top of page
Search

Acupuncture points on lung functions and inflammatory markers in patients with asthma – An interventional study

Abstract Background

Acupuncture is commonly utilized as an alternative method for managing bronchial asthma and has the added benefit of being cost-effective while improving the quality of life. Although previous studies have demonstrated the effectiveness of acupuncture in treating patients with bronchial asthma, there is a lack of evidence regarding its impact on inflammatory markers associated with the condition. Therefore, the purpose of this study was to assess the effects of acupuncture treatment on pulmonary function and blood inflammatory markers in patients diagnosed with bronchial asthma.


Methods

In this particular study, a group of 15 patients diagnosed with mild or moderate bronchial asthma were included. These patients underwent acupuncture treatment sessions lasting 20 min each, once a day, for a duration of one month. Before and after the treatment period, patients' pulmonary functions and inflammatory markers were estimated.


Results

The results of the study revealed significant improvements in pulmonary function parameters following acupuncture treatment in patients with asthma. Specifically, there was a notable increase in Forced Vital Capacity (FVC) and the ratio of Forced Expiratory Volume in one second (FEV1) to FVC. Additionally, acupuncture was associated with increased levels of Interleukin-10 (IL-10) and Dehydroepiandrosterone sulfate (DHEA-S), which is a sulphated metabolite of dehydroepiandrosterone. Also, there was a significant decrease in levels of Tumor Necrosis Factor-alpha (TNF-α), cortisol, and salivary alpha amylase (sAA).


Conclusion

These findings suggest that acupuncture treatment in patients with asthma may lead to improvements in pulmonary function and modulation of inflammatory markers. The increase in IL-10 and DHEA-S, along with the decrease in TNF-α, cortisol, and sAA, may indicate a potential anti-inflammatory effect of acupuncture in asthma management.

Introduction

Bronchial asthma is a chronic respiratory disease characterized by airway inflammation, hyperresponsiveness, and reversible airflow obstruction affecting approximately 300 million people worldwide[1]. The pathophysiology involves chronic inflammation of the airways mediated by complex interactions between inflammatory cells including eosinophils, neutrophils, T-lymphocytes, mast cells, and epithelial cells, leading to bronchial hyperresponsiveness and variable airflow obstruction [2], [3]. This inflammatory cascade results in structural changes including airway remodeling, smooth muscle hypertrophy, and mucus hypersecretion, which collectively contribute to the clinical manifestations of asthma [4].

The global burden of asthma continues to increase, with respiratory diseases representing a leading cause of morbidity and mortality worldwide, particularly in low- and middle-income countries where access to effective asthma medications remains limited [5]. Current standard management relies primarily on inhaled corticosteroids, long-acting β2-agonists, leukotriene receptor antagonists, and in severe cases, biologic therapies [6]. However, these pharmacological interventions are associated with significant side effects including growth suppression in children, increased risk of pneumonia, oral candidiasis, and in some cases, paradoxical bronchospasm [7]. Moreover, many patients experience inadequate symptom control despite optimal conventional therapy, highlighting the need for complementary therapeutic approaches [8].

Acupuncture, a cornerstone of Traditional Chinese Medicine (TCM), has emerged as a promising complementary therapy for respiratory disorders, including bronchial asthma. Studies have shown that acupuncture is effective in treating bronchial asthma, with mechanisms proposed to include modulation of the immune system, anti-inflammatory effects, bronchodilation, and regulation of neurotransmitter release [9], [10]. From a TCM perspective, asthma is often attributed to deficiency patterns involving the lung, kidney, and spleen systems, with acupuncture treatment aimed at strengthening these organ systems and restoring balance [11].

Recent systematic reviews and meta-analyses have provided increasingly robust evidence for acupuncture's efficacy in asthma management (Table 1). Results indicated that acupuncture was well-tolerated and could improve FEV1 % compared with sham/placebo acupuncture [MD 6.11, 95 % CI 0.54–11.68]. Multiple studies have demonstrated that acupuncture can significantly improve pulmonary function parameters, reduce inflammatory markers, enhance quality of life, and decrease the frequency of asthma exacerbations when used as an adjunct to conventional therapy [12], [13].

The proposed mechanisms underlying acupuncture's therapeutic effects in asthma include: [1] modulation of inflammatory cytokines including interleukin-4 (IL-4), IL-5, IL-13, and tumor necrosis factor-α (TNF-α); [2] regulation of immunoglobulin E (IgE) levels and T-helper cell balance; [3] activation of the hypothalamic-pituitary-adrenal axis leading to endogenous corticosteroid release; [4] stimulation of β-endorphin release with subsequent bronchodilation; and [5] modulation of autonomic nervous system function affecting bronchial smooth muscle tone [12], [14], [15].

Despite growing evidence supporting acupuncture's efficacy, several knowledge gaps remain. There is limited consensus regarding optimal acupoint selection, treatment frequency, and duration for maximum therapeutic benefit. Furthermore, while several studies have examined acupuncture's effects on pulmonary function, comprehensive evaluation of its impact on specific inflammatory markers and immune parameters in asthmatic patients remains incomplete. The heterogeneity in acupoint selection across different studies makes it challenging to identify the most effective treatment protocols.

Given the increasing global prevalence of asthma, the limitations of current pharmacological approaches, and the emerging evidence supporting acupuncture's therapeutic potential, there is a critical need for rigorous clinical investigations to establish standardized, evidence-based acupuncture protocols for asthma management. This study aims to address the existing knowledge gaps by systematically evaluating the effects of carefully selected acupuncture points on both pulmonary function parameters and inflammatory biomarkers in patients with bronchial asthma, thereby contributing to the development of more effective, integrative treatment approaches for this prevalent respiratory condition.


Section snippets

Subjects

A total of fifteen patients (9 Males and 6 females, 32.50 ± 9.66 yrs of mean age) having mild or moderate bronchial asthma who visited outpatient department of Respiratory medicine between August - 2018 to January - 2019 were recruited in the present study. These patients continued their routine medications throughout the study period.

Intervention details

The recruited patients received acupuncture treatment once a day for one month, in addition to their regular medications. Acupuncture points selection was done in accordance with the literature description for traditional prescription as well as the previous studies and practices using acupuncture for bronchial asthma [17]. Standardization of the selected acupuncture points was based on the expertise in clinical experiences over the past decade. The standardized acupuncture points used in the

Outcome measurements

Pulmonary function tests (PFT) were performed using RMS Helios 401. Calibration was done prior to each recording. Spirometry test was performed in standing position with their nose closed by nose clips. For the FVC maneuver, the participants were instructed to take deep maximum inhalation followed by force full (blast) exhalation for 6 s and finally inhale to starting point for the completion. Maximum of eight attempts with 5 min resting was allowed for all the participants to achieve the end

Results

The Anthropometric data of the participating patients are given in the Table 2. Following acupuncture intervention, the spirometric parameters in patients with asthma shows a significant (P = 0.04) improvement (Table 3) only in FVC, FEV1/FVC ratio. Although other variables such as FEV1(L), FEF 25–75 % (L), PEFR (L/sec) did not found to be statistical significant (p > 0.05), the observed results suggesting the post acupuncture effects with an effect size estimates (>0.50) can be applied in

Discussion

The selective improvement in FVC and FEV1/FVC ratio represents a clinically significant pattern suggesting enhanced respiratory mechanics and reduced airway obstruction.The significant improvements in FVC (p = 0.04) and FEV1/FVC ratio (p = 0.04) align with established literature demonstrating acupuncture's bronchodilatory effects. These findings corroborate previous studies showing significant FEV1 improvements [18] and FEV1/FVC ratio enhancement [13] following acupuncture intervention. The

Conclusion

These findings support acupuncture's potential as a valuable adjunctive therapy in asthma management, offering a safe and well-tolerated treatment option that may complement conventional therapeutic approaches. The moderate to large effect sizes observed across multiple parameters indicate clinical relevance and warrant larger-scale clinical trials to establish standardized treatment protocols and confirm long-term therapeutic benefits.


References (36)


 
 
bottom of page