基于多准则决策的通窍止鼾方联合点刺治疗儿童腺样体肥大痰瘀互结证效益-风险评价

Benefit-risk Assessment of Tongqiao Zhihan Formula Combined withAcupuncture Treatment for Adenoid Hypertrophy Children with Phlegm andBlood Stasis Syndrome Based on Multiple Criteria Decision Making

目的:评价基于多准则决策的通窍止鼾方联合点刺治疗儿童腺样体肥大(adenoid hypertrophy,AH)痰瘀互结证效益-风险。方法:72例AH痰瘀互结证患儿按照随机数字表法平均分为研究组(36例)和对照组(36例)。建立通窍止鼾方联合点刺治疗儿童AH痰瘀互结证的多准则决策(multi-criteria decision analysis,MCDA)模型。结果:治疗后,研究组的主症状积分、中医症状总积分、A/N值、OSA-18评分及腺样体分级积分均显著低于对照组(P<0.05),研究组有效率(97.22%)显著高于对照组(83.33%)(P<0.05),研究组不良反应发生率(8.33%)显著低于对照组(30.56%)(P<0.05)。MCDA模型定量评估结果显示,通窍止鼾方联合点刺治疗AH痰瘀互结证患儿的效益高、风险低,获益高于风险,且优于糠酸莫米松鼻联合孟鲁司特钠治疗。结论:通窍止鼾方联合点刺AH痰瘀互结证患儿疗效显著,不良反应发生率较低。

Objective:To explore the benefit risk assessment of Tongqiao Zhisnoring Formula Combined with Acupuncture Treatment for Children with Adenoid Hypertrophy(AH)Syndrome of Phlegm and Blood Stasis.Method:72 children with AH phlegm stasis syndrome were randomly divided into a study group(36 cases)and a control group(36 cases)using a random number table method.Establish a multi criteria decision analysis(MCDA)model for the combination of Tongqiao Zhisnore Formula and acupuncture treatment of phlegm stasis syndrome in children with AH.Result:After treatment,the main symptom score,total score of traditional Chinese medicine symptoms,A/N value,OSA-18 score,and adenoid volume grading of the study group were significantly lower than those of the control group(P<0.05).The effective rate of the study group(97.22%)was significantly higher than that of the control group(83.33%)(P<0.05),and the incidence of adverse reactions in the study group(8.33%)was significantly lower than that of the control group(30.56%)(P<0.05).The quantitative evaluation results of the MCDA model show that the combination of Tongqiao Zhisnore Formula and needling in the treatment of children with AH phlegm stasis syndrome has high benefits and low risks,with benefits higher than risks,and is superior to the treatment of mometasone furoate nasal combined with montelukast sodium.Conclusion:The combination of Tongqiao Zhisnore Formula and acupuncture has a significant therapeutic effect on children with phlegm stasis syndrome of AH,and the incidence of adverse reactions is relatively low.