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针刺治疗慢性自发性荨麻疹患者的最小临床重要差异:来自中国多中心随机对照试验的二次分析。

Minimal clinically important difference for acupuncture for patients with chronic spontaneous urticaria: secondary analysis from a multicentre randomised controlled trial in China.

机构信息

School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Disease Prevention Center, Chengdu First People's Hospital, Chengdu, China.

出版信息

BMJ Open. 2024 Oct 29;14(10):e085041. doi: 10.1136/bmjopen-2024-085041.

Abstract

OBJECTIVES

To evaluate the minimal clinically important difference (MCID) value for acupuncture treatment in chronic spontaneous urticaria (CSU), providing guidance for its application in CSU management.

DESIGN

Secondary analysis of data from a multicentre randomised controlled trial.

SETTING

Three tertiary hospitals across three cities in China.

PARTICIPANTS

103 CSU patients (78.7% female) with an average age of 39.97 years.

INTERVENTIONS

Participants received acupuncture treatment for 4 weeks in the original study.

OUTCOME MEASURES

MCID and minimal detectable change (MDC) for the Urticaria Activity Score over 7 days (UAS7) in acupuncture treatment of CSU. Convergent validity assessed by intraclass correlation coefficient (ICC). Responsiveness evaluated through Spearman correlation between UAS7 improvements and anchor tools (physician's and patient's assessments). MDC calculated using SE of measurement of changes in UAS7 scores. MCID estimated using distribution-based and anchor-based methods.

RESULTS

The ICC for UAS7 was 0.86. Improvements in UAS7 scores were significantly correlated with patient (r=0.44, p<0.01) and physician (r=0.85, p<0.01) assessments of CSU activity shifts. The MDC for UAS7 was 5.08. The MCID for acupuncture treatment in CSU was 8.3.

CONCLUSIONS

This study provides the first MCID value for acupuncture treatment in CSU. These findings contribute to the understanding of acupuncture's effects in treating CSU and may inform future research and clinical practice in the management of this condition.

TRIAL REGISTRATION NUMBER

ChiCTR1900022994.

摘要

目的

评估针刺治疗慢性自发性荨麻疹(CSU)的最小临床重要差异(MCID)值,为其在 CSU 管理中的应用提供指导。

设计

多中心随机对照试验的二次分析。

地点

中国三个城市的三家三级医院。

参与者

103 例 CSU 患者(78.7%为女性),平均年龄 39.97 岁。

干预

参与者在原研究中接受了 4 周的针刺治疗。

结局测量

针刺治疗 CSU 时 7 天荨麻疹活动评分(UAS7)的 MCID 和最小可检测变化(MDC)。通过组内相关系数(ICC)评估收敛效度。通过 UAS7 改善与锚定工具(医生和患者评估)之间的 Spearman 相关性评估反应性。使用 UAS7 评分变化的测量变化的标准误计算 MDC。使用基于分布和基于锚定的方法估计 MCID。

结果

UAS7 的 ICC 为 0.86。UAS7 评分的改善与患者(r=0.44,p<0.01)和医生(r=0.85,p<0.01)对 CSU 活动变化的评估显著相关。UAS7 的 MDC 为 5.08。CSU 针刺治疗的 MCID 为 8.3。

结论

本研究首次提供了针刺治疗 CSU 的 MCID 值。这些发现有助于了解针刺治疗 CSU 的效果,并可能为该疾病的管理提供未来的研究和临床实践依据。

临床试验注册号

ChiCTR1900022994。

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