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Original Investigation
June 11, 2012

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

Author Affiliations

Author Affiliations: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto (Drs M. Suzuki, Muro, Sato, and Mishima), Division of Respiratory Medicine, Respiratory Disease Center Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Osaka (Drs M. Suzuki, Aihara, Matsumoto, S. Suzuki, Itotani, Ishitoko, Takemura, Ueda, Kagioka, and Fukui), Biostatistics Group, Center for Product Evaluation, Pharmaceuticals and Medical Devices Agency, Tokyo (Ms Ando), Epidemiology and Biostatistics Laboratory, Faculty of Culture and Information Science, Doshisha University, Kyoto (Dr Omori), Department of Respiratory Medicine, Ako City Hospital, Ako City (Dr Shiota), Department of Respiratory Medicine, Hyogo Prefectural Amagasaki Hospital, Hyogo (Drs Endo, Hara, and Hirabayashi), and Department of Clinical Acupuncture and Moxibustion, Meiji University of Integrative Medicine, Kyoto (Dr M. Suzuki), Japan.

Arch Intern Med. 2012;172(11):878-886. doi:10.1001/archinternmed.2012.1233

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