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Original Investigation |

A Randomized, Placebo-Controlled Trial of Acupuncture in Patients With Chronic Obstructive Pulmonary Disease (COPD):  The COPD-Acupuncture Trial (CAT)

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
Arch Intern Med. 2012;172(11):878-886. doi:10.1001/archinternmed.2012.1233.
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Background  Dyspnea on exertion (DOE) is a major symptom of chronic obstructive pulmonary disease (COPD) and is difficult to control. This study was performed to determine whether acupuncture is superior to placebo needling in improving DOE in patients with COPD who are receiving standard medication.

Methods  Sixty-eight of 111 patients from the Kansai region of Japan who were diagnosed as having COPD and were receiving standard medication participated in a randomized, parallel-group, placebo-controlled trial (July 1, 2006, through March 31, 2009) in which the patients, evaluators, and statistician were unaware of the random allocation. Participants were randomly assigned to traditional acupuncture (real acupuncture group, n = 34) or placebo needling (placebo acupuncture group, n = 34). Both groups received real or placebo needling at the same acupoints once a week for 12 weeks. The primary end point was the modified Borg scale score evaluated immediately after the 6-minute walk test. Measurements were obtained at baseline and after 12 weeks of treatment.

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.

Trial Registration  umin.ac.jp/ctr Identifier: UMIN000001277

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Figures

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Figure 1. Acupuncture points used. The acupuncture points were selected according to traditional Chinese medicine theory: (1) LU1 (Zhongfu) and (2) LU9 (Taiyuan) in the lung meridian; (3) LI18 (Futu) in the large intestine meridian; (4) CV4 (Guanyuan) and (5) CV12 (Zhongwan) in the conception vessel; (6) ST36 (Zusanli) in the stomach meridian; (7) KI3 (Taixi) in the kidney meridian; (8) GB12 (Wangu) in the gallbladder meridian; and (9) BL13 (Feishu), (10) BL20 (Pishu), and (11) BL23 (Shenshu) in the bladder meridian.

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Figure 2. Study participant flow diagram. GOLD indicates Global Initiative for Chronic Obstructive Lung Disease; PAG, placebo acupuncture group; and RAG, real acupuncture group.

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Figure 3. Differences in the Borg scale score and 6-minute walk distance (6MWD) test in the placebo acupuncture group (PAG) and the real acupuncture group (RAG). Differences in the Borg scale score (A) and 6MWD (B) between baseline and at the end of the intervention. Open circles indicate patients younger than 75 years; closed circles, patients 75 years or older. Estimated mean differences (95% CIs) (error bars) were −3.58 (−4.27 to −2.90) and 78.68 (54.16 to 103.21) for the Borg scale score and 6MWD, respectively.

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