摘要
探索临床针刺治疗脑梗塞的真实疗效。采用回顾性队列研究方法调查住院病历344例,按有无接受针刺治疗分为针刺组207例和无针刺组137例,分别采用倾向评分(PS)匹配法、回归法、加权法,以肌力疗效为效应指标,探索针刺是否对脑梗塞患者肌力产生明确的影响。匹配前运用COX回归模型和Logistic回归模型,分别采用PS分层回归法、PS逆处理概率加权法(IPTW)、PS标准化死亡加权法(SMRW)对两组肌力变化与总有效率的关系进行分析。发现针刺组疗效优于无针刺组,差异有统计学意义(P<0.05);是否康复治疗对疗效评价也有明显影响(OR=2.737,P=0.005 5)。PS匹配法匹配后利用Logistic回归模型分析是否针刺和是否康复治疗对肌力总有效率的影响,表明是否康复对疗效有明显影响(OR=2.930,P=0.024 7);扣除康复的效应后,针刺组疗效有优于无针刺组的趋势,但差异尚无统计学意义(OR=2.235,P=0.058 7)。说明常规治疗基础上,扣除康复治疗的效应,针刺有提高脑梗塞患者肌力的趋势,但尚需增加病例继续进行验证。
The actual efficacy of acupuncture on cerebral infarction was explored in clinical practice. The retrospective cohort study was adopted to investigate 344 cases via inpatient＇s medical cases. According to whether acu- puncture was received or not, an acupuncture group （207 cases） and a non-acupuncture group （137 cases） were di- vided. The matching method, regression method and weighting method of propensity score （PS） were adopted, and the efficacy on muscle strength was taken as effect index so that the specific impacts of acupuncture were ex- plored on the muscle strength in the patients of cerebral infarction. Before matching, COX regression model and Logistic regression model were used. And PS hierarchical regression, PS inverse probability weighting method （IPTW） and PS standardized mortality weighting method （SMRW） were applied to the analysis on the relationship between the muscle strengthen changes and the total effective rate in the two groups. It was found that the efficacy in the acupuncture group was better than that in the non-acupuncture group, indicating the significant difference （P〈0. 05）. Meanwhile, the rehabilitation therapy also brought the obvious impacts on the efficacy evaluation （OR=2. 737, P=0. 005 5）. After PS matching, the Logistic regression model was used to analyze whether acu- puncture or rehabilitation therapy impacted the total effective rate of muscle strength. The results showed that the efficacy was impacted apparently with the rehabilitation therapy involved （OR= 2. 930, P= 0. 024 7）. Without the rehabilitation effect considered, the efficacy in the acupuncture group was better potentially than that in the non-acu- puncture group, but without significant difference （OR=2. 235, P=0,058 7）. All of these indicate that on the basis of routine treatment, without the effect of rehabilitation therapy considered, acupuncture improves in tenden- cy of the muscle strength of the patients with cerebral infarction. However, it is expected to increas
出处
《中国针灸》
CAS
CSCD
北大核心
2015年第1期72-76,共5页
Chinese Acupuncture & Moxibustion
基金
国家自然基金项目:81273877
河南省中医临床学科领军人才培育计划项目:2013-10
关键词
中风
脑梗塞
针刺
倾向评分
疗效评价
stroke, cerebral infarction
acupuncture
propensity score
efficacy evaluation
