摘要
目的通过多模型融合分析方法,深入探究影响温肺固元脐灸治疗慢性阻塞性肺疾病(COPD)稳定期患者疗效的关键因素,为临床个体化诊疗提供依据。方法纳入107例接受温肺固元脐灸治疗的COPD稳定期患者,将其治疗13周、随访26周的研究数据进行清洗整理,分别根据治疗阶段和随访阶段患者是否存在急性加重情况分为急性加重组和未急性加重组,运用Lasso回归、弹性网络、随机森林等方法分别对其进行影响因素的初筛,再以任意两种方法筛选出的共同因素,进行Logistic回归分析,筛选出影响温肺固元脐灸治疗稳定期COPD患者疗效的因素。结果共纳入患者107例。治疗13周时,采用Lasso回归、弹性网络和随机森林方法筛选出任意2种方法共同筛选出的影响因素5个,分别为乏力评分、血红蛋白(HGB)及健康状况调查问卷(SF-36)—生理机能得分、社会功能得分、身体疼痛得分。Logistic回归分析显示,治疗13周时影响温肺固元脐灸治疗COPD疗效的因素有HGB(OR=0.973,P=0.031)、SF-36—社会功能得分(OR=1.833,P=0.043)。随访26周时,采用Lasso回归、弹性网络和随机森林方法筛选出任意2种方法共同筛选出的影响因素7个,分别为咯痰评分、喘息评分、乏力评分、SF-36—精力得分、SF-36—精神健康得分、慢阻肺患者报告结局量表修订版(mCOPD-PRO)—环境领域得分、慢阻肺患者疗效满意度问卷修订版(mESQ-COPD)—环境适应能力得分。Logistic回归分析显示,随访26周影响温肺固元脐灸治疗COPD疗效的因素有咯痰评分(OR=2.175,P=0.042)、SF-36—精神健康得分(OR=1.312,P=0.012)。结论HGB、咯痰症状、社会功能和精神健康可能是影响温肺固元脐灸治疗COPD临床疗效的因素。
Objective To explore the key factors influencing the effectiveness of Wenfei Guyuan Umbilical Moxibustion(温肺固元脐灸)in the treatment of patients with stable chronic obstructive pulmonary disease(COPD)through a multi-model fusion analysis,so as to provide a basis for clinical individualized diagnosis and treatment.Methods A total of 107 patients with stable COPD who received Wenfei Guyuan Umbilical Moxibustion were recruited.The study data of 13 weeks of treatment and 26 weeks of follow-up were cleaned and sorted out.The patients were divided into an acute exacerbation group and a non-acute exacerbation group according to the presence or absence of acute exacerbation at the 13-week treatment stage and the 26-week follow-up stage,respectively.Lasso regression,elastic net,random forest and other methods were used to conduct preliminary screening of influencing factors.Then logistic regression analysis was performed on the common factors screened by any two methods to identify the factors affecting the effectiveness of Wenfei Guyuan Umbilical Moxibustion in treating stable COPD.Results A total of 107 patients were included.At the 13 th weeks of treatment,five influencing factors were identified by any two of the methods including Lasso regression,elastic net and random forest,namely fatigue score,hemoglobin(HGB),Short Form 36-Item Health Survey(SF-36)physical function score,SF-36 social function score,and SF-36 physical pain score;logistic regression analysis showed that the factors affecting the effectiveness of Wenfei Guyuan Umbilical Moxibustion in treating COPD at 13 weeks were HGB(OR=0.973,P=0.031)and SF-36 social functioning score(OR=1.833,P=0.043).At 26 weeks of follow-up,seven influencing factors were identified by any two of the methods including Lasso regression,elastic net and random forest,namely expectoration score,wheezing score,fatigue score,SF-36 vitality score,SF-36 mental health score,the Modified Patient-Reported Outcome Scale for Chronic Obstructive Pulmonary Disease(mCOPD-PRO)environmental domain score,and the Modified of the Efficacy Satisfaction Questionnaire for patients with Chronic Obstructive Pulmonary Disease(mESQ-COPD)environmental adaptability score;logistic regression analysis showed that the factors affecting the effectiveness of Wenfei Guyuan Umbilical Moxibustion in treating COPD at 26 weeks were expectoration score(OR=2.175,P=0.042)and SF-36 mental health score(OR=1.312,P=0.012).Conclusion HGB,expectoration symptoms,social functioning,and mental health may be key factors affecting the clinical effectiveness of Wenfei Guyuan Umbilical Moxibustion in the treatment of COPD.
作者
赵娣
王明航
孟圆圆
王高明
ZHAO Di;WANG Minghang;MENG Yuanyuan;WANG Gaoming(The First Affiliated Hospital of Henan University of Chinese Medicine/National Regional Traditional Chinese Medicine(Pulmonary Diseases)Diagnosis and Treatment Centre,Zhengzhou,45000O;The First Clinical Medical College,Henan University of Chinese Medicine)
出处
《中医杂志》
北大核心
2026年第3期291-303,共13页
Journal of Traditional Chinese Medicine
基金
国家重点研发计划(2023YFC3502602)
河南省高校科技创新团队支持计划(23IRTSTHN027)
中医药古籍文献和特色技术传承专项(CZY-KJS-2020-075)
国家中医临床研究基地科研专项(2022JDZX046)
河南省科技发展计划(232102310472)。
关键词
慢性阻塞性肺疾病
稳定期
隔药灸
多模型融合分析
温肺固元脐灸
chronic obstructive pulmonary disease
stable stage
medicinal-separated moxibustion
logistic regression
Wenfei Guyuan Umbilical Moxibustion(温肺固元脐灸)
