Efficacy of acupuncture-based treatment in Chronic Obstructive Pulmonary Disease – A systematic review and meta-analysis

Background: The COPD population will steadily increase due to continuous exposure to COPD risk factors and the aging demographics. Acupuncture, as a common modality in complementary medicine, has been widely applied in the treatment of COPD in recent years. However, systematic reviews of the efficacy of acupuncture-based traditional Chinese external treatment in COPD are relatively scarce and when considering the quality of randomized controlled trials evidence remains insufficient. Objective: To provide an updated systematic review and meta-analysis of the effectiveness of acupuncture-based treatment for COPD using the latest data and a rigorous evaluation system. Methods: Randomized controlled trials evaluating any form of acupuncture in COPD in a stable phase or acute exacerbation phase (AECOPD) were selected from Medline, Cochrane Library, Web of Science, Embase, CNKI, the Wanfang database, VIP, and SinoMed, encompassing a publication period from January 1st, 2000, to May 1st, 2025. The completeness of each study was evaluated according to the Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Interventions in Clinical Trials of Acupuncture guidelines (STRICTA). A meta-analysis was conducted using Cochrane RevMan. Results: A total of 1294 articles were retrieved from the selected database and 25 articles meeting the criteria were included. According to CONSORT, 8 studies rated as high quality, 16 studies as moderate quality, and 1 study as low quality. Due to the heterogeneity of outcome parameters and the limited number of AECOPD studies, meta-analysis could only be performed for COPD in the stable phase. In the meta-analysis, acupuncture-based treatments were significantly superior to controls in COPD in the primary outcome 6-minute walk distance (6MWD: p