title: Association between skin reactions and efficacy of summer acupoint application treatment on chronic pulmonary disease: A prospective study.
abstract: OBJECTIVE
  To examine the variations in the prevalence of skin reactions and the association between skin reactions and efficacy of summer acupoint application treatment (SAAT) on chronic pulmonary disease (CPD).
  
  
  METHODS
  A total of 2,038 patients with CPD were enrolled at 3 independent hospitals (defined as Groups A, B and C, respectively) in China. All patients were treated by SAAT, as applying a herbal paste onto the acupoints of Fengmen (BL 12) and Feishu (BL 13) on the dog days of summer, according to the lunar calendar, in 2008. Ten days after treatment, skin reaction data (no reaction, itching, stinging, blistering, and infection) were obtained via face-to-face interviews. Patients were retreated in the same hospital one year later, thereby allowing doctors to assess treatment efficacy based on the patients' symptoms, the severity of the spirometric abnormalities, and the concomitant medications used.
  
  
  RESULTS
  A large number of patients (85.3%) displayed reactive symptoms; however, the marked associations between reactive symptoms and age or gender were not observed. An increased number of patients from Group B (99.3%) and Group C (76.5%) displayed reactive symptoms due to the increased mass of crude Semen Sinapis Albae. The effective rate of SAAT was as high as 90.4% for patients of Group B, which was followed by Group A (70.9%) and Group C (42.2%). Using stratified analyses, a convincing association between reactive symptoms and therapeutic efficacy was observed for patients with asthma [itching: odds ratio (OR)=2.17, 95% confidence interval (CI): 1.49 to 3.14; blistering: OR=0.43, 95% CI: 0.25 to 0.73; and no reaction: OR=0.56, 95% CI: 0.35 to 0.90]. However, the same tendency was not observed for patients with chronic bronchitis and chronic obstructive pulmonary disease.
  
  
  CONCLUSIONS
  SAAT can induce very mild skin reactions for patients with CPD, among which patients with asthma displayed a strong association between skin reactions and therapeutic efficacy. The skin reactions may be induced by the crude Semen Sinapis Albae.
authors.affiliation: Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
authors.forename: Xia-qiu
authors.initials: XQ
authors.lastname: Wu
authors.affiliation: Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Peng
authors.affiliation: Department of Respiration, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
authors.forename: Guo-qin
authors.initials: GQ
authors.lastname: Li
authors.affiliation: Department of Respiration, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
authors.forename: Hui-ping
authors.initials: HP
authors.lastname: Su
authors.affiliation: Department of Respiration, Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, 230061, China.
authors.forename: Guang-xia
authors.initials: GX
authors.lastname: Liu
authors.affiliation: China Academy of Chinese Medical Sciences, Beijing, 100700, China. pengjin2000@163.com.
authors.forename: Bao-yan
authors.initials: BY
authors.lastname: Liu
mesh_terms: D015669:Acupuncture Points; D000328:Adult; D000368:Aged; D001768:Blister / Q000209:etiology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011537:Pruritus / Q000209:etiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D012867:Skin / Q000473:pathology*; D016896:Treatment Outcome
keywords: Chinese medicine; chronic pulmonary disease; moxibustion; skin reaction; summer acupoint application treatment