中医穴位贴敷治疗腹泻回顾性队列研究OA

Objective To explore the effectiveness of Chinese medicine(CM)acupoint application therapy in the treatment of diarrhea,as well as the characteristics of responsive patient populations and prescription patterns.Methods A retrospective cohort study was conducted utilizing data from diarrhea cases recorded on an online healthcare platform between May 2022 and May 2023.Patients were categorized into an exposure group(acupoint application group)and a non-exposure group(non-acupoint application group).Propensity score matching(PSM)was employed to adjust for confounding factors such as age and sex.Primary outcomes were diarrhea resolution rates on days 1,2,and 3.Multivariate logistic regression was used to assess treatment effectiveness.Association rule mining was performed to analyze the characteristics of effective subpopulations and commonly used prescriptions.Results Following PSM,the acupoint application group(3 012 cases)demonstrated significantly higher diarrhea resolution rates on days 1 and 2 compared to the non-application group(1 593 cases,P＜0.001),with odds ratios(OR)of 1.933(95％CI:1.623～2.304)and 1.507(95％CI:1.321～1.718),respectively.The median time to resolution was shorter in the treatment group(2.333 vs.3.042 days,x2=43.874,P＜0.001).Multivariate regression further confirmed higher resolution rates in the treatment group on days 1,2,and 3(all P＜0.001),with OR of 2.028(95％CI:1.639～2.510),1.744(95％CI:1.480～2.055),and 1.395(95％CI:1.197～1.627),respectively.Interaction analysis revealed significant effect modification by the use of antibiotics or other antidiarrheal agents(P＜0.001);the beneficial effects of acupoint application were evident only in patients not receiving these concurrent treatments.Among the 10 803 cases with effective responses to acupoint therapy,children under 3 years of age constituted the largest subgroup.The most frequently applied acupoints were Shenque(CV8),Zhongwan(CV12),Dazhui(GV14),and Yongquan(KI1),with the most common combination being Zhongwan(CV12)and Shenque(CV8)(support:58.42％).The most commonly used herbal ingredients included Coptis chinensis,Natrii Sulfas,Evodia rutaecarpa,and Agastache rugosa,with Coptis chinensis most frequently applied to the Shenque(CV8)(support:33.33％).Conclusions CM acupoint application appears effective for the treatment of diarrhea.Monotherapy showed certain advantages than combination therapy,Shenque(CV8)and Coptis chinensis were the most frequently used acupoint and herbal agent,respectively.