Objective: To provide the evidence for the efficacy of acupoint application (AA) for patients with diarrhea in a real-world setting.
Methods: This study is a national multicenter retrospective cohort study. Our study consecutively collected outpatient medical records of patients with diarrhea from hundreds of primary hospitals nationwide registered in Chun Bo Wan Xiang cloud platform from 22nd August, 2020 to 5th November, 2020. The patients were divided into the treatment group and the control group according to patient's condition and willingness. The control group was treated with Western Medicine, oral Chinese Medicine decoction, or both. The treatment group was added with AA based on the control group. Multiple logistic regression was used to evaluate the independent efficacy of AA in diarrheal recovery on the 3rd, 7th, 14th and 28th day. As a next step, we also performed stratified analysis and likelihood ratio test (LRT). Sensitivity analyses included propensity score matching (PSM), four PSM-related analyses and E-value.
Results: The treatment group showed better efficacy than the control group on the 14th and 28th day [the 14th day: = 1.58, 95% (1.15, 2.19), 0.005; the 28th day: = 2.03, 95% (1.43, 2.88), < 0.001]. No difference was observed in efficacy of AA for the treatment of diarrhea among the subgroups ( > 0.05). PSM-related analyses confirmed the efficacy of AA in diarrheal recovery. The findings are unlikely to be nullified by an unmeasured confounding variable according to the results of E-values.
Conclusions: The efficacy in the treatment group was significantly more improved than that in the control group on the 14th and 28th day.
Keywords: Xiaozhong Zhitong Tie; acupoint application; diarrhea; real-world study; retrospective cohort study.