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Effect of Acupuncture on Patients With Chronic Obstructive Pulmonary Disease

Phase 3
Conditions
Pulmonary Disease, Chronic Obstructive
Interventions
Other: Acupuncture
Drug: Conventional drug
Other: Acupuncture plus conventional drug
Registration Number
NCT03169504
Lead Sponsor
Henan University of Traditional Chinese Medicine
Brief Summary

This study aims to compare the efficacy of three therapies for chronic obstructive pulmonary disease (COPD) patients: one, conventional drug based on Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 and Chinese Medical Association Guidelines; another, acupuncture, an important part of traditional Chinese Medicine; and finally, the combination of conventional drug and acupuncture, and then determine which therapy is the most suitable for patients with COPD.

Detailed Description

COPD, characterized by progressive airflow obstruction, airway inflammation, and systemic effects or comorbidities, is a leading cause of morbidity and mortality and is projected to be the third leading cause of death worldwide by 2030. Since breathlessness, exercise limitation and health status impairment broadly exist in COPD patients, effective management should be based on an individualized assessment of disease in order to reduce both current symptoms, which involves relieving symptoms, improving exercise tolerance and health status. At present, although appropriate pharmacologic therapy can relieve COPD symptoms, reduce the frequency and severity of exacerbations, and improve health status and exercise tolerance, its cost and adverse effects can never be ignored.

Acupuncture, an important part of traditional Chinese Medicine, has been used for thousands of years in treating many painful and non-painful conditions. To date, it has become popular and widely practiced in many countries around the world. In the past two decades, acupuncture research has grown markedly, in both the proportion of randomized clinical trials (RCTs) and the impact factor of journals. Evidences from both clinicians and patients suggest that there is some beneficial effect of acupuncture on COPD.

At present, there are many therapies available for patients with COPD, it is difficult for us to identify the most suitable therapy. Thus, this study aims to compare the efficacy of conventional drug, acupuncture and the combination of conventional drug and acupuncture, and then determine which is the most suitable therapy, providing a scientific basis for clinical decision.

This is a multi-center, randomized, controlled trial to compare the efficacy of three therapies for patients with COPD. After a 14-day run-in period, 150 subjects will be randomly assigned to one of the three therapies (conventional drug, acupuncture, and the combination of conventional drug and acupuncture) for 12 weeks treatment. After the treatment period, subjects in three arms will be followed up for 12 weeks. The primary outcomes will include exercise capacity (6MWD) and St. George's Respiratory Questionnaire (SGRQ), and secondary outcomes dyspnea (mMRC), acute exacerbation, lung function, quality of life (COPD assessment test, clinical symptom assessment questionnaire, COPD-PRO and EQ-5D) and health economics.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
150
Inclusion Criteria
  • A diagnosis of COPD with classification of airflow limitation severity from GOLD 1 to GLOD 3 according to GOLD 2017.
  • Syndrome differentiation meets criteria of Qi deficiency of the lung ZHEGN, Qi deficiency of the lung and spleen ZHEGN, Qi deficiency of the lung and kidney ZHEGN, or Qi and Yin deficiency of the lung and kidney ZHEGN.
  • Age ranges from 40 years to 80 years.
Exclusion Criteria
  • Pregnant and lactating women.
  • Patients with severe cardiovascular and cerebrovascular diseases.
  • Patients with severe liver and kidney disease.
  • Patients with bronchiectasis, active pulmonary tuberculosis, pulmonary embolism or other severe respiratory diseases.
  • Patients with tumor after resection, radiotherapy or chemotherapy in the past 5 years.
  • Patients with severe neuromuscular disorders.
  • Patients with severe arthritis.
  • Patients with severe peripheral vascular diseases.
  • Patients with severe cognitive and psychiatric disorders.
  • Patients who have participated in other clinical studies in the past 4 weeks.
  • Patients who have experienced one or more acute exacerbation in the past 4 weeks.
  • Patients unwilling to sign informed consent.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
AcupunctureAcupuncturePatients in this arm will receive acupuncture.
Conventional drugConventional drugPatients will be individually divided into Group A, Group B, Group C and Group D according to GOLD 2017. For Group A, Salbutamol Sulphate Inhalation Aerosol (Ventolin®, GlaxoSmithKline Australia Pty Ltd) will be used. For Group B and Group C, Tiotropium Bromide Powder for Inhalation (Spiriva®, Boehringer Ingelheim International GmbH) will be used. As for Group D, Tiotropium Bromide Powder for Inhalation (Spiriva®, Boehringer Ingelheim International GmbH) or Fluticasone Propionate Powder for Inhalation (Seretide®, Laboratoire GlaxoSmithKline) will be used.
Acupuncture plus conventional drugAcupuncture plus conventional drugPatients in this arm will receive both acupuncture and conventional drug.
Primary Outcome Measures
NameTimeMethod
6MWDChange from baseline 6MWD at week 4, week 8, week 12 of the treatment phase, and week 12 of the follow-up phase.

6-minute walk test will be conducted to assess exercise capacity.

SGRQChange from baseline SGRQ score at week 12 of the treatment phase and week 12 of the follow-up phase.

St. George's Respiratory Questionnaire (SGRQ) will be used to assess quality of life.

Secondary Outcome Measures
NameTimeMethod
mMRCChange from baseline mMRC score at week 4, week 8, week 12 of the treatment phase, and week 12 of the follow-up phase.

The modified Medical Research Council dyspnoea scale (mMRC) will be used to assess severity of dyspnea.

Lung functionChange from baseline lung function at week 12 of the treatment phase and week 12 of the follow-up phase.

Spirometry will be conducted to assess lung function.

EQ-5DChange from baseline EQ-5D score at week 12 of the treatment phase and week 12 of the follow-up phase.

EuroQol 5D (EQ-5D) will be used to assess quality of life.

Clinical symptom assessment questionnaireChange from baseline clinical symptom assessment questionnaire score at week 12 of the treatment phase and week 12 of the follow-up phase.

Clinical symptom assessment questionnaire of COPD will be used to assess symptom.

COPD-PROChange from baseline COPD-PRO score at week 12 of the treatment phase and week 12 of the follow-up phase.

COPD patient-reported outcome scale (COPD-PRO) will be used to assess quality of life.

Health economicsUp to week 12 of the follow-up phase.

Cost of the treatment phase and follow-up phase will be recorded.

Frequency of acute exacerbationChange from baseline frequency of acute exacerbation at week 4, week 8, week 12 of the treatment phase, and week 12 of the follow-up phase.

Frequency of acute exacerbation will be recorded.

CATChange from baseline CAT score at week 12 of the treatment phase and week 12 of the follow-up phase.

COPD assessment test (CAT) will be used to assess quality of life.

Trial Locations

Locations (1)

The First Affiliated Hospital of Henan University of Traditional Chinese Medicine

🇨🇳

Zhengzhou, Henan, China

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