世界针灸学会联合会

(CN/EN)Q&A from the International Lectures of COVID-19 by Dr Change Xiaorong and Chen Rixin

author:WFAS source:WFAS Click:635 update:2020-05-10
  

问题1:在方舱医院如何使用艾灸又不因为烟熏影响整体环境?

——时空针灸学院西班牙分院

Q1How to avoid the smoke of moxa when using it in the temporary hospital? 

——Spanish Branch of the Space-Time Acupuncture College

常小荣教授:根据最近新闻报道和临床研究来看,艾灸在新冠肺炎治疗中得到了广泛应用。我们湖南省针灸学会寄去了很多艾条,随湖南中医医疗队带去了艾灸产品,据医疗队从前方方舱医院反馈中得知,由于院感方面的严格要求,方舱医院是封闭式,里面有酒精杀毒,明火灸的使用受限,我们就推荐使用艾灸类的产品,即没有明火的电热疗法的产品,比如扶阳罐、代温灸膏,都是热疗刺激,可以代替艾灸疗法产生温热刺激,所以我们湖南省针灸学会第一时间联合企业,为武汉江夏方舱医院提供了扶阳罐、代温灸膏,使用疗效非常好,受到患者们的喜爱。因为方舱医院里都是轻型、普通型的新冠肺炎患者,用这些灸类产品可以缓解一些症状,比如说食欲不振、乏力、呕物、胸闷等症状,达到补益肺气、健脾养胃、祛除邪气的功效,所以在方舱医院不能使用明火艾灸情况下,建议使用电子发热、有温热刺激的灸类灸具产品。

Prof. Chang Xiaorong: According to recent news reports and clinical studies, moxibustion has been widely used in the treatment of COVID-19. We, Hunan Acupuncture and Moxibustion Society, have sent (there) a lot of moxa sticks and the Hunan TCM medical team brought moxibustion products with them. According to the feedback from the temporary hospitals, because of the strict requirements for preventing nosocomial infection, the temporary hospital is closed and disinfected with alcohol, so the use of open-fire moxibustion is limited. Therefore, we recommend moxibustion products, i.e. electro thermal products without open flame, such as Fu Yang Guan and moxibustion plaster, all of which can generate thermal stimulation and replace moxibustion therapy. Therefore, at the earliest possible time, we, the Hunan acupuncture and Moxibustion Society joined some enterprises to provide the Wuhan Jiang Xia Temporary Hospital with Fu Yang Guan and moxibustion plaster. The curative effect is very good and they become popular among patients. Because all the patients in temporary hospitals belong to mild and common types of COVID-19, moxibustion products can relieve some symptoms, such as poor appetite, fatigue, vomiting, chest tightness and other symptoms, and achieve the effects of invigorating lung qi, invigorating spleen, nourishing stomach and dispelling pathogenic qi. Therefore, in the case that open-fire moxibustion cannot be used in temporary hospitals, moxibustion products with electronic heating and warm stimulation are recommended.


问题2:很多年前我在南昌的时候就认识您了。您是一位杰出的艾灸大师,我想知道您对艾灸治疗和预防无症状感染的病例的意见和建议。

——巴西中医学院 

Q2: I would like to know your opinion and suggestions for the use of moxa after the patient has been confirmed positive on COVID-19 but is not symptomatic.

—— Brazilian College of Chinese Medicine

陈日新教授:这个问题问的非常好,关键是无症状的感染者,我们要让这类感染者不发病(出现症状),通过自身免疫力来消灭病毒,按照我们长期临床经验和此次进入新冠肺炎隔离病房的临床实践,总结出这么一个规律,人体阳气足内湿轻的内环境,那么他是不容易发病的;对于阳气不足,体内有一定程度内湿的人群(易发病),我们就可以用艾灸来温阳益气、芳香化湿。我介绍一个非常有用的方案,来帮助人体温阳益气、芳香化湿,如果你是自己艾灸,就选神阙、天枢两个穴位,一定要灸出得气、透热感,温热感透到肚子(腹部)深部,甚至手心和脚心发热感。如果是有人能互灸,你还可以加一组穴位:肺俞和膏肓,隔日灸。腹部和背部的两组穴位交替灸。对于我们进入新冠肺炎隔离病房的医生,我都要求他们每天进隔离病房前,都自灸一次这些穴位,他们告诉我灸完之后整个精气神大大提升,虽然带着护目镜、穿着防护服进病房开展诊疗,但在工作中身体感到非常轻松、精力充沛,这就是阳气足。所以我们通过艾灸方法使人体阳气足内湿轻,对于无症状的病毒感染者可以做到很好的防护以及治未病。

Prof.Chen Rixin: This is a very good question, the point of these asymptomatic patients is that we should prevent such asymptomatic infections from developing (symptoms) and eliminate the virus through their own immunity. According to our long-term clinical experience and our clinical practice in the COVID-19 isolated ward this time, we summed up such a rule: it is not easy to get ill for those people who have strong yang qi and light dampness in their internal environment. However, for people with yang deficiency and a certain degree of internal dampness in the body (easy to get sick), moxibustion can be used to warm yang,replenish qi, and aromatize dampness. I'd like to introduce a very useful program to help the body. If you do self-moxibustion, choose Shen Que (CV8) and Tian Shu (ST25) acupoints. You must obtain “deqi” (sensation of qi) and feel heat penetrating deeply into the belly (abdomen), even to the palms and soles. If you do moxibustion to each other, you can also add a group of acupoints: Fei Shu (BL13) and Gao Huang (BL43), do moxibustion every other day. Alternate moxibustion for two groups of points on the abdomen and back. For our doctors who entered the COVID isolation ward, I asked them to do self-moxibustion on these acupoints before entering the isolation ward every day. They told me that after the moxibustion, the whole spirit was greatly improved. Although they entered the ward to do diagnosis and treatment with goggles and protective clothing, they felt very relaxed and energetic at work, that is, yang qi is sufficient. Therefore, we use moxibustion to replenish the body's yang qi and remove the dampness, which can protect the asymptomatic virus-infection patients and prevent the disease.


问题3: 在中国的一些报道中我们看到,有些医院采用熏艾消毒病房,在医疗环境里施用熏艾预防疫病传染;对居家隔离的民众,也建议在自家可用熏艾消毒,我想问一下艾熏消毒是否真的有意义?能介绍一下艾熏的使用方法和频率吗?

——中国针灸学会会员

Q3: From some reports in China we have seen that moxa has been used in some hospitals to disinfect the wards, or to prevent disease transmission. For people in home isolation, it is also recommended to use moxa for disinfection. I would like to ask if it really makes sense. Can you tell us about the method and frequency of moxa?

——Member of China Association of Acupuncture and Moxibustion

常小荣教授:关于艾灸用于空气消杀,一直是个争议性的话题,关键是两个问题,一是艾熏烟雾对人体是否有害?二是对人体是否有用?首先我们来看第一个方面,艾熏烟雾对人体是否有害?我们国内已做过很多研究,总结归纳起来主要是以下几点:长期暴露在高浓度的艾熏环境中,对人体呼吸系统有一定的影响,主要表现比如咽部不适、咳嗽、流泪等(这些主观上的不适),但是对肺泡肺功能的指标、疾病的相关指标并没有太大的影响,我们没有进行长期的随访。因此艾灸消杀病毒对暴露的人群来讲,是否存在着安全隐患?我们团队做过一个实验,在一个12平米的房间里,没有通风设备,用60根艾条同时燃烧后测试为微毒。目前从我们这个状况来看是不可能的,因为现在所有的艾灸门诊或病房,都有排烟装置的,即不是封闭环境中燃烧艾条产生烟雾,另外我们在使用艾灸消杀病毒的之后,都会开窗通风,所以艾熏烟雾对人体是没有损害的。

第二个方面艾熏对空气消杀到底是否有效(有用)的问题,也做了很多相关的研究,比如说我们湖南高圣集团公司专门做艾灸的,在中国疾控中心做了一个立项课题,证明了艾灸消杀空气是有效的,他们在艾灸里加了菖蒲、苍术,专门做了空气消杀的艾条,此次新冠肺炎的爆发期我们都在使用这种艾条,艾烟单独使用或者联合紫外线,可以显著的改善空气消毒的效果;南阳的一家艾条公司和广东省中医院也联合研制了此类艾条,对于空气的消杀有广谱的杀菌作用,所以艾烟具有空气消毒的作用,况且我们中国古代就有这样的记载,艾灸可以预防传染病,这是自古以来公认且流行的预防方法。

至于如何使用,建议大家在新冠肺炎疫病爆发期时,可每天一次,每次一根艾条,在点燃艾条前先把关闭门窗,艾熏约30分钟后,再开窗通风。等疫情风险级别下降之后,可以隔天一次,或每周三次,来艾熏消杀病毒。

Prof. Chang Xiaorong: Moxibustion for air disinfection has always been a controversial topic. There are two main problems. First, is the smoke of moxa harmful to human body? Second, is it useful for human body? 

First of all, let’s look at the first aspect. Is the moxa smoke harmful to the human body? We have done a lot of research in China, which can be summarized as follows: Long-term exposure to high concentration of moxa smoke has certain effects on human respiratory system, mainly manifested as throat discomfort, cough, tearing, etc (subjective discomforts), but it does not have much impact on the indicators of alveolar lung function and disease-related indicators, we did not conduct long-term follow-up. Therefore, Is there any potential safety hazard to the exposed population by using moxibustion to eliminate virus? Our team conducted an experiment in a 12-square-meter room without ventilation equipment and burned with 60 moxa sticks at the same time, the test result was slightly toxic. At present, it is impossible from our situation, because all moxibustion clinics or wards now have smoke exhaust devices, that is, the moxa sticks are not burned in a closed environment to generate smoke. And after using moxibustion to eliminate viruses, the windows will be opened for ventilation, so the moxa smoke is not harmful to human body.

The second aspect is whether moxa fumigation is effective (useful) in air sterilization. We have also done a lot of related research. For example, Hunan Gaosheng medical company specializing in moxibustion has made a project in the Chinese Center for Disease Control and Prevention, proving that moxibustion is effective in air sterilization. They added calamus and atractylodes rhizome and made special moxa sticks for air sterilization. We all used this moxa stick during the outbreak of COVID-19. Moxa smoke alone or combined with ultraviolet rays can significantly improve the air disinfection effect. A moxa stick company in Nanyang and Guangdong Provincial Hospital of Traditional Chinese Medicine have jointly developed this kind of moxa stick, which has broad-spectrum bactericidal effect on air disinfection. So the moxa smoke has the effect of air disinfection. Besides, we have such records in ancient China that moxibustion can prevent infectious diseases, which is a recognized and popular preventive method since ancient times.

As for how to use it, it is recommended that during the outbreak of COVID-19, you can use one moxa stick once a day. Before lighting the moxa stick, close the doors and windows. After about 30 minutes of moxa (burning), open the window to ventilate. After the epidemic risk level drops, you can use moxa burning to eliminate the virus once every other day or three times a week.


问题4按照现在新冠肺炎的中医临床分期,哪几期热敏灸介入治疗比较合适?

—中国-葡萄牙中医药中心

Q4: According to the 4 different phases of Covid-19, the use of moxa is more appropriate in which stages? 

—China-Portugal Chinese Medicine Center

陈日新教授:我认为艾灸对于新冠肺炎治疗全程,包括预防、治疗、康复,都能发挥一定的作用。那么在预防阶段,我们有一个“一艾三用方”,在中医药管理局发布的《江西省新型冠状病毒感染的肺炎中医药防治方案(试行第二版)》中,详见可以查询。在治疗发病期,我们目前实践过的主要是普通型和轻型患者,艾灸有明确的效果,主要是寒湿郁肺和湿热蕴肺证型,包括影响到中焦脾胃的寒湿、湿热都有效。对于恢复期的肺脾气虚型,艾灸也是有明确的效果;对于以气虚为主的气阴不足型,也是有非常好的疗效;对于阳气不足、痰瘀阻络的,因为艾灸有非常好的温阳通络的作用,使用艾灸也会有很好的疗效。

Prof.Chen Rixin: In my opinion, moxibustion can play a certain role in the whole treatment process of COVID-19, including prevention, treatment and rehabilitation. Well, in the prevention phase, we have a recommendation of "One Moxa and Three Prescriptions". For details, please refer to"Traditional Chinese Medicine (TCM) Prevention and Treatment Protocol for COVID-19, Jiangxi Province (Trial Version 2)", issued by the Traditional Chinese Medicine Administration Bureau. During the treatment period, we have mainly practiced on common and mild symptom patients. Moxibustion has a clear effect to patients mainly with cold-dampness stagnation of lung and damp-heat accumulation of lung, including cold-dampness and damp-heat affecting spleen and stomach in the middle energizer.

Moxibustion also has a definite effect for the lung and spleen Qi deficiency in the recovery period;It is also very effective for the Qi and Yin deficiency which is mainly caused by Qi deficiency. As for Yang deficiency and dampness blocked the channel, moxibustion also shows good effect. Because it has great function of warming up the Yang and clearing the channel.


问题5:法国这两周内出现手足皮肤病变的现象,主要表现为通红或肿痛。一开始大家都以为是过度洗手什么的引起的过敏,因为没有别的明显感染病毒的症状。最近新闻里也有相关报道,越来越多的人出现这些皮肤症状,而且这些人是接触过感染病毒的人。请问国内有没有感染病毒的人出现皮肤症状的? 您对此有什么建议?

——法国传统自由中医学院

Q5: Since two weeks in France, a new symptom has been found among people: hand and foot skin lesions, mainly manifested in redness or swelling pain. At first people thought it was an allergy caused by excessive hand washing, because there were no other obvious symptoms of infection. Recently, it has also been reported in the news that more and more people are showing these skin symptoms, and that these people have been exposed to the infected cases. I’m wondering if people infected with COVID-19 in China have skin symptoms. Do you have any suggestions for this? 

——French Faculty free Traditional Chinese Medicine

常小荣教授:目前从我国国内的临床症状来看,没有发现有手足红肿的临床表现,而且也没有看见这类情况的报道。这个情况的出现,如果是接触了感染者,但是本身不是感染者,我分析可能是不是过度的使用了消毒剂或者频繁的接触消毒剂,所导致皮肤过敏的这种情况;但是如果感染者出现了这个皮肤红肿、肿痛,从中医理论去分析,肺主皮毛,邪热壅肺以后导致的脉络堵塞不通,出现皮肤的红肿,我们讲皮肤病也是归肺所致的。但是他没有症状,只是接触者并不是感染者,所以我建议观察一下,避免可能导致过敏的消毒剂,因为疫情爆发时,各种的消毒剂都出来了,接触消毒剂后用清水冲洗、擦干,也可以涂抹一下无刺激性的霜剂乳剂,比如维生素E乳膏,凡士林、护手霜、润肤乳等,继续注意观察。我们也观察一下,可能这方面报道很少,或没出现这种皮肤手足红肿的情况,咱们一起来共同关注。

Prof. Chang Xiaorong: At present, according to the clinical symptoms in our country(China), no clinical manifestations of redness and swelling of the hands and feet have been found, and I haven’t seen any report of such case. If the symptoms show in the people who contacted with the infected person but not the infected person themselves, I think it may be caused by excessive use of disinfectant or frequent contact with disinfectant leading to skin allergies. But if the infected person appears the redness, swelling and pain of the skin. Based on theory of traditional Chinese medicine, lung is connected with skin and fur. Pathogenic heat clogged in the lung will lead to blockage of channels and meridians and cause redness and swelling of the skin. However, if he has no symptoms, and is only the contact person but not an infected person, I would suggest him to observe for a while and avoid disinfectants that may cause allergies.

When the epidemic breaks out, all kinds of disinfectants flood into the market. Wash and dry your hands after using the disinfectants. You can also apply some non-irritating cream or emulsion, such as vitamin E cream, petrolatum, hand cream, body lotion, etc. and continue to observe the symptoms. We have also observed that there may be few reports in this regard, or there is no such skin swelling of hands and feet. Let's pay attention together.