基于内容分析法探讨长蛇灸治疗AS疗效及其影响因素

Efficacy and influencing factors of long snake-like moxibustion on AS based on content analysis method

目的:采用内容分析法通过文献样本分析、总结与强直性脊柱炎(AS)患者疗效相关的影响因素。方法:基于内容分析法,通过中国知网、维普中文科技期刊全文数据库、万方数据知识服务平台、中国生物医学文献数据库、PubMed期刊数据库进行检索分析。优化研究中选取AS患者60例,均行长蛇灸治疗,按照最终疗效分为总有效组与无效组,分析影响效应指标有无应答的因素。结果:相关影响因素主要为24种,包括患者人口社会学、遗传、生活环境、病情评估、生物学信息、血清炎性指标、基因多态性与磁共振动态增强成像指标等8大类。要素差异分析显示发病年龄、病程、风湿病家族史、吸烟史、肠道感染、Bath强直性脊柱炎疾病活动指数评分、强直性脊柱炎疾病活动评分-C反应蛋白评分、神经功能分级、骨赘形成、基线白介素-34(IL-34)、IL-35、IL-18、IL-37、基线红细胞沉降率、基线C反应蛋白、基线中性粒细胞与淋巴细胞比率、基线血小板与淋巴细胞比率、亚甲基四氢叶酸还原酶1298(CC基因型)、增强因子(骶侧/髂侧)、增强斜率(骶侧/髂侧)、容积转移常数(骶侧/髂侧)、血管外细胞外间隙容积比(骶侧/髂侧)等均是影响效应指标有无应答的因素。结论:临床应重视AS患者的相关影响因素,并探索未知因素及其组合影响的深宽度,优化能有效治疗AS患者的针对性治疗方案。

Objective:To analyze and summarize the influencing factors related to the efficacy of ankylosing spondylitis(AS)patients by literature samples based on the content analysis method.Methods:The data retrieved from the China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,China Biomedical Literature Database,and PubMed Journal Database were analyzed.Sixty patients with AS treated with long snake moxibustion were selected by optimization study and divided into a total effective group and an ineffective group according to the final efficacy of their treatment,and the factors affecting the presence or absence of response of the effect indicators were analyzed.Results:There were 24 main relevant influencing factors,including eight categories:patient demographic and sociologic,genetic living environment,disease assessment,biological information,serum inflammatory index,genetic polymorphism and magnetic resonance dynamic enhancement imaging index. Factor difference analysis revealed that the age of onset, disease duration, family history of rheumatic disease, smoking history, intestinal infections, Bath ankylosing spondylitis disease activity index score, ankylosing spondylitis disease activity score-C-reaction protein score, neurologic grading, bone flab formation, baseline interleukin-34 (IL- 34), IL-35, IL-18, IL-37, baseline erythrocyte sedimentation rate, baseline C-reactive protein, baseline neutrophil-to-lymphocyte ratio, baseline platelet lymphocyte ratio, 5,10-methylenetetrahydrofolate reductase 1 298 (CC genotype), enhancement factor (sacral/iliac side), enhancement slope (sacral/iliac side), transfer constant (sacral/iliac side), and extravascular extracellular volume (sacral/iliac side) were all factors influencing the presence of effector indexes of response. Conclusion: Clinical attention should be paid to the relevant influencing factors of AS patients, and the deep width of the influence of unknown factors and their combinations should be explored to optimize the targeted therapeutic protocols for the effective treatment of AS patients.