[Development and analysis of clinical prediction model of acupuncture and moxibustion treatment for stroke at recovery stage].

OBJECTIVE: To develop the clinical prediction model of therapeutic effect in treatment with acupuncture and moxibustion for the patients with stroke at recovery stage under different conditions so as to provide a tool for predicting the therapeutic effect of acupuncture and moxibustion. METHODS: A total of 1410 patients with stroke at recovery stage were collected from the Third Affiliated Hospital of Zhejiang Chinese Medical University from 2012 to 2019. The relevant data were extracted, i.e. sex, age, time of onset, neurological functional deficit score (NFDS) and acupuncture and moxibustion therapy. The difference of NFDS before and after treatment was adopted to evaluate the therapeutic effect in the patients. Using SPSS26.0 software and CART decision tree analysis, the clinical prediction model was developed. RESULTS: The key variables in the prediction model of therapeutic effect in the patients with stroke at recovery stage under different conditions included age, time of onset, hypertension, cardiac disease, diabetes, TCM diagnosis, hemoglobin (HB), serum homocysteine (HCY) and acupuncture and moxibustion therapy. There were 12 main rules generated by the decision tree model, including 8 rules for predicting the improvements of therapeutic effect and 4 rules for predicting the absence of improvements (i.e. no change and deterioration). The accuracy rates of the model training set and test set were 80.0% and 72.8% respectively, the area under curve (AUC) of ROC was 0.797 and the model identification and classification results were satisfactory. CONCLUSION: The clinical prediction model developed by CART decision tree analysis is high in accuracy for the prediction of the therapeutic effect in the patients with stroke at recovery stage under different conditions. Based on the therapeutic effect predicted in the hospital visit, the physicians may adopt the corresponding regimens of acupuncture and moxibustion therapy in patients.

Comparative Efficacy of Acupuncture-Related Techniques for Urinary Retention After a Spinal Cord Injury: A Bayesian Network Meta-Analysis.

BACKGROUND: Urinary retention is one of the most frequent complications of spinal cord injuries (SCI) and negatively impacts patient satisfaction and quality of life. Acupuncture as an integral part of traditional Chinese medicine (TCM) has recently drawn widespread attention for its potential in the management of urinary retention. However, there are many different styles of acupuncture-related techniques, and the optimal choice of acupuncture for urinary retention after SCI is still unclear. Hence, this study uses a Bayesian network meta-analysis (NMA) to compare the efficacy of different types of acupuncture therapies using both direct and indirect evidence. METHODS: Randomized controlled trials of acupuncture-related techniques for treating urinary retention after SCI were retrieved from the following electronic databases: Pubmed, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), the Chinese Biomedical Literature Service System (SinoMed), the Wan-Fang database, and the Chinese Scientific Journals Database (VIP). The retrieval time was from inception to November 2020. Clinical effective rate (CER) was the primary outcome indicator and residual urine volume (RUV) was the secondary outcome indicator. A Bayesian NMA was performed using the Markov chain Monte Carlo method in R software (version 3.6.1) interfacing with JAGS software (version 4.3.0). The node-splitting method was used to identify inconsistencies. In addition, a comparative adjusted funnel plot was used to assess publication bias. RESULTS: A total of 26 randomized controlled trials involving 1,652 patients were included. Bayesian NMA showed that electroacupuncture combined with moxibustion ranks first in both CER and RUV. In addition, in terms of cumulative probability, electro-acupuncture combined with moxibustion ranked first in CER. The results of the node splitting method revealed that direct and indirect evidence were consistent (P > 0.05). In addition, publication bias was detected. CONCLUSION: A Bayesian NMA that combined direct and indirect comparisons showed that electro-acupuncture combined with moxibustion had a better effect on urinary retention due to SCI. However, it still needs a large sample size and high-quality randomized controlled trials to verify this finding.Systematic Review Registration: https://inplasy.com/, identifier: INPLASY2021110005.