Three months of acupuncture improved breathing problems in people with chronic lung disease, in a new study from Japan.
According to one researcher, the benefits seen with the alternative treatment were on par with, or better than, what’s been shown for conventional drugs and exercises used to treat the disease. But the study was small, he added, and more research will be needed to convince doctors and policymakers of acupuncture’s usefulness.
“We don’t know if this is going to extend life, but the study suggests it improves quality of life,” said Dr. George Lewith, from the University of Southampton in England.
“If I had enough money and I was the patient, I would give acupuncture a try.”
Chronic obstructive pulmonary disease, or COPD, is irreversible impairment of lung function, including emphysema and chronic bronchitis, often caused by smoking. One large national health survey suggested 24 million Americans have the condition, according to the Centers for Disease Control and Prevention.
Shortness of breath is one of the main symptoms of COPD. Typical treatment includes steroids and bronchodilators, as well as breathing exercises.
Because of that, it’s not totally surprising that an alternative therapy known to promote relaxation would help patients with breathing problems, according to Lewith.
“What acupuncture does is it seems to relax all the muscles around the chest wall,” said Lewith, who wrote a commentary published with the new study in the Archives of Internal Medicine.
“It’s absolutely consistent with what we’re trying to do conventionally, which is help with their breathing exercises and their relaxation techniques.”
STUDY INCLUDED ‘FAKE’ ACUPUNCTURE
The new findings are based on 68 patients treated with real or fake acupuncture. More robust studies will be needed before health insurance companies and programs like Medicare, for example, start funding acupuncture for this group, Lewith said.
For this study, researchers led by Masao Suzuki from Kyoto University in Japan randomly spilt patients with COPD and trouble breathing into two groups.
Half of them had weekly acupuncture sessions, with needles placed at points on the arms, stomach, back, chest and legs that have been tied to asthma and other lung problems. Participants in the comparison group went through similar sessions but with sham acupuncture treatment - when practitioners use needles that don’t actually pierce the skin.
All patients were allowed to stay on whatever medications they were already taking.
Before starting treatment and at the end of the 12 weeks, patients did a standard six-minute walking test when researchers measured how far they got in that time and how much breathing trouble they had doing it.
Breathlessness was assessed on a standard 10-point scale, with 10 representing the most difficulty breathing.
In the real acupuncture group, shortness of breath was initially rated at 5.5 out of 10 after walking. After 12 weeks of treatment, that fell to 1.9. The average distance those patients were able to walk in six minutes also improved, from about 370 meters to 440 meters.
In the comparison group, breathlessness scores held steady - at 4.2 before treatment and 4.6 after - and there was no improvement in patients’ walk distance.
“In a disease like COPD, we need to expand our thinking and come up with varying strategies to improve quality of life and relieve breathlessness,” said Dr. Ravi Kalhan, head of Northwestern University Feinberg School of Medicine’s asthma and COPD program in Chicago.
Some patients respond better to conventional medications than others, he said - and it’s promising that people in the new study seemed to benefit from acupuncture over and above the effect of those drugs.
Costs of acupuncture vary widely by location and practitioner, but a single session can run for about $100 and is often not covered by insurance. That may not be feasible for typical COPD patients, according to Lewith, who are often older and working class.
But for people who can spare the cost, the researchers agreed there’s nothing stopping them from trying out the alternative therapy.
“For me, as long as the therapy is safe and someone wants to try it and it might help and won’t hurt, I absolutely encourage it,” Kalhan, who wasn’t involved in the new study, told Reuters Health.
“I don’t think we have enough of a data base to recommend it and say: ‘This is going to help you,’” he said. “I would always prioritize traditional medicine over this right now.”
SOURCE: Archives of Internal Medicine, online May 14, 2012
A Randomized, Placebo-Controlled Trial of Acupuncture in Patients With Chronic Obstructive Pulmonary Disease (COPD)
Result After 12 weeks, the Borg scale score after the 6-minute walk test was significantly better in the real acupuncture group compared with the placebo acupuncture group (mean [SD] difference from baseline by analysis of covariance, −3.6 [1.9] vs 0.4 [1.2]; mean difference between groups by analysis of covariance, −3.58; 95% CI, −4.27 to −2.90). Patients with COPD who received real acupuncture also experienced improvement in the 6-minute walk distance during exercise, indicating better exercise tolerance and reduced DOE.
Conclusion This study clearly demonstrates that acupuncture is a useful adjunctive therapy in reducing DOE in patients with COPD.
Masao Suzuki, LAc, PhD; Shigeo Muro, MD, PhD; Yuki Ando, MSc; Takashi Omori, PhD; Tetsuhiro Shiota, MD, PhD; Kazuo Endo, MD; Susumu Sato, MD, PhD; Kensaku Aihara, MD; Masataka Matsumoto, MD; Shinko Suzuki, MD; Ryo Itotani, MD; Manabu Ishitoko, MD; Yoshikazu Hara, MD; Masaya Takemura, MD, PhD; Tetsuya Ueda, MD, PhD; Hitoshi Kagioka, MD, PhD; Masataka Hirabayashi, MD; Motonari Fukui, MD, PhD; Michiaki Mishima, MD, PhD