Zhongguo quanke yixue (Dec 2023)
Construction of Optimized Treatment Plan of Acupuncture for Migraine Based on Entropy Weight-TOPSIS Method
Abstract
Background With the accumulation of high-quality evidence, the clinical effectiveness of acupuncture for migraine has been increasingly recognized. Numerous acupuncture clinical studies in China highlight and validate various acupuncture intervention schemes through clinical trials. Integrating and selecting these advantageous schemes to guide clinical practice has become a new focus in acupuncture research. Objective To conduct multicriteria decision making (MCDM) by using technique for order preference by similarity to an ideal solution (TOPSIS) method based on Meta-analysis, screen optimized treatment plan (OTP) of acupuncture for migraine and explore the ideas for constructing OTPs of acupuncture. Methods Wanfang Data, VIP, CNKI, SinoMed, PubMed, Web of Science, and EmBase were searched by computer for randomized controlled trials (RCTs) on acupuncture treatment for migraine published before April 2022. Two researchers independently screened the literature, extracted basic characteristics of literature〔author, year of publication, sample size, cure rate, efficiency rate and visual analogue score (VAS), etc.〕, and assessed the quality of the RCTs by using modified Jadad scale. Acupuncture treatment plans for migraine were summarized based on the characteristics of the included RCTs, and Meta-analysis was performed. The relative risk (RR) of cure rate and efficiency rate, and the mean difference (MD) of VAS scores for each plan were extracted based on the Meta-analysis results. The treatment frequency and score of the modified Jadad scale were calculated for each plan using sample size as the weight. The data were all included in the MCDM analysis, the weights of different decision criterion were determined using the entropy weight method. The TOPSIS method was finally used to select OTP of acupuncture for migraine. Results A total of 17 RCTs were included and categorized into 8 types of treatment plans of acupuncture for migraine (Tongyuan acupuncture, six-spirit points, bone-nearby acupuncture, conventional acupuncture, Gallbladder Meridian acupoints, head acupoints, penetration needling method and Siguan acupoints) according to the results of Meta-analysis. The TOPSIS evaluation indicated that the treatment plan of acupuncture focusing primarily on head acupoints is OTP, involving needling the head acupoints of Fengfu, Touwei, Toulinqi, Taiyang, Shuaigu, and Fengchi once daily or every other day, with an average treatment number of 11, with the main advantages of shorter treatment time and significant reduction in VAS. Conclusion The OTP of acupuncture for migraine screened and constructed in the study can provide reference for clinical application. The utilization of the entropy weight-TOPSIS method based on Meta-analysis presents a novel approach for constructing the OTPs of acupuncture for migraine.
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