O6.11 Complementary therapies

A systematic review by Guo (Guo 2006) concluded there was no clear evidence supporting the effectiveness of herbal medicines for treating COPD.

There is some evidence that acupuncture may reduce exertional dyspnoea and improve exercise tolerance in people with moderate to severe COPD [evidence level II]. One placebo-controlled double blinded randomised trial (n=68), carried out in Japan (Suzuki 2012), compared acupuncture applied once a week for 12 weeks and sham acupuncture. Eleven standardised acupuncture points, including those close to the respiratory accessory muscles, were used with treatment lasting 50 minutes each session. Compared to sham acupuncture, real acupuncture reduced dyspnoea at the end of a 6-minute walk test (6MWT) by -3.58 points (95% CI -4.27 to -2.90) on the Borg 0-10 dyspnoea scale and improved 6-minute walk distance (6MWD) by 46metres in the treatment group when compared to the sham acupuncture group. A possible mechanism proposed for the benefits was an improvement in rib cage mobility and accessory muscle function due to suppressed electromyogram activity of the accessory muscles by the acupuncture. A well designed randomised controlled trial, including sham acupuncture, with blinding of all involved apart from the acupuncturists themselves, demonstrated an 80 metre improvement in 6-minute walk distance as well as improvements in quality of life (Feng 2016). The effect of the lack of blinding of the acupuncturist is uncertain.  Further studies are required to evaluate the effects of acupuncture and to determine whether any longer-term benefits of treatment occur.