Evaluation Of Curative Effect Of External Therapy Of Traditional Chinese Medicine In The Treatment Of Stable COPD Based On Literature Research

Purpose:To study the literature of TCM External Therapy in the treatment of stable COPD,explore its clinical application,and summarize its development and clinical data in recent years.Meta analysis and network meta analysis were used to explore the clinical data,to explore the bias of literature and the safety of clinical application,and to select the best intervention measures according to the improvement of different indicators.Material and method:Based on CNKI,sinomed,Wanfang,VIP and Pub Med,through literature screening and inclusion criteria,the number of included literatures,external treatment of traditional Chinese medicine,year,province,fund,literature randomization method,syndrome,number of clinical trials,clinical related indicators and acupoint selection and medication of various external treatment of traditional Chinese medicine were analyzed and summarized.To collect the relevant literature of randomized controlled trials of external treatment of traditional Chinese medicine in the treatment of stable COPD.After literature screening and referring to the Cochrane system evaluation manual,the quality of the included literature was evaluated.Revman5.4 and Stata 14.0 software were used for meta-analysis and network meta-analysis.Results:1.Bibliometric study on the treatment of stable COPD by external treatment of traditional Chinese medicineA total of 286 literatures were included in this part,and 28321 people participated in the clinical trials.The clinical application of external treatment of traditional Chinese medicine includes acupoint application,moxibustion,acupoint injection,acupuncture,acupoint catgut embedding,and traditional skills.The clinical application of external treatment of traditional Chinese medicine in the treatment of stable COPD is increasing year by year,especially in Guangdong,Shanghai,Henan,Jiangsu and other places,the amount of published papers is in the majority,the fund support is relatively more in the southern region,the quality of literature is significantly improved,the combined application of external treatment of traditional Chinese medicine has significant curative effect,high safety and less side effects,which is worthy of wide promotion in clinical practice in the future.2.Meta and network meta analysis of external treatment of traditional Chinese medicine in the treatment of stable COPDMeta analysis of clinical effective rate:OR=4.04,95%CI:（2.89-5.63）,Z=8.21,P<0.01,the difference was statistically significant;Meta analysis of TCM syndrome score:MD=2.86,95%CI:（1.3-4.41）,Z=3.59,P<0.05,the difference was statistically significant;Meta analysis of cat score:MD=2.77,95%CI:（1.66-3.88）,Z=4.88,P<0.05,the difference was statistically significant;Meta analysis of FVC:the results showed that there was a significant difference after Moxibustion and Acupoint injection therapy combined with effective dose;Meta analysis of FEV₁/FVC:MD=2.43,95%CI:（0.49-4.37）,Z=2.45,P=0.01<0.05,the difference was statistically significant.Net meta analysis:Moxibustion group>Acupoint injection group>Western medicine routine group>Acupuncture group>Acupoint application group>Acupoint catgut embedding group>Placebo combined with western medicine routine group>Traditional skill group>Routine education group;Meta analysis of FEV₁change value:the results showed that the difference was statistically significant after the combination of Moxibustion,Traditional skill and Acupoint injection combined with the effect amount.Network meta analysis:Moxibustion group>Acupoint injection group>Traditional skill group>Acupoint catgut embedding group>Placebo combined with routine western medicine group>Routine Western Medicine group>Acupoint application group>Routine education group>Acupuncture group;Meta analysis of FEV₁%change value:the results showed that the difference was statistically significant after Moxibustion,Traditional exercise,Acupoint injection,Acupoint application and effect amount.Conclusion:1.Through the analysis of large sample data,TCM external treatment is safe and effective in the treatment of stable COPD,which can significantly improve the treatment efficiency and improve the lung function of patients.2.In clinical,different external treatment methods of traditional Chinese medicine are used to improve the efficacy index and improve the clinical treatment effect.Among them, moxibustion and acupoint injection have strong advantages in improving FVC and FEV1/FVC.Moxibustion,traditional skill and acupoint injection have strong improvement on FEV1.Moxibustion,traditional skill,acupoint injection,acupuncture and acupoint application have obvious effect on improving FEV1%.