Clinical Effects Of Acupuncture On The Pathophysiological Mechanism Of Chronic Obstructive Pulmonary Disease During Exercise.
Purpose
Pharmacological therapy and pulmonary rehabilitation are useful for exertional dyspnoea in patients with chronic obstructive pulmonary disease (COPD); however, several patients have no meaningful improvements. Although acupuncture significantly improves exercise intolerance and dyspnoea, the pathophysiological mechanism of these effects is unknown; therefore, we evaluated this mechanism using cardiopulmonary exercise testing in a single-arm, open experimental study.


Patients and methods
Sixteen patients with COPD underwent acupuncture once a week for 12 weeks. Primary outcomes were exercise performance parameters, including peak oxygen uptake in the incremental exercise tests (IETs) and the time to the limit of tolerance measured in constant work rate exercise tests (CWRETs) at 70% peak work-rate of the IET. IETs and CWRETs were performed at baseline and at weeks 12, 16, and 24.


Results
During the time course, there were significant increases in peak oxygen uptake (p = 0.018) and minute ventilation (V̇E, p = 0.04) in the IETs. At 12 weeks, the endurance time significantly increased (810 ± 470 vs 1125 ± 657 s, p < 0.001) and oxygen uptakes at terminated exercise were significantly lower (771 ± 149 mL/min, p < 0.05) than those at baseline (822 ± 176 mL/min) in CWRETs. The significant decreases in oxygen uptake and minute ventilation and improvements in Borg scale scores were also observed during CWRETs after acupuncture. The decreases at isotime in the Borg scale (r = -0.789, p = 0.0007) and V̇E (r = -0.6736, p = 0.0042) were significantly correlated with the improvement of endurance time.


Conclusion
The positive effects of acupuncture on exertional dyspnoea were associated with increased endurance time influenced by improved oxygen utilisation and reduced ventilation during exercise. Acupuncture may be a new intervention for COPD in addition to conventional maintenance therapies.
['Maekura|Tomonori|T|0000-0003-1235-1919', 'Miki|Keisuke|K|', 'Miki|Mari|M|', 'Kitada|Seigo|S|0000-0002-6368-0686', 'Maekura|Ryoji|R|0000-0003-0788-1157']
D015670:Acupuncture Therapy D000368:Aged D000369:Aged, 80 and over D004417:Dyspnea D005080:Exercise Test D017079:Exercise Tolerance D005260:Female D006801:Humans D008168:Lung D008297:Male D008875:Middle Aged D010101:Oxygen Consumption D011237:Predictive Value of Tests D029424:Pulmonary Disease, Chronic Obstructive D012123:Pulmonary Ventilation D020127:Recovery of Function D013997:Time Factors D016896:Treatment Outcome
acupuncture chronic obstructive pulmonary disease COPD exercise intolerance and dyspnoea cardiopulmonary exercise test CPET