Li Rui, Li Qing-Na, Lu Fang, Zi Ming-Jie, Li Chen-Fei, Gao Rui
Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing 100091, China; NMPA for Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Beijing 100091; National Clinical Research Center for Chinese Medicine Cardiology, Beijing 100091; Postdoctoral Work Station of Yabao Pharmaceutical Group Co., Ltd., Yuncheng 044000, Shanxi Province.
Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing 100091, China; NMPA for Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Beijing 100091; National Clinical Research Center for Chinese Medicine Cardiology, Beijing 100091.
Zhongguo Zhen Jiu. 2022 Apr 12;42(4):390-6. doi: 10.13703/j.0255-2930.20210330-k0005.
To explore the effectiveness on exogenous fever and the characteristics of effective population, as well as the specialties of prescription of acupoint application.
Using the internet electronic diagnosis and treatment platform (Spring Broadcast Wanxiangyun Clinic Database, and the main TCM suitable technology promoted by this platform is acupoint application therapy), from August 24, 2020 to November 5, 2020, the patients complained with fever and diagnosed as common cold, with a record of initial visit and at least one return visit, were included as the subjects. According to whether acupoint application therapy was received or not, the subjects were divided into an exposure group (with acupoint application therapy, 26 664 cases) and a non-exposure group (without acupoint application therapy, 515 cases). Using the propensity score, the mixed factors, e.g. age and sex, were matched between the two groups. The disappearance rate of fever (within 2 days) and the time for the first fever disappearance were taken as the effect indexes. The association rules extraction was adopted to analyze the characteristics of effective population and acupoint application prescription in treatment of exogenous fever.
After propensity score matching, there were 1 229 cases in the application group and 423 cases in the non-application group. The disappearance rate of fever in the application group was 1.82 times as high as that in the non-application group (<0.05). The time for the first fever disappearance in the application group was shorter than the non-application group (<0.01). A total of 5 370 cases were effective with acupoint application therapy, of which, the median age was 2 years old and the proportion of children patients under 6 years old was relatively high. In the effective crowd, the most commonly-used acupoints were Shenque (CV 8), Dazhui (GV 14), Yongquan (KI 1) and Tiantu (CV 22), etc. Shenque (CV 8) and Dazhui (GV 14) were highly associated and the support was 62.57%. The most common herbal materials in the acupoint application therapy included , , , and , etc. and were most commonly used at Shenque (CV 8) and the supports were 57.49% and 57.21% respectively. was most commonly applied to Shenque (CV 8) and Dazhui (GV 14) and the supports were 48.21% and 43.91% respectively. was the most common herb at Dazhui (GV 14) with the support of 46.61%. Besides, the most commonly combined western drugs included cefixime and keteling in the acupoint application therapy and the supports were 13.07% and 12.72% respectively.
Acupoint application is effective on exogenous fever. The common therapy refers to and plaster at Shenque (CV 8), while and at Dazhui (GV 14).
探讨穴位敷贴对外感发热的疗效、有效人群特征及穴位敷贴用药特点。
利用互联网电子诊疗平台(春天广播万象云诊所数据库,该平台主推的中医适宜技术为穴位敷贴疗法),选取2020年8月24日至2020年11月5日期间,以发热为主诉,诊断为普通感冒,有初诊记录且至少有一次复诊记录的患者作为研究对象。根据是否接受穴位敷贴疗法,将研究对象分为暴露组(接受穴位敷贴疗法,26 664例)和非暴露组(未接受穴位敷贴疗法,515例)。采用倾向得分法对两组的年龄、性别等混杂因素进行匹配。以发热消失率(2天内)及首次发热消失时间为疗效指标,采用关联规则挖掘分析外感发热有效人群特征及穴位敷贴用药规律。
倾向得分匹配后应用组1 229例,非应用组423例。应用组发热消失率是非应用组的1.82倍(P<0.05),应用组首次发热消失时间短于非应用组(P<0.01)。穴位敷贴疗法共纳入有效病例5 370例,其中位年龄为2岁,6岁以下儿童患者占比相对较高。有效人群中,最常用穴位有神阙(CV 8)、大椎(GV 14)、涌泉(KI 1)、天突(CV 22)等。神阙(CV 8)与大椎(GV 14)关联性高,支持度为62.57%。穴位敷贴疗法最常用的中药材料有[具体中药1]、[具体中药2]、[具体中药3]、[具体中药4]、[具体中药5]等。[具体中药1]和[具体中药2]最常用于神阙(CV 8),支持度分别为57.49%和57.21%。[具体中药3]最常用于神阙(CV 8)和大椎(GV 14),支持度分别为48.21%和43.91%。[具体中药4]是大椎(GV 14)最常用的中药,支持度为46.61%。此外,穴位敷贴疗法最常用的联用西药有头孢克肟和小儿退热栓,支持度分别为13.07%和12.72%。
穴位敷贴治疗外感发热有效。常用治法为神阙(CV 8)贴[具体中药1]和[具体中药2]膏剂,大椎(GV 14)贴[具体中药3]和[具体中药4]。