针刺干预新冠肺炎后嗅觉障碍疗效评价:系统评价与初步随机对照试验OA

Objective:Olfactory dysfunction(OD)is a common and persistent symptom of coronavirus disease 2019(COVID-19)for which effective treatments remain limited.Acupuncture,widely used in Chinese medicine for olfactory disorders has uncertain efficacy in post-COVID-19 OD.Therefore,in this study,we aimed to explore the feasibility and preliminary efficacy of acupuncture in patients with post-COVID-19 OD. Methods:This study was a dual-phased study.Phase I involved a systematic review conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines,encompassing eight databases.Phase II consisted of a pilot randomized controlled trial(RCT)enrolling 25 patients with moderate to severe post-COVID-19 OD.Participants were randomly assigned to receive either real(group A)or sham(group B)acupuncture.The intervention included eight sessions over 4 weeks,with assessments at baseline,post-cycle 1,2-week washout,post-cycle-2 treatment,and 2-week follow-up.The primary outcome was the change in scores on the 12-item Assessment of Self-Reported Olfactory Functioning and Quality of Life(ASOF).Secondary outcomes included the short version of the Questionnaire of Olfactory Disorders-Negative Statements(sQOD-NS)and the traditional Chinese version of the University of Pennsylvania Smell Identification Test(UPSIT-TC). Results:The systematic review identified 22 studies(15 case reports,seven RCTs)suggesting that acupuncture may positively influence olfactory function.In the pilot RCT,no significant baseline differences were observed between groups.Group A showed steady improvement across all ASOF domains during Cycle 1(SOC,mean=5.86;SRP,mean=3.26;ORQ,mean=3.98),with slight declines during cycle 2 and 2-week follow-up,though scores remained above baseline.Post-cycle 1,group A showed higher mean SOC and ORQ scores compared with group B(7.00 vs.4.67;3.98 vs.3.39).Improvements in secondary outcomes were also more pronounced in group A,whereas group B showed minimal changes. Conclusion:Acupuncture appears to be a safe and potentially effective treatment for post-COVID-19 OD,warranting validation through larger clinical trials.