[Influence of acupoint application on clinical use of antibiotics: a real world study of 1.23 million primary clinic patients].

To observe the influence of acupoint application on the use of antibiotics in primary clinic practice, and explore the effect of acupoint application and its influence on the use of antibiotics based on common diseases in primary clinic (fever, cough, diarrhea, sore throat).With the help of the internet electronic diagnosis and treatment platform (the main TCM suitable technology promoted by this platform is acupoint application therapy), the diagnosis and treatment data of 1.23 million patients in 2 000 primary clinics from August 24, 2020 to March 31, 2021 were collected. The patients were divided into an application group (acupoint application treatment) and a non-application group (non-acupoint application treatment), and the proportion of antibiotic use in the two groups was compared. The propensity score was used to match age, gender, concomitant symptoms, diagnosed diseases and other confounding factors of treatment, and the disappearance rate of symptoms (fever, cough, diarrhea, sore throat) and the time to first disappearance of symptoms were compared between the two groups.A total of 1 230 923 patients were analyzed, including 1 048 382 cases in the application group, accounting for 85.2%; 182 541 cases in the non-application group, accounting for 14.8%. The most patients who used acupoint application treatment were 0-2 years old, followed by 3-6 years old, and the patients over 15 years old who did not use acupoint application treatment were the most. The proportion of antibiotic use in the application group was 2.4%, lower than that in the non-application group (44.2%, P<0.001). The proportion of antibiotic use in all ages of patients in the application group was lower than that in the non-application group (P<0.001). Among the common diseases in primary clinic (fever, cough, diarrhea and sore throat), the proportion of antibiotic use in the application group was lower than that in the non-application group (P<0.01); the disappearance rate of symptoms in the application group was higher than that in the non-application group, and the time to first disappearance of symptoms was shorter than that in the non-application group (P<0.001).Acupoint application has a certain influence on the use of antibiotics in primary clinic patients. In the treatment of common diseases, patients treated with acupoint application have better curative effect and lower proportion of antibiotic use.目的：观察穴位贴敷对基层临床抗生素使用的影响，并基于基层常见病（发热、咳嗽、腹泻、咽痛），探讨穴位贴敷的疗效及对抗生素使用的影响。方法：借助互联网电子诊疗平台（该平台推广的主要中医适宜技术为穴位贴敷疗法），收集2020年8月24日至2021年3月31日2 000多个基层诊所123万例患者诊疗数据，将其分为贴敷组（使用穴位贴敷治疗）和非贴敷组（未使用穴位贴敷治疗），比较两组患者的抗生素使用比例。用倾向性评分对年龄、性别、伴随症状、诊断疾病及其他治疗方法混杂因素进行匹配，比较两组患者症状（发热、咳嗽、腹泻、咽痛）消失率和症状首次消失时间。结果：本研究共分析患者1 230 923例，其中贴敷组1 048 382例，占85.2%；非贴敷组182 541例，占14.8%。使用穴位贴敷治疗者以0~2岁患儿最多，其次是3~6岁患儿，不使用穴位贴敷治疗的患者15岁以上最多。贴敷组患者抗生素使用比例为2.4%，低于非贴敷组的44.2%（P<0.001）；贴敷组患者各年龄段抗生素使用比例均低于非贴敷组（P<0.001）。基层常见病症发热、咳嗽、腹泻、咽痛中，贴敷组患者抗生素使用比例均低于非贴敷组（P<0.01）；贴敷组患者症状消失率均高于非贴敷组、症状首次消失天数短于非贴敷组（P<0.001）。结论：穴位贴敷的应用对基层患者抗生素使用有一定的影响，在常见病治疗中，使用穴位贴敷治疗的患者疗效较好、抗生素使用比例较低。.