Chronic obstructive pulmonary disease (COPD) is thought to be the fourth most common cause of death worldwide, and the World Health Organisation anticipates that by 2020 it will have become the third (WHO 2006). In 2004, 27,478 men and women living in the UK died of chronic obstructive lung disease; more than 90% of these deaths occurred in those aged over 65 years (BTS 2006).
COPD is characterised by airflow limitation that is largely irreversible because of damage to the airways and lung tissue; it therefore does not include asthma, where the airflow obstruction is potentially fully reversible (DTB 2001). However, both diseases are common and in some patients coexist. The main cause of COPD is tobacco smoking (Chen 1999). Patients with stable COPD experience chronic symptoms such as breathlessness, cough, sputum production, wheeze and chest tightness, which worsen slowly over time, and they may eventually develop respiratory failure or signs of right heart failure (NICE 2004).
The aim of treatment is to alleviate symptoms; to prevent exacerbations; to preserve optimal lung function; to improve activities of daily living, quality of life, and survival, with minimal adverse effects from treatment. Conventional medical treatment includes short-acting inhaled Î²2-agonists used on an 'as required' basis, regular use of an inhaled antimuscarinic bronchodilator or a long-acting Î²2-agonist, oral theophylline, mucolytics, inhaled corticosteroids, pulmonary rehabilitation programmes, oxygen therapy, and surgery to remove a single large bulla or functionless areas of lung, or lung transplantation (NICE 2004, DTB 2001).
British Thoracic Society, 2006. The Burden of Lung Disease. 2nd Edition. British Thoracic Society [online]. Available: http://www.brit-thoracic.org.uk/c2/uploads/finalproof.pdf
Chen JC, Mannino DM. Worldwide epidemiology of chronic obstructive pulmonary disease. Curr Opin Pulm Med 1999; 5: 93-9.
Managing stable chronic obstructive pulmonary disease. DTB 2001; 39: 81-5.
Clinical guideline 12 [online]. Available: http://www.nice.org.uk/nicemedia/pdf/CG012_niceguideline.pdf
World Health Organization (WHO), 2006. COPD: Burden. World Health Organization [online]. Available: http://www.who.int/respiratory/copd/burden/en/index.html
How acupuncture can help
Clinical trials to date suggest that acupuncture may be a useful adjunct to standard medical care for COPD (Bausewein 2008, Suzuki 2008, Lau 2008, Lewith 2004), though this requires corroboration with larger studies (see Table overleaf).
Acupuncture may help relieve COPD by:
- reducing bronchial immune-mediated inflammation (Carneiro 2005), and reducing inflammation in general by promoting release of vascular and immunomodulatory factors (Kavoussi 2007, Zijlstra 2003).
- improving both airway mucociliary clearance and the airway surface liquid (Tai 2006).
- regulating cytokine production (Jeong 2002, Joos 2000).