Zha Qing-lin, He Yi-ting, Yan Xiao-ping, Su Li, Song Yue-jin, Zeng Sheng-ping, Liu Wei, Feng Xing-hua, Qian Xian, Zhu Wan-hua, Lin Se-qi, Lü Cheng, Lü Ai-ping
National Center of Pharmaceutical Engineering Research, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi Province 330006, China.
Zhong Xi Yi Jie He Xue Bao. 2007 Jan;5(1):32-8. doi: 10.3736/jcim20070107.
To analyze the indications of the therapies for rheumatoid arthritis (RA) with neural network model analysis.
Three hundred and ninety-seven patients were included in the clinical trial from 9 clinical centers. They were randomly divided into Western medicine (WM) treated group, 194 cases; and traditional Chinese herbal medicine (CM) treated group, 203 cases. A complete physical examination and 18 common clinical manifestations were prepared before the randomization and after the treatment. The WM therapy included voltaren extended action tablet, methotrexate and sulfasalazine. The CM therapy included Glucosidorum Tripterygii Totorum Tablet and syndrome differentiation treatment. The American College of Rheumatology 20 (ACR20) was taken as efficacy evaluation. All data were analyzed on SAS 8.2 statistical package. The relationships between each variable and efficacy were analyzed, and the variables with P<0.2 were included for the data mining analysis with neural network model. All data were classified into training set (75%) and verification set (25%) for further verification on the data-mining model.
Eighteen variables in CM and 24 variables in WM were included in the data-mining model. In CM, morning stiffness, swollen joint number, peripheral immunoglobulin M (IgM) level, tenderness joint number, tenderness, rheumatoid factor (RF), C-reactive protein (CRP) and joint pain were positively related to the efficacy, and disease duration and more urination at night negatively related to the efficacy. In WM, erythrocyte sedimentation rate (ESR), weak waist, white fur in tongue, joint pain, joint stiffness and swollen joint were positively related to the efficacy, and yellow fur in tongue, red tongue, white blood negatively related to the efficacy. In the analysis with the neural network model in the patients of verification set, the predictive response rates of 20% patients would be 100% and 90% in the treatment with CM and WM, respectively.
Neural network model analysis, based on the full clinical trial data with collection of both traditional Chinese medicine and modern medicine diagnostic information, shows a good predictive role for the information in the efficacy in rheumatoid arthritis.
采用神经网络模型分析类风湿关节炎(RA)治疗方法的适应证。
9个临床中心的397例患者纳入临床试验。随机分为西药治疗组194例和中药治疗组203例。随机分组前及治疗后进行全面体格检查及18项常见临床表现检查。西药治疗包括双氯芬酸缓释片、甲氨蝶呤和柳氮磺胺吡啶。中药治疗包括雷公藤多苷片及辨证论治。以美国风湿病学会20(ACR20)作为疗效评价。所有数据用SAS 8.2统计软件包进行分析。分析各变量与疗效之间的关系,将P<0.2的变量纳入神经网络模型进行数据挖掘分析。所有数据分为训练集(75%)和验证集(25%),对数据挖掘模型进行进一步验证。
数据挖掘模型纳入中药组18个变量和西药组24个变量。中药组中,晨僵、关节肿胀数、外周免疫球蛋白M(IgM)水平、压痛关节数、压痛、类风湿因子(RF)、C反应蛋白(CRP)及关节疼痛与疗效呈正相关,病程及夜尿增多与疗效呈负相关。西药组中,红细胞沉降率(ESR)、腰软、舌苔白、关节疼痛、关节僵硬及关节肿胀与疗效呈正相关,舌苔黄、舌红、白细胞与疗效呈负相关。在验证集患者的神经网络模型分析中,中药和西药治疗中分别有20%患者的预测有效率将达到100%和90%。
基于收集了中医和现代医学诊断信息的完整临床试验数据的神经网络模型分析,对类风湿关节炎疗效信息具有良好的预测作用。