Ravivõimalused

Diagosis and treatment protocol for COVID19 patients
(Tentative 10th Version)
(2023, China)

Released by National Health Commission of People’s Republic of China & National Administration of Traditional Chinese Medicine on January 5, 2023.

11.8 | Traditional Chinese medicine (TCM) therapy
This disease belongs to plague in TCM, caused by epidemic pathogenic factors.
According to the different local climate characteristics and individual states of illness and physical conditions, the following treatment Protocol may vary. …

https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.36

Zhang Z. Diagnosis and treatment protocol for COVID19 patients (Tentative 10th Version). Health Care Sci. 2023;2:10–24. https://doi.org/10.1002/hcs2.36

Therapeutic drug combinations against COVID-19
obtained by employing a collaborative filtering method

(2023, China)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9958039/pdf/main.pdf

TCM can effectively treat COVID-19, decrease the conversion of mild cases to severe cases, shorten the virus clearance time, and improve the clinical prognosis of mild and common COVID-19 patients

In March 2020, the State Medical Products Administration announced that
Jinhua Qinggan Granules will be converted from prescription drugs to Class A
non-prescription drugs.

Jinhua Qinggan Granules can be used for fever, cough, and malaise caused by viral infection, in addition to being used for the routine treatment of novel coronavirus pneumonia.

The antipyretic and antiviral effects of Jinhua Qinggan Granules can effectively ameliorate the clinical symptoms of COVID-19 patients.
Jinhua Qinggan Granules acted on PTGS2, TNF-α, NF-κB, IL-6, and CASP-8 targets and exerted anti-COVID-19 effects through Toll-like receptor signaling pathways.

The State Food and Drug Administration issued supplementary approval in May 2020, Jinhua Qinggan granule is suitable for the treatment of mild and common types of novel coronavirus pneumonia.

On March 31, 2022, the World Health Organization (WHO) released the “World Health Organization Expert Evaluation Meeting on Traditional Chinese Medicine against COVID-19” on its official website, which fully affirmed the contribution of TCM in fighting the epidemic situation of COVID-19.

Previous studies have shown that a variety of western drugs may block neo-coronavirus infection, but thus far, there are still no specific efficacious drugs.

Jinhua Qinggan Granules, e.g., are extracted from Yinqiao Powder and Maxing Shigan decoction, and the substance is further refined by the subsequent removal and addition of some Chinese herbal medicines from the formula. This herbal product is well-known for dispelling wind, invigorating the lungs, clearing heat, and detoxification.

Cell culture experiments showed Omicron to be less fusogenic than Delta and than
an ancestral strain of SARS-CoV-Although the novel coronavirus continues to mutate,
the vaccine is still effective in preventing severe illness and death.
At the present stage, most infected people are asymptomatic and mild.
Jinhua Qinggan Granules is effective and more accurate at this stage.

In addition, on March 31, 2020, the State Medical Products Administration converted
Jinhua Qinggan Granules from a prescription drug to A Class A non-prescription drug,
which fully demonstrated its clinical applicability and practicability.
Current studies have fully verified the clinical effectiveness, antiviral activity, and anti-inflammatory effect of Jinhua Qinggan Granules.

In the COVID-19 Treatment Protocol (Trial Version 8) issued by the National Health and Wellness Commission, a variety of TCM prescriptions are recommended, among which the efficacious six formulas, (i) Jinhua Qinggan Granules, (ii) Lianhua Qingwen Capsules, (iii) Xuebijing Injection, (iv) Qingfei Paidu Decoction, (v) Huashi Baidu Formula, and (vi) Xuanfei Baidu Formula, have made great contributions to the global fight against epidemics.

Jinhua Qinggan is an effective traditional Chinese medicine developed in 2009 in the fight against influenza A (H1N1). It is an innovative Chinese medicine that combines past knowledge on optimal remedies for typhoid and febrile disease with the new knowledge of modern Chinese medicine and the use of modern pharmaceutical technology to determine a choice of remedies. It is mainly used for fever, mild or no chills, red throat, sore throat, stuffy nose, runny nose, thirst, cough, or cough with phlegm.
In a double-blind randomized controlled clinical trial for the treatment of influenza with wind-heat offending lung syndrome, this formula decreased the time and rate of fever reduction, ameliorated the clinical symptoms of TCM (with fever, head, and body pain, red throat, and sore throat as the main symptoms), increased the rate of viral transitions, and was confirmed to be safe and effective under conventional-dose treatment.

From the perspective of TCM clinical manifestations, H1N1 influenza is mainly a “heat toxin”, while COVID-19 is mainly a “damp toxin” epidemic, and although the etiology of the two is different, fever is their common characteristic.
The study of the pharmacological effect of Jinhua Qinggan Granules revealed that it decreases the mortality rate, prolongs the survival time, and decreased the amount of lung tissue lesions in a mouse model of influenza virus pneumonia.
Among the constituent flavors of this formula, various herbal extracts and ingredients such as honeysuckle flower, weeping forsythia capsule, licorice, and skullcap have anti-influenza virus or respiratory syncytial virus effects.
As a Chinese medicine recommended in the treatment plan, the antipyretic and antiviral effects of Jinhua Qinggan Granules can effectively ameliorate the clinical symptoms of COVID-19 patients.

Through a network pharmacology study, Peng et al. found that Jinhua Qinggan Granules acted on PTGS2, TNF-α, NF-κB, IL-6, and CASP-8 targets and exerted anti-COVID-19 effects through Toll-like receptor signaling pathways. Because TCM emphasizes syndrome differentiation and treatment, it should be combined with the actual situation of patients in clinical practice.

Nõelravi kasulik toime on paljude haiguste puhul tõestatud,
kuid ikkagi on see ravimeetod alakasutuses

British Medical Journal, 2022

Evidence on acupuncture therapies is underused in clinical practice and health policy
https://www.bmj.com/content/bmj/376/bmj-2021-067475.full.pdf

Annual advances of acupuncture research in 2021

Annual advances of acupuncture research in 2022

https://scholar.google.com/scholar?q=Annual+advances+of+acupuncture+research+in+2022&hl=en&as_sdt=0&as_vis=1&oi=scholart

Nõelravi on morfiinist mõjusam EMOs olevatel valuga patsientidel

Tuneesia haigla erakorralise meditsiini osakonnas (EMO) viidi läbi uuring, milles võrreldi nõelravi ja morfiini analgeetilist (valuvaigistavat) toimet. Selgus, et akupunktuurne analgeesia avaldus kiiremini, oli efektiivsem ja paremini talutav.

Uuringus osales  300 patsienti mõõduka või tugeva valuga, mille leevendamiseks tehti nõelravi või süstiti veeni morfiini. Nõelravis kasutati antud seisundi puhul soovitatavaid akupunkte ja ashi punkte. Akupunktid valiti selliselt, et raviseanss oleks piisavalt standardiseeritud replitseerimise hõlbustamiseks ning samal ajal ka piisavalt paindlik ravi individualiseerimiseks.

Ravi tulemuslikkuse kriteeriumiks oli valu intensiivsuse langus vähemalt 50 % võrreldes algsega. Nõelravigrupis oli efektiivsus 92%, morfiinigrupis 78%. Valu taandumisaeg nõelravigrupis 16 minutit, morfiinigrupis 28 minutit. Nõelravigrupis esines kõrvaltoimeid oluliselt vähem.

Acupuncture vs intravenous morphine in the management of acute pain in the ED.
Am J Emerg Med. 2016 Jul 20. pii: S0735-6757(16)30422-3.

Nõelravi ja valusündroomiga tüsistunud depressioon

Inglismaal võrreldi erinevate sekkumiste – nõelravi, nõustamine või nn tavaravi – efektiivsust valusündroomiga tüsistunud depressiooni puhul. Uuring hõlmas 755 patsienti, kellel esines lisaks depressioonile mõõdukas kuni väga tugev valu. Tulemust hinnati 3 kuu möödudes. Depressioon ja valu olid kõige enam vähenenud nõelravigrupis, järgnes nõustamisgrupp ning seejärel nn tavaravigrupp.

Acupuncture, counselling or usual care for depression and comorbid pain: secondary analysis of a randomised controlled trial. BMJ Open. 2014 May 2;4(5):e004964.
www.ncbi.nlm.nih.gov/pubmed/24793257

Nõelravi aitab leevendada kroonilist valu

USA: Nõelravi lisamine tavaravile võimaldab vähendada valu ja parandada elukvaliteeti.

495 patsiendist sai nõelravi 226; kõige sagedasem põhjus alaseljavalu, järgnes osteoartriit. Patsiendid olid eakad, said sageli puude tõttu abiraha, neil oli halb tervislik üldseisund ja kõrge valufoon. Nõelraviseansid toimusid 1 x nädalas, tehti keskmiseselt 9, 7 raviseanssi.
Nii 12 kui ka 24 nädalat hiljem oli seisund oluliselt algfoonist parem- valu tunduvalt nõrgem ja füüsiline üldseisund parem.

Outcomes of acupuncture for chronic pain in urban primary care.
J Am Board Fam Med. 2013 Nov-Dec;26(6):692-700.
www.ncbi.nlm.nih.gov/pubmed/24793257

Nõelravi on efektiivsem kui ravivõimlemine Achilleuse kõõluse põletiku puhul

Hiina uuringus  osales 64 patsienti, kes jagati randomiseeritult nõelravi- või ravivõimlemisgruppi.
Nõelravi toimel taandus valu ja paranes kõõlusefunktsioon oluliselt paremini.

Acupuncture for chronic achilles tendinopathy: A randomized controlled study.
Chin J Integr Med. 2012 Dec 21. [Epub ahead of print]).

Nõelravi ja taimravi aitavad kehakaalu langetada

Nõelravi ja hiina taimravi toime kehakaalu langetamisele ületab platseebo ja elustiili muudatuste oma. 49 hiina taimravi uuringu, 44 nõelravi uuringu ja 3 kombineeritud ravi uuringu analüüs näitas, et hiina taimravi ja nõelravi mõju sarnaneb nn lääne rasvumisvastaste ravimite mõjule, kuid kõrvaltoimeid on vähem.

A systematic review on use of Chinese medicine and acupuncture for treatment of obesity. Obes Rev. 2012 May;13(5):409-430.

Nõelravi leevendab ebaselgeid sümptomeid

Inglismaal läbiviidud uuring näitas, et nõelravi võib anda märgatava ja püsiva kergenduse haigetele, kes pöörduvad sageli esmatasandi arsti poole meditsiiniliselt raskestiselgitatavate kehaliste sümptomite tõttu.
Tavameditsiinile nõelravi lisamisel püsis paranenud tervislik seisund ja heaolu 12 kuu vältel.

Acupuncture for ‘frequent attenders’ with medically unexplained symptoms:
a randomised controlled trial (CACTUS study).
Br J Gen Pract. 2011 Jun;61(587):295-305.

Teine artikkel kirjeldas uuringust osavõtnute suhtumist. Patsiendid hindasid, et võeti aega nendega suhtlemiseks, raviseansid olid interaktiivsed ja holistilised. Paljusid patsienti aktiveeriti võtmaks osa oma ravist ja muutma oma elustiili. Osalejad tõid välja laialdase spektriga positiivsed muutused tervises k.a suurenenud füüsiline ja mentaalne aktiivsus, suurenenud enesekontrolli võime, rahulikkus ja relaksatsioon.

Traditional acupuncture for people with medically unexplained symptoms:
a longitudinal qualitative study of patients’ experiences.
Br J Gen Pract. 2011 Jun;61(587):306-315.

Põlveliigese osteoartriit

Marylandi Ülikooli Meditsiinikoolis 570 põlveliigese artriiti põdeval patsiendil läbiviidud pikaajaline uuring näitas, et nõelravi toimel vähenes valu põlves 40 % ja põlveliigese funktsioon paranes ligikaudu 40 %.
Uuringut rahastasid NCCAM ja National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), mis mõlemad kuuluvad US National Institutes of Health koosseisu.
Stephen E. Strauss, NCCAM Director: “Need tulemused näitavad, et akupunktuur võib olla efektiivseks täienduseks tavaravile ja parandada põlveliigese osteoartriidi käes vaevlejate elukvaliteeti.”

Ann Intern Med, Dec 2004; 141: 901-910.