Chronic obstructive pulmonary disease (COPD) is a common disease that seriously jeopardizes human health and affects patients' quality of life. The clinical efficacy of acupuncture in treating COPD is definite, and it can exert positive effects such as improving skeletal muscle degradation, airway mucus hypersecretion and pulmonary vascular remodeling in COPD rats. In recent years, the research on the underlying mechanisms of acupuncture in improving COPD has become more and more in-depth. In this review, we searched and organized the domestic and international literatures on the basic experimental aspects of acupuncture in COPD treatment, and found that the underlying mechanisms of acupuncture mainly include (1) reducing the number of inflammatory cells in the lung tissue, regulating inflammasome, epigenetic modification and inflammation-related signaling pathways to inhibit the synthesis and release of cytokines, inhibiting the level of autophagy and inhibiting the release and expression of neurotransmitters; (2) improving antioxidant capacity and reducing oxidative damage, suppressing oxidative stress in the lung tissue; (3) regulating protease/antiprotease imbalance to maintain pulmonary homeostasis. These results provide a theoretical basis and a new way of thinking for the clinical application of acupuncture in the treatment of COPD.
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