Moxibustion for stable chronic obstructive pulmonary disease

Abstract

Background: There is no optimal treatment to alleviate the decline of lung function in the stable phase of chronic obstructive pulmonary disease (COPD). The effectiveness of moxibustion as an adjunctive treatment for COPD in the stable phase has been reported clinically, but the conclusions on efficacy and safety have not been unified. This study will systematically evaluate the efficacy and safety of moxibustion on the treatment of COPD in the stable phase, providing clinical-based evidence Methods: We will systematically search 7 literature databases and 2 clinical trial registration platforms. The searching time will be conducted from the establishment of databases to March 31, 2021, regardless of language. We will include the randomized controlled trial (RCT) evaluation of moxibustion combined with basic therapy vs basic therapy alone for the treatment of stable COPD. We will assess the risk of bias for individual RCTs using the Cochrane Handbook 5.1.0 evaluation tool. The primary outcome is forced expiratory volume in 1 second/forced vital capacity. The secondary outcomes include forced expiratory volume in 1 second, forced vital capacity, six-minute walking distance, COPD assessment test score, maximum ventilation, response to treatment, and incidence of adverse events. We will collect the effective data of individual RCT through systematic analysis of the random effect model. Heterogeneity will be tested by Cochran Q test and I-squared statistics. Two subgroup analyses will be performed to explore the sources of heterogeneity based on clinical experience. Excluding RCTs with a high risk of bias, fixed-effect model will be used for sensitivity analysis to test the robustness of the meta-analysis results. The publication bias will be assessed by funnel plot and Egger test. Results: This study will provide systematic evidence on the efficacy and safety of moxibustion on the treatment of patients with stable COPD through strict quality assessment and reasonable data synthesis. We hope that the results will be submitted to a peer-reviewed journal for publication. Conclusion: This systematic review will provide the best current evidence for the adjuvant treatment of stable COPD with moxibustion. INPLASY registration number: INPLASY202140047.

Acupuncture techniques for COPD: a systematic review

“…In this publication we included the results from 35 trials (36 publications) which used all other techniques except filiform needle: AcuTENS (7 trials) [9][10][11][12][13][14][15], moxibustion (13 trials) [8,[16][17][18][19][20][21][22][23][24][25][26][27], acupressure (7 trials from 8 publications) [28][29][30][31][32][33][34][35], ear acupuncture (6 trials) [36][37][38][39][40][41], acupressure combined with ear acupuncture (1 trial) [42] and cupping technique (1 trial) [43] (one trial with multiple arms was included in the filiform needle group and the ear acupuncture group) (Fig. 1).…”

“…The thirteen studies included used multiple moxibustion techniques, including moxa stick [16,18,20,22,23,26], heat sensitivity moxibustion [23,24,27], cone moxibustion [8,17], moxibustion boxes [25] and ginger moxibustion [19,21]. There were a number of acupuncture points used, ranging from 1 to 12, but most of the trials used from 3 to 7 points [8,[18][19][20]23]. Most common acupuncture points used were.…”

“…Bl13 (7 trials, 53%), GV14, BL20 and ST36 (5 trials, 28%). Treatment regimens were also different, with two studies using from 3 to 6 treatment courses of 10-14 consecutive days during a year [16,18], three studies using daily treatments for a period of 2 to 4 weeks [19,20,23], two using from 2 to 5 treatments a week over a month [8,21], two trials using 5 treatments a week over 3 to 4 months [24,25], one using nine treatments every 10 days over 3 months [17] and one trial using one treatment per month [22]. In all thirteen papers, moxibustion was added to the usual treatment and compared with the usual treatment alone.…”

“…Lung function Ten trials analysed lung function, all using FEV 1 [16-18, 20-24, 26, 27], eight using FEV 1 / FVC [16,17,[20][21][22][23][24]27] and three trials using FVC [18,20,21]. Meta-analysis was not possible due to the high heterogeneity for FEV 1 and FEV 1 /FVC (I 2 = 93 and 80% respectively).…”

“…Meta-analysis was not possible due to the high heterogeneity for FEV 1 and FEV 1 /FVC (I 2 = 93 and 80% respectively). Seven trials for FEV 1 showed a statistical benefit for moxibustion [16,17,20,[22][23][24]27] and three showed no effect [18,21,26] (Fig. 3b).…”