Tag Archives: COPD

COPD – Condition Resources

Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.

Chronic obstructive pulmonary disease (COPD) is group of lung diseases where the airways become permanently narrowed, making it difficult to empty air out of the lungs. It also known as emphysema.

Research and Resources on COPD and Acupuncture:

A scholarly search of the available research papers on the terms “acupuncture” + “COPD” OR “emphysema” yields over 11,800 papers, and narrowing this to “RCT” to identify Randomised Controlled Trials, gives over 1090 results; of which 39% have been carried out since 2017 (Google Scholar). This suggests that acupuncture is being used traditionally and currently in this area, research is being done, the pace of which is increasing in recent years, and as such there is a recognition of a need to scientifically appraise any merit it may have in the field.

The British Acupuncture Council has produced an evidence based factsheet about COPD including specific research, trials and mechanisms of action for acupuncture in this condition.

Interpreting the research:

When reading health research, it is important to know that Systematic Reviews or Meta Analyses of a large number of high-quality research studies are the very best way to be able to say to what extent a given treatment can address a condition, symptom, or set of symptoms.  The next best level of evidence is the individual Randomised Controlled Study (RCT) which uses a systematic technique to compare two or more groups of patients receiving different treatments (or a treatment against a “control”, or no treatment).  In acupuncture trials, the nature of the control group is of particular interest as it is hard to blind a patient to whether they are having a needle inserted or not, and even more challenging to blind the researcher/team to this.

The means and quality of how research is carried out varies considerably from country to country, and in terms of how an intervention is compared to another intervention (or a control).  Of note is the fact that “sham” acupuncture (where needles are placed in apparently inert locations rather than traditional acupuncture points) is not really an inert process as it has physiological effects, so that comparing sham and “true acupuncture” may therefore not give a clear picture alone; but and form a part of a research body where acupuncture versus no treatment, vs conventional treatment or vs a different approach/modality also form part of the evidence base.

The n= figure (where quoted in research) tells you how many people were participants in the study, and usually the larger a study (when it is of good quality and design), the more likely it is to be reliable and applicable to larger populations. When (statistical) “significance” is discussed in view of studies it has a very particular meaning – it is the confidence in the data (using statistical tests) that tells us how likely a result could have just come about by chance. The lower the possibility of a chance result, the more likely it is due to the intervention in the experiment. When you are reading a trial/study, the “p” is the number telling us of significance, and this must be under 5% (or p less than 0.05) to mean we can say it is a (statistically) “significant” result.

The Research:

This is an area of research with fewer RCT’s than many other areas of acupuncture so far, although the pace of research is increasing. There have been systematic reviews in this area, including one which concluded that health-related quality of life (HRQL) improvements were seen in COPD patients receiving body acupuncture therapy (Hsieh et al, 2019), improved quality of life was also a conclusion in XIao et al’s (2020) systematic review of 11 RCT’s.

However in terms of addressing symptomatic issues, Wang et al, (2018) looked at 19 RCT’s and whilst there were positive trends in some areas of symptoms, further high-quality RCT’s were called for in order to draw stronger conclusions. A more recent systematic review (Fernández-Jané et al, 2020) looking at acupuncture techniques in this field reached the same conclusion as Wang et al, as did von Trott et al (2020) regarding breathlessness and exercise tolerance in 12 studies, again seeing a positive trend in acupuncture groups, but noting the RCT’s examined overall were low-powered and further quality research warranted. Chu et al (2021) also concurred with this in their recent review of systematic reviews.

Recently Wang et al (2021) put forward a protocol for a systematic review of moxibustion (acupuncture adjunct technique) in COPD – the forthcoming result will be of interest.

Regarding Your Individual Condition and Symptoms:

Whilst the scientific studies are of great interest to researchers and acupuncturists in terms of comparing protocols, for the patient not versed in research they are less accessible, which is why when we asked “can acupuncture work for my (condition or symptom) we are not able to give a simple yes or no response.  We are able to tell you what experience we have had in our decades of experience in practise, of the types of outcomes we have seen in similar cases, and give you an idea of our level of experience and knowledge in that area, and how this could relate to your own individual situation.  For this, we recommend booking a free telephone consultation where we can answer any questions you have and give a realistic appraisal of what acupuncture may be able to provide.

Resources:

British Acupuncture Council evidence based factsheet about COPD including specific research, trials and mechanisms of action for acupuncture in this condition.

References:

Chun, L., Li, X., Feng, Z., Xie, Y. and Li, J., 2021. Role of Acupuncture in the Treatment of COPD: An Overview of Systematic Reviews. International Journal of General Medicine14, p.1079.

Fernández-Jané, C., Vilaró, J., Fei, Y., Wang, C., Liu, J., Huang, N., Xia, R., Tian, X., Hu, R., Wen, L. and Yu, M., 2020. Acupuncture techniques for COPD: a systematic review. BMC complementary medicine and therapies20, pp.1-18.

Hsieh, P.C., Yang, M.C., Wu, Y.K., Chen, H.Y., Tzeng, I.S., Hsu, P.S., Lee, C.T., Chen, C.L. and Lan, C.C., 2019. Acupuncture therapy improves health-related quality of life in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Complementary therapies in clinical practice35, pp.208-218.

von Trott, P., Oei, S.L. and Ramsenthaler, C., 2020. Acupuncture for breathlessness in advanced diseases: a systematic review and meta-analysis. Journal of pain and symptom management59(2), pp.327-338.

Wang, J., Li, J., Yu, X. and Xie, Y., 2018. Acupuncture therapy for functional effects and quality of life in COPD patients: a systematic review and meta-analysis. BioMed research international2018.

Wang, Y., Huang, M., Tang, L., Xu, L., Wu, J., Wang, F. and Zhang, Y., 2021. Moxibustion for stable chronic obstructive pulmonary disease: A protocol for systematic review and meta-analysis. Medicine100(17).

Helen
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