隐蔽分组方法和过程:
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由一名独立研究人员使用在线工具(https://www.sealedenvelope.com/simple-randomiser/v1/lists)按照1:1:1:1的比例、以研究中心为分层因素进行随机分组。随机分组结果封存于不透明密封信封中,由麻醉医生依据信封内容将患者按1:1:1:1的比例随机分配至TD、TT、SD或ST组。
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Process of allocation
concealment:
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An independent researcher will generate random numbers using an online tool (https://www.sealedenvelope.com/simple-randomiser/v1/lists) with a 1:1:1:1 allocation ratio, stratified by center (Ordos Central Hospital and Suzhou Xiangcheng People's Hospital). Stratified randomization will ensure balanced allocation of parturients across the two centers. The randomization results will be stored in sealed, opaque envelopes. The anesthesiologist will open these envelopes immediately before the procedure and assign parturients to one of the four groups (TEAS with dexamethasone, TEAS with tropisetron, sham stimulation with dexamethasone, or sham stimulation with tropisetron) according to the randomization list.
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盲法:
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根据随机数字信息进行盲法,试验药物根据随机编码信息以盲法方式标记,整个研究采用双盲设计。患者的临床管理与数据收集按编号顺序进行,并由未直接参与研究的医务人员负责,以保证盲法实施。为维持盲法,地塞米松与托烷司琼均通过外观一致的5 ml注射器进行分发。由于TEAS干预过程中需评估产妇是否出现“得气”感,操作者对刺激形式不实施盲法,但其不参与研究的其他环节。产妇将被统一告知:刺激可能会引起疼痛,也可能无明显感觉,但其对所接受的为真实刺激或假刺激保持盲态。除干预操作者外,所有研究人员,包括围术期评估者,均对受试者分组情况保持盲态。
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Blinding:
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Trial drugs were labeled in a blinded manner based on random number information. The trial had a double-blind design. Clinical management of patients and data collection were sequentially numbered and disclosed by medical staff not directly involved.To maintain blinding, dexamethasone and tropisetron will be distributed in identical 5-ml syringes. The TEAS intervention is not blinded for the interventionist, as they will need to inquire about the "de qi" sensation during the procedure. However, the interventionist will not participate in other aspects of the study. Parturients will be informed that the stimulation may cause pain, or it may not, and will remain blinded to whether they are receiving real or sham stimulation. All other study personnel, including perioperative assessors, will also remain blinded to group allocation.
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揭盲或破盲原则和方法:
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盲法解除时间节点:所有受试者将在本研究完成后统一解除盲法。
盲法解除方式:盲法解除过程将由独立的数据监查委员会(Data Monitoring Committee, DMC)负责监督执行。DMC将在整个研究期间保管并管理所有与随机分组相关的数据,直至规定的解除时间点。
紧急解除盲法:若研究期间发生紧急医疗事件,需立即解除盲法以便实施恰当的医学干预。在此情况下,由主要研究者联系DMC进行紧急解除盲法,并对解除盲法的原因及过程进行详细记录与备案。
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Rules of uncover or
ceasing blinding:
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Unblinding Timeline: All participants will be unblinded following the completion of the study.
Unblinding Method: The unblinding process will be overseen by an independent DMC. The DMC will oversee and retain all data related to randomization until the designated time for unblinding.
Emergency Unblinding: In the event of an emergency during the trial, unblinding will be performed immediately to facilitate appropriate medical intervention. In such cases, the principal investigator will contact the DMC for emergency unblinding, and the reasons for and process of unblinding will be thoroughly documented.
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统计方法名称:
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用Shapiro-Wilk检验对各变量进行正态性检验。符合正态分布的计量资料以均数±标准差(x̄±s)表示,非正态分布资料以中位数(四分位间距)表示,计数资料以例数和百分比表示。
本研究的主要分析集中于TEAS干预与剖宫产术后恶心呕吐(PONV)发生率之间的关系。考虑到本研究采用2×2析因设计,首先构建logistic回归模型,以PONV为因变量,纳入TEAS与止吐药组之间的交互项,判断是否存在显著交互作用。若未发现显著交互作用,则分别评估TEAS与假刺激、地塞米松与托烷司琼之间的主效应;如存在显著交互作用,则需在另一干预因素不同水平下分别分析干预效应。
根据变量类型与分布特点,组间比较选用独立样本t检验、Mann-Whitney秩和检验、χ²检验或Fisher确切概率法。差异以**均值差或中位数差及其95%置信区间(95%CI)**表示。主要结局的检验显著性水平设定为α=0.05,并采用Bonferroni法进行两两比较校正,每个干预主效应的显著性阈值为P<0.025。
对涉及多时间点重复测量的数据(如术后各时间点的VAS评分、PONV严重程度等),将采用广义估计方程(GEE)或混合效应模型进行分析。
次要结局指标的统计分析不进行多重比较校正,所有结果视为探索性分析,需谨慎解释。
此外,将对四个析因组合组之间的差异进行预设探索性分析,依据数据分布类型选用单因素方差分析、Kruskal-Wallis检验或χ²检验。
主要分析将基于所有完成随机分组并具有完整结局资料的受试者进行,不进行缺失值填补。
所有统计学分析均使用“SPSS 25.0统计软件(IBM公司)”完成。
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Statistical method:
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The Shapiro-Wilk test was used to assess the normality of the data. Data are presented as mean ± standard deviation (SD), median (interquartile range [IQR]), or number (%), depending on the variable type and distribution. The primary analysis focused on the relationship between the primary outcome, PONV, and the use of TEAS. Given the factorial design of the study, an analysis was conducted to determine whether an interaction existed between the intervention groups. In this analysis, a logistic regression model was developed with PONV as the outcome variable, incorporating an interaction term between the TEAS and antiemetic drug groups.
If no significant interaction was observed, treatment effect estimates were summarized by comparing TEAS vs. sham stimulation and dexamethasone vs. tropisetron. If a significant interaction was found, the effect of each intervention was assessed within the context of the other intervention’s levels.
To evaluate the main effects, data will be analyzed using the unpaired t-test, Mann-Whitney rank-sum test, χ² test, or Fisher’s exact test, as appropriate. Between-group differences will be reported as the mean or median difference with the corresponding 95% confidence interval (CI). The overall significance level will be set at 0.05, with a significance threshold of 0.025 for each intervention effect (0.05/2, Bonferroni correction) for the primary outcome in the two comparisons. Repeated-measures analyses, including generalized estimating equations with robust variance, will be used to assess differences in the median pain scores (at rest and during movement) and the severity of PONV between groups using mixed-model regression. No multiple comparison adjustments will be made for secondary outcomes. Therefore, all results for secondary analyses should be interpreted as exploratory.
Pre-specified exploratory analyses will be conducted across the four factorial groups (representing each combination of TEAS and antiemetic drugs) using one-way ANOVA, Kruskal-Wallis test, or χ² test, as appropriate. Primary analyses will be performed for all randomized patients with available outcome data. No imputation will be performed for missing data. All statistical analyses will be performed using SPSS software (version 25.0, IBM SPSS Inc.).
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试验完成后的统计结果(上传文件):
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Calculated Results ater
the Study Completed:
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上传试验完成后的统计结果:
Statistical results after completion of the test file upload
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是否公开试验完成后的统计结果:
Calculated Results after
the Study Completed(upload file):
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公开
Public
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全球唯一识别码:
UTN
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