针刺联合刺血及清瘟泄热汤对新型冠状病毒感染轻中型患者临床疗效观察

Observation of clinical efficacy of acupuncture combined with bloodletting therapy and Qingwen Xiere decoction in mild to moderate COVID-19 patients

目的:观察针刺联合刺血及中药清瘟泄热汤对轻中型新型冠状病毒(COVID-19)感染患者的临床疗效及安全性。方法:将2022年12月至2023年2月收治的100例COVID-19轻中型患者,按照1∶1比例随机分为对照组和观察组,每组50例。对照组予以中药清瘟泄热汤口服,连续服用6 d。观察组在对照组基础上加用针刺联合刺血治疗,针刺每日1次,每次30 min,连续治疗6 d;刺血隔日1次,治疗3次。治疗前和治疗结束当日,记录患者的中医证候评分和肺部CT评分,采用ELISA法检测患者血清C反应蛋白(CRP)、白细胞介素6(IL-6)及肿瘤坏死因子α(TNF-α)水平,采用汉密尔顿抑郁量表(HAMD)及汉密尔顿焦虑量表(HAMA)评价患者抑郁焦虑水平,并评定两组治疗的安全性。结果:与本组治疗前比较,治疗后对照组患者在发热、干咳、咽痛和中医证候评分总分方面有所改善(P<0.01),而肌肉酸痛、乏力未见明显好转;观察组患者中医症候评分总分和各项证候均显著改善(P<0.01);两组患者肺部CT评分、HAMA和HAMD评分、血清CRP和IL-6含量均降低(P<0.01),观察组患者血清TNF-α含量降低(P<0.01)。治疗后观察组各项指标的改善均优于对照组(P<0.01,P<0.05)。两组患者均未出现不良反应。结论:针刺联合刺血及口服清瘟泄热汤治疗轻中型COVID-19感染,可明显改善患者临床症状,缓解肺部炎性损伤,降低炎性因子含量,减轻焦虑和抑郁情绪,且无不良反应发生。

Objective To evaluate the clinical efficacy and safety of acupuncture combined with bloodletting therapy and Qingwen Xiere decoction in mild to moderate COVID-19 patients.Methods A total of 100 mild to moderate COVID-19 patients collected from December 2022 to February 2023 were randomly divided into control and observation groups,with 50 patients in each group.Patients in the control group received oral Qingwen Xiere decoction for 6 days.The observation group received acupuncture combined with bloodletting therapy in addition to oral Qingwen Xiere decoction,with the acupuncture(at Kongzui[LU6],Hegu[LI4],Quchi[LI11],Feishu[BL13],Zhongwan[CV12],Qihai[CV6],Yinlingquan[SP9])administered 30 min each day for 6 days,and bloodletting(at Shaoshang[LU11],Shangyang[LI1],Dazhui[GV14])administered every other day for 3 times.Traditional Chinese medicine syndrome scores and pulmonary CT scores were recorded before and after treatment.Serum contents of C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor-alpha(TNF-α)were measured using ELISA.Anxiety and depression degree were assessed using the Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA).Safety of the treatments was evaluated in both groups.Results Compared with before treatment,after treatment,the control group showed improvement in fever,dry cough,sore throat,and total traditional Chinese medicine syndrome scores(P<0.01),but no significant improvement in muscle pain or fatigue;the observation group showed significant improvement in total traditional Chinese medicine syndrome and individual symptoms scores(P<0.01);both groups demonstrated reductions in pulmonary CT scores,HAMA score,HAMD score and serum contents of CRP and IL-6(P<0.01);serum TNF-αcontent significantly decreased in the observation group(P<0.01).All outcome measures were superior in the observation group to the control group(P<0.01,P<0.05).No adverse reactions were reported in either group.Conclusion Acupuncture combined with bloodletting therapy and oral Qingwen Xiere decoction effectively improves clinical symptoms,alleviates pulmonary inflammatory injury,reduces inflammatory cytokine contents,and mitigates anxiety and depression in mild to moderate COVID-19 patients,and without adverse effects.