生存质量与生存时间联合模型在慢性阻塞性肺疾病结局测量中的应用与思考

Application and consideration of combined quality of life and survival time model in chronic obstructive pulmonary disease outcome measurement

慢性阻塞性肺疾病(COPD)病程长,伴随反复急性加重,严重影响患者生存质量。但当前以临床流行病学和循证医学为主导的结局指标测量方法,未能揭示COPD患者生存质量与生存时间结局指标的动态变化及内在关联,亟需开展对COPD生存质量与生存时间结局的联合评价研究。文章阐述了纵向与生存数据联合模型研究的演进脉络,以及在呼吸系统疾病、中医药临床试验的应用现状,分析联合模型运用于COPD研究生存质量与生存时间联合分析的必要性与潜在价值。并基于COPD中医临床试验数据,将联合模型初步应用于探索COPD生存质量与急性加重的内在关联,以期为中医临床试验结局测量研究提供新的思路与方法。

Chronic obstructive pulmonary disease(COPD) has a long course,accompanied by repeated acute exacerbation,which seriously affects patients' quality of life.However,the current outcome index measurement methods dominated by clinical epidemiology and evidence-based medicine fail to reveal the dynamic change and internal correlation of COPD patients' quality of life and survival time outcome index,so it is urgent to carry out a joint evaluation study of COPD quality of life and survival time outcome.This paper describes the evolution of longitudinal and survival data combined model research,as well as its application status in respiratory diseases and traditional Chinese medicine clinical trials,and analyzes the necessity and potential value of the combined model applied in COPD studies for quality of life and survival time analysis.Based on COPD clinical trial data,the combined model was preliminary applied to explore the internal correlation between COPD quality of life and acute exacerbation,in order to provide new ideas and methods for the outcome measurement of TCM clinical trials.