Acupuncture outperforms drug therapy for the treatment of asthma. Researchers from Xiamen Chinese Medicine Hospital (a Fujian Traditional Chinese Medical University affiliate) compared the efficaciousness of acupuncture with salmeterol xinafoate plus fluticasone propionate drug therapy for the treatment of chronic asthma. Salmeterol xinafoate is a bronchodilator and fluticasone propionate is an inhaled corticosteroid used to control asthma. Drug therapy achieved an 88.9% total effective rate and acupuncture achieved a 93.3% total effective rate. [1]
All patients underwent immune function and pulmonary ventilation function assessments before and after treatments. The immune function indicators used in the study included immunoglobulin G (IgG), IgM, IgE, peripheral T lymphocytes (CD3+), helper T lymphocytes (CD4+), suppressor T lymphocytes (CD8+), and the ratio of CD4+/CD8+. IgG, IgM, and IgE are antibodies produced by the body. High levels of IgE are correlated with severe symptoms. In addition, asthma patients are usually found with lower CD3+ and CD4+ levels and CD4+/CD8+ ratio. The pulmonary ventilation function was measured by peak expiratory flow (PEF), forced expiratory volume in one second (FEV1), and forced vital capacity (FVC). Higher levels of these three parameters are correlated with an improved function of pulmonary ventilation.
For both groups, the values of IgG, IgM, CD3+, CD4+, and the CD4+/CD8+ ratio were higher than those before treatment, while IgE and CD8+ were lower than those before treatment. There was a statistically significant difference before and after treatment and the acupuncture group significantly outperformed the control group. The values of FEV1, PEF, and FVC for both groups were higher than those before treatment. There was a statistically significant difference before and after treatment and the acupuncture group significantly outperformed the control group.
A total of 180 patients from the acupuncture and respiratory departments of Xiamen Chinese Medicine Hospital were evaluated in the study. Participants were randomly divided into an acupuncture treatment group and a drug control group, with 90 patients in each group. Inclusion criteria were as follows. All participants were diagnosed with chronic asthma according to the Guidelines for the Prevention and Treatment of Bronchial Asthma published by the Chinese Medical Society Respiratory Branch. In addition, patients participating in the study were categorized into 1 of 4 tiers:
Intermittent persistent (level 1): symptoms <one time per week, short duration, nighttime asthma symptoms ≤2 times per month, percentage of predicted FEV1 value ≥80% or PEF≥80% of the personal best value, PEF or the mutation rate of FEV1 <20%.
Mild persistent (level 2): symptoms ≥one time per week but <one time per day), may affect physical activities and sleep, nighttime asthma symptoms >two times per month but <one time per week, percentage of predicted FEV1 value ≥80% or PEF ≥80% of the personal best value, PEF or the mutation rate of FEV1 >20% but <30%.
Moderate persistent (level 3): symptoms occur daily and affect physical activities and sleep, nighttime asthma symptoms ≥two times a week, percentage of predicted FEV1 value accounts >60% but <79% or PEF 60%–79% of the personal best value, PEF or the mutation rate of FEV1 >30%.
Severe persistent (level 4): symptoms occur daily, frequent occurrences, frequent nighttime asthma symptoms, limited physical activities due to asthma, percentage of predicted FEV1 value accounts <60% or PEF <60% of the personal best value, PEF or the mutation rate of FEV1 >30%.
The statistical breakdown for each randomized group was as follows. The treatment group had 50 males, 40 females, mean age 40 years, average course of disease 9.2 years. The control group had 47 males, 43 females, mean age 40 years, average course of disease 9.2 years. Both groups were equivalent in all relevant demographics before treatment.
Drug and Acupuncture Treatment For the drug control group, level 1 and 2 patients received one inhalation (50 μg of salmeterol xinafoate and 100 μg of fluticasone propionate) each time, twice daily (one in the morning and one in the evening). Level 3 and 4 patients received two inhalations each time, twice daily (one in the morning and one in the evening). Each treatment course consisted of 20 days of drug treatment followed by a 2-day break before the next course. All drug group patients received 4 treatment courses in total. The acupuncture group received manual acupuncture at the following acupoints:
GV14 (Dazhui)
BL13 (Feishu)
CV17 (Danzhong)
EX-B1 (Dingchuan)
PC5 (Jianshi)
TB6 (Zhigou)
KI3 (Taixi)
ST36 (Zusanli)
Treatment commenced with patients in a seated position. After disinfection of the acupoint sites, a 0.30 mm × 40 mm or 0.25 mm × 25 mm needle was inserted into each acupoint. For Dazhui and Zusanli, needles were inserted perpendicularly to a depth of 25–30 mm. For Feishu, the needle was inserted at a 15 degree angle towards the spine, reaching a depth of 15–25 mm. For Dingchuan, the needle was inserted at a 15 degree angle towards the spine, reaching a depth of 15 mm. For Danzhong, the needle was inserted transverseley upward to a depth of 25 mm. For Zhigou and Jianshi, needles were inserted perpendicularly to a depth of 20–30 mm. For Taixi, the needle was inserted perpendicularly to a depth of 25 mm.
Dazhui, Feishu, Taixi, and Zusanli were applied with tonifying manipulation techniques. Danzhong, Dingchuan, Zhigou, and Jianshi were applied with attenuating techniques. The needles were manipulated every 10 minutes during a 30-minute treatment time, for a total of three times. The acupuncture treatment was conducted every two days.
The results indicate that acupuncture is more effective than administration of medications for the treatment of chronic asthma. The study mentioned in this report demonstrates that acupuncture can improve immune system and pulmonary ventilation function for patients with chronic asthma.
Reference: 1. Xie YL, Wan WR, Zhao YL, Xie JJ, Wu QY. Impacts on Asthma at Persistent Stage and Immune Function in the Patients Treated with Acupuncture for Warming Yang and Benefiting Qi [J]. Chinese Acupuncture, 2015,35(11):1089-1093.