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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5 minutes

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>
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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>
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<li>Luo, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Radical+oxygen+species%3A+An+important+breakthrough+point+for+botanical+drugs+to+regulate+oxidative+stress+and+treat+the+disorder+of+glycolipid+metabolism%5BTitle%5D)+AND+%22Front+Pharmacol%22%5BJournal%5D)">Radical oxygen species: An important breakthrough point for botanical drugs to regulate oxidative stress and treat the disorder of glycolipid metabolism.</a> Front Pharmacol. 14, 1166178(2023).</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. Continuous diarrhea often causes dehydration, electrolyte disturbance, fatigue, loss of appetite, and other problems in patients, which delays the recovery of patients with COPD and hinders the selection of treatment drugs for the patients.
Ginger moxibustion is a unique non-pharmacological traditional Chinese medicine therapy. In recent years, ginger moxibustion has achieved good clinical effects in treating diarrhea. The theory of meridians and collaterals states that the Shenque acupoint is an essential acupoint on the Ren channel. The Shenque acupoint is connected to the 12 meridians and the 12 visceral organs and the whole body29,31; it regulates the intestine, preventing diarrhea, strengthening the spleen and stomach, and regulating Yin and Yang. According to modern medicine, the navel has thin skin, high sensitivity, strong permeability, and fast absorption as it contains a large number of microvessels. Drug molecules are more accessible to pass through the corneum of the umbilical skin, enter the interstitial cell, quickly disperse into the blood, and play a role in the whole body. Moxibustion has the functions of warming meridians and collaterals, warming the middle, strengthening the spleen, and preventing diarrhea. Ginger is of immense value in treating various digestive diseases like gastric ulcerations, gastritis, dyspepsia, nausea, indigestion, belching, bloating, epigastric discomfort, and vomiting32. Ginger moxibustion on Shenque Acupoint strengthens the spleen, soothing the liver, warming kidneys, and stopping diarrhea. When we introduced it to treating diarrhea in COPD patients, we found that it also had excellent efficacy. Our experimental results show that the combined use of ginger moxibustion in the treatment of COPD accompanied by diarrhea has a better effect than conventional therapy.
Some possible accidents and countermeasures 
First, if patients feel burning when the moxa pillar is not fully burned, replace the patient&#39;s navel with a thicker piece of ginger. Second, if the moxa wick has burned out but the patient has no unmistakable warm feeling, replace it with thinner ginger slices or prick more holes in the ginger slices. Be careful that the patient is not sensitive to temperature perception. Third, if blisters appear on the patient&#39;s navel after the treatment, ask the patient to avoid touching the navel and destroying the blisters. If the blisters are too large, use disposable acupuncture needles to puncture the blisters and release the exudate without damaging the blister membrane. During the treatment, if the patient feels the need to defecate or pass gas, pause the treatment and proceed after the bowel movement; calm the patient&#39;s stress. For patients with empty stomachs, excessive stomachs, extreme fatigue, and fear of moxibustion, moxibustion should be used carefully to prevent the burning moxa from falling off, burning the skin and clothes.
Limitations 
Frequent operation: The operator needs to light the moxa cone during the treatment process, pay attention to the patient&#39;s feelings, observe the patient&#39;s skin, and replace the moxa cone, all of which will be carried out in a very short time. Insufficient sample size: This experiment mainly confirmed that the standard operation of ginger moxibustion had a significant effect on relieving diarrhea symptoms in patients with COPD lung disease, but the sample size is small. Limited effect: This operation can only control the diarrhea symptoms associated with COPD. It is necessary to identify the cause and actively control the primary disease. Given these situations, we put forward some improvement measures to facilitate the follow-up work.
Improvement measures 
There should be two medical personnel present during the operation; one is the operator, and each operation step should be skillfully mastered before the operation to avoid accidents during the operation. The other is an observer, responsible for recording the problems and accidents that may occur in operation, paying attention to the reaction of patients, and dealing with emergencies promptly. Since the sample size of this trial is small, we will continue to carry out this operation in the future to obtain more trial data to ensure the universality of this therapy.
As an effective non-pharmacological therapy, ginger moxibustion can effectively improve diarrhea. Our trial shows that ginger moxibustion can also help treat diarrhea in COPD patients. We hope our conclusions can help more researchers focus on this field and jointly alleviate the life troubles of COPD patients.

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 preparations, antibiotics, and antidiarrheal medications), and the control group only received conventional symptomatic treatment for 5 days.
Observed indicators 
The COPD Assessment Test (CAT)1 and Stool characteristics and defecation frequency (SCDF) were compared between the two groups. CAT is an 8-item questionnaire that assesses COPD patients' health status. It was developed to be applicable worldwide. SCDF is used according to the Bristol stool chart5,27 and defecation frequency score standard28. (see Table 3)
Experimental results 
We used the independent sample T-test to determine whether there were differences between the control and the treatment groups before treatment. A paired-sample T-test was used to compare the mean values before and after treatment in the groups to determine whether there were differences in efficacy.
The CAT scores between the two groups post treatment are shown in Table 4. After treatment, the mean values of CAT in both groups were lower than before treatment, and the mean CAT value in the treatment group was lower than that in the control group (P &lt; 0.05).
The SCDF scores of the two groups post treatment are shown in Table 5. After treatment, the mean SCDF values of the two groups were lower than before, and the mean SCDF value of the treatment group was lower than that of the control group (P &lt; 0.05). The results showed that the combined application of ginger moxibustion and conventional therapy could improve the symptoms of COPD and diarrhea better than conventional therapy alone.
<img alt="Traditional moxibustion setup with moxa cones, ginger, and tools for therapeutic heat application." class="xfigimg" src="/files/ftp_upload/67224/67224fig01.jpg" data-altupdatedat="1788304762000" data-alt="Figure 1"> 
Figure 1: Materials. Ginger; moxa cones; dry cotton swabs; box cutter; tweezers; iodophor cotton swabs; medical bending disc; disposable medical treatment towel; lighter. <a href="https://www.jove.com/files/ftp_upload/67224/67224fig01large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Human torso diagram with Shenque acupoint (CV8) marked, relevant for acupuncture study." class="xfigimg" src="/files/ftp_upload/67224/67224fig02.jpg" data-altupdatedat="1788304762000" data-alt="Figure 2"> 
Figure 2: Shenque acupoint (CV 8). A photograph of the Shenque acupoint as described in the national standard: Illustrations for the location of acupuncture points26. <a href="https://www.jove.com/files/ftp_upload/67224/67224fig02large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Moxibustion on shoulder; sequence: treatment setup, during treatment, post-treatment result." class="xfigimg" src="/files/ftp_upload/67224/67224fig03.jpg" data-altupdatedat="1788304762000" data-alt="Figure 3"> 
Figure 3: Before and during treatment. (A) The position of the navel (CV 8) before treatment. (B) The ignited moxibustion and ginger slices were placed on the CV 8. (C) The extinguished moxa cone. <a href="https://www.jove.com/files/ftp_upload/67224/67224fig03large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Inclusion criteria</td>
			<td>(1) The COPD patient should has  dyspnea, chronic cough or sputum productionand/or a history of exposure to risk factors for the disease. At the same time, spirometry demonstrates the presence of FEV1/FVC &lt; 0.7; 
			(2) The Definition of diarrhea met the type 5 and above for "Bristol stool chart". (Type 5 feces: Soft blobs with clear-cute dges (passed easily); Type 6 feces: Fluffy pieces with ragged edges, a mushy stool; Type 7 faeces: Watery, no solid pieces ENTIRELY LIQUID)</td>
		</tr>
		<tr>
			<td>Exclusion criteria</td>
			<td>(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 
			(5) those with known diarrhea due to other diseases</td>
		</tr>
	</tbody>
</table>
Table 1: Patient inclusion and exclusion criteria. Determine the inclusion criteria according to GOLD 20241 and Bristol stool chart6. Exclusion criteria are based on previously published literature29.
<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>GROUP</td>
			<td>Gender</td>
			<td>Age(years)</td>
			<td>BMI</td>
			<td>FEV1/FVC (%)</td>
			<td>pre-CAT</td>
			<td>pre-SCDF</td>
			<td>post-CAT</td>
			<td>post-SCDF</td>
		</tr>
		<tr>
			<td>1</td>
			<td>Male</td>
			<td>55</td>
			<td>20.07</td>
			<td>54.50</td>
			<td>23.00</td>
			<td>8.00</td>
			<td>18.00</td>
			<td>4.00</td>
		</tr>
		<tr>
			<td>1</td>
			<td>Female</td>
			<td>75</td>
			<td>26.48</td>
			<td>68.69</td>
			<td>16.00</td>
			<td>6.00</td>
			<td>15.00</td>
			<td>0.00</td>
		</tr>
		<tr>
			<td>1</td>
			<td>Male</td>
			<td>61</td>
			<td>28.13</td>
			<td>67.25</td>
			<td>21.00</td>
			<td>8.00</td>
			<td>16.00</td>
			<td>6.00</td>
		</tr>
		<tr>
			<td>1</td>
			<td>Female</td>
			<td>61</td>
			<td>34.34</td>
			<td>64.12</td>
			<td>22.00</td>
			<td>10.00</td>
			<td>17.00</td>
			<td>4.00</td>
		</tr>
		<tr>
			<td>1</td>
			<td>Female</td>
			<td>65</td>
			<td>22.18</td>
			<td>62.13</td>
			<td>20.00</td>
			<td>8.00</td>
			<td>16.00</td>
			<td>4.00</td>
		</tr>
		<tr>
			<td>1</td>
			<td>Male</td>
			<td>58</td>
			<td>31.23</td>
			<td>61.23</td>
			<td>22.00</td>
			<td>8.00</td>
			<td>17.00</td>
			<td>4.00</td>
		</tr>
		<tr>
			<td>1</td>
			<td>Male</td>
			<td>69</td>
			<td>24.54</td>
			<td>60.54</td>
			<td>21.00</td>
			<td>10.00</td>
			<td>20.00</td>
			<td>4.00</td>
		</tr>
		<tr>
			<td>1</td>
			<td>Male</td>
			<td>55</td>
			<td>18.81</td>
			<td>54.53</td>
			<td>26.00</td>
			<td>8.00</td>
			<td>20.00</td>
			<td>2.00</td>
		</tr>
		<tr>
			<td>1</td>
			<td>Female</td>
			<td>77</td>
			<td>23.78</td>
			<td>35.02</td>
			<td>27.00</td>
			<td>10.00</td>
			<td>23.00</td>
			<td>2.00</td>
		</tr>
		<tr>
			<td>2</td>
			<td>Female</td>
			<td>57</td>
			<td>23.50</td>
			<td>68.20</td>
			<td>15.00</td>
			<td>6.00</td>
			<td>15.00</td>
			<td>2.00</td>
		</tr>
		<tr>
			<td>2</td>
			<td>Female</td>
			<td>50</td>
			<td>25.97</td>
			<td>68.52</td>
			<td>18.00</td>
			<td>6.00</td>
			<td>16.00</td>
			<td>4.00</td>
		</tr>
		<tr>
			<td>2</td>
			<td>Male</td>
			<td>48</td>
			<td>20.20</td>
			<td>65.33</td>
			<td>18.00</td>
			<td>8.00</td>
			<td>16.00</td>
			<td>6.00</td>
		</tr>
		<tr>
			<td>2</td>
			<td>Male</td>
			<td>54</td>
			<td>25.14</td>
			<td>63.98</td>
			<td>17.00</td>
			<td>10.00</td>
			<td>15.00</td>
			<td>4.00</td>
		</tr>
		<tr>
			<td>2</td>
			<td>Male</td>
			<td>73</td>
			<td>29.03</td>
			<td>63.22</td>
			<td>25.00</td>
			<td>10.00</td>
			<td>23.00</td>
			<td>4.00</td>
		</tr>
		<tr>
			<td>2</td>
			<td>Female</td>
			<td>50</td>
			<td>25.39</td>
			<td>61.34</td>
			<td>22.00</td>
			<td>10.00</td>
			<td>21.00</td>
			<td>2.00</td>
		</tr>
		<tr>
			<td>2</td>
			<td>Female</td>
			<td>44</td>
			<td>22.04</td>
			<td>59.67</td>
			<td>23.00</td>
			<td>8.00</td>
			<td>19.00</td>
			<td>2.00</td>
		</tr>
		<tr>
			<td>2</td>
			<td>Female</td>
			<td>59</td>
			<td>17.12</td>
			<td>48.18</td>
			<td>26.00</td>
			<td>12.00</td>
			<td>25.00</td>
			<td>6.00</td>
		</tr>
		<tr>
			<td>2</td>
			<td>Male</td>
			<td>69</td>
			<td>24.69</td>
			<td>46.34</td>
			<td>27.00</td>
			<td>8.00</td>
			<td>25.00</td>
			<td>10.00</td>
		</tr>
	</tbody>
</table>
Table 2: Case data. Including basic patient Information (groups, sex, age, BMI, FEV1/FVC), CAT scores before treatment (preCAT), SCDF scores before treatment (preSCDF), CAT scores after treatment(postCAT), and SCDF scores after treatment(postSCDF). Abbreviations: BMI = body mass index; FEV1/FVC = (forced expiratory volume in 1 second/ forced vital capacity); COPD = chronic obstructive pulmonary disease; CAT = The COPD Assessment Test; SCDF = Stool characteristics and defecation frequency.
<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td></td>
			<td>0 score</td>
			<td>2 score</td>
			<td>4 score</td>
			<td>6 score</td>
		</tr>
		<tr>
			<td>stool property</td>
			<td>Like a sausage or snake, smoothand soft</td>
			<td>Soft blobs with clear-cut edges(passed easily)</td>
			<td>Fluffy pieces with ragged edges, amushy stool</td>
			<td>Watery, no solid pieces.Entirely Liquid</td>
		</tr>
		<tr>
			<td>Frequency of bowel movements (times/day)</td>
			<td>&lt;3</td>
			<td>3-4</td>
			<td>5-6</td>
			<td>≥7</td>
		</tr>
	</tbody>
</table>
Table 3: The SCDF Scoring Criteria. These were developed with reference to the Bristol stool chart5,27 and defecation frequency score standard28. Abbreviation: Stool characteristics and defecation frequency.
<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td></td>
			<td>Number of cases</td>
			<td>Pre-treatment</td>
			<td>Post-treatment</td>
		</tr>
		<tr>
			<td>treatment group</td>
			<td>9</td>
			<td>22.00±3.24</td>
			<td>18.00±2.55</td>
		</tr>
		<tr>
			<td>control group</td>
			<td>9</td>
			<td>21.22±4.35</td>
			<td>19.44±4.19</td>
		</tr>
	</tbody>
</table>
Table 4: The CAT scores comparison between the two groups. Scores are expressed as x ± s. Abbreviation: COPD = chronic obstructive pulmonary disease; CAT = The COPD Assessment Test.
<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td></td>
			<td>Number of cases</td>
			<td>Pre-treatment</td>
			<td>Post-treatment</td>
		</tr>
		<tr>
			<td>treatment group</td>
			<td>9</td>
			<td>8.44±1.33</td>
			<td>3.33±1.73</td>
		</tr>
		<tr>
			<td>control group</td>
			<td>9</td>
			<td>8.67±2.00</td>
			<td>4.44±2.60</td>
		</tr>
	</tbody>
</table>
Table 5: The SCDF scores comparison between the two groups. Scores are expressed as x ± s. Abbreviation: Stool characteristics and defecation frequency.

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

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