基于真实世界针灸治疗动脉粥样硬化方法探索

A Primer on Real World Study from the Treatment of Atherosclerosis by Acupuncture

近年来,真实世界研究(real-world study,RWS)日益受到中医领域研究者的关注。通过对动脉粥样硬化(atherosclerosis,AS)的针灸真实临床数据特点和RWS在AS针灸临床应用的可行性进行分析,认为RWS在该疾病研究中具有独特优势,RWS将针灸临床实际作为数据源,但也存在一些问题:①如何对样本进行分类;②如何设定高效的观察期;③如何提高数据质量。针对以上问题,该文将根据危险因素、合并疾病、风险修正因子、中医证候进行样本分类;根据基线、终点事件、终点预测模型确定观察时间;利用倾向评分重叠加权法控制数据的混杂因素,强调敏感性分析与辅助变量相结合,充分体现针灸临床数据优势,以期为动脉粥样硬化的针灸疗效评价提供思路。

In recent years,more and more intention has been paid for real world study in the field of traditional Chinese medicine.In this paper,we have explored the feasibility of the clinical application of atherosclerosis by using the real-world acupuncture data and analysed the characteristic of this real world clinical data.Our research reveals that real world study has a unique advantage in atherosclerosis research,and we are able to regard actual clinical data from acupuncture as data source.However,there are also some problems:①How to classify samples;②How to set an efficient observation period;③And how to tackle missing data and confounders.In the view of the above issues,this paper is based on the risk factors,comorbidity,risk modifiers,syndrome of Chinese medicine to classify samples;based on base line,overcome events,destination prediction model to set observation time;based on propensity score overlap weighting to control confounding factors,and the combination of sensitivity analysis and auxiliary variables,which fully symbolizes the priority of acupuncture,and these provide a better method for the evaluation of efficacy analysis of acupuncture for atherosclerosis.