基于多指标决策法的针刺治疗强直性脊柱炎的优势方案研究

Acupuncture treatment of ankylosing spondylitis based on multi-index decision making method

关键词:  强直性脊柱炎  针刺  多指标决策  优势方案筛选

Key words:  ankylosing spondylitis  acupuncture  multi-index decision-making  advantage scheme screening

摘要:

[目的] 通过将网状Meta分析与多指标决策法（MCDM）相结合，构建多维度评价体系，对针刺治疗强直性脊柱炎的优势方案进行筛选，为临床决策提供科学依据。[方法] 检索中国知网、万方知识服务平台、维普数据库、SinoMed、PubMed、EMbase、Cochrane Library、Web of Science 8个数据库截至2025年1月1日收录的有关针刺治疗强直性脊柱炎的随机对照研究（RCTs），采用改良Jadad量表对证据质量进行评价，网状Meta分析计算有效率RR值和巴氏强直性脊柱炎疾病活动性指数（BASDAI）评分的累积排序概率图下面积（SUCRA）值、加权干预次数和改良Jadad评分，构建决策矩阵。使用线性比例法建立标准化决策矩阵。采用熵权法进行指标权重确定和再分配，并运用TOPSIS法、VIKOR法和PROMETHEE法3种决策方法筛选优势方案。[结果] 共纳入17项研究，得到14种干预方案和4种评价指标，3种决策结果之间具有高度相似性，通督热针法为针刺治疗强直性脊柱炎的最佳优势方案。[结论] 研究通过网状Meta分析与多准则决策方法相结合，筛选出针刺治疗强直性脊柱炎的优势方案，其中通督热针法为最优选择。两种方法的结合应用为针刺优势方案的筛选提供了新思路，为针灸临床决策提供了参考依据。

Abstract:

[Objective] To construct a multidimensional evaluation system by integrating network Meta-analysis with multi-criteria decision-making（MCDM） methods，aiming to identify the optimal acupuncture protocol for treating ankylosing spondylitis（AS） and provide a scientific basis for clinical decision-making. [Methods] Randomized controlled trials（RCTs） of acupuncture for AS were retrieved from eight databases including CNKI，Wanfang database，VIP，SinoMed，PubMed，EMbase，Cochrane Library and Web of Science up to January 1，2025. The modified Jadad scale was used to assess evidence quality. Network meta-analysis was performed to calculate the relative risk（RR） for effectiveness，surface under the cumulative ranking curve（SUCRA） values for Bath Ankylosing Spondylitis Disease Activity Index（BASDAI） scores，weighted intervention frequencies，and modified Jadad scores，forming a decision matrix. The entropy weight method is used to determine and redistribute the index weights，and the TOPSIS method，VIKOR method and PROMETHEE method are used to screen the optimal acupuncture protocol. [Results] Seventeen studies were included，involving 14 intervention protocols and 4 evaluation indicators. The results of the three decision-making methods showed high consistency，with the Tongdu Rezhen method method identified as the optimal protocol for AS. [Conclusion] This study combined network Meta-analysis with multi-criteria decision-making to identify the most effective acupuncture protocol for AS，with Tongdu Rezhen method emerging as the top recommendation. The integration of these methods offers a novel approach for selecting optimal acupuncture protocols and provides a reference for clinical decision-making of acupuncture.