The effect of wet cupping on reactive airway dysfunction syndrome (RADS) caused by early exposure to chlorine gas: A randomized clinical trial.

Objective: In the absence of targeted antidotes for chlorine gas poisoning, a common yet concerning problem, this study investigates the effect of Wet Cupping Therapy (WCT, or "Hijamat") on the recovery process in chlorine-induced reactive airway dysfunction syndrome (RADS) patients.

Materials and methods: This randomized controlled trial enrolled 24 patients experiencing acute inhalation of chlorine poisoning in Tehran, Iran (2020-2021). Patients were randomly divided into control (n=12, receiving conventional treatment) and intervention (n=12, receiving conventional treatment plus WCT) groups. Signs and symptoms were assessed pre-intervention, and in the first hour, first week, and first month post-intervention.

Results: Medical records of 24 patients, including 3(12.5%) men and 21(87.5%) women, with a mean age of 42.92 years old, were evaluated. Baseline characteristics were similar between the groups. WCT significantly improved symptoms (dyspnea, cough, chest tightness, etc.) within the first hour (p=0.003) compared to the controls, with no future significant changes during the first week and first-month post-WCT. Comparison between the groups revealed substantial differences in the following variables: dyspnea scale (p=0.009), respiratory rate (p=0.026), cough (p=0.001), breath shortness (p=0.006), chest tightness (p=0.002), chest pain (p=0.010), substernal burning (p=0.015), throat sore (p=0.005) and hoarseness (p=0.027). Peak flow meter readings, reflecting lung function, were also significantly higher in the WCT group at all time-points (p<0.007).

Conclusion: WCT may offer a rapid and sustained improvement in pulmonary and respiratory symptoms following acute chlorine inhalation injury.