针刺防治新型冠状病毒肺炎及其并发脓毒症的科学依据探讨

探索针刺参与防治新型冠状病毒肺炎(NCP)及并发脓毒症的科学依据。新型冠状病毒感染所引发的炎性反应是NCP患者最为重要的病理基础,特别是后期危重患者多并发脓毒症而死亡。系统检索、查阅古今中外针刺抗炎相关文献,发现几千年的临床实践及循证依据显示针刺抗炎作用显著,现代研究发现针刺可以通过交感神经肾上腺素能、迷走神经胆碱能、多巴胺能等多条抗炎通路参与抗脓毒症,这些年部分研究也发现针刺可改善脓毒症后期的免疫抑制状态,联合针刺疗法干预脓毒症的临床应用也越来越广泛,积累了一定的临床证据。故我们建议NCP患者可采用针刺疗法调节炎性反应,早期干预可调节免疫,抑制炎性反应,减轻"炎性反应因子风暴"危险,后期针刺治疗,可改善脓毒症的免疫抑制状态。

Discussion on the Scientific Basis of Acupuncture in the Prevention and Treatment of Novel Coronavirus Pneumonia Complicated with Sepsis

The purpose of this article is to explore the scientific basis of acupuncture involved in the prevention and treatment of novel coronavirus pneumonia(NCP) complicated with sepsis.The inflammation caused by 2019-nCoV infection is the most important pathological basis of NCP patients,and critical patients are often complicated with sepsis and even die in late stage. After systematical searching and consulting relevant literature on anti-inflammation effect of acupuncture,at home and abroad,it is found that thousands of years of clinical practice and evidence-based basis have revealed that acupuncture possess significant anti-inflammatory effects. The anti-inflammatory effect is mainly realized from two aspects: inhibiting inflammatory reaction and improving immunosuppression. Modern studies have shown that acupuncture could alleviatesepsis through multiple anti-inflammatory pathways, such as sympathetic adrenergic, vagal cholinergic, dopaminergic and so on. Additionally,in recent years,clinical application of combined acupuncture therapies in the intervention of sepsis has become increasingly extensive and further clinical evidence has been accumulated. Therefore,we suggest that acupuncture could be applied to regulate inflammatory response in patients with NCP. Not only the early intervention could inhibit excessive inflammation in the early stage of sepsis and reduce the risk of "inflammatory factor storm", but also the later intervention could improve sepsis-induced immunosuppression.