Name: Ginger Moxibustion, A Non-pharmacological Treatment, for Diarrhea in Patients with Chronic Obstructive Pulmonary Disease (Video) | JoVE Journal
Uploaded: 2024-12-27T12:40:00.000+00:00
Duration: 3 min 25 s
Description: Learn ginger moxibustion for treating diarrhea in COPD patients using this non-pharmacological therapy. This method explores the gut-respiratory connection and offers alternative treatment options.

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This work was supported by the 2022 &#34;Tianfu Qingcheng Plan&#34; 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), &#34;100 Talent Plan&#34; 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 (2021MS539, 2023MS608). Sichuan Science and Technology Program (2023ZYD0050, 24NSFJQ0077), Science and Technology Development Fund Project of Hospital of Chengdu University of Traditional Chinese Medicine (22HL11).

The study protocol was reviewed and approved by the Clinical Research Approval Committee of the Hospital of Chengdu University of Traditional Chinese Medicine (KY2022027). Written informed consent was obtained from all subjects.
1. Preparation of materials
NOTE: See Figure 1 and the Table of Materials for details about materials used in this protocol.
<ol>
	<li>Use a utility knife to cut out five pieces of ginger, each piece ~0.4-0.6 cm-thick and 2-3 cm in diameter. Prick out five small holes in each piece with a cotton swab24.</li>
	<li>Take the moxa sticks apart, remove an appropriate amount of moxa, and knead them into a mass in the palm. Make a moxa cone with a bottom diameter of ~0.3 cm and a height of ~0.3 cm.</li>
</ol>
2. Preparation of the doctor
<ol>
	<li>Prepare a separate treatment room to avoid exposing the patient&#39;s privacy and keep the patient warm.</li>
	<li>Select cases according to the inclusion and exclusion criteria formulated in advance (see Table 1).</li>
	<li>Wear a clean white coat, medical surgical mask, and disposable operating cap.</li>
	<li>Disinfect hands before operation.</li>
</ol>
3. Subject preparation
<ol>
	<li>Ask the patient to empty their bladder, lie on the back, expose the abdomen, and relax.</li>
</ol>
4. Operation
<ol>
	<li>Locate the Shenque Acupoint (CV 8) according to the national standard: Nomenclature and location of meridian points25. Disinfect the skin for ~5 cm around the acupoint. 
	NOTE: The Shenque acupoint is in the upper abdomen, in the center of the umbilicus, located at the intersection of the anterior superior iliac spine level and the midline of the abdomen26 (see Figure 2).</li>
	<li>Cut a hole in the center of the treatment towel and lay it over the Shenque Acupoint to prevent the rest of the abdomen from getting cold and prevent burning of the skin by the burning moxa.</li>
	<li>Place the moxa cone on a piece of ginger and light it. With tweezers, transfer the ginger piece with tweezers from the operating table to the patient&#39;s Shenque Acupoint (Figure 3A,B).</li>
	<li>Place a new moxa cone on top of another piece of ginger and light it after 3 min. 
	NOTE: A moxa cone takes ~3-5 min to burn.</li>
	<li>Remove the ginger and moxa cone from the patient&#39;s Shenque Acupoint. When the cone burns out, replace it with a new one. Put the burnt-out moxa cone into water to extinguish it (Figure 3C).</li>
	<li>Repeat steps 4.4 and 4.5 4x. Then, finish the treatment. 
	NOTE: The entire treatment lasts for 5 days and must be performed once a day.</li>
</ol>

Assessing the Efficacy of Ginger Moxibustion in Diarrhea Management in COPD

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<li>Walker, C. L., Black, R. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Zinc+treatment+for+serious+infections+in+young+infants%5BTitle%5D)+AND+%22Lancet%22%5BJournal%5D)">Zinc treatment for serious infections in young infants.</a> Lancet. 379 (9831), 2031-2033 (2012).</li>
<li>Hegner, R. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((A+carnivorous+diet+in+the+treatment+of+flagellate+diarrhea%5BTitle%5D)+AND+%22JAMA%22%5BJournal%5D)">A carnivorous diet in the treatment of flagellate diarrhea.</a> JAMA. 83 (1), 23-24 (1924).</li>
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<li>Zhuang, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Effect+of+ginger-partitioned+moxibustion+combined+with+skin+needle+on+gastrointestinal+reaction+in+patients+with+malignant+tumor+chemotherapy%5BTitle%5D)+AND+%22Zhen+Ci+Yan+Jiu%22%5BJournal%5D)">Effect of ginger-partitioned moxibustion combined with skin needle on gastrointestinal reaction in patients with malignant tumor chemotherapy.</a> Zhen Ci Yan Jiu. 49 (7), 700-706 (2024).</li>
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<li>Wang, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Clinical+observation+of+ginger+moxibustion+combined+with+external+application+of+chinese+medicine+and+tdp+magic+lamp+irradiation+in+the+treatment+of+knee+arthralgia+with+cold+and+damp+arthralgia%5BTitle%5D)+AND+%22China%27s+Naturopathy%22%5BJournal%5D)">Clinical observation of ginger moxibustion combined with external application of chinese medicine and tdp magic lamp irradiation in the treatment of knee arthralgia with cold and damp arthralgia.</a> China's Naturopathy. 32 (11), 49-52 (2024).</li>
<li>Chen, J., Tong, X. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Clinical+study+on+the+treatment+of+chronic+atrophic+gastritis+with+spleen+and+stomach+weakness+by+ginger+moxibustion+combined+with+weifuchun+capsule%5BTitle%5D)+AND+%22New+Chinese+Medicine%22%5BJournal%5D)">Clinical study on the treatment of chronic atrophic gastritis with spleen and stomach weakness by ginger moxibustion combined with weifuchun capsule.</a> New Chinese Medicine. 56 (08), 121-126 (2024).</li>
<li>Yunbo, Z., Chunyan, Y., Sheng, X. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Treatment+of+30+cases+of+diarrheal+irritable+bowel+syndrome+with+ginger+moxibustion+at+shenque+point%5BTitle%5D)+AND+%22Jiangxi+Journal+of+Chinese+Medicine%22%5BJournal%5D)">Treatment of 30 cases of diarrheal irritable bowel syndrome with ginger moxibustion at shenque point.</a> Jiangxi Journal of Chinese Medicine. (08), 69-70 (2007).</li>
<li>Dongmei, S., Shubin, L., Hua, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Clinical+observation+of+30+cases+of+diarrheal+irritable+bowel+syndrome+treated+with+ginger+and+medicinal+moxibustion+at+shenque+point%5BTitle%5D)+AND+%22World+Journal+of+Traditional+Chinese+Medicine%22%5BJournal%5D)">Clinical observation of 30 cases of diarrheal irritable bowel syndrome treated with ginger and medicinal moxibustion at shenque point.</a> World Journal of Traditional Chinese Medicine. (05), 12(2017).</li>
<li>N. a. O. T. C Medicine. <a target="_blank" href="http://scholar.google.com/scholar?hl=en&safe=off&q=%22Vol.+GB%2FT+21709.1-2008+6+General+Administration+of+Quality+Supervision%2C+Inspection+and+Quarantine+of+the+People%27s+Republic+of+China%22">Vol. GB/T 21709.1-2008 6 General Administration of Quality Supervision, Inspection and Quarantine of the People's Republic of China</a>. , Standardization Administration of China. China, Beijing. (2008).</li>
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</ol>

The authors have no conflicts of interest to declare.

The causes of diarrhea in COPD patients are various, including gastrointestinal infection, irritable bowel, antibiotic abuse, food factors (cold diet, lactose intolerance, excessive fat intake), drugs (laxatives such as magnesium sulfate and lactulose, dehydrating agents such as mannitol and sorbitol)6, Chinese medicinal herbs-natural herbs-are used worldwide and have significant effects on human glucose and lipid metabolism, intestinal inflammation, and oxidative stress30....

Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous lung condition characterized by chronic respiratory symptoms (dyspnea, cough, sputum production, or exacerbations) due to abnormalities of the airways (bronchitis, bronchiolitis) and/or alveoli (emphysema) that cause persistent, often progressive, airflow obstruction1,2. COPD has become a severe chronic disease with high morbidity, high mortality, high disability rate, and heavy disease burden. The &#34;China Lung Health Study&#34; shows that the incidence of COPD in people over 40 years old in China is 13.7%3. The total number of COPD patients in China is ~100 million. Acute exacerbations occur 0.5-3.5 times in patients with COPD each year and are the main cause of death in COPD patients. In 2013, the total number of deaths from COPD in China was 910,000, ranking third for a single disease, accounting for 31.1% of the total number of deaths from COPD in the world4.
Diarrhea refers to an increased frequency of bowel movements, thin stool, mucus, pus, blood, undigested food, urgent bowel movements, or even fecal incontinence. Precisely, diarrhea consists of more than three bowel movements per day, with the fecal water content greater than 85%5,6. Diarrhea is a common extrapulmonary complication in COPD patients and is usually accompanied by loss of appetite, bloating, fatigue, anxiety, and other discomfort. Studies have shown that the incidence of diarrhea in COPD patients during antibiotic treatment is ~5%-25%7. Diarrhea leads to water and electrolyte disturbances in patients and aggravates the risk of malnutrition in patients. It not only reduces the quality of life of patients with COPD but also impedes the recovery of respiratory function and affects the prognosis of COPD8,9,10. The management of diarrhea mainly includes antidiarrheic, oral or intravenous rehydration, probiotics, antibiotics (where there is evidence of infection)11,12,13,14, zinc treatment15, and diet therapy16,17. However, antidiarrheal drug treatment can only temporarily control the symptoms of diarrhea, which cannot be cured entirely. Other methods have a longer course of treatment, which increases the burden on patients. Therefore, an easily implemented non-pharmacological therapy is necessary for treating diarrhea in COPD patients.
Ginger moxibustion involves cutting fresh ginger (Zingiber officinale) into thin slices, lighting moxa sticks on the ginger slices, and then placing moxibustion at specific acupuncture points. Moxa is a traditional Chinese herbal medicine, which can warm channels to dispel coldness Moxibustion can eliminate many uncomfortable symptoms through the warming meridian. It is effective in treating knee joint disease, irritable bowel syndrome, chronic atrophic gastritis, post chemotherapy nausea, and vomiting18,19,20,21. Ginger slices have the effect of dispelling cold22,23. In clinical practice, most COPD patients have diarrhea symptoms. Acute exacerbation of DOPD is usually triggered by infection; antibiotics can control the infection but tend to worsen diarrhea symptoms. Dietary adjustment, antidiarrheal drugs, and intestinal flora supplementation have some benefits for diarrhea, but they are not enough. Ginger moxibustion is an ancient traditional Chinese medicine technique, which has the functions of warming the body and dispelling cold, reconciling qi and blood, fueling health, and enhancing spleen and stomach function. It has been observed to have an outstanding effect on diarrhea in clinical settings. It is simple and easy to perform, has no apparent side effects, and is easy for patients to accept.
Here, we present a randomized controlled trial using ginger moxibustion as a non-pharmacological therapy to treat COPD patients with diarrhea, comparing it to conventional therapy to confirm the effectiveness and superiority of ginger moxibustion therapy. Detailed descriptions of the procedure and video demonstrations will help further promote this traditional Chinese medicine therapy.

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ginger moxibustion, a non-pharmacological treatment, for diarrhea in patients with chronic obstructive pulmonary disease

Ginger Moxibustion, A Non-pharmacological Treatment, for Diarrhea in Patients with Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) is a common and frequently occurring disease in the elderly population, and it tends to progressively worsen. Diarrhea is a common extrapulmonary complication in patients with COPD. Diarrhea can cause dehydration, electrolyte imbalances, weakness, and a loss of appetite, among other adverse consequences, which seriously affect the quality of life and nutritional status of patients. These consequences are not conducive to improving airway obstruction in COPD patients. At present, modern medicine has poor curative effects, fails to control symptoms fully, causes a relapse after drug withdrawal, has side effects, and increases the medication burden of patients. Ginger moxibustion is a unique non-pharmacological therapy of traditional Chinese medicine, which is safe and effective in controlling diarrhea, has few side effects, and is easy to accept. It is, therefore, an ideal alternative therapy. This article aims to introduce the protocol of ginger moxibustion for treating diarrhea in COPD patients.

Basic conditions 
A total of 18 patients with COPD complicated with diarrhea were divided into a treatment group (9 cases) and a control group (9 cases) (see Table 2). All patients met the diagnostic criteria1, accompanied by symptoms of diarrhea, and were type 5 or above according to the Bristol stool chart5. The treatment group received ginger moxibustion treatment and conventional symptomatic treatment (including inhalation preparatio...

Here, we present the method of using ginger moxibustion to treat diarrhea in patients with chronic obstructive pulmonary disease.

Chronic Obstructive Pulmonary Disease (COPD) is a common and frequently occurring disease in the elderly population, and it tends to progressively worsen. ...

ginger-moxibustion-non-pharmacological-treatment-for-diarrhea

Research

JoVE Journal

Medicine

Here we demonstrate acupoint application combined with acupoint massage for treating constipation in a patient with chronic obstructive pulmonary disease (COPD).

Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease

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

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

This protocol presents the clinical efficacy of heat-sensitive moxibustion in treating chronic obstructive pulmonary disease (COPD) combined with insomnia and outlines the procedure for heat-sensitive moxibustion.

Heat-sensitive Moxibustion as a Traditional Chinese Medicine Therapy for Chronic Obstructive Pulmonary Disease Combined with Insomnia

We explore the use of repetitive transcranial magnetic stimulation (rTMS) to improve language abilities in patients with chronic stroke and non-fluent aphasia.  After identifying a site in the right frontal gyrus for each patient that responds optimally to stimulation, we target this site during ten days of rTMS treatment.

Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia

The degree of vascular dysfunction and contributing physiological mechanisms can be assessed in patients with chronic kidney disease by measuring brachial artery flow-mediated dilation, aortic pulse-wave velocity, and vascular endothelial cell protein expression.

Assessment of Vascular Function in Patients With Chronic Kidney Disease

This study describes the successful generation of a new chronic obstructive pulmonary disease (COPD) animal model by repeatedly exposing mice to high concentrations of ozone.

Generation of a Chronic Obstructive Pulmonary Disease Model in Mice by Repeated Ozone Exposure

This protocol introduces an effective method to improve the sleep condition of patients with chronic obstructive pulmonary disease and alleviate cough symptoms by using auricular acupuncture techniques to percutaneously stimulate specific acupoints in the patients' ears.

Auricular Acupuncture as a Traditional Chinese Medicine Therapy for Chronic Obstructive Pulmonary Disease Combined with Sleep Disorders

In this protocol, a knee osteoarthritis model was prepared using the modified Videman method, and the operation procedures and precautions of acupotomy are detailed. The effectiveness of acupotomy has been demonstrated by testing the mechanical properties of quadriceps femoris and tendon and the mechanical and morphological properties of cartilage.

Application of Acupotomy in a Knee Osteoarthritis Model in Rabbit

The moxibustion experimental platform can fix the rats without restriction, and the rats can undergo multi-acupoint moxibustion in the awake state, ensuring the welfare of the rats, protecting the safety of the operators, ensuring therapeutic efficacy, and improving the efficiency of the experiment.

Using Herbal-Cake-Separated Moxibustion for the Treatment of Rats with Chronic Renal Failure

This protocol describes an effective therapy using auricular acupressure to relieve wheezing symptoms in stable chronic obstructive pulmonary disease.

Auricular Acupressure as an Adjuvant Treatment for Wheezing in Stable Chronic Obstructive Pulmonary Disease

Learn ginger moxibustion for treating diarrhea in COPD patients using this non-pharmacological therapy. This method explores the gut-respiratory connection and offers alternative treatment options.

Ginger Moxibustion, A Non-pharmacological Treatment, for Diarrhea in Patients with Chronic Obstructive Pulmonary Disease

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