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慢性下腰部疼痛患者耳穴穴位按压疗效应答的基线预测因素

Nada Lukkahatai Wanqi Chen Jennifer Kawi Hulin Wu Claudia M.Campbell Johannes Thrul Xinran Huang Paul Christo Constance M.Johnson

临床传统医学和药理学（英文）2025，Vol.6Issue(2)：9-18,10.
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临床传统医学和药理学（英文）2025，Vol.6Issue(2)：9-18,10.DOI:10.1016/j.ctmp.2025.200215

慢性下腰部疼痛患者耳穴穴位按压疗效应答的基线预测因素

Baseline predictors of responders to auricular point acupressure in chronic low back pain

Nada Lukkahatai 1Wanqi Chen 2Jennifer Kawi 3Hulin Wu 2Claudia M.Campbell 4Johannes Thrul 5Xinran Huang 2Paul Christo 4Constance M.Johnson3

作者信息

  • 1. School of Nursing,Johns Hopkins University,Baltimore,MD 21205,USA
  • 2. School of Public Health,University of Texas Health Science Center at Houston,Houston,TX 77030,USA
  • 3. Cizik School of Nursing,The University of Texas Health Science Center at Houston,Houston,TX 77030,USA
  • 4. School of Medicine,Johns Hopkins University,Baltimore,MD 21205,USA
  • 5. Bloomberg School of Public Health,Johns Hopkins University,Baltimore,MD 21205,USA
  • 折叠

摘要

Abstract

Background:Chronic low back pain(cLBP)is a major cause of disability,with varied patient responses to treat-ments.Auricular point acupressure(APA)has shown potential as a non-pharmacological intervention,but indi-vidual responses may differ significantly. Objective:This study aimed to determine the predictability of baseline characteristics,including functional dis-ability,symptom severity,and treatment expectancy,on clinically significant responses to APA in reducing pain and improving function. Methods:A secondary analysis was performed using data from a randomized controlled trial with 263 cLBP patients.Participants were randomly assigned to targeted APA(T-APA),non-targeted APA(NT-APA),or to a control group.APA responders were defined as those with at least a 1.5-point reduction in pain intensity or a 2.5-point improvement in the Roland-Morris Disability Questionnaire(RMDQ).Predictors of response were assessed using logistic regression and machine learning models,including the Random Forest and Support Vector Machine(SVM). Results:Baseline pain,physical function,sleep disturbance,and treatment expectancy were key predictors.The Random Forest model had the highest accuracy for T-APA;however,logistic regression performed best in NT-APA.SVM was most accurate in the control group,with predictive accuracy varying by group(AUC 60.9％-80％).The Least Absolute Shrinkage and Selection Operator(LASSO)method was found to be overly aggressive,often eliminating important variables. Conclusion:This study highlights the variability in APA treatment responses for cLBP.While predictive mod-els provide useful insights,further research with larger datasets is needed to improve prediction accuracy and generalizability,enhancing personalized treatment approaches for cLBP.

关键词

耳穴穴位按压/慢性下腰部疼痛/身体功能/疼痛/耳疗法/APA响应

Key words

Auricular point acupressure/Chronic low back pain/Physical function/Pain/Auriculotherapy/APA responders

引用本文复制引用

Nada Lukkahatai,Wanqi Chen,Jennifer Kawi,Hulin Wu,Claudia M.Campbell,Johannes Thrul,Xinran Huang,Paul Christo,Constance M.Johnson..慢性下腰部疼痛患者耳穴穴位按压疗效应答的基线预测因素[J].临床传统医学和药理学（英文）,2025,6(2):9-18,10.

基金项目

This study was supported by the National Institute on Aging under grant number R01AG056587. （）

临床传统医学和药理学（英文）

2097-3829

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