Q1: How to avoid the smoke of moxa when using it in the temporary hospital?
——Spanish Branch of the Space-Time Acupuncture College
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.
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
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.
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
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.
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
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.
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
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.