A randomized, controlled, crossover study in patients with mild and moderate asthma undergoing treatment with traditional Chinese acupuncture

Abstract

OBJECTIVES:This study sought to verify the effects of acupuncture as an adjuvant treatment for the control of asthma.METHODS:This was a randomized, controlled, crossover trial conducted at the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. A total of 74 patients with mild/moderate, persistent asthma were randomized into two therapeutic groups: Group A – 31 patients underwent 10 real weekly acupuncture sessions, followed by a 3-week washout period and 10 sham weekly acupuncture sessions; and Group B - 43 patients underwent 10 sham weekly acupuncture sessions, followed by a 3-week washout period and 10 real weekly acupuncture sessions. Patients used short- and long-acting β-2 agonists and inhaled corticosteroids when necessary. Prior to treatment and after each period of 10 treatment sessions, the patients were evaluated for spirometry, induced sputum cell count, exhaled nitric oxide (NO) and with the Short Form 36 (SF-36) and Questionnaire on Quality of Life-Asthma (QQLA) questionnaires. Daily peak flow and symptom diaries were registered. The level of significance adopted was 5% (α=0.05).RESULTS:In Group B, after real acupuncture, there was a decrease in eosinophils (p=0.035) and neutrophils (p=0.047), an increase in macrophages (p=0.001) and an improvement in peak flow (p=0.01). After sham acupuncture treatment, patients experienced less coughing (p=0.037), wheezing (p=0.013) and dyspnea (p=0.014); similarly, after real acupuncture, patients reported less coughing (p=0.040), wheezing (p=0.012), dyspnea (p<0.001) and nocturnal awakening episodes (p=0.009). In Group A, there was less use of rescue medication (p=0.043). After the sham procedure, patients in Group A experienced less coughing (p=0.007), wheezing (p=0.037), dyspnea (p<0.001) and use of rescue medication (p<0.001) and after real acupuncture, these patients showed improvements in functional capacity (p=0.004), physical aspects (p=0.002), general health status (p<0.001) and vitality (p=0.019). Sham acupuncture also led to significant differences in symptoms, but these were not different from those seen with real acupuncture. Spirometry and exhaled NO levels did not show a difference between sham and real acupuncture treatment. In addition, no significant difference was demonstrated between treatments regarding the quality of life evaluation.CONCLUSION:Real and sham acupuncture have different effects and outcomes on asthma control. The crossover approach was not effective in this study because both interventions led to improvement of asthma symptoms, quality of life and inflammatory cell counts. Thus, sham acupuncture cannot serve as a placebo in trials with acupuncture as the main intervention for asthma.

Acupuncture for chronic persistent asthma based on the theory of Meridian-viscera Association: study protocol for a multi-center randomized controlled trial in China

“…The lung is close to the heart anatomically, so the two viscera have close association physio-pathologically. Based on the theory of Meridian-viscera Association and clinical practice, the Lung meridian and the Heart meridian are the commonly used meridians for pulmonary disorders including asthma [ 17 , 18 ]. Hence, this study will select Taiyuan (LU9), Lieque (LU7), and Chize (LU5) on the Lung meridian and Shenmen (HT7), Yinxi (HT6), and Shaohai (HT3) on the Heart meridian for the following reasons: (1) these acupoints have been proved to be effective in improving QoL and relieving symptoms of asthma patients [ 18 , 23 ], (2) all of these acupoints are specific acupoints on the two meridians, and (3) the selected acupoints are on the medial side of the upper arm and at the same nerve segment based on the modern anatomy so as to minimized the bias of comparison.…”

“…Acupuncture, as a main complementary and alternative therapy, has traditionally been used to control asthma in China for thousands of years. Recently, accumulating evidence has supported the benefit of acupuncture for asthma [ 17 , 18 ]. It is reported that acupuncture can significantly relieve the asthma-related symptoms, improve QoL, influence inflammatory cell counts [ 17 ], ameliorate of peak expiratory flow (PEF) variability [ 14 ], and increase the forced expiratory volume in 1 s (FEV1) [ 19 ].…”

“…Recently, accumulating evidence has supported the benefit of acupuncture for asthma [ 17 , 18 ]. It is reported that acupuncture can significantly relieve the asthma-related symptoms, improve QoL, influence inflammatory cell counts [ 17 ], ameliorate of peak expiratory flow (PEF) variability [ 14 ], and increase the forced expiratory volume in 1 s (FEV1) [ 19 ]. However, most of these studies have focused on whether acupuncture is useful for asthma by comparing the efficacy differences between acupuncture and medication intervention [ 14 , 18 ], or verum acupuncture and sham acupuncture [ 15 , 17 ].…”

Effect of acupuncture and its influence on cerebral activity in patients with persistent asthma: study protocol for a randomized controlled clinical trial

“…Accumulating evidence indicates that acupuncture treatment can both significantly improve asthma-related quality of life (QoL) and lung function and decrease medication dosages for patients with asthma [5][6][7][8][9][10]. A recent meta-analysis including nine randomized controlled trials (RCTs) with a total of 777 patients demonstrated that the symptom response rate of conventional treatments plus acupuncture for asthma is statistically higher than that of conventional treatments alone [11].…”

Effect of acupuncture and its influence on cerebral activity in patients with persistent asthma: study protocol for a randomized controlled clinical trial

“…Accumulating evidence indicates that acupuncture treatment can both significantly improve asthmarelated quality of life (QoL) and lung function, and decrease medication dosages for asthmatic patients (5)(6)(7)(8)(9)(10). A recent meta-analysis, including nine randomized controlled trials (RCTs) with a total of 777 patients, demonstrated that the symptom response rate of conventional treatments plus acupuncture for asthma is statistically higher than conventional treatments alone (11).…”