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Medicine

A Preliminary Study on Warm Acupuncture and Moxibustion for Treating Chronic Obstructive Pulmonary Disease with Abdominal Distension

Published: September 1, 2023 doi: 10.3791/65318
Automatic Translation
*1, *2, 1, 1, 1, 1, 1, 1, 3, 1
1Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, 2Department of General Diseases, Sichuan Cancer Hospital, 3Department of Nursing, Hospital of Chengdu University of Traditional Chinese Medicine
* These authors contributed equally

Summary

Here, we present a protocol to properly manipulate warm acupuncture and moxibustion for treating chronic obstructive pulmonary disease (COPD) with abdominal distension.

Abstract

Most patients with COPD have a combination of abdominal distension, which has been shown to adversely affect pulmonary symptoms, frequency of acute exacerbations, and quality of life in patients with COPD. Warm acupuncture and moxibustion have been shown to be effective in relieving symptoms in patients with COPD combined with abdominal distention. Warm acupuncture and moxibustion are highly effective, easy to perform, and inexpensive forms of traditional Chinese medicine treatments. The standardized practice of warm acupuncture and moxibustion is very important for the treatment of COPD combined with abdominal distension. The specific steps include selecting the appropriate acupoints for needling through syndrome differentiation treatment and selecting moxa sticks of appropriate length for moxibustion for about 30 min after the De-qi. The course of treatment lasts for one week. The following indicators are specifically assessed: the score of the COPD Assessment Test (CAT) and the abdominal distension visual analog scale (VAS). This article will clearly illustrate how to standardize the manipulation of warm acupuncture and moxibustion to relieve COPD combined with abdominal distention.

Introduction

Chronic obstructive pulmonary disease (COPD) is a common chronic consumptive disease of the respiratory system. Patients with COPD mainly manifest in chronic cough and sputum, with the progressive development of the disease and gradual decline in lung function. The disease may be complicated by chronic pulmonary cardiac disease, respiratory failure, and heart failure in the later stages of the disease, which seriously affects the quality of life of patients. It is reported that alterations in gut microbiota are associated with disease progression in COPD1. In addition to pulmonary symptoms, 40.31% of patients with stable COPD reported abdominal distention. Abdominal distension can have a significant impact on worsening pulmonary symptoms, increasing the frequency of acute exacerbations of COPD, and impairing the quality of life of patients with stable COPD2,3. The causes of abdominal distension in COPD are considered to be multifactorial which may include as follows: (1) dysbiosis of bacteria; (2) ascites, which increases intra-abdominal pressure; (3) electrolyte disturbances; (4) right heart failure and congestion of the liver or digestive tract; (5) prolonged bed rest4; (6) medications5 and mechanical ventilation6.

Some Chinese medicine scholars have proposed that the development process of COPD is the process of four states:(1) lung qi deficiency; (2) spleen qi deficiency; (3) kidney qi deficiency; (4) Yin and yang deficiency7,8. If the spleen fails to transport and transform and the stomach is weak and unable to receive, abdominal distension may occur, which in turn can lead to muscle thinning and weakness due to the lack of chemical sources9. At present, the drugs commonly used in the clinical treatment of COPD include bronchodilators, glucocorticoids, antibiotics, and other drugs10. There are no guidelines specifying standardized treatment protocols for COPD combined with abdominal distention, which is often treated symptomatically.

Warm acupuncture and moxibustion in traditional Chinese medicine can guide Qi to dredge the meridians, invigorate blood circulation, remove blood stasis, replenish deficiency to warm yang, and dissipate cold. They can produce antioxidant substances and thus play a regulatory role, which can promote immune system stress response and improve blood circulation11,12. Warm acupuncture and moxibustion can be used to treat cervical spondylosis13, knee arthritis14, dysmenorrhea15, constipation16, irritable bowel syndrome17, and so on. Experimental studies have turned out that acupuncture can relieve abdominal distension by regulating the brain-gut axis18. Acupuncture combined with moxibustion significantly reduces abdominal distention19, which may be exerted through the regulation of plasma prostaglandin E2 and gastrin levels in plasma and gastric mucosal tissues20. Meanwhile, warm acupuncture and moxibustion are superior to prokinetics and sham acupuncture in terms of improving the symptoms of functional dyspepsia21. Acupuncture can strengthen the diaphragm and relieve respiratory muscle fatigue, as well as improve carbon dioxide retention, and hypoxia, and prevent and relieve respiratory failure22. Warm acupuncture and moxibustion improve lung function, clinical symptoms, and quality of life in patients with stable COPD23,24.

According to the theory of Chinese medicine that "The lung stands in interior-exterior relationship with the large intestine", the warming acupuncture and moxibustion treatment used in this study aim to promote the recovery of gastrointestinal function and improve pulmonary function and quality of life. Warm acupuncture and moxibustion are highly effective, easy to perform, and inexpensive forms of traditional Chinese medicine treatments. In conclusion, it is necessary to propose a standard protocol on how to properly operate the use of warm acupuncture and moxibustion to relieve COPD with abdominal distension. This article describes how to properly manipulate the use of warm acupuncture and moxibustion treatment to relieve COPD with abdominal distension.

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Protocol

The clinical study protocol was reviewed and approved by the Clinical Research Approval Committee of the Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine (Record No. KY 2022010).

1. Equipment preparation

  1. Prepare disposable sterile acupuncture needles (size 0.25 mm x 40 mm), moxa sticks (size 1.2 cm x 1.2 cm), medical sterilization swabs, iodophor swabs, lighter, and several 60 mm x 60 mm cardboards (see Figure 1).

2. Doctor preparation

  1. Ensure that patients meet the diagnostic criteria for COPD in the Primary Care Guidelines for Chronic Obstructive Pulmonary Disease and have abdominal distension.
  2. Exclude patients with the following conditions:(1) those with skin ulceration, poor glycemic control, poor blood pressure control, and dizziness; (2) those with silicosis, tuberculosis, malignant tumors, asthma, coagulation disorders, and severe cardiac insufficiency; (3) those with rheumatic heart disease, congenital heart disease, renal failure, liver failure, and so on; (4) those with poor compliance.
  3. Wear a medical mask and hat.
  4. Wash the hands with soapy water, leave them dry, and use alcohol hand sanitizer before holding the needle to operate.

3. Patient preparation

  1. Ask the patient to empty the bladder.
  2. Measure the patient's blood pressure, heart rate, respiratory rate, and oxygen saturation.
  3. Make sure the skin is not damaged and festering.
  4. After the above basic signs are normal, instruct the patient to choose the supine or prone position to expose the acupuncture points.
  5. Advise the patient to inform the physician in case of discomfort during the procedure.

4. Acupoints selection

  1. Wipe the skin of the sites to be needled with Iodophor swabs.
  2. According to the standardized acupuncture points, choose Feishu (BL13), Taiyuan (LU9), Dingchuan (EX-B1), Zusanli (ST36), Zhongwan (RN12), Tianshu (ST25)24,25,26 (see Figure 2).

5. Acupuncture and needling manipulation

  1. Stretch out flat the five fingers of the left hand, and place apart the index and middle fingers at the place of stabbing.
  2. Hold the needle handle by the thumb and index finger of the right hand, the end of the middle finger is close to the point, and the finger belly is against the needle body.
  3. Press downward the thumb and index finger while the middle finger is flexed and insert the needle into the international standardized acupuncture angles and depths.
  4. Uniformly lift and thrust the needle handle along the acupuncture angle, the depth is about 3 mm, and the frequency is about 60 times/min27.
  5. Rotate the needle handle forward and backward at an angle of 180 degrees or less; the frequency is about 60 times/min until the patient feels De-qi27.

6. Place moxa sticks

  1. Lit the moxa sticks from the bottom 2-3 cm from the skin28 so that the patient has a warm sensation and redness on the body surface. Treatment takes about 30 min.

7. Place cardboards

  1. Place the 60 mm x 60 mm cardboard under the moxa sticks to prevent the ash from burning the skin until the moxa sticks burn out (see Figure 3).

8. Picking the needles

  1. Gently pick up the burned-out moxa sticks with the end of the bamboo swab.
  2. Gently apply pressure to the needle sites with medical sterilization swabs in the hand.
  3. Do a small twist with the needles and slowly lift them to the subcutaneous, leave them for a moment, and then remove them.
  4. After the needles come out, use medical sterilization swabs to lightly press the needle holes for a moment to prevent bleeding and reduce pain.
  5. After the needles are withdrawn, carefully check whether the needle holes are bleeding, ask the patient whether there is any discomfort, and check whether the number of needles is missing.

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Representative Results

General conditions
A total of 12 patients (Table 1) with COPD combined with abdominal distension were divided into observation and control groups, with 6 cases in each group, respectively. All met the diagnostic criteria of the ''Primary Care Guidelines for Chronic Obstructive Pulmonary Disease (2018)''29 and had abdominal distension. The control group was given pseudo-needling. We chose the same acupoints as the observation group and inserted needles vertically into the skin at 2.5 cm beside these acupoints and punctured them superficially for 1-3 mm without needling manipulation and moxibustion. The patients in the control group were provided with basic treatment according to the Primary Care Guidelines for Chronic Obstructive Pulmonary Disease (2018)29. The patients in the observation group were given warm acupuncture, moxibustion, and basic treatment according to the Primary Care Guidelines for Chronic Obstructive Pulmonary Disease (2018)29. Patients in both groups received treatment for 1 week.

Observed indicators
The quality of life (the score of COPD Assessment Test [CAT])29 and abdominal distension VAS scores30 were compared between the two groups.

Representative results
Independent samples t-test was used for comparison between the control and observation groups, and Paired t-test was used for comparison before and after treatment within each group.

The comparison of CAT scores between the 2 groups before and after treatment is shown in Table 2. After treatment, the CAT scores of both groups were lower than those before treatment (P < 0.001), and the scores of the observation group were lower than those of the control group (P = 0.012).

The comparison of abdominal distension VAS scores between the 2 groups before and after treatment is shown in Table 3. After treatment, the abdominal distension VAS scores of both groups were lower than those before treatment (P < 0.05), and the scores of the observation group were lower than those of the control group (P = 0.011).

Figure 1
Figure 1. Required materials. Disposable sterile acupuncture needles (size 0.25 mm x 40 mm); moxa sticks (size 1.2 cm x 1.2 cm); medical sterilization swabs; Iodophor swabs; lighter; several 60 mm x 60 mm cardboards. Please click here to view a larger version of this figure.

Figure 2
Figure 2. Acupoint selection. The acupuncture points were selected according to traditional Chinese medicine theory and the relevant references: Equation 1 Zhongwan (RN12); Equation 2 Taiyuan (LU9); Equation 3 Tianshu (ST25); Equation 4 Zusanli (ST36); Equation 5 Dingchuan (EX-B1); Equation 6 Feishu (BL13). (A) Taiyin lung channel of hand; (B) Conception channel; (C) Yangming stomach channel of the foot; (D) Taiyang bladder channel of the foot. Please click here to view a larger version of this figure.

Figure 3
Figure 3. Warm acupuncture and moxibustion manipulation diagram. Select the appropriate acupoints for needling and select moxa sticks of appropriate length for moxibustion for about 30 min after De-qi. Please click here to view a larger version of this figure.

Gender Age (years) BMI FVC1/FVC (%)
Female 79 27.12 35.25
Male 59 17.58 58
Female 74 19.22 57
Male 65 16.83 35.24
Male 84 17.58 46
Male 80 22.41 38.35
Male 67 16.65 35.47
Male 67 20.83 66.64
Male 83 16.53 56.99
Male 64 20.76 62
Male 85 26.4 60
Male 82 19.1 56

Table 1: General information of the patients included in the study.

Group  Number of cases  Pre-treatment  Post-treatment
Observation group 6 22.83 ± 2.317 13.00 ± 1.095
Control group 6 22.67 ± 3.011 15.33 ± 1.506
Note:
Equation 1 Compared with the same group before treatment, P < 0.001 
Equation 2 Compared with the control group after treatment, P = 0.012

Table 2. The comparison of CAT scores between the two groups before and after treatment. Scores are expressed as Equation 7 ± s.

Group  Number of cases  Pre-treatment  Post-treatment
Observation group 6 7.67 ± 0.816 2.67 ± 0.516
Control group 6 6.67 ± 1.633 3.83 ± 0.753
Note:
Equation 1 Compared with the same group before treatment, P < 0.05 
Equation 2 Compared with the control group after treatment, P = 0.011

Table 3. The comparison of abdominal distension VAS scores between the two groups before and after treatment. Scores are expressed as Equation 7 ± s.

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Discussion

It is well known that the pathogenesis of abdominal distension caused by COPD is not fully understood, which hinders the development of new therapies and drugs. In recent years, warm acupuncture and moxibustion have been widely applied to COPD combined with abdominal distention.The therapeutic mechanism of warm acupuncture and moxibustion is mainly the effect of acupuncture, the moxibustion warming effect, and the heat-conducting effect of the needle body31. Moxibustion focuses on the local warming of acupuncture points. It activates local specific receptors, heat shock proteins, heat-sensitive immune cells, etc., which exerts the local effect of warming the meridians and opening the collaterals32. Modern Chinese medicine believes that acupuncture and moxibustion of the RN12, ST25, and ST36 can exert cellular protection of the gastric mucosa33. Warm acupuncture and moxibustion can effectively improve COPD combined with abdominal distention25, which makes it stand out from the improvement of abdominal distension caused by COPD.

Here are some points to note during the operation of warm acupuncture and moxibustion. The treatment room should be regularly disinfected to ensure good air exchange devices. The mattress, pillowcase, blanket, mat, and other items on the treatment table should be changed and dried on time34. The following preparatory exercises can be performed before the operation to achieve the desired therapeutic effect: (1) finger strength exercises; (2) manipulation exercises; (3) handedness exercises35. When manipulating the needle, one should not twirl the needle in one direction to avoid the needle body being entangled by the muscle fibers, causing local pain or sticking of the needle and making it difficult to remove. Meanwhile, here are some needling abnormalities that need to be addressed and prevented; the common ones are as follows: (1) fainting during acupuncture; (2) sticking of the needle; (3) hematoma of the skin; (4) piercing other internal organs36. Besides, the De-qi is a reaction such as heat, coolness, itching, pain, and convulsions. Sometimes there are phenomena such as conduction and diffusion along certain directions and sites. Besides, the doctor's pricking hand can experience reactions such as sinking and tightness under the needle, astringency, or trembling of the needle's body as appropriate37.

In addition to the precautions for acupuncture, moxibustion also has some precautions. For patients with perceptual impairment, the physician can place the middle and index fingers on the body surface of the patient on either side of the filiform needle to sense the heat on the patient's body surface. In general, moxibustion should be applied with caution to patients with an empty stomach, too full, extreme fatigue, and fear of moxibustion38. The process of moxibustion should prevent the burning moxa from falling off and burning the skin and clothing.

Warm acupuncture and moxibustion are safe for patients, easy and quick to operate, highly reproducible, and easy to apply once the operator is familiar with the technique. However, we acknowledge that the experiment has limitations, such as (1) labor-intensive: when warm acupuncture and moxibustion are performed, a person must watch over the moxa sticks in order to replace them in time when they burn out and to prevent the moxa fire from dislodging and burning the patient39; (2) small sample size: the study mainly demonstrated the standardized operation of warm acupuncture and moxibustion to relieve COPD with abdominal distension, so the results are representative of the small sample size; (3) limitations of therapeutic effects: warm acupuncture and moxibustion can only relieve abdominal distension caused by COPD, if one wants to cure the symptoms, it is necessary to actively treat the original disease.

It is believed that with the revolution of science and technology, warm acupuncture and moxibustion will be fully revealed their mechanism of action and method of operation, bringing a bright future for the treatment of abdominal distension caused by COPD in ethnomedicine.

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Disclosures

The authors have no conflicts of interest to declare.

Acknowledgments

This work was supported by the 2022 "Tianfu Qingcheng Plan" Tianfu Science and Technology Leading Talents Project (Chuan Qingcheng No. 1090), the National TCM Clinical Excellent Talents Training Program (National TCM Renjiao Letter [2022] No. 1), "100 Talent Plan" Project of Hospital of Chengdu University of Traditional Chinese Medicine (Hospital office [2021] 42), Special subject of scientific research of Sichuan Administration of Traditional Chinese Medicine (2021MS093, 2021MS539, 2023MS608).

Materials

Name Company Catalog Number Comments
Moxa stick Dr. Moxi N/A size: 1.2 cm x 1.2 cm
Disposable sterile acupuncture needle HWATO 2001-0020 size:  0.25 mm x 40 mm
Iodophor swabs BEIJIAER 20162140536
Cardboard In-house In-house size: 60 mm x 60 mm 

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References

  1. Li, N., et al. Gut microbiota dysbiosis contributes to the development of chronic obstructive pulmonary disease. Respiratory Research. 22, 274 (2021).
  2. Kirschner, S. K., et al. Intestinal function is impaired in patients with chronic obstructive pulmonary disease. Clinical Nutrition. 40 (4), 2270-2277 (2021).
  3. Sun, Y., et al. Correlation between lower gastrointestinal tract symptoms and quality of life in patients with stable chronic obstructive pulmonary disease. Journal of Traditional Chinese Medicine. 33 (5), 608-614 (2013).
  4. Liu, J., Wu, G. Clinical observation of Da Cheng Qi Tang in the treatment of abdominal distension in chronic obstructive pulmonary disease. Journal of Clinical Pulmonology. 11, 1188 (2007).
  5. Kesten, S., Celli, B., Decramer, M., Leimer, I., Tashkin, D. Tiotropium HandiHaler in the treatment of COPD: A safety review. International Journal of Chronic Obstructive Pulmonary Disease. 4, 397-409 (2009).
  6. Windisch, W. Impact of home mechanical ventilation on health-related quality of life. The European Respiratory Journal. 32 (5), 1328-1336 (2008).
  7. Li, J. S., Li, S. Y., Wang, Z. W. Diagnostic criteria for Chinese medical evidence of chronic obstructive pulmonary disease (2011 version). Journal of Chinese Medicine. 53 (02), 177-178 (2012).
  8. Feng, Z., Xie, Y., Chun, L., He, W., Li, J. A study of the underlying evidential features in the literature of stable chronic obstructive pulmonary disease based on association rules combined with hidden structure models. World Science and Technology - Modernization of Chinese Medicine. 23 (02), 552-559 (2021).
  9. He, W., Li, G. The efficacy of Shizi heat ironing therapy to improve gastrointestinal function in patients with chronic obstructive pulmonary disease. New Chinese Medicine. 44 (02), 31-32 (2012).
  10. Commission Emergency Medical Quality Control C, Emergency Medical Branch Of Chinese Medical A, Chinese Medical Doctor Association Emergency Medical B, World Federation Of Chinese Medicine Societies Emergency Professional C, Pulmonary Disease Academy Of China Association Of Chinese M, Chinese Society For Integrated Chinese And Western Medicine Intensive Medicine Specialized C. Expert consensus of Chinese and Western medicine treatment on acute exacerbation of chronic obstructive pulmonary disease in China (2021). Chinese Critical Care Emergency Medicine. 33 (11), 1281-1290 (2021).
  11. Zhong, L. Preliminary study on the mechanism of traditional moxibustion. Chinese Journal of Basic Medicine of Traditional Chinese Medicine. 6, 47-48 (1999).
  12. Liu, H. Y. T. A preliminary investigation of the biophysical mechanism of moxibustion therapy. Chinese Acupuncture. 10, 17-59 (1996).
  13. Sun, D. P., et al. Cervical spondylosis of nerve root type with qi stagnation and blood stasis treated with warming needle with different lengths of moxa stick: a randomized controlled trial. Chinese Acupuncture. 42 (8), 873-878 (2022).
  14. Zhang, H., Liu, J., Wen, S., Tian, B. Efficacy of warm acupuncture in treating patients with gouty arthritis of the knee joint with evidence of damp-heat entrapment and its effects on joint pain, joint function and serum inflammatory indexes. Hebei Chinese Medicine. 43 (07), 1170-1173 (2021).
  15. Zhang, Y., Wang, S., Sun, Y., Yang, D., Sun, Y. Clinical effects of warm acupuncture in the treatment of dysmenorrhea secondary to cold clotting and blood stasis type of adenomyosis. China Pharmaceutical Herald. 20 (05), 146-159 (2023).
  16. Ma, Q., He, X. Clinical study on the treatment of Yang deficiency type chronic functional constipation with warm acupuncture and moxibustion at the Baliao. Journal of Guangzhou University of Chinese Medicine. 40 (02), 363-367 (2023).
  17. Wei, X., Jin, H., Yan, X. Clinical study on the treatment of diarrhea-type irritable bowel syndrome by strengthening the spleen, tonifying the spirit and warming acupuncture. Shanxi Traditional Chinese Medicine. 44 (02), 245-254 (2023).
  18. Tan, L. H., et al. Effect of electroacupuncture at different acupoints on the expression of NMDA receptors in ACC and colon in IBS rats. Evidence-Based Complementary and Alternative Medicine: eCAM. 2019, 4213928 (2019).
  19. Anastasi, J. K., McMahon, D. J., Kim, G. H. Symptom management for irritable bowel syndrome: A pilot randomized controlled trial of acupuncture/moxibustion. Gastroenterology Nursing. 32 (4), 243-255 (2009).
  20. Wu, X., Guo, Y., Zheng, J., Liu, Z. Protective effect of warm-through acupuncture on stress gastric mucosal injury. Shanghai Acupuncture and Moxibustion Journal. 4, 40-41 (2001).
  21. Zhang, J., et al. Efficacy comparison of different acupuncture treatments for functional dyspepsia: A systematic review with network meta-analysis. Evidence-Based Complementary and Alternative Medicine: eCAM. 2020, 3872919 (2020).
  22. Liu, Q., et al. Rehabilitation effects of acupuncture on the diaphragm dysfunction in chronic obstructive pulmonary disease: A systematic review. International Journal of Chronic Obstructive Pulmonary Disease. 16, 2023-2037 (2021).
  23. Xie, F., Wu, Y. P., Liu, L., Ren, J. G., Zhang, B. D. Warm acupuncture on chronic obstructive pulmonary disease with phlegm-turbid obstructing of the lung: a randomized controlled trial. Zhongguo Zhen Jiu. 39 (9), 918-922 (2019).
  24. Gao, J., et al. A comparative study of the effects of warm acupuncture on lung function and quality of life in patients with stable COPD. Chinese Acupuncture. 31 (10), 893-897 (2011).
  25. Shi, Z., Ni, T., Wang, X. Clinical study on moxibustion combined with salmeterol xinafoate and fluticasone propionate powder for inhalation for COPD in stable stage. Chinese Medicine. 53 (14), 150-153 (2021).
  26. Yang, L. Clinical efficacy of warm acupuncture in 55 cases of functional dyspepsia. Modern Wellness. 282 (18), 170 (2016).
  27. Yuan, Y., Hai, Y., Gu, X., Wang, Z., Peng, J. Preliminary study on the standardization of acupuncture techniques. Journal of Traditional Chinese Medicine. 2, 230-231 (2002).
  28. Zhou, H. J. Effects of moxa-stick ignition locations on temperature of needle body and surrounding environment during warm needling. Zhongguo Zhen Jiu. 34 (7), 675-677 (2014).
  29. Chinese Medical Association. Primary care guidelines for chronic obstructive pulmonary disease (2018). Chinese Journal of General Practitioners. 11, 856-870 (2018).
  30. Geyer, M., Guller, U., Beglinger, C. Carbon dioxide insufflation in routine colonoscopy is safe and more comfortable: results of a randomized controlled double-blinded trial. Diagnostic and Therapeutic Endoscopy. 2011, 378906 (2011).
  31. Chen, L., Jin, X., Li, R. Analysis of the current situation and problems in the development of warm acupuncture operation technology. Chinese Journal of Traditional Chinese Medicine. 33 (09), 3768-3771 (2018).
  32. Huang, K., Liang, S., Sun, Z., Zhang, J. Startup mechanism of moxibustion warming and dredging function. Zhongguo Zhen Jiu. 37 (9), 1023-1026 (2017).
  33. Gao, X., et al. Experimental study on the effect of acupuncture on gastric mucosal barrier function. China Chinese Medicine Technology. 5, 277-278 (2001).
  34. Liang, F., Wang, H. Science of Acupuncture and Moxibustion. China Press of Traditional Chinese Medicine. 133, (2016).
  35. Liang, F., Wang, H. Science of Acupuncture and Moxibustion. China Press of Traditional Chinese Medicine. , 136-137 (2016).
  36. Zheng, W., Zhang, J., Shang, H. Ancient Chinese medicine practitioners' understanding of the contraindications of acupuncture. Chinese Journal of Traditional Chinese Medicine. 26 (09), 1928-1930 (2011).
  37. Shi, X. Acupuncture and Moxibustion. Chinese Traditional Clinical Medicine Series. , (2004).
  38. National Standard of the People's Republic of China. Acupuncture technical practice part 1: Moxibustion. Chinese Acupuncture. 30 (06), 501-504 (2010).
  39. Zhang, M., Gao, X. The clinical application of warm acupuncture and penetration moxibustion by professor GAO Xiyan. Zhongguo Zhen Jiu. 38 (12), 1325-1328 (2018).

Tags

Warm Acupuncture Moxibustion Chronic Obstructive Pulmonary Disease COPD Abdominal Distension Traditional Chinese Medicine Symptom Relief Treatment Effectiveness Standardized Practice Acupoints Syndrome Differentiation Treatment Moxa Sticks Course Of Treatment COPD Assessment Test CAT Visual Analog Scale VAS
A Preliminary Study on Warm Acupuncture and Moxibustion for Treating Chronic Obstructive Pulmonary Disease with Abdominal Distension
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Cite this Article

Yu, S., Wang, T., Ying, R., Zhu, Y., … More

Yu, S., Wang, T., Ying, R., Zhu, Y., Liu, K., Yuan, F., Yang, H., Chen, K., Shi, J., Luo, X. A Preliminary Study on Warm Acupuncture and Moxibustion for Treating Chronic Obstructive Pulmonary Disease with Abdominal Distension. J. Vis. Exp. (199), e65318, doi:10.3791/65318 (2023).

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