Systematic Review And Orthogonal Design In Bronchial Asthma Control With The Medical Vesiculation Therapy

Bronchial asthma is a disease equivalent "Asthma disease" in traditional medicine.It is a common disease in clinics.With the poor air quality in recent years,the incidence of asthma increased constantly.Asthma harms people’s health and quality of life seriously.Effective way to Western medicine treatment of asthma is primarily an anti-inflammatory and anti spasmodic,but it has side effects and dependence problem.The medical vesiculation therapy in the treatment of asthma has unique advantages,with its easy to operate,a significant effect and no side effects,have been widely recognized by doctors and patients.ObjectiveIn this study,a systematic review of the efficacy of vesiculation therapy on asthma will be take with a comprehensive collection and screening to literatures.Clinical trials based on this study will be do in researching the effects of vesiculation therapy on asthma in terms of time factor,using 3 factors,3 levels orthogonal design to observe which combined solution has the best affect as the timing of intervention(dog days,the coldest days,dog-coldest days),sticking times(1 time,3 times,5 times)and drug patching time(2h,5h,8h).Method1 Systematic ReviewAccording to cochrane systematic review requirements,collectting all published(as of December 2013)clinical journal articles of vesiculation therapy on asthma with randomized controlled trial,contains five database as PubMed Internet databases,China National Knowledge Infrastructure database(CNKI),Chinese BioMedical Literature database(CBMdisc),VIP database for Chinese Technical Periodicals(VIP),Wanfang Data Knowledge Service Platform(Wanfang).Key words are the medial vesiculation therapy,acupoint application and asthma.Take a review for the qualified literature,and do meta-analysis to the extracted data.2 Clinical ResearchSelect asthmatic patients from July 2013 to January 2014 who visited the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,with treatment as the medial vesiculation therapy.Grouping by L9(34)orthogonal design,to observe which combined solution has the best affect as the timing of intervention(dog days,the coldest days,dog-coldest days),sticking times(1 time,3 times,5 times)and drug patching time(2h,5h,8h).The qualified patients were randomly divided into 9 groups,and took related treatment respectively.Analyze the patient’s lung function(Forced expiratory volume in one second,FEV1;Peak expiratory flow,PEF),TCM symptom,asthma control test(ACT)and asthma quality of life questionnaire(AQLQ)before and after treatment,then concluded the best treatment plan about intervention timing,sticking times and drugs patching time.Results1 Systematic ReviewA total of 46(45 Chinese,English 1)Qualified literature were included,according to the different timing of intervention,divided the literature into four groups as daily vesiculation group,dog days vesiculation group,the coldest days vesiculation group and dog-coldest days vesiculation group,then did systematic review respectively.The therapeutic evaluation showed that there was no difference(P>0.05)between daily therapy and medicine which Bronchial asthma at acute stage.All of daily therapy,dog days therapy and dog-coldest days therapy were effective for which Bronchial asthma at non-acute stage(P<0.05),and better than other interventional treatments as medicine,acupuncture and Chinese medicine.Dog days therapy showed significant difference(P<0.05)in non-acute asthmatic patients’ effect of TCM syndromes.The medical vesiculation therapy can reduce asthmatic patients’ times of asthma attacks(P<0.05):,improve their asthmatic symptoms(P<0.05),enhance their quality of life(P<0.05),improve their lung function(P<0.05)and lower their blood eosinophils(P<0.05).Daily vesiculation therapy showed little effect on improving immunologic function which Bronchial asthma at acute stage(P>0.05).Dog days vesiculation therapy also showed little effect on improving lung function FEV1/predicted value%for non-acute asthma(P>0.05).2 Clinical ResearchThe subject finally included 540 cases of eligible patients;fall off in 41 cases,the actual completion of 499 cases.Off rate 7.59%<20%.After the course of treatment,from the timing of intervention point of view,indexes as FEV1,ACT and AQLQ selected dog days or dog-coldest days vesiculation therapy were both valid(P<0.05),and better than the coldest days intervention levels(P<0.05);Indexes as PEF and asthma symptoms of TCM pointed out that dog-coldest days therapy was better than dog days intervention(P<0.05)or the coldest days intervention(P<0.05).Views from sticking times,all indicators pointed out that sticking five times were the best,better than both sticking three times(P<0.05)or 1 time(P<0.05).From the point of view of time patching,indexes as asthma symptoms of TCM pointed out that patching 5h or 8h were both better than patching 2h(P<0.05),indexes as FEV1,PEF,ACT and AQLQ pointed out that patching 5h were the best,better than both 8h or 2h P<0.05).Year after treatment,indexes as ACT or AQLQ pointed out that the dog-coldest days therapy was better than dog days intervention(P<0.05),the dog days therapy was better than the coldest days intervention(P<0.05),sticking five times was better than sticking three times(P<0.05),sticking three times was better than sticking 1 time(P<0.05),patching 5h was better than patching 8h(P<0.05),patching 8h was better than patching 2h(P<0.05).Conclusion1 Systematic ReviewAll three the medical vesiculation therapy interventions were effective for the treatment of non-acute asthma,can reduce the number of asthma attacks,improve asthma symptoms of TCM,improve their lung function and enhance quality of life.2 Clinical ResearchComprehensive recent course of treatment and long-term annual treatment,select dog-coldest days intervention,sticking five times,patching 5h was the best plan for the medical vesiculation treatment of bronchial asthma.