Acupuncture Continuing Education

Acupuncture Effective For Alleviating Sepsis

acupuncture ceu LI4 Hegu1

Acupuncture increases the total effective rate of the drug moxifloxacin for the relief of sepsis. Researchers from the Guang'anmen Affiliated Hospital of China Academy of Chinese Medical Science combined acupuncture with standard drug therapy. Patients receiving both moxifloxacin injections and acupuncture in a combined treatment protocol had superior patient outcomes compared with patients receiving only moxifloxacin. The researchers conclude that the addition of acupuncture to a moxifloxacin treatment regimen reduces body temperature, mitigates inflammatory responses, and improves immune system function in patients with pneumonia-induced sepsis by activating the cholinergic anti-inflammatory pathway. [1]

Sepsis is a life-threatening condition caused by the body’s overactive response to an infection and is a leading cause of death in intensive care unit patients. [2] Since it is a viral infection, COVID-19 can lead to sepsis. Antibiotics are helpful for secondary bacterial infections due to a compromised immune system from COVID-19 but do not treat the viral infection itself.

A primary treatment for sepsis is antibiotics. While often an effective life-saving medicine, the downside is that antibiotics may lead to serious allergic reactions or digestive problems. This investigation was conducted to determine the effects of acupuncture and standard antibiotic therapy on sepsis treatment.

Researchers (Wang et al.) used the following study design. A total of 120 patients were treated and evaluated in this study. The patients were diagnosed with concomitant sepsis and pneumonia They were randomly divided into an acupuncture treatment group and a control group, with 60 patients in each group. The control group patients received moxifloxacin, while the treatment group received acupuncture in addition to the identical antibiotic treatment administered to the drug control group.

The statistical breakdown for each randomized group was as follows. There were 32 males and 28 females in the treatment group. The average age was 55.9 ±12.3 years. There were 34 males and 26 females in the control group. The average age in the control group was 56.1 ±12.5 years. There were no significant statistical differences in gender, age and other factors prior to initiation of the investigation.

For both groups, patients received intravenous injections of moxifloxacin for 90 minutes. The treatment group patients also received one session of acupuncture therapy for 30 minutes. The acupoints used for the treatment group included the following:

  • LI4 (Hegu)
  • LI11 (Quchi)​​

Electroacupuncture was applied after the administration of manual acupuncture. After achieving a deqi sensation, the acupuncture needles were connected to an electroacupuncture device with a sparse-dense wave, with the frequency set to 2/100 Hz. The needles were retained for 30 minutes once electroacupuncture began.

Patients were evaluated before and four hours after the treatment. First, the fever abatement time (indicated by a decrease in body temperature) and the fever clearance time were recorded. Second, serum levels of inflammatory factors (TNF-α,IL-1β,IL-8,and IL-10) were measured. Third, serum levels of acetylcholine (ACh) and choline acetyltransferase (ChAT) were recorded. ChAT is an enzyme responsible for synthesizing ACh, which is a main neurotransmitter of the vagus nerve and can reduce inflammation by acting on macrophages. [3] Finally,immune system indicators (CD4+ percentage,CD8+ percentage, CD4+/CD8+ ratio) were compared between the two groups.

After treatment fever abatement time and fever clearance time in the treatment group were statistically significantly shorter than those in the control group. Serum levels of pro-inflammatory TNF-α,IL-1β, and IL-8 in the treatment group were significantly lower than those in the control group, while serum levels of the anti-inflammatory cytokine IL-10 in the treatment group were significantly higher than that in the control group.

Serum levels of ACh and ChAT in the treatment group were significantly higher than those in the control group. CD4+ percentage, CD4+/CD8+ ratio in the treatment group were statistically significantly higher than those in control group,while CD8+ percentage in the treatment group was statistically significantly lower than that in the control group.

The results indicate that acupuncture with standard antibiotic therapy is more effective than moxifloxacin as a standalone therapy. The study mentioned in this report demonstrates that acupuncture is safe and effective for the treatment of pneumonia-induced sepsis. Important features of the combined protocol is that it reduces the body temperature, relieves the inflammatory reaction, and improves the immunologic function.

 

References:
[1] Wang S, et al. (2018). Curative effect of electroacupuncture of large intestine meridian YUAN point combined with HE-sea point in treating sepsis patients caused by pneumonia and the impact on cholinergic anti-inflammatory pathway. Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 26 (8):66-69.
[2] Hong Y. (2004). Sepsis: challenges and responses Chinese Critical Care Medicine, 2004, 16(2):325-327.
[3] Zhou WH, Li JG. (2016). Sepsis and the establishment of a cholinergic anti-inflammatory pathway model. Journal of Wuhan University, 37(5): 748-751, 771. DOI:10.14188/j.1671-8852.2016.05.013.

 

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