| Acupoint application is an effective therapy in clinical work. But the literature review on exsisting studies show that there is no evaluation or solution about the main factors which affect the effect, such as drug choice, the selection of herbs and adjuvants. This makes the results of these studies not strongly commeasurable, and most of them are only the summaries on their own experience.This study is to decompose the entire treatment process of acupoint application on chronic superficial gastritis for the first time. It is devided into six trials by the effect influencing factors. Each trial studies on just one of the influencing factors while the other five factors are same. Every trial is devided into 3 groups. It could identify the preferred plan of the factors separately. Finally, the clinical optimization plan on acupoint application was made from the preferred plan of the six trials.The six effect influencing factors are:selection of herbs, selection of acupoints, duration of apllication, course of treatment, selection of adjuvant, selection of cutaneous permeable agents. The six trials are:Trial 1:Objective:To compare the effect of three commonly used herbal formula of the acupoint application.Methods:49 patients diagnosied with chronic superficial gastritis/meet the standards were divided into three groups. Group 1 treated with the fomula of Bi Bo(long pepper)as the chief herb, group 2 with the fomula of Huang Lian(Coptis chinensis) as the chief herb, and group 3 with the fomula of Zhi zi(Gardenia) as the chief herb. All patients were treated with different fomulas, but the basic treatment were same. The therapeutic effects were evaluated by the safety, effect, clinical symptom score, endoscopy evaluation, and quality of life score in TCM, etc.Results:According to the scores of clinical symptom, there were differences both between group 1 and group 2, group 2 and group 3. Scores of group 2 improved most after treatment. According to PRO scale score, there were differences both between group 1 and group 2, group 1 and group 3 in addition to the "psychological field" and "social field". Scores of group 2 and group 3 improved more than thoses of group 1 after treatment.Results:the effect of Group two (Copt is, Mu Xiang, Yuan Hu, Gardenia (1:1:1:1)) was the best.Trial 2:Objective:To compare the effect of three commonly used acupoints fomula of the acupoint application.Methods:54 patients diagnosied with chronic superficial gastritis/meet the standards were divided into three groups. Group 1 treated with the fomula of Shenque as main point, group 2 with Bian Men as main point, group 3 with Zhongwan as the main point. The treatment course and effect evaluation were similar to Trial 1.Results:According to the scores of clinical symptom, there were differences both between group 1 and group 3, group 2 and group 3 on the total scores and the scores of stomach symptom. Scores of group 3 improved most after treatment. According to PRO scale score, scores of group 3 improved more than group 1 or group 2 after treatment.Result:the effect of Group three (in the epigastric, internal relations, Gongsun, Zusanli, gu, under the giant virtual) was the best.Trial 3:Objective:To compare the effect of three durations of acupoint application. Methods:42 patients diagnosied with chronic superficial gastritis/meet the standards were divided into three groups. Group 1 was treated for 2 hours each time, group 2 for 4 hours, and group 3 for 12 hours. The herbs, acupoints, course of application and effect evaluation were similar to Trial 1.Results:According to the scores of clinical symptom, there were differences both between group 1 and group 2, group 1 and group 3. Scores of group 1 improved most after treatment. According to PRO scale score, scores of group 1 improved more than group 2 or group 3 after treatment. On the "physical field" and "social field", through therapy, scores of group 1 improved more than those of Group 2 and Group 3.Result:the effect of Group one was the best. Considering the better induction period and half time, longer time for application made the acupoints less reactive and the effect decreased.Trial 4:Objective:To compare the effect of three different courses of acupoints application.Methods:56 patients diagnosied with chronic superficial gastritis/meet the standards were divided into three groups. Group 1 was treated for 2 weeks, group 2 for 4 weeks, and group 3 for 6 weeks. The herbs, acupoints, durations of application and effect evaluation were similar to Trial 1.Results:According to the scores of clinical symptom, group 2 and group 3 improved more than group 1. But it showed no difference between the two groups, but better than the group 1. According to PRO scale score, scores of group 2 and group 3 improved more than group 1. However, there was no difference between group 2 and group 3.Result:It showed that Group 2 and Group 3 got better effect, and that no significant difference between them. The effect of the two groups was similar, though the courses were different. In clinical practice, course of 4 weeks worked shorter and better. Considering the basic treatment including oral western medicine and Chinese herbal decotion, the recommended course could not be used separately.Trial 5:Objective:To compare the effect of three different adjuvant.Methods:57 patients diagnosied with chronic superficial gastritis/meet the standards were divided into three groups. Group 1 was treated with ginger juice as adjuvant, group 2 with, yellow rice wine and group 3 with vinegar. The treatment course and effect evaluation were similar to Trial 1.Results:According to the scores of clinical symptom, there were differences both between group 1 and group 2, group 1 and group 3. Scores of group 1 improved most after treatment. According to PRO scale score, scores of group 1 improved more than group 2 or group 3 after treatment.Result:the effect of ginger juice was the best. Because ginger could regulate stomach and allevieate vomitting. It could relieve the bitter and cold of Huang Lian and Zhi Zi, and avoid injury to stomache qi.Trial 6:Objective:To compare the effect of three different cutaneous permeable agents.Methods:40 patients diagnosied with chronic superficial gastritis/meet the standards were divided into three groups. Group 1 was treated with Chuan Xiong extract as cutaneous permeable agent, group 2 with clove and group 3 with menthol. The treatment course and effect evaluation were similar to Trial 1.Result:According to the comparison on scores of clinical symptom and PRO scale score, all P values were larger than 0.05. There were no significant differences in all groups.Conclusion:In trial 6, it showed there were no significant differences on the effect. The result could be affected by the promoting permeation effect of Coptis and ginger.
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