaneous Urticaria:A Secondary Analysis Based on the Results of a Randomized Controlled Trial

作　　者：肖显俊[1] 石云舟 曹炜 邹子豪 陈思珏 杨茜 罗亚兰 戴雪纯 李瑛[1] 金荣疆[1] 李涓[1] Xiao Xianjun;Shi Yunzhou;Cao Wei;Zou Zihao;Chen Sijue;Yang Qian;Luo Yalan;Dai Xuechun;Li Ying;Jin Rongjiang;Li Juan(Chengdu University of Traditional Chinese Medicine,Chengdu,610075,China)

机构地区：[1]成都中医药大学,四川成都610075

出　　处：《成都中医药大学学报》2024年第5期19-24,共6页Journal of Chengdu University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年项目(82205283,82105026,82305410);中国博士后科学基金(2022MD723719,2021M693787);四川省科技厅基金项目(24NSFSC1549);国家重点研发计划项目(2017YFC1703605)。

摘　　要：目的:本研究通过对前期多中心随机对照试验数据进行二次分析,评估针刺作为非药物疗法在减少慢性自发性荨麻疹(Chronic Spontaneous Urticaria,CSU)患者对应急使用抗组胺药依赖方面的潜力,为CSU的多元化管理提供新的证据。方法:患者随机分配到针刺组、假针刺组和等待治疗组,并记录了4周治疗期及4周随访期内应急使用抗组胺药的情况。本研究主要评估指标为应急使用抗组胺药的平均天数,通过单因素方差分析(ANOVA)及Tukey HSD多重比较探讨不同时期组间应急使用抗组胺药的平均天数差异。对于组内比较,采用Welch的t检验评估不同时期的差异。非参数Mann-Whitney-U检验进一步验证了组间差异的稳健性。卡方检验和Fisher精确检验用于分析治疗组间用药人数的统计学差异。结果:共分析了296名患者的数据。与针刺组相比,等待治疗组在治疗期(0.30,95%CI0.08 to 0.53,P=0.005)和随访期(0.31,95%CI0.12 to 0.50,P<0.001)应急使用抗组胺药的频率增加。组内分析表明,尽管3组应急使用抗组胺药的平均天数有所下降,但这些变化无统计学意义(P>0.05)。此外,与等待治疗组相比,治疗和随访期间接受针刺治疗的患者中应急用药的人数较少(P<0.05)。结论:针刺治疗显示了减轻CSU患者依赖应急用药的潜力,为减少药物负担提供了一个有效的非药物治疗选择。Objective:This study conducts a secondary analysis of data from a previous multicenter randomized controlled trial to assess the potential of acupuncture as a non-pharmacological therapy in reducing the dependence of CSU patients on emergency use of antihistamines,providing new evidence for the diversified management of CSU.Methods:Patients were randomly assigned to acupuncture,sham acupuncture,and waiting treatment groups,with records of emergency antihistamine use during a 4-week treatment period and a 4-week follow-up period.The primary outcome was the average number of days of emergency antihistamine use,which was investigated for differences between groups during different periods through one-way analysis of variance(ANOVA) and Tukey HSD multiple comparisons.For within-group comparisons,Welch's t-test was used to assess differences between periods.The robustness of the differences between groups was further verified by the non-parametric Mann-Whitney U test.Chi-square tests and Fisher's exact test were used to analyze the statistical differences in the number of people using medication between treatment groups.Results:Data from 296 patients were analyzed.Compared to the acupuncture group,the waiting list group showed a significant increase in the frequency of emergency use of antihistamines during the treatment period(0.30,95%CI 0.08 to 0.53,P=0.005) and the follow-up period(0.31,95%CI 0.12 to 0.50,P<0.001).Intra-group analysis indicated that,despite a decrease in the average days of emergency antihistamine use across all three groups,these changes were not statistically significant.Moreover,compared to the waiting treatment group,a significantly fewer number of patients in the acupuncture group resorted to emergency medication during the treatment and follow-up periods(P<0.05).Conclusion:Acupuncture treatment has shown potential in reducing the reliance of CSU patients on emergency medication,offering an effective non-pharmacological option for reducing the medication burden.

关 键 词：慢性自发性荨麻疹 针刺 二次分析 抗组胺药 综合管理策略 

分 类 号：R245[医药卫生—针灸推拿学] R269[医药卫生—中医临床基础]