Abstract
BackgroundThis is the second part of a large spectrum systematic review which aims to identify and assess the evidence for the efficacy of non-pharmacological acupuncture techniques in the treatment of chronic obstructive pulmonary disease (COPD). The results of all techniques except for filiform needle are described in this publication.MethodsEleven different databases were screened for randomised controlled trials up to June 2019. Authors in pairs extracted the data and assessed the risk of bias independently. RevMan 5.3 software was used for the meta-analysis.ResultsThirty-three trials met the inclusion criteria, which involved the follow techniques: AcuTENS (7 trials), moxibustion (11 trials), acupressure (7 trials), ear acupuncture (6 trials), acupressure and ear acupuncture combined (1 trial) and cupping (1 trial). Due to the great heterogeneity, only 7 meta-analysis could be performed (AcuTENS vs sham on quality of life and exercise capacity, acupressure vs no acupressure on quality of life and anxiety and ear acupuncture vs sham on FEV1 and FEV1/FVC) with only acupressure showing statistical differences for quality of life (SMD: -0.63 95%CI: − 0.88, − 0.39 I2 = 0%) and anxiety (HAM-A scale MD:-4.83 95%CI: − 5.71, − 3.94 I2 = 0%).ConclusionsOverall, strong evidence in favour of any technique was not found. Acupressure could be beneficial for dyspnoea, quality of life and anxiety, but this is based on low quality trials.Further large well-designed randomised control trials are needed to elucidate the possible role of acupuncture techniques in the treatment of COPD.Trial registrationPROSPERO (identifier: CRD42014015074).
Highlights
Chronic obstructive pulmonary disease (COPD) is one of the most prevalent lung diseases, with 251 million cases globally in 2016, and is the 4th cause of death worldwide, with more than 3.2 million instances in 2015 [1]
We found that very few trials reported important clinical outcomes commonly assessed in chronic obstructive pulmonary disease (COPD) such as dyspnoea (7/33), QoL (11/33), exercise capacity (7/33), anxiety (5/33) and depression (2/33)
No strong evidence was found for any of the included outcomes for patients with COPD treated with nonfiliform needle acupuncture techniques
Summary
Chronic obstructive pulmonary disease (COPD) is one of the most prevalent lung diseases, with 251 million cases globally in 2016, and is the 4th cause of death worldwide, with more than 3.2 million instances in 2015 [1]. COPD is characterised by a chronic and irreversible airflow obstruction caused by an inflammation in the airways and lung parenchyma which leads to structural abnormalities in the airways These alterations specially affect force expiratory volume in the first second (FEV1) compared to force vital capacity (FVC) [3]. The main symptoms of this disease are progressive dyspnoea, chronic cough, sputum production and recurrent respiratory infections Those symptoms get worse as the disease evolves, with many effects on exercise capacity and quality of life [4]. This is the second part of a large spectrum systematic review which aims to identify and assess the evidence for the efficacy of non-pharmacological acupuncture techniques in the treatment of chronic obstructive pulmonary disease (COPD). The results of all techniques except for filiform needle are described in this publication
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