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| Evaluation of the therapeutic effect of Xifeng Tongnao Capsule on acute cerebral infarction based on HIS system real world data |
| Hits 329 Download times 264 Received:June 10, 2023 |
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| DOI
10.11656/j.issn.1672-1519.2023.10.02 |
| Key Words
acute cerebral infarction;propensity score;Xifeng Tongnao Capsule;confounding factor;balance effect |
| Author Name | Affiliation | E-mail | | SUN Chunmei | Department of Acupuncture and Moxibustion, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan 528400, China | | | ZHANG Zhiqiang | Department of Acupuncture and Moxibustion, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan 528400, China | gdzszzq@126.com |
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| Abstract
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| [Objective] To evaluate the efficacy of Xifeng Tongnao Capsule in the treatment of acute cerebral infarction（ACI） in the real clinical world based on propensity score（PS） matching method. [Methods] The research data comes from the data of HIS cases in Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine from June 2021 to June 2023. A total of 240 ACI patients treated with Xifeng Tongnao Capsules were used as the observation group，and 240 patients who were not treated with Xifeng Tongnao Capsules were matched 1∶1 according to age and gender data as the control group. The treatment efficiency of the two groups was compared，and the influence of confounding factors on treatment allocation was analyzed. The propensity score of the Generalized Boosted Model（GBM） was used to balance the confounding factors. The treatment effects of the two groups of patients were analyzed by using logistic regression without PS weighting，PS weighting Logistic regression，and PS weighting Logistic regression with covariate adjustment. [Result] Without considering confounding factors，the treatment effective rate of the observation group was 68.33%，54.17% higher than that of the control group，and the difference was statistically significant（P＜0.05）. The GBM propensity score weighting method was used to balance the various confounding factors. The results showed that before weighting，covariates such as cost category，responsible artery，infarct size，heart disease history，and cerebral protective agent were different between the two groups（P＜0.05）. After weighting，the difference in cost category，responsible artery，infarct size，heart disease history，and brain protective agent between the two groups was not significant （P＞0.05）. It can be considered that the differences in the distribution of covariates between the two groups after weighting are basically balanced. Three methods，namely logistic regression without PS weighting，logistic regression with PS weighting，and logistic regression with PS weighting with covariate adjustment，were used to analyze the treatment effect of the two groups of patients. The results showed that the P value without PS-weighted Logistic regression score was less than 0.001，it is believed that Xifeng Tongnao Capsule is better than the control group in the treatment of ACI. PS-weighted Logistic regression P value <0.05，it is considered that Xifeng Tongnao Capsule was better than the control group in the treatment of ACI. PS weighted with covariates Logistic regression was <0.05，and it is considered that Xifeng Tongnao Capsule was better than the control group in the treatment of ACI. The above results indicate that from a statistical point of view，after balancing the effects of covariates，the efficacy of the observation group was still better than that of the control group. [Conclusion] Using Xifeng Tongnao Capsules to treat ACI is better than not using Xifeng Tongnao Capsules，and it is confirmed by PS weighting to improve the efficacy. |
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