Acupuncture Continuing Education

Acupuncture And Herbs COVID-19 (Coronavirus) Findings

Acupuncture And COVID-19 (Coronavirus)

Acupuncture and herbal medicine are effective for the treatment of COVID-19 (coronavirus disease 19). The Beijing Health Commission notes that 87% of COVID-19 patients in Beijing received traditional Chinese medicine treatment (acupuncture and herbs). The commission documents that the total effective rate for patients receiving TCM (traditional Chinese medicine) treatment is 92%. [1]

Gao Xiaojun, spokesperson for the Beijing Health Commission, announced that Chinese medicine practitioners will determine Chinese medicine treatment plans for newly diagnosed, affected, severe, and critically ill COVID-19 patients. In a formal announcement, Gao Xiojun cited a brief history of one COVID-19 patient suffering from fever. Three TCM experts from Dongzhimen Hospital and Ditan Hospital formulated and administered a TCM treatment plan. By the next morning, the patient’s temperature dropped significantly to 37.2 degrees Celcius.

The spokesperson added that there are many similar cases and that Chinese medicine has “played an active role in improving the cure rate and reducing the mortality rate.” [2] The Beijing Health Commission has established city, district, and hospital level TCM expert groups to establish treatment protocols for the prevention and treatment of COVID-19 patients.

The National Administration of Traditional Chinese Medicine (NATCM) reports significant results. Hong-Zhi et al. document that the herbal formula Qing Fei Pai Du Tang had a 90% response rate for 214 COVID-19 patients with pneumonia. [3] Out of the 90%, symptoms markedly improved in ≥60% of patients and the remaining 30% stabilized.

According to Hong-Zhi et al., Chinese medicine physicians adjust treatments based on differential diagnostics dependent upon current presentations of pneumonia. Although Qing Fei Pai Du Tang is recommended by the NATCM, treatment protocols vary according to diagnostic considerations. [4]

Li Yu (Department of Science and Technology of the State Administration of Traditional Chinese Medicine director) notes that of 701 COVID-19 patients treated with Qing Fei Pai Du Tang, 130 patients were cured, symptoms including fever and coughing completely resolved in an additional 51 patients, symptom improvements occurred in an additional 268 patients, and stabilization occurred in 212 patients. [5]

In a detailed analysis of 351 patients, Li Yu notes that 112 patients had a body temperature in excess of 37.3 degrees Celsius. After taking Qing Fei Pai Du Tang for one day, 51.8% of patients’ body temperatures returned to normal. After 6 days, 94.6% returned to normal temperature.

Of the 351 patients, 214 had coughs. After one day of drinking Qing Fei Pai Du Tang, 46.7% of patients’ coughs completely resolved. After 6 days, 80.6% had significant reductions in coughing. [6] In related findings from two independent investigations, the herbal medicine Lian Hua Qing Wen Capsule helped resolve COVID-19 symptoms and promoted recovery. [7, 8]

To have acupuncture help TCM practitioners battle the coronavirus outbreak, the China Association of Acupuncture and Moxibustion issued Acupuncture Treatment Guidelines for COVID-19 (Second ​Edition). [9] The guidelines have been divided into three stages: prevention, treatment, and recovery. For the prevention stage, acupuncture is administered to strengthen zheng qi (healthy energy) and to benefit lung and spleen functions to combat foreign pathogens. The primary acupoints selected for this stage are categorized into 3 groups; 1–2 acupoints are selected from each group during one acupuncture session:

  • Group 1: BL12 (Fengmen), BL13 (Feishu), BL20 (Pishu)
  • Group 2: LI4 (Hegu), LI11 (Quchi), LU5 (Chize), LU10 (Yuji)
  • Group 3: CV6 (Qihai), ST36 (Zusanli), SP6 (Sanyinjiao)

A secondary set is added dependent upon individual symptoms. For fever, the following acupoints are added:

  • GV14 (Dazhui)
  • CV22 (Tiantu)
  • LU6 (Kongzui)

For nausea, loose stools, enlarged tongue with greasy coating, and soft (soggy) pulse, the following acupoints are added:

  • GV14 (Zhongwan)
  • ST25 (Tianshu)
  • ST40 (Fenglong)

For fatigue and poor appetite, the following acupoints are added:

  • CV12 (Zhongwan)
  • CV9 (Shuifen), CV7 (Yinjiao), KI16 (Qizhousixue)
  • BL20 (Pishu)

For clear nasal discharge, sore and painful back, pale tongue with white coating, and moderate pulse, the following acupoints are added:

  • BL10 (Tianzhu)
  • BL12 (Fengmen)
  • GV14 (Dazhui)

In the treatment stage, acupuncture is applied to interrupt disease progress based on the Pei Tu Sheng Jin (bank up earth to engender metal) principle and to relieve low mood. The primary acupoints selected for this stage are categorized into 3 groups. For mild to moderate cases, 2–3 acupoints are selected from groups 1 and 2 during each acupuncture session. For severe cases, additional 2–3 acupoints are recommended from group 3.

  • Group 1: LI4 (Hegu), LR3 (Taichong), CV22 (Tiantu), LU5 (Chize), LU6 (Kongzui), ST36 (Zusanli), SP6 (Sanyinjiao)
  • Group 2: BL11 (Dashu), BL12 (Fengmen), BL13 (Feishu), BL15 (Xinshu), BL17 (Geshu)
  • Group 3: LU1 (Zhongfu), CV17 (Danzhong), CV6 (Qihai), CV4 (Guanyuan), CV12 (Zhongwan)

A secondary set is added dependent upon individual symptoms. For persistent fever, the following acupoints are added:

  • GV14 (Dazhui)
  • LI11 (Quchi)
  • EX-UE11 (Shixuan)
  • EX-HN6 (Erjian)

For chest tightness and shortness of breath, the following acupoints are added:

  • PC6 (Neiguan)
  • LU7 (Lieque)
  • CV14 (Juque)
  • LR14 (Qimen)
  • KI6 (Zhaohai)

For coughing with sputum, the following acupoints are added:

  • LU7 (Lieque)
  • ST40 (Fenglong)
  • EX-B1 (Dingchuan)

For diarrhea with loose stools, the following acupoints are added:

  • ST25 (Tianshu)
  • ST37 (Shangjuxu)

For cough with yellow and sticky sputum and constipation, the following acupoints are added:

  • CV22 (Tiantu)
  • TB6 (Zhigou)
  • ST25 (Tianshu)
  • ST40 (Fenglong)

For low grade fever, nausea, loose stools, and a pale-red tongue with a white-greasy coating, the following acupoints are added:

  • BL13 (Feishu)
  • ST25 (Tianshu)
  • SP14 (Fujie)
  • PC6 (Neiguan)

In the recovery stage, acupuncture is applied to eliminate pathogens from the body and to recover lung and spleen functions. The following primary acupoints are recommended:

  • P6 (Neiguan)
  • ST36 (Zusanli)
  • GV14 (Zhongwan)
  • ST25 (Tianshu)
  • CV6 (Qihai)

A secondary set of acupuncture points are added dependent upon individual symptoms. For lung and spleen qi deficiency, sets of points are added for specific conditions:

  • If lung symptoms (e.g., chest tightness, shortness of breath) are pronounced, CV17 (Danzhong), BL13 (Feishu), and LU1 (Zhongfu) are added.
  • If spleen symptoms (e.g., poor appetite, diarrhea) are pronounced, CV13 (Shangwan) and SP9 (Yinlingquan) are added. 

For patients with qi and yin deficiency, the following acupoints are recommended for specific presentations:

  • If there is fatigue and shortness of breath, CV17 (Danzhong) and CV8 (Shenque) are added.
  • If there is dry mouth and thirst, KI3 (Taixi) and TB4 (Yangchi) are added.
  • If there are palpitations, BL15 (Xinshu) and BL14 (Jueyinshu) are added.
  • If there s profuse sweating, LI4 (Hegu), KI7 (Fuliu), and ST36 (Zusanli) are added.
  • If there is insomnia, HT7 (Shenmen), EX-HN3 (Yintang), EX-HN 19 (Anmian), and KI1 (Yongquan) are added.

 

Additional guidelines were published for patients with sputum and stasis blocking the channels with underlying lung and spleen deficiency:

  • For patients with lung, spleen and heart symptoms (e.g., chest tightness, shortness of breath), BL13 (Feishu), BL20 (Pishu), BL15 (Xinshu), BL17 (Geshu), LU1 (Zhongfu), and CV17 (Danzhong) are added.
  • If sputum is unproductive, ST40 (Fenglong) and EX-B1 (Dingchuan) are added.

The aforementioned acupoints can be stimulated with acupuncture, moxibustion, or massage. If acupuncture is used, needles should be manipulated with the mild reinforcement and attenuation (Ping Bu Ping Xie) technique during the 20–30 minute needle retention time. If moxibustion is applied, the moxa should warm the points for 10–15 minutes. Treatment is administered once daily.

 

Prior Research
Beijing Hospital of Traditional Chinese Medicine researchers, whose research was published in the Chinese Acupuncture and Moxibustion Journal, concluded that acupuncture is effective for the treatment of the 2003 SARS coronavirus. [10] A total of 20 patients were evaluated in the study. They presented with fatigue, shortness of breath, chest tightness, and other symptoms. X-ray imaging was used in the process of determining improvements. Acupoints were selected for patients from the the following:

  • BL11 (Dashu)
  • BL12 (Fengmen)
  • BL13 (Feishu)
  • BL17 (Geshu)
  • BL43 (Gaohuangshu)
  • BL20 (Pishu)
  • BL21 (Weishu)
  • SI12 (bingfeng)
  • SI13 (Quyuan)
  • CV22 (Tiantu)
  • CV17 (Danzhong)
  • LU1 (Zhongfu)
  • KI26 (Yuzhong)
  • ST16 (Yingchuang)
  • LU5 (Chize)
  • PC7 (Daling)
  • LI2 (Erjian)
  • LI11 (Quchi)
  • ST36 (Zusanli)

Beijing Guang'anmen Hospital of China Academy of Chinese Medical Sciences researchers had significant results in their 2003 SARS investigation. [11] Zhao et al. used the following acupuncture points for SARS patients in the recovery stage:

  • GV14 (Dazhui)
  • BL43 (Gaohuangshu)
  • ST36 (Zusanli)

Moxibustion instead of acupuncture was applied on the acupoints. The frequency of treatment was once per day for a total of 7 days. All 9 patients had documented chest radiographic improvements, one of whom no longer had radiographic abnormalities. In addition, the percentage of CD4 among T-cell subgroups increased in 4 out of 9 patients, indicating that moxibustion assists the body’s immune function against SARS coronavirus.

 

References:
[1] xinhuanet.com/politics/2020-02/24/c_1125620808.htm. 3-23-2020.
[2] xinhuanet.com/politics/2020-02/24/c_1125620808.htm. 3-23-2020.
[3] Hong-Zhi, D. U., H. O. U. Xiao-Ying, M. I. A. O. Yu-Huan, H. U. A. N. G. Bi-Sheng, and L. I. U. Da-Hui. "Traditional Chinese Medicine: an effective treatment for 2019 novel coronavirus pneumonia (NCP)." Chinese Journal of Natural Medicines 18, no. 3 (2020): 1-5.
[4] Hong-Zhi, D. U., H. O. U. Xiao-Ying, M. I. A. O. Yu-Huan, H. U. A. N. G. Bi-Sheng, and L. I. U. Da-Hui. "Traditional Chinese Medicine: an effective treatment for 2019 novel coronavirus pneumonia (NCP)." Chinese Journal of Natural Medicines 18, no. 3 (2020): 1-5.
[5] Yu, Li. China Administration of Traditional Chinese Medicine. "Qingfei Paidu Decoction has good effect on new coronary pneumonia." 2-17-2020.
[6] Yu, Li. China Administration of Traditional Chinese Medicine. "Qingfei Paidu Decoction has good effect on new coronary pneumonia." 2-17-2020.
[7] Yao KT, Liu MY, Li X, Huang JH, Cai HB. Retrospective Clinical Analysis on Treatment of Novel Coronavirus-infected Pneumonia with Traditional Chinese Medicine Lianhua Qingwen. Chin J Exp Tradit Med Form. 2020: 1-7.
[8] Lv RB, Wang WJ, Li X. Treatment of suspected new coronavirus pneumonia with Chinese medicine Lianhua Qingwen. Clinical observation of 63 suspected cases. J Tradit Chin Med. 2020: 1-5.
[9] Acupuncture Treatment Guidelines for COVID-19 (Second Edition) [J/OL]. Chinese Acupuncture and Moxibustion:1-2[2020-03-21].
[10] Liu HL, Wang LP, Xuan YB, He PR. The preliminary research on 89 cases of SARS in rehabilitation clinic [J]. Chinese Acupuncture and Moxibustion, 2003(10):66-67.
[11] Zhao H, Li YS, Liu B, Li J, Wang S, Hua BJ, Tian CH. Nine cases of the chronic stage of SARS treated by moxibustion [J]. Chinese Acupuncture and Moxibustion, 2003(09):66-67.

 

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