We acknowledge the financial support from the National Training Program for Clinical Excellence in Chinese Medicine (National Chinese Medicine Human Education Letter [2022] No. 1), &#34;100 Talent Plan&#34; Project of the Hospital of Chengdu University of Traditional Chinese Medicine (Hospital office [2021] 42) and Sichuan Provincial Administration of Traditional Chinese Medicine Scientific and Technological Research Program (2021MS093, 2021MS539, 2023MS608).

The clinical study protocol was reviewed and approved by the Clinical Research Approval Committee of the Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine (Record No. KY2022014).
1. Preparations before operation
<ol>
	<li>Items preparation:
	<ol>
		<li>Prepare items such as Rheum officinale Baill, normal saline, Iodine volts swab, medical tape, medical gauze, medical bending plate, hand disinfectant, and medical rubber glove (Table of Materials).</li>
		<li>Use an ultra-micro pulverizer to make 100 g of Rheum officinale Baill into powder in advance and seal it in a plastic bag for later use.</li>
		<li>Before treatment, please take 15&#160;g of Rheum officinale Baill powder and use 15 mL of normal saline to make a paste of medicinal powder. Place the paste on a curved plate.</li>
	</ol>
	</li>
	<li>Patient preparation:
	<ol>
		<li>Advise the patient to empty the bladder in advance. Let the patient lie on his/her back, bend the knees, relax, and fully expose the abdomen.</li>
	</ol>
	</li>
	<li>Operator preparation:
	<ol>
		<li>Close doors and windows, pay attention to protect the patient&#39;s privacy and prevent the patient from catching a cold.</li>
		<li>Select Shenque point (RN8) and bilateral Tianshu points (ST25) on the patient&#39;s abdomen10, and evaluate the local skin of the patient&#39;s points to ensure that the skin around the selected points is free of lesions or damage while keeping the local points clean and dry (Figure 1 and Figure 2). 
		&#8203;NOTE: The Shenque acupoint (RN8) is in the umbilical region, central umbilical cord. The Tianshu point (ST25) is located in the abdomen, 2 finger-cun each around the navel (finger-cun means the proportional unit of the thumb, 2 finger-cun equals ~6.67 cm)15.</li>
	</ol>
	</li>
</ol>
2. Operating steps
<ol>
	<li>Disinfect the hands, then press the Shenque point (RN8) and bilateral Tianshu points (ST25) of the patient&#39;s abdomen with the thumb fingertip. Press each acupuncture point 50 times, and make sure to rotate the thumb in a clockwise direction while pressing (Figure 3).
	<ol>
		<li>Change the intensity of pressing the acupoints from weak to strong. Press at ~1 s/time and at a frequency of 30-60 times/min until the patient feels a slight feeling of soreness. If the patient does not tolerate it during the procedure, stop the operation immediately.</li>
	</ol>
	</li>
	<li>Rub the palms of both hands until they are warm, then massage the patient&#39;s abdomen 50 times clockwise with the palms (Figure 4). Gradually massage from the navel to the outer circle and then from the outer circle back to the navel. 
	NOTE: The scope of the circle is centered on the navel, with 2 finger-cun as the radius, i.e., the radius is equal to ~6.67 cm.
	<ol>
		<li>Ensure the massage action is gentle and the force is not too heavy. Ensure the frequency of massage is from slow to fast, stable and moderate, about 30-50 times/min. It is best to feel slightly warm in the abdomen. If the patient develops intolerance during the procedure, stop the operation immediately.</li>
	</ol>
	</li>
	<li>Wear medical rubber gloves and use iodine volts swabs to disinfect the patient&#39;s local acupoints. Take about 3/4 of the prepared medicine from the medical bent plate, roughly divide it into 3 equal parts, make them into a shape similar to a ring (diameter x thickness of about 3 cm x 0.5 cm) and apply them to medical gauze separately.</li>
	<li>Fix the medical gauze containing the medicine to the Shenque point (RN8) and Tianshu points (ST25) in the patient&#39;s abdomen with medical tape, respectively. Remove it 6 h later.</li>
	<li>Require the patient to wear clean and breathable clothes after the acupoint application operation.
	<ol>
		<li>Ask the patient to avoid strenuous exercise to prevent the drug from falling off and flowing. Promptly remove the drug residues from the patient&#39;s local skin and assist the patient in getting dressed.</li>
		<li>Inform the patient not to scratch if the local skin is itching, burning, or painful, and remove the drug in time. Keep the local skin clean with normal saline.</li>
	</ol>
	</li>
</ol>

There are no competing financial interests in this article.

The elderly population is at high risk of COPD. Older people experience varying degrees of gastrointestinal decline, while hypoxia and reduced activities in COPD patients increase the risk of constipation. In addition, COPD patients are prone to negative psychological emotions such as nervousness, anxiety, depression, depression, and restlessness, which can cause increased pelvic floor muscle tone, resulting in paradoxical movements between rectal and canals during defecation and inhibition of intestinal peristalsis<sup ...

Chronic respiratory diseases are the third leading cause of death in the world, and COPD is the leading cause of death from chronic respiratory diseases, placing a heavy burden on both individuals and society1. China has the largest number of patients with COPD in the world: about 99 million, with a prevalence rate of 8.6%2. Constipation is a common complication in COPD patients and is associated with high levels of polypharmacy3. There is evidence that more than 39% of COPD patients experience constipation, and constipation was positively correlated with the severity of dyspnea, timing of exacerbations, and complications of COPD4.&#160;It is highly suspected that constipation is associated with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). AECOPD accelerates the disease progression in COPD patients and is the leading cause of death in COPD patients5. Therefore, it is time to pay attention to the treatment of constipation in patients with COPD.
The majority of patients manage their constipation by themselves, mainly using dietary adjustments and laxatives. Studies have shown that osmotic laxatives are often the drug of choice for people with constipation6. However, the use of medications is sometimes not effective in improving constipation symptoms. It is associated with adverse reactions or poor tolerance. Up to 50% of patients with constipation are not fully satisfied with the results of their current treatments7,8. Therefore, it is necessary to find alternative therapies with good efficacy and high security. In the treatment of chronic constipation, acupoint stimulation therapy is beginning to show some advantages9. With the guidance of the concept of holism, syndrome differentiation, and treatment, as well as meridian acupoint theory in TCM, both acupoint application and acupoint massage are used to treat diseases by stimulating specific acupuncture points on the body surface10,11. Acupoint application can make the drug directly absorbed by the local skin. It achieves the effect of channeling meridians and harmonizing qi and blood by stimulating the acupuncture points, thereby improving the symptoms of constipation10. Acupoint massage stimulates the sacral nerve, regulating defecation by increasing the interstitial cell number and controlling rhythmic contractions or peristalsis through activating bowel movements12. Numerous pharmacological and clinical studies have confirmed the clear efficacy of herbs such as Rheum officinale Baill in the treatment of constipation13,14. A demonstration of acupoint application combined with acupoint massage for treating constipation in a patient with chronic obstructive pulmonary disease is presented in this article.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Chinese herbal decoction piece rhubarb</td>
			<td>Sichuan Guoqiang Chinese Medicine Decoction Pieces Co., Ltd</td>
			<td>21120104</td>
			<td></td>
		</tr>
		<tr>
			<td>Gauze swab</td>
			<td>Shandong Angyang Medical Technology Co., Ltd</td>
			<td>2022060201</td>
			<td></td>
		</tr>
		<tr>
			<td>Hand disinfectant</td>
			<td>Gamma Disinfection Products (Foshan) Co., Ltd. Sichuan Branch</td>
			<td>CNSQV3180322A</td>
			<td></td>
		</tr>
		<tr>
			<td>Iodine volts swab</td>
			<td>Zhejiang Baigar Health Technology Co., Ltd</td>
			<td>20220301</td>
			<td></td>
		</tr>
		<tr>
			<td>Medical adhesive tape</td>
			<td>Minnesota Mining Manufacturing Medical Equipment (Shanghai) Co., Ltd</td>
			<td>2105NF8</td>
			<td></td>
		</tr>
		<tr>
			<td>Medical bending plate</td>
			<td>Shanghai Medical Instrument (Group) Co., Ltd. Surgical Instrument Factory</td>
			<td>181001</td>
			<td></td>
		</tr>
		<tr>
			<td>Medical rubber glove</td>
			<td>Shanghai Kebang Medical Latex Equipment Co., Ltd</td>
			<td>2112019S</td>
			<td></td>
		</tr>
		<tr>
			<td>Normal saline</td>
			<td>Sichuan Kelun Pharmaceutical Co., Ltd</td>
			<td>N22061906</td>
			<td></td>
		</tr>
	</tbody>
</table>

acupoint application combined with acupoint massage for treating constipation in a patient with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a common and frequent disease in elderly patients, with a tendency for progressive exacerbation. Constipation that reduces the quality of life and triggers the risk of diseases is a common concomitant symptom in patients with COPD. Currently, western medical treatment does not achieve the desired results for patients. A high recurrence rate accompanies it, whereas traditional Chinese medicine (TCM) has a long history and rich experience in treating chronic diseases. Both acupoint application and acupoint massage are characteristic therapies of TCM, with minor side effects, high safety, simple operation, and outstanding advantages. They are effective in treating constipation for patients with COPD and are considered an ideal alternative therapy for patients with chronic constipation. The purpose of this article is to introduce the method of acupoint application combined with acupoint massage for the treatment of constipation in patients with COPD, including the selection of points, items, treatment time, and operation procedure.

Patients with COPD are diagnosed and treated according to &#34;The Global Initiative for Chronic Obstructive Lung Disease&#34;, published in 202316. The diagnostic criteria for constipation referred to the &#34;Clinical Practice Guideline on the Evaluation and Management of Chronic Constipation for Chinese Adults&#34; issued by the Chinese Society of Colorectal Surgery, Chinese Society of Surgery, Chinese Medical Association in 202217. Efficacy was assessed based on the Pat...

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

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

Chronic obstructive pulmonary disease (COPD) is a common and frequent disease in elderly patients, with a tendency for progressive exacerbation. ...

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1.5K Views.  Hospital of Chengdu University of Traditional Chinese Medicine. Here we demonstrate acupoint application combined with acupoint massage for treating constipation in a patient with chronic obstructive pulmonary disease (COPD).

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

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

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation and lung parenchymal destruction. It has a very high incidence in aging populations. The current conventional therapies for COPD focus mainly on symptom-modifying drugs; thus, the development of new therapies is urgently needed. Qualified animal models of COPD could help to characterize the underlying mechanisms and can be used for new drug screening. Current COPD models, such as lipopolysaccharide (LPS) or the porcine pancreatic elastase (PPE)-induced emphysema model, generate COPD-like lesions in the lungs and airways but do not otherwise resemble the pathogenesis of human COPD. A cigarette smoke (CS)-induced model remains one of the most popular because it not only simulates COPD-like lesions in the respiratory system, but it is also based on one of the main hazardous materials that causes COPD in humans. However, the time-consuming and labor-intensive aspects of the CS-induced model dramatically limit its application in new drug screening. In this study, we successfully generated a new COPD model by exposing mice to high levels of ozone. This model demonstrated the following: 1) decreased forced expiratory volume 25, 50, and 75/forced vital capacity (FEV25/FVC, FEV50/FVC, and FEV75/FVC), indicating the deterioration of lung function; 2) enlarged lung alveoli, with lung parenchymal destruction; 3) reduced fatigue time and distance; and 4) increased inflammation. Taken together, these data demonstrate that the ozone exposure (OE) model is a reliable animal model that is similar to humans because ozone overexposure is one of the etiological factors of COPD. Additionally, it only took 6 - 8 weeks, based on our previous work, to create an OE model, whereas it requires 3 - 12 months to induce the cigarette smoke model, indicating that the OE model might be a good choice for COPD research.

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.

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation and lung parenchymal destruction. It has a very high ...

Acupoint Needle-Embedding Combined with Ironing Therapy for Postoperative Pain After Anal Surgery

Acupoint needle-embedding combined with ironing therapy is a non-drug treatment method to release postoperative pain after anal surgery. The practice is guided by traditional Chinese medicine (TCM) syndrome differentiation theory and employs acupoint stimulation and heat to alleviate pain. Although prior research has shown that these are dependable methods for pain relief, the combined effect of the two techniques has not been described. In our research, we found that compared to using diclofenac sodium enteric-coated capsules alone, adding acupoint needle-embedding combined with ironing therapy was more effective for reducing pain levels at different stages after hemorrhoid surgery. Although this technique is efficient and commonly used in clinics, due to its invasive practice, acupoint needle embedding still carries risks relating to hospital-acquired infections and broken needles. Ironing therapy, on the other hand, can result in burns and connective tissue injuries. Therefore, there is an urgent need to develop a standardized protocol for medical staff. Our protocol refines the traditional techniques and provides detailed instructions on patient preparation, operation techniques, and postoperative care to ensure the therapy is carried out safely and efficiently. By standardizing this therapy, this technique is expected to become an important complementary therapy for postoperative pain relief&#160;in hemorrhoids, which will significantly improve patients &#39;life quality after anal surgery.

The high incidence of pain after anal surgery is due to the physiological structure and pathological status of the anus. At present, the use of painkillers cannot provide satisfactory pain relief, which makes complementary therapy important. This paper proposes acupoint needle-embedding combined with ironing therapy to relieve postoperative pain.

Acupoint needle-embedding combined with ironing therapy is a non-drug treatment method to release postoperative pain after anal surgery. The practice is ...

Acupuncture Stimulation of Ears to Alleviate Sleeping Disorders in COPD Patients

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

Chronic obstructive pulmonary disease (COPD) is a clinical syndrome characterized by persistent and irreversible airflow limitation and chronic respiratory symptoms. It has a wide spectrum of complications, and sleep disorders, as part of it, are common in severe cases, especially in elderly patients. Long-term lack of sleep may lead to the aggravation of the original disease, reducing patients' quality of life. Benzodiazepines are mainly used for symptomatic treatment of COPD combined with sleep disorders. However, such drugs have the side effect of respiratory central inhibition and could probably aggravate hypoxia symptoms. Auricular acupuncture is a special method of treating physical and psychosomatic dysfunctions by stimulating specific points in the ear. This article explains the specific methods of clinical operation of auricular acupuncture in detail, including assessment of patient eligibility, medical devices used, acupuncture points, course of treatment, post-treatment care, responses to emergencies, etc. The Pittsburgh sleep quality index (PSQI) and chronic obstructive pulmonary disease assessment scale (CAT) were used as the observational index of this method. So far, clinical reports have proved that auricular acupuncture has a definite curative effect in the treatment of COPD combined with sleep disorders, and its advantages of simple operation, few adverse reactions are worthy of further study and promotion, which provide a reference for the clinical treatment of such diseases.

Author Spotlight: Utilizing Traditional Chinese Acupuncture of the Ear to Improve Sleep Disorders 

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.

Chronic obstructive pulmonary disease (COPD) is a clinical syndrome characterized by persistent and irreversible airflow limitation and chronic ...

Warm Acupuncture and Moxibustion to Relieve COPD with Abdominal Distension

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

Most patients with COPD have a combination of abdominal distension, which has been shown to adversely affect pulmonary symptoms, frequency of acute exacerbations, and quality of life in patients with COPD. Warm acupuncture and moxibustion have been shown to be effective in relieving symptoms in patients with COPD combined with abdominal distention. Warm acupuncture and moxibustion are highly effective, easy to perform, and inexpensive forms of traditional Chinese medicine treatments. The standardized practice of warm acupuncture and moxibustion is very important for the treatment of COPD combined with abdominal distension. The specific steps include selecting the appropriate acupoints for needling through syndrome differentiation treatment and selecting moxa sticks of appropriate length for moxibustion for about 30 min after the De-qi. The course of treatment lasts for one week. The following indicators are specifically assessed: the score of the COPD Assessment Test (CAT) and the abdominal distension visual analog scale (VAS). This article will clearly illustrate how to standardize the manipulation of warm acupuncture and moxibustion to relieve COPD combined with abdominal distention.

Author Spotlight: An Effective Traditional Chinese Medicinal Treatment for Chronic Obstructive Pulmonary Disease with Abdominal Distension 

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

Most patients with COPD have a combination of abdominal distension, which has been shown to adversely affect pulmonary symptoms, frequency of acute ...

Performing Warm Moxibustion on Chronic Obstructive Pulmonary Disease (COPD) Patients with Abdominal Distension

Auricular Acupuncture for Chronic Obstructive Pulmonary Disease

Traditional Chinese Medicine Ear Point Therapy for Wheezing in COPD Patients

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

Chronic obstructive pulmonary disease (COPD) is a major public health problem. Due to the restriction of expiratory airflow, it is characterized by emphysematous destruction of the lungs. Shortness of breath is one of the main clinical symptoms. Auricular acupressure is a clinical therapy characteristic of Chinese medicine that treats the disease by compressing ear points. Usually, the seeds of Vaccaria segetalis are used to stimulate ear points, which has the effect of regulating qi and alleviating wheezing. In this paper, we propose this characteristic therapy of traditional Chinese medicine (TCM) for the clinical symptoms of wheezing of lung and kidney qi deficiency type in stable COPD patients. Ear points are selected as the treatment protocol for Lung (CO14), Spleen (CO13), Kidney (CO10), Shen Men (TF4), and Ping Chuan (AT1.2.4i) points. The protocol describes a case study using auricular acupressure for a patient with chronic obstructive pulmonary disease to relieve wheezing symptoms.

Author Spotlight: Efficacy of Auricular Pressure Bean Therapy in Reducing Wheezing Symptoms

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

Chronic obstructive pulmonary disease (COPD) is a major public health problem. Due to the restriction of expiratory airflow, it is characterized by ...

Cupping Therapy as a Complementary Treatment for AECOPD Relief

Alternative Therapy for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Moving Cupping Along Meridians

Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory condition characterized by persistent and progressive airflow obstruction, resulting in chronic respiratory symptoms like dyspnea, cough, and sputum production, accompanied by wheezing, chest tightness, fatigue, and reduced physical activity. Under the influence of various factors, patients with COPD often experience acute exacerbations, which have a significant negative impact on the prognosis, quality of life, and life span of patients. As a branch of cupping therapy, moving cupping along meridians is an essential complementary therapy of the traditional Chinese medicine system. Cupping plays a unique role in treating and preventing many diseases by stimulating the local skin with negative pressure.
This article elaborately describes the procedure of moving cupping along meridians therapy in the treatment of AECOPD. The effectiveness and feasibility of moving cupping along meridians therapy in relieving symptoms and enhancing the quality of life is demonstrated by comparing the changes in the 36-item Short-Form (SF-36) health survey questionnaire, the modified Medical Research Council dyspnea scale (mMRC), and the COPD Assessment Test (CAT) score before and after the treatment. As a cost-effective complementary treatment, the protocol for the moving cupping along meridians treatment described in this article is expected to provide a reference for non-pharmacological treatment options for AECOPD.

Author Spotlight: Evaluating the Therapeutic Efficacy of Moving Cupping Along Meridians for Acute Exacerbation of COPD

This protocol presents a novel approach to alleviating the symptoms and improving the quality of life of patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) by employing moving cupping along meridians therapy to stimulate the first sideline of the bladder meridian.

Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory condition characterized by persistent and progressive airflow obstruction, ...

Acupoint and Ear Plaster Therapy for Treating Sleep Disorders in AECOPD Patients

Acupoint Application Combined with Ear Plaster Therapy for Treating Sleep Disorders with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) is a lung disease characterized by persistent airflow limitation, which is not fully reversible and progressive. Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) refers to acute changes in respiratory distress, cough, and sputum in COPD patients at baseline levels. Sleep disorders are a very common complication in patients with AECOPD. At present, long-term use of sedative-hypnotics alone has many side effects, such as mental and physical dependence and cognitive impairment. While the efficacy of other special intervention methods is not clear, and the cost is high, there is an urgent need for effective and safe treatment in clinics. Acupoint application and ear plaster therapy are considered the characteristic therapies of traditional Chinese medicine. They have the advantages of small side effects, high safety, and simple procedure. This study will elucidate in detail the specific process and efficacy of the two treatment methods for AECOPD complicated with sleep disorders, including medical devices used, selection of acupoints, procedure, and posttreatment care. This study is intended to provide a new reference for the clinical treatment modality of this type of disease.

Author Spotlight: Traditional Chinese Medicine for Sleep Disorders in Acute COPD &#8212; A Safe, Cost-Effective Approach

The present protocol describes the specific process and efficacy of the acupoint application combined with ear plaster therapy for sleep disorders in a patient with acute exacerbation of chronic obstructive pulmonary disease, including medical devices, selection of acupoints, operating methods, and posttreatment care.