{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T19:28:46Z","timestamp":1793647726665,"version":"4.5.1"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"42","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10,16]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Acute urticaria is a common condition that can affect individuals across all age groups. Current pharmacological treatments primarily rely on antihistamines and corticosteroids. However, these therapies may be limited by suboptimal efficacy, dose- and time-dependence, and potential adverse effects. Therefore, the incorporation of effective adjunctive therapies is of considerable clinical value. This study aimed to evaluate the impact of auricular bloodletting (BL) therapy on the length of hospital stay in patients with acute urticaria. Poisson regression was used to compare differences in hospitalization duration between groups. Propensity score matching (PSM) was applied to minimize selection bias. Subgroup analyses by sex and age, as well as robustness checks using bootstrap resampling and Rosenbaum sensitivity analysis, were also performed. Before PSM, Poisson regression indicated that the bloodletting group had significantly shorter hospital stays. The effect was significant in the male, female, and adult subgroups. After PSM, the incidence rate ratios remained below 1 in all models, and statistical significance was observed. No significant differences were observed in the female or adult subgroups post-matching, whereas statistical significance was retained in the male subgroup. No adverse events were reported. Bootstrap and Rosenbaum sensitivity analyses confirmed the robustness of the findings. Patients who received auricular BL experienced shorter hospital stays. Post-matching results showed that statistical significance was retained in the male subgroup. Given the limited sample size in the intervention group, further prospective studies with larger cohorts are warranted to validate these findings and elucidate the underlying mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/md.0000000000051145","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:01:15Z","timestamp":1792173675000},"page":"e51145","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of auricular bloodletting therapy for acute urticaria"],"prefix":"10.1097","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1419-4654","authenticated-orcid":false,"given":"Lan","family":"Xu","sequence":"first","affiliation":[{"name":"Department of First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiujuan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Quzhou TCM Hospital at the Junction of Four Provinces Affiliated to Zhejiang Chinese Medical University, Quzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuejun","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruyi","family":"Ju","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueping","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahui","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6747-7467","authenticated-orcid":false,"given":"Yi","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Dermatology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20261102","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.jaad.2018.01.020","article-title":"Urticaria: a comprehensive review: epidemiology, diagnosis, and work-up.","volume":"79","author":"Antia","year":"2018","journal-title":"J Am Acad Dermatol"},{"key":"R2-20261102","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.pop.2025.05.010","article-title":"Urticaria: diagnosis and management.","volume":"52","author":"Bass","year":"2025","journal-title":"Prim Care"},{"key":"R3-20261102","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1111\/all.15090","article-title":"The international EAACI\/GA2LEN\/EuroGuiDerm\/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria.","volume":"77","author":"Zuberbier","year":"2022","journal-title":"Allergy"},{"key":"R4-20261102","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1007\/s12016-017-8628-1","article-title":"Urticaria and angioedema: an update on classification and pathogenesis.","volume":"54","author":"Radonjic-Hoesli","year":"2018","journal-title":"Clin Rev Allergy Immunol"},{"key":"R5-20261102","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1097\/00063110-199406000-00006","article-title":"Particularities of urticaria seen in the emergency department.","volume":"1","author":"Simonart","year":"1994","journal-title":"Eur J Emerg Med"},{"key":"R6-20261102","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1038\/s41572-022-00389-z","article-title":"Urticaria.","volume":"8","author":"Kolkhir","year":"2022","journal-title":"Nat Rev Dis Primers"},{"key":"R7-20261102","first-page":"279","article-title":"An interrogative study of 158 urticaria patients.","volume":"31","author":"Sehgal","year":"1973","journal-title":"Ann Allergy"},{"key":"R8-20261102","first-page":"717","article-title":"Acute and chronic urticaria: evaluation and treatment.","volume":"95","author":"Schaefer","year":"2017","journal-title":"Am Fam Physician"},{"key":"R9-20261102","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.iac.2013.07.010","article-title":"Acute urticaria.","volume":"34","author":"Sabroe","year":"2014","journal-title":"Immunol Allergy Clin North Am"},{"key":"R10-20261102","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/1710-1492-5-10","article-title":"Urticaria and infections.","volume":"5","author":"Wedi","year":"2009","journal-title":"Allergy Asthma Clin Immunol"},{"key":"R11-20261102","first-page":"1","article-title":"Acute urticaria: etiologies, clinical course and quality of life.","volume":"26","author":"Kulthanan","year":"2008","journal-title":"Asian Pac J Allergy Immunol"},{"key":"R12-20261102","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1111\/j.0736-8046.2004.21202.x","article-title":"The etiology of different forms of urticaria in childhood.","volume":"21","author":"Sackesen","year":"2004","journal-title":"Pediatr Dermatol"},{"key":"R13-20261102","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s12948-020-00123-8","article-title":"Urticaria: recommendations from the Italian Society of Allergology, Asthma and Clinical Immunology and the Italian Society of Allergological, Occupational and Environmental Dermatology.","volume":"18","author":"Nettis","year":"2020","journal-title":"Clin Mol Allergy"},{"key":"R14-20261102","first-page":"386","article-title":"Usefulness of a short course of oral prednisone in antihistamine-resistant chronic urticaria: a retrospective analysis.","volume":"20","author":"Asero","year":"2010","journal-title":"J Investig Allergol Clin Immunol"},{"key":"R15-20261102","doi-asserted-by":"crossref","first-page":"295","DOI":"10.2340\/0001555576295297","article-title":"Acute urticaria: clinical aspects and therapeutic responsiveness.","volume":"76","author":"Zuberbier","year":"1996","journal-title":"Acta Derm Venereol"},{"key":"R16-20261102","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S0196-0644(95)70002-1","article-title":"Outpatient management of acute urticaria: the role of prednisone.","volume":"26","author":"Pollack","year":"1995","journal-title":"Ann Emerg Med"},{"key":"R17-20261102","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1111\/bjd.14768","article-title":"Updosing nonsedating antihistamines in patients with chronic spontaneous urticaria: a systematic review and meta-analysis.","volume":"175","author":"Guill\u00e9n-Aguinaga","year":"2016","journal-title":"Br J Dermatol"},{"key":"R18-20261102","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1136\/ard.2008.092163","article-title":"Dose-related patterns of glucocorticoid-induced side effects.","volume":"68","author":"Huscher","year":"2009","journal-title":"Ann Rheum Dis"},{"key":"R19-20261102","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/00004836-200110000-00006","article-title":"Side effects of corticosteroid therapy.","volume":"33","author":"Buchman","year":"2001","journal-title":"J Clin Gastroenterol"},{"key":"R20-20261102","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s11655-018-3009-2","article-title":"Blood-letting therapy for hypertension: a systematic review and meta-analysis of randomized controlled trials.","volume":"25","author":"Xiong","year":"2019","journal-title":"Chin J Integr Med"},{"key":"R21-20261102","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1007\/s11655-015-2109-2","article-title":"Effect of ear-acupoint pressing and Ear Apex (HX6,7) bloodletting on haemorheology in chloasma patients with Gan depression pattern.","volume":"22","author":"Shi","year":"2016","journal-title":"Chin J Integr Med"},{"key":"R22-20261102","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1002\/jhm.2010","article-title":"An intellectual agenda for hospitalists: lessons from bloodletting.","volume":"8","author":"Goldman","year":"2013","journal-title":"J Hosp Med"},{"key":"R23-20261102","first-page":"2022","article-title":"Bloodletting over the centuries.","volume":"80","author":"Seigworth","year":"1980","journal-title":"N Y State J Med"},{"key":"R24-20261102","doi-asserted-by":"crossref","first-page":"6598708","DOI":"10.1155\/2020\/6598708","article-title":"Efficacy of bloodletting therapy in patients with chronic idiopathic urticaria: a randomized control trial.","volume":"2020","author":"Ma","year":"2020","journal-title":"Evid Based Complement Alternat Med"},{"key":"R25-20261102","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1159\/000056237","article-title":"Stressful life events and skin diseases: disentangling evidence from myth.","volume":"70","author":"Picardi","year":"2001","journal-title":"Psychother Psychosom"},{"key":"R27-20261102","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1037\/0033-2909.112.1.155","article-title":"A power primer.","volume":"112","author":"Cohen","year":"1992","journal-title":"Psychol Bull"},{"key":"R28-20261102","doi-asserted-by":"crossref","first-page":"b2393","DOI":"10.1136\/bmj.b2393","article-title":"Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls.","volume":"338","author":"Sterne","year":"2009","journal-title":"BMJ"},{"key":"R29-20261102","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1080\/00273171.2011.568786","article-title":"An introduction to propensity score methods for reducing the effects of confounding in observational studies.","volume":"46","author":"Austin","year":"2011","journal-title":"Multivariate Behav Res"},{"key":"R30-20261102","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1016\/j.jclinepi.2015.04.009","article-title":"A new weighted balance measure helped to select the variables to be included in a propensity score model.","volume":"68","author":"Caruana","year":"2015","journal-title":"J Clin Epidemiol"},{"key":"R31-20261102","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1093\/aje\/kwq224","article-title":"Statistical criteria for selecting the optimal number of untreated subjects matched to each treated subject when using many-to-one matching on the propensity score.","volume":"172","author":"Austin","year":"2010","journal-title":"Am J Epidemiol"},{"key":"R32-20261102","doi-asserted-by":"crossref","first-page":"475","DOI":"10.3171\/2018.5.PEDS1876","article-title":"Intraoperative intracranial pressure monitoring in the pediatric craniosynostosis population.","volume":"22","author":"Judy","year":"2018","journal-title":"J Neurosurg Pediatr"},{"key":"R33-20261102","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1016\/S2213-8587(17)30313-3","article-title":"Cardiovascular safety and efficacy of the PCSK9 inhibitor evolocumab in patients with and without diabetes and the effect of evolocumab on glycaemia and risk of new-onset diabetes: a prespecified analysis of the FOURIER randomised controlled trial.","volume":"5","author":"Sabatine","year":"2017","journal-title":"Lancet Diabetes Endocrinol"},{"key":"R34-20261102","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1093\/qjmed\/hcab074","article-title":"Could bloodletting have helped?","volume":"114","author":"Thachil","year":"2021","journal-title":"QJM"},{"key":"R35-20261102","doi-asserted-by":"crossref","first-page":"814842","DOI":"10.1155\/2013\/814842","article-title":"Cancer incidence and mortality in a cohort of US blood donors: a 20-year study.","volume":"2013","author":"Vahidnia","year":"2013","journal-title":"J Cancer Epidemiol"},{"key":"R36-20261102","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1093\/jnci\/djn209","article-title":"Decreased cancer risk after iron reduction in patients with peripheral arterial disease: results from a randomized trial.","volume":"100","author":"Zacharski","year":"2008","journal-title":"J Natl Cancer Inst"},{"key":"R37-20261102","first-page":"281","article-title":"Effect of auricular acupuncture with low power laser on four chronic allergic dermatoses and serum IgE level.","volume":"20","author":"Hou","year":"2005","journal-title":"Chin Med Sci J"},{"key":"R38-20261102","first-page":"157","article-title":"Chronic spontaneous urticaria treated with bloodletting therapy and auricular point sticking on the base of xuanfu theory: a randomized controlled trial.","volume":"42","author":"Wang","year":"2022","journal-title":"Zhongguo Zhen Jiu"},{"key":"R39-20261102","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1038\/429363a","article-title":"Pigment chemistry: the red sweat of the hippopotamus.","volume":"429","author":"Saikawa","year":"2004","journal-title":"Nature"},{"key":"R40-20261102","doi-asserted-by":"crossref","first-page":"6627393","DOI":"10.1155\/2023\/6627393","article-title":"Auriculotherapy modulates macrophage polarization to reduce inflammatory response in a rat model of acne.","volume":"2023","author":"Zuo","year":"2023","journal-title":"Mediators Inflamm"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/MD.0000000000051145","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T19:01:16Z","timestamp":1793646076000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/MD.0000000000051145"}},"subtitle":["A propensity score-matched retrospective cohort study"],"short-title":[],"issued":{"date-parts":[[2026,10,16]]},"references-count":39,"journal-issue":{"issue":"42","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000051145","relation":{},"ISSN":["0025-7974","1536-5964"],"issn-type":[{"value":"0025-7974","type":"print"},{"value":"1536-5964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,16]]},"assertion":[{"value":"2025-11-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}