Analysis Of The Related Influencing Factors On The Acupuncture For Treating Functional Constipation

bjective:In this study,univariate and binary Logistic regression analysis was used to explore the related factors that influence the clinical efficacy of acupuncture treating for Functional Constipation(FC),so as to provide evidence for the clinical application of acupuncture treatment for FC,and to better serve the clinical practice.Methods:In the multi-center clinical randomized trial of acupuncture treatment for functional constipation,a total of 380 patients were enrolled into the Shu-Mu point group,the He Point Group and the He-Mu-Shu Point Group,receiving 16 sessions of electroacupuncture treatment in 4 weeks and a four-week follow-up.Correlation analysis was performed in this study based on the data from previous clinical trials,including demographic data(sex,age,education,body mass index),clinical features(duration,average weekly stool frequency,difficulty of defecation,stool quality),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),the MOS item Short From health survey(SF-36).380 Patients were divided into Responder Group and Non-Responder Group according to the number of weekly complete spontaneous bowel movements(CSBMs)in 8 weeks.Those patients with an increase of at least one CSBM from the baseline had a better response to acupuncture treatment,which indicated that acupuncture treatment was effective for them.Those patients who had decrease or no increase in stool times per week,showed no response or positive response to acupuncture treatment,indicating that acupuncture treatment was ineffective.A univariate analysis and binary Logistic regression analysis were used to screen out the influencing factors related to the effect.In order to avoid missing out the possible influencing factors,we expanded the scope of screening in the single factor analysis,taking the difference of p<0.20 as statistical significance,and then carried out the second binary Logistic regression analysis after incorporating the new influencing factors into the model.The results of two 4multivariate analyses were compared to explore the influence of related factors on acupuncture therapeutic effect.Results:1.The result of the univariate analysis showed that,there were significant differences between the Responer Group(306 cases)and the Non-Responder Group(74 cases)in age,duration,baseline weekly stool frequency,knowledge of acupuncture,education,difficulty of defecation,Body Mass Index(BMI),SAS,SDS,case resource,Physical Functioning(PF)and General Health(GH)scores of SF-36(p<0.05).Taking the difference of p<0.20 as statistical significance,there were also significant differences in occupation,acupuncture expectancy,Vitality(VT),Social Functioning(SF),Reported Health Transition(HT),Role-Physical(RP)scores between the responder and non-responder groups.These 13 factors were included in the second binary Logistic regression analysis.2.Two Binary Logistic regression analyses showed that there were significant differences in the degree of knowledge about acupuncture,weekly number of CSBMs and the source of the case(p<0.05).Compared with Chengdu,There were significant differences in the patients from Hunan Center and Changchun Center(p <0.05).Compared with Beijing,there were significant differences in the patients from Hunan Center,Changchun Center and Shanxi Center(p < 0.05).Conclusion:1.The knowledge of acupuncture and baseline weekly number of CSBMs may be related factors to the therapeutic effect of acupuncture on FC.The source of the case may be an indirect factor.2.FC patients who know more about acupuncture are more likely to respond to acupuncture treatment,and acupuncture effect may be better.3.Patients with FC who have less spontaneous defecation in baseline period are more likely to respond to acupuncture treatment,and acupuncture effect may be better.4.FC patients from different clinical centers have different responses to acupuncture treatment,due to the numbers of patients in each center,the degree ofknowledge about acupuncture,the degree of education and other factors.The source of the cases may be an indirect factor related to effect,which needs further study.