<meta charset="utf8"></head><body>הערכת היעילות של מוקסיבציה של ג'ינג'ר בניהול שלשולים ב- COPD

<ol>
	<li>Venkatesan, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=GOLD+COPD+report:+2024+update.">GOLD COPD report: 2024 update.</a> Lancet Respir Med. 12 (1), 15-16 (2024).</li><li>Agusti, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Global+initiative+for+chronic+obstructive+lung+disease+2023+report:+Gold+executive+summary.">Global initiative for chronic obstructive lung disease 2023 report: Gold executive summary.</a> Eur Respir J. 61 (4), 2300239 (2023).</li><li>Quanying, H., Cuiling, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Expert+consensus+on+integrated+chinese+and+western+medicine+management+of+chronic+obstructive+pulmonary+disease+(2023+edition).">Expert consensus on integrated chinese and western medicine management of chronic obstructive pulmonary disease (2023 edition).</a> Journal of Chinese General Practice. 26 (35), 4359-4371 (2023).</li><li>Wang, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prevalence+and+risk+factors+of+chronic+obstructive+pulmonary+disease+in+china+(the+china+pulmonary+health+[cph]+study):+A+national+cross-sectional+study.">Prevalence and risk factors of chronic obstructive pulmonary disease in china (the china pulmonary health [cph] study): A national cross-sectional study.</a> Lancet. 391 (10131), 1706-1717 (2018).</li><li>Arasaradnam, R. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Guidelines+for+the+investigation+of+chronic+diarrhoea+in+adults:+British+society+of+gastroenterology,+3rd+edition.">Guidelines for the investigation of chronic diarrhoea in adults: British society of gastroenterology, 3rd edition.</a> Gut. 67 (8), 1380-1399 (2018).</li><li>Schiller, L. R., Pardi, D. S., Sellin, J. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Chronic+diarrhea:+Diagnosis+and+management.">Chronic diarrhea: Diagnosis and management.</a> Clin Gastroenterol Hepatol. 15 (2), 182-193.e3 (2017).</li><li>H&#246;genauer, C., Hammer, H. F., Krejs, G. J., Reisinger, E. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mechanisms+and+management+of+antibiotic-associated+diarrhea.">Mechanisms and management of antibiotic-associated diarrhea.</a> Clin Infect Dis. 27 (4), 702-710 (1998).</li><li>Vollenweider, D. J., Frei, A., Steurer-Stey, C. A., Garcia-Aymerich, J., Puhan, M. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Antibiotics+for+exacerbations+of+chronic+obstructive+pulmonary+disease.">Antibiotics for exacerbations of chronic obstructive pulmonary disease.</a> Cochrane Database Syst Rev. 10 (10), Cd010257 (2018).</li><li>Nord&#233;n, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nutrition+impact+symptoms+and+body+composition+in+patients+with+copd.">Nutrition impact symptoms and body composition in patients with copd.</a> Eur J Clin Nutr. 69 (2), 256-261 (2015).</li><li>Zhu, X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=effect+analysis+of+information-guided+enteral+nutrition-associated+diarrhea+treatment+process+in+patients+with+chronic+obstructive+pulmonary+disease+undergoing+continuous+non-invasive+assisted+ventilation:+A+mixed+cohort+study+of+pre-+and+post-control].">effect analysis of information-guided enteral nutrition-associated diarrhea treatment process in patients with chronic obstructive pulmonary disease undergoing continuous non-invasive assisted ventilation: A mixed cohort study of pre- and post-control].</a> Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 36 (1), 62-66 (2024).</li><li>Kuehn, B. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=For-profit+african+clinics+underuse+oral+rehydration+therapy+for+diarrhea.">For-profit african clinics underuse oral rehydration therapy for diarrhea.</a> JAMA. 311 (18), 1845 (2014).</li><li>Hempel, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Probiotics+for+the+prevention+and+treatment+of+antibiotic-associated+diarrhea.">Probiotics for the prevention and treatment of antibiotic-associated diarrhea.</a> JAMA. 307 (18), 1959-1969 (2012).</li><li>DuPont, H. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Persistent+diarrhea.">Persistent diarrhea.</a> JAMA. 315 (24), 2712-2723 (2016).</li><li>Videlock, E. J., Cremonini, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Probiotics+for+antibiotic-associated+diarrhea.">Probiotics for antibiotic-associated diarrhea.</a> JAMA. 308 (7), 665 (2012).</li><li>Walker, C. L., Black, R. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Zinc+treatment+for+serious+infections+in+young+infants.">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/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+carnivorous+diet+in+the+treatment+of+flagellate+diarrhea.">A carnivorous diet in the treatment of flagellate diarrhea.</a> JAMA. 83 (1), 23-24 (1924).</li><li>Husain, A., Korzenik, J. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nutritional+issues+and+therapy+in+inflammatory+bowel+disease.">Nutritional issues and therapy in inflammatory bowel disease.</a> Semin Gastrointest Dis. 9 (1), 21-30 (1998).</li><li>Zhuang, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+ginger-partitioned+moxibustion+combined+with+skin+needle+on+gastrointestinal+reaction+in+patients+with+malignant+tumor+chemotherapy.">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><li>Wang, Z., Jing, X., Wu, S., Yang, X. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Acupuncture+combined+with+ginger+moxibustion+on+cv+8+treatment+of+diarrhea+type+irritable+bowel+syndrome+of+spleen+and+kidney+yang+deficiency+syndrome+research.">Acupuncture combined with ginger moxibustion on cv 8 treatment of diarrhea type irritable bowel syndrome of spleen and kidney yang deficiency syndrome research.</a> Traditional Chinese Medicinal Research. 37 (05), 62-66 (2024).</li><li>Wang, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&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.">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/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+study+on+the+treatment+of+chronic+atrophic+gastritis+with+spleen+and+stomach+weakness+by+ginger+moxibustion+combined+with+weifuchun+capsule.">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/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Treatment+of+30+cases+of+diarrheal+irritable+bowel+syndrome+with+ginger+moxibustion+at+shenque+point.">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/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+observation+of+30+cases+of+diarrheal+irritable+bowel+syndrome+treated+with+ginger+and+medicinal+moxibustion+at+shenque+point.">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://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Vol. GB/T 21709.1-2008 6 General Administration of Quality Supervision, Inspection and Quarantine of the People's Republic of China. , (2008).</li><li>N. a. O. T. C Medicine. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Vol. GB/T 12346-2021 38 General Administration of Quality Supervision, Inspection and Quarantine of the People's Republic of China. , (2008).</li><li>N. a. O. T. C Medicine. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Vol. GB/T 22163-2008 71 General Administration of Quality Supervision, Inspection and Quarantine of the People's Republic of China. , (2008).</li><li>Blake, M. R., Raker, J. M., Whelan, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Validity+and+reliability+of+the+bristol+stool+form+scale+in+healthy+adults+and+patients+with+diarrhoea-predominant+irritable+bowel+syndrome.">Validity and reliability of the bristol stool form scale in healthy adults and patients with diarrhoea-predominant irritable bowel syndrome.</a> Aliment Pharmacol Ther. 44 (7), 693-703 (2016).</li><li>Shengsheng, Z., Chuijie, W., Yufeng, L., Nan, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Consensus+opinion+on+TCM+diagnosis+and+treatment+of+diarrhea+(2017).">Consensus opinion on TCM diagnosis and treatment of diarrhea (2017).</a> Journal of Traditional Chinese Medicine. 58 (14), 1256-1260 (2017).</li><li>Yu, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+preliminary+study+on+warm+acupuncture+and+moxibustion+for+treating+chronic+obstructive+pulmonary+disease+with+abdominal+distension.">A preliminary study on warm acupuncture and moxibustion for treating chronic obstructive pulmonary disease with abdominal distension.</a> J Vis Exp. (199), e65318 (2023).</li><li>Luo, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Radical+oxygen+species:+An+important+breakthrough+point+for+botanical+drugs+to+regulate+oxidative+stress+and+treat+the+disorder+of+glycolipid+metabolism.">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><li>Yuan, F., Lu, F., Guo, Y., Zhang, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Acupoint+application+combined+with+acupoint+massage+for+treating+constipation+in+a+patient+with+chronic+obstructive+pulmonary+disease.">Acupoint application combined with acupoint massage for treating constipation in a patient with chronic obstructive pulmonary disease.</a> J Vis Exp. (198), e64900 (2023).</li><li>Haniadka, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+review+of+the+gastroprotective+effects+of+ginger+(Zingiber+officinale+roscoe).">A review of the gastroprotective effects of ginger (Zingiber officinale roscoe).</a> Food Funct. 4 (6), 845-855 (2013).</li></ol>

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>box cutter</td>
			<td>Deli Group Co., LTD</td>
			<td>/</td>
			<td></td>
		</tr>
		<tr>
			<td>disposable medical treatment towel</td>
			<td>Sichuan Hualikang Medical Technology Co., LTD</td>
			<td>2024010902</td>
			<td></td>
		</tr>
		<tr>
			<td>dry cotton swabs</td>
			<td>Chengdu Zhongxin sanitary materials, LLC.</td>
			<td>20240102</td>
			<td></td>
		</tr>
		<tr>
			<td>fresh ginger</td>
			<td>Qingyang community comprehensive market</td>
			<td>/</td>
			<td></td>
		</tr>
		<tr>
			<td>iodophor cotton swabs</td>
			<td>Zhejiang Beijiaer hygiene Technology Co., LTD</td>
			<td>20231201</td>
			<td></td>
		</tr>
		<tr>
			<td>lighter</td>
			<td>Xiayi Shuntong Lighter manufacturing Co., LTD</td>
			<td>25625</td>
			<td></td>
		</tr>
		<tr>
			<td>medical bending disc</td>
			<td>HYNAUT</td>
			<td>100062487683</td>
			<td></td>
		</tr>
		<tr>
			<td>moxa sticks</td>
			<td>Nanyang Fuaitang wormwood biological products Co., LTD</td>
			<td>15941917095</td>
			<td></td>
		</tr>
		<tr>
			<td>tweezers</td>
			<td>HYSTIC</td>
			<td>100013619175</td>
			<td></td>
		</tr>
	</tbody>
</table>

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

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.

<meta charset="utf8"></head><body>מחבר זרקור: חקר טיפולים לא תרופתיים למחלות נשימה כרוניות - קישור תובנות מיקרוביום המעי לטיפול ב- COPD

ג'ינג'ר מוקסיבציה, טיפול לא תרופתי, לשלשולים בחולים עם מחלת ריאות חסימתית כרונית

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

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

272 Views.  Hospital of Chengdu University of Traditional Chinese Medicine. כאן, אנו מציגים את השיטה של שימוש moxibustion זנגביל לטיפול שלשולים בחולים עם מחלת ריאות חסימתית כרונית.

Video: מחבר זרקור: חקר טיפולים לא תרופתיים למחלות נשימה כרוניות - קישור תובנות מיקרוביום המעי לטיפול ב- COPD

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.

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

Ginger Moxibustion for Treating Diarrhea in COPD Patients

To begin, use a utility knife to cut out five pieces of ginger. Using a cotton swab, prick five small holes in each ginger piece. Now take the moxa sticks apart, and remove an appropriate amount of moxa.Need the moxa into a mass in the palm. Then shape it into a cone with a bottom diameter of approximately 0.3 centimeters and a height of 0.3 centimeters. Locate the shenshu acupoint by following the national standard, nomenclature and location of Meridian points.Disinfect an area of approximately five centimeters around the acupoint. Then cut a hole in the center of the treatment towel and lay it over the shenshu acupoint to insulate the rest of the abdomen and prevent skin burns from the burning moxa. Next place a prepared moxa cone on a piece of ginger and light it.Using tweezers, transfer the ginger piece onto the patient's shenshu acupoint. After three minutes, place a new moxa cone on top of another ginger piece and light it. Remove the used ginger and moxa cone from the patient's shenshu acupoint.Extinguish the burnt moxa cone by placing it in water and repeat this process four times, After treatment, the mean COPD assessment test score in the treatment group decreased to 18.00 from a pre-treatment score of 22.00, while the control group decreased to 19.44 from 21.22. The mean stool characteristics and defecation frequency score in the treatment group decreased to 3.33 from a pre-treatment score of 8.44 while the control group decreased to 4.44 from 8.67.