CLINICAL TRIAL article

Front. Neurol.

Sec. Experimental Therapeutics

Volume 16 - 2025 | doi: 10.3389/fneur.2025.1577976

Effectiveness and Safety of Chinese Herbal Acupoint Application in Adult Patients with Fever and Mild-to-Moderate COVID-19: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial

Provisionally accepted
Yicheng  LiuYicheng Liu1Jiaheng  ShiJiaheng Shi1*Xinting  LiuXinting Liu1Zongchen  JiangZongchen Jiang1Benliang  ZouBenliang Zou2Rui  ZhangRui Zhang2Qiuyan  LiQiuyan Li2Peili  WangPeili Wang2Chenhao  ZhangChenhao Zhang3Jia  WangJia Wang3Zhixi  ZhangZhixi Zhang4Jiao  HuangJiao Huang4Baojin  HuaBaojin Hua1Luqi  HuangLuqi Huang5Wensheng  QiWensheng Qi1*
  • 1Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
  • 2Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
  • 3Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, Beijing Municipality, China
  • 4Eye Hospital, China Academy of Chinese Medical Sciences, Beijing, China, Beijing, China
  • 5China Academy of Chinese Medical Sciences, Beijing, Beijing Municipality, China

The final, formatted version of the article will be published soon.

Background: Chinese herbal acupoint application is recommended by certain guidelines for treating mild-to-moderate COVID-19; however, evidence supporting its effectiveness remains limited. This study aimed to evaluate the effectiveness and safety of Chinese herbal acupoint application in adult patients with fever and mild-to-moderate COVID-19. Methods: This multicenter, randomized, double-blind, placebo-controlled trial was conducted at six hospitals in China. Overall, 364 participants were randomly assigned in a 1:1 ratio to receive either the herbal or placebo acupoint application. All participants received applications at the Dazhui (GV14) and Feishu (BL13) acupoints three times daily for 2 h per application over five days and Fuzheng Jiebiao Decoction orally three times daily, three bags per dose. The primary outcome was complete fever relief time. Secondary outcomes included the onset time of fever reduction, changes in symptom scores, routine blood tests, and acetaminophen usage rates and dosages.Results: Regarding the primary outcome, herbal acupoint application significantly reduced complete fever relief time compared to placebo (31.75 h vs. 52.00 h; P < 0.0001). Regarding secondary outcomes, the herbal group also demonstrated a shorter onset time of fever reduction than the placebo group (24.35 h vs. 34.42 h; P < 0.0001). Herbal acupoint application significantly reduced total symptom scores, particularly fever, headache, and cough symptoms. Moreover, 52 patients (29.05%) in the herbal group used acetaminophen, with a median dosage of 0.3 g (0.3, 0.6), which was significantly lower than that in the placebo group, with 94 patients using 0.6 g (0.3, 0.9) (P < 0.05). No significant differences were observed in routine blood test results between the groups (P > 0.05), and no serious adverse events were reported in either group. Conclusion: Chinese herbal acupoint application effectively and safely shortened the complete fever relief time and onset time of fever reduction; alleviated clinical symptoms, particularly fever, headache, and cough; and reduced the need for antipyretic analgesics in adult patients with fever and mild-to-moderate COVID-19.

Keywords: Traditional Chinese herbal, COVID-19, Acupoint application, Antipyretic effect, relief symptom

Received: 24 Feb 2025; Accepted: 30 May 2025.

Copyright: © 2025 Liu, Shi, Liu, Jiang, Zou, Zhang, Li, Wang, Zhang, Wang, Zhang, Huang, Hua, Huang and Qi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Jiaheng Shi, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
Wensheng Qi, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China

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