来源：风湿病与关节炎,2022,11（5）:10-15.

黑骨藤追风活络胶囊联合枸橼酸托法替布治疗寒痹证类风湿关节炎短期疗效达标预测模型的建立研究（临床研究）

刘卓枫¹，梁　江²，陈大琳¹，卢　云²，余　谦²，王　晶¹

　　【摘　要】目的：分析黑骨藤追风活络胶囊联合枸橼酸托法替布治疗寒痹证类风湿关节炎的疗效相关影响因素，构建3个月内短期疗效预测模型。方法：回顾性分析2019年1月至2021年9月在贵州中医药大学第一附属医院收治的198例寒痹证类风湿关节炎患者的临床资料，根据最小绝对收缩选择算子（LASSO）回归法筛选变量确定独立危险因素并建立预测模型，ROC曲线评估模型效能。结果：来氟米特的使用、初始治疗的DAS28（DAS280）、治疗1个月后的CRP（CRP1）是黑骨藤追风活络胶囊联合枸橼酸托法替布治疗寒痹证类风湿关节炎预后短期疗效达标的主要影响因素，并构建列线图预测模型，模型ROC曲线下面积为0.768，准确度为73.5%。结论：该临床预测模型具有较好的区分度和准确度，根据该模型可快速计算出患者达到低疾病活动度的概率。

　　【关键词】　类风湿关节炎；黑骨藤追风活络胶囊；临床预测模型；疗效影响因素；LASSO分析

Efficacy of Heiguteng Zhuifenghuoluo Jiaonang（黑骨藤追风活络胶囊）Combined with Tofatib Citrate on the Short-term Efficacy Prediction Models in the Treatment of Rheumatoid Arthritis with Cold Bi Syndrome

LIU Zhuo-feng,LIANG Jiang,CHEN Da-lin,LU Yun,YU Qian,WANG Jing

　　【ABSTRACT】Objective:To analyze the related factors of Heiguteng Zhuifenghuoluo Jiaonang（黑骨藤追风活络胶囊）combined with tofatib citrate in the treatment of rheumatoid arthritis with cold bi syndrome,and to build a short-term efficacy prediction model within 3 months.Methods:The clinical data of 198 patients with rheumatoid arthritis with cold bi syndrome treated in the First Affiliated Hospital of Guizhou University of Chinese Medicine from January 2019 to September 2021 were analyzed retrospectively.The variables were selected according to the LASSO regression method,the independent risk factors were determined,the prediction model was established,and the efficiency of the model was evaluated by ROC curve.Results:The use of leflunomide,DAS28（DAS280）of initial treatment and CRP（CRP1）after one month of treatment were the main influencing factors of the short-term efficacy of Heiguteng Zhuifenghuoluo Jiaonang combined with tofatib citrate in the treatment of rheumatoid arthritis with cold bi syndrome.A nomogram prediction model was constructed.The area under the ROC curve of the model was 0.768 and the accuracy was 73.5%.Conclusion:The clinical prediction model has good discrimination and accuracy.According to the model,the probability of patients reaching low disease activity can be calculated quickly.

　　【Keywords】rheumatoid arthritis;Heiguteng Zhuifenghuoluo Jiaonang（黑骨藤追风活络胶囊）;clinical prediction model;influencing factors of curative effect;LASSO analysis