[1]赵东方,谭昊,虢书彰,等.基于多中心 RCT 的颈型颈椎病复发影响因素分析及风险预测模型构建[J].中国中医骨伤科杂志,2026,34(06):25-35.[doi:10.20085/j.cnki.issn1005-0205.260604]
　ZHAO Dongfang,TAN Hao,GUO Shuzhang,et al.Analysis of Factors Influencing Recurrence in Neck Type Cervical Spondylosis and Construction of a Risk Prediction Model Based on a Multicenter Randomized Controlled Trial[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2026,34(06):25-35.[doi:10.20085/j.cnki.issn1005-0205.260604]
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基于多中心 RCT 的颈型颈椎病复发影响因素分析及风险预测模型构建()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第34卷
期数:
2026年06期
页码:
25-35
栏目:
椎间盘疾病
出版日期:
2026-06-15

文章信息/Info

Title:
Analysis of Factors Influencing Recurrence in Neck Type Cervical Spondylosis and Construction of a Risk Prediction Model Based on a Multicenter Randomized Controlled Trial
文章编号:
1005-0205(2026)06-0025-11
作者:
赵东方1; 谭昊1; 虢书彰1; 孙旗2△
1北京中医药大学第一临床医学院(北京,100029)
2北京中医药大学东直门医院
Author(s):
ZHAO Dongfang1; TAN Hao1; GUO Shuzhang1; SUN Qi2△
1The First Clinical Medical College,Beijing University of Chinese Medicine,Beijing 100029,China; 2Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China.
关键词:
颈型颈椎病;  复发;  危险因素;  Logistic回归;  预测模型
Keywords:
neck type cervical spondylosis;  recurrence;  risk factors;  Logistic regression;  prediction model
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.260604
文献标志码:
A
摘要:
目的:探讨颈型颈椎病复发的独立影响因素,并构建风险预测模型。方法:基于多中心随机对照研究数据,纳入127例颈型颈椎病患者(复发组46例、未复发组81例),收集人口学及临床相关资料。采用单因素与多因素Logistic回归分析筛选复发关联因素,采用受试者工作特征曲线评估预测。结果:单因素分析显示,治疗前C2～C7矢状位垂直轴(SVA)值是颈型颈椎病复发的显著危险因素。多因素分析显示,长期伏案史、治疗前数字疼痛评分(NRS)是颈型颈椎病复发独立危险因素,针刺联合健康管理治疗为保护因素,治疗前C2～C7 SVA值与复发风险呈边缘性显著(P=0.051)。受试者工作特征曲线显示NRS、C2～C7 SVA值及联合预测模型的曲线下面积(AUC)分别为0.647 9,0.642 8及0.703 0,基于约登指数确定的最佳截断值NRS≥4.5 分,C2～C7 SVA≥20.61 mm及预测概率≥0.269 4,对应50%复发概率的值分别为6.127分和27.17 mm。结论:长期伏案行为和高基线疼痛是颈型颈椎病复发的主要危险因素,针刺联合健康管理可有效降低复发风险。基于疼痛评分与C2～C7 SVA参数的预测模型具有良好区分能力。
Abstract:
Objective:To identify independent factors influencing the recurrence of neck type cervical spondylosis(NTCS)and to develop a risk prediction model.Methods:Based on data from a multicenter randomized controlled trial,127 NTCS patients(46 in the recurrence group,81 in the non-recurrence group)were included.Demographic and clinical data were collected.Univariate and multivariate Logistic regression analyses were employed to identify factors associated with recurrence,and predictive performance was evaluated using ROC curves.Results:Univariate analysis identified the pre-treatment C2 to C7 SVA value as a significant risk factor for NTCS recurrence.Multivariate analysis demonstrated that a history of prolonged desk work and a higher pre-treatment NRS score were independent risk factors for recurrence,while acupuncture combined with health management served as a protective factor.The pre-treatment C2 to C7 SVA value showed a trend towards significance(P=0.051).ROC curve analysis revealed that the AUC values for the NRS score,C2 to C7 SVA value,and the combined prediction model were 0.647 9,0.642 8,and 0.703 0,respectively.Based on the Youden index,the optimal cutoff values were determined as NRS ≥ 4.5 points,C2 to C7 SVA ≥ 20.61 mm,and predicted probability ≥0.2 694.The values corresponding to a 50% recurrence probability were 6.127 points and 27.17 mm,respectively.Conclusion:Prolonged desk work and a high baseline pain level are major risk factors for NTCS recurrence,while acupuncture combined with health management can effectively reduce recurrence risk of recurrence.The prediction model incorporating the pain score and C2 to C7 SVA parameter demonstrates good discriminatory ability.

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(收稿日期:2025-10-29)

备注/Memo

备注/Memo:
基金项目:北京卫生健康委员会首都发展专项基金项目(首发2022-2-4191)
△通信作者 E-mail:sunqi2001@sina.com
更新日期/Last Update: 2026-06-15