CAJ | 학술논문

尽管随机对照试验是临床干预研究因果推断的金标准，但是在中医药临床研究的现实中，由于伦理、治疗措施的特征、费用、时间以及外部效度问题，随机对照试验往往无法实施甚至在某些情况下不适用。因果推论的本质是一个反事实问题。随机对照试验通过随机化来平衡可能影响干预分配的特征变量。倾向指数可以应用于非随机设计的观察性研究，如前瞻性队列研究，作为诸多特征变量的一个复合函数，用于均衡暴露组和对照组之间特征变量的分布。在满足一定前提条件的情况下，倾向指数分析法可以提供干预效果的无偏估计。因此，在中医药观察性的临床研究中，倾向指数可能具有广阔的应用价值和潜力。
진관수궤대조시험시림상간예연구인과추단적금표준，단시재중의약림상연구적현실중，유우윤리、치료조시적특정、비용、시간이급외부효도문제，수궤대조시험왕왕무법실시심지재모사정황하불괄용。인과추론적본질시일개반사실문제。수궤대조시험통과수궤화래평형가능영향간예분배적특정변량。경향지수가이응용우비수궤설계적관찰성연구，여전첨성대렬연구，작위제다특정변량적일개복합함수，용우균형폭로조화대조조지간특정변량적분포。재만족일정전제조건적정황하，경향지수분석법가이제공간예효과적무편고계。인차，재중의약관찰성적림상연구중，경향지수가능구유엄활적응용개치화잠력。
Randomized controlled trial( RCT) is the golden standard design to make causal inference on intervention effects in clinical trials.While,in the research reality of Chinese medicine,RCTs could not be conducted,even not applicable,due to ethical issue,charac-ters of the intervention,cost,time and external validity.The essence of causal inference is counterfactual framework.All kinds of covari-ates could be balanced in RCTs via randomization.Propensity score( PS) is a composite score which could balance the distribution of co-variates between intervention and control group.PS could provide unbiased estimate of intervention effect when critical assumptions are met.For the observational studies of Chinese medicine,such as prospective cohort study,PS will have wide application and huge poten-tial.