Efficacy of acupuncture therapy for stable chronic obstructive pulmonary disease: A systematic review and meta-analysis

Background: Acupuncture therapy (AT) is a widely used, alternative medicine in China. AT is an effective treatment for many diseases, but its efficacy in stable chronic obstructive pulmonary disease (COPD) remains controversial. Therefore, we performed the present meta-analysis to evaluate the efficacy of AT in stable COPD patients. Methods: Randomized controlled trials (RCTs) for AT efficacy in stable COPD patients were searched in literature databases from the inception to December 31, 2021. Pooled effect sizes of outcome measurements with respect to lung function (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], FEV1 in predicted value [FEV1%], FEV1/FVC), quality of life (St. George respiratory questionnaire [SGRQ]), exercise capacity (6-minute walking distance [6MWD]) and effective rate were estimated by calculating weighted mean difference (WMD) or odds ratio (OR) with corresponding 95% confidence interval (95% CI), respectively, by a random-effect model. Results: A total of 28 RCTs with 2130 COPD patients were included. AT group had significant improvement in FVC (WMD = 0.29 L, 95% CI: 0.22-0.36, P <.001), FEV1 (WMD = 0.33 L, 95% CI: 0.23-0.43, P <.001), FEV1% (WMD = 3.30%, 95% CI: 3.30-4.64, P <.001), FEV1/FVC (WMD = 5.45%, 95% CI: 4.41-6.49, P <.001), 6MWD (WMD = 45.48 m, 95% CI: 28.21-62.16, P <.001), SGRQ (WMD = -7.79, 95% CI: -12.34 to -3.24, P <.001), and a higher effective rate (OR = 3.71, 95% CI: 2.50-5.52, P <.001) compared to the control group. Subgroup analysis stratified by comparison model (AT combined with other treatments vs other treatments, AT alone vs sham AT) and treatment duration (>= 8 weeks, <8 weeks) also showed more improvement in AT arm than control arm without significant between-subgroup difference. Adverse events were reported in a few studies and only mild reactions were observed. Conclusion: AT is effective in improving lung function, quality of life and exercise capacity, and can be used as an adjunctive treatment in patients with stable COPD.