Clinical Outcomes of High-Flow Nasal Cannula Combined with Standardized Acupoint Application in Acute Exacerbations of COPD: A Retrospective Study.
4 affiliations
- 1Department of Respiratory and Critical Care Medicine, Yongjia County People's Hospital, Wenzhou, Zhejiang, 325100, People's Republic of China.
- 2Department of Pathology, Yongjia County People's Hospital, Wenzhou, Zhejiang, 325100, People's Republic of China.
- 3Department of Cardiology, Yongjia County People's Hospital, Wenzhou, Zhejiang, 325100, People's Republic of China.
- 4Department of Respiratory and Critical Care Medicine, Wenzhou Central Hospital, Wenzhou, Zhejiang, 325000, People's Republic of China.
Abstract
Purpose
To evaluate the clinical outcomes associated with adding standardized acupoint application (AA) to high-flow nasal cannula (HFNC) in hospitalized patients with acute exacerbation of COPD (AECOPD).Patients and methods
This retrospective comparative effectiveness study included 178 consecutive AECOPD patients treated between February 2024 and April 2025 who received either HFNC alone (n=89) or HFNC plus AA (n=89). All patients received guideline-based conventional care. Propensity score matching was used to adjust for baseline differences. Clinical outcomes were assessed at day 10, including a validated Traditional Chinese Medicine (TCM) syndrome-scoring scale (primary outcome), selected to holistically capture the multi-symptom response targeted by the integrative intervention, pulmonary function (FEV₁, FVC), arterial blood gases (PaO₂, PaCO₂, SaO₂), inflammatory biomarkers (IL-8, IL-17, TNF-α, hs-CRP, PCT), immune subsets (CD4⁺, CD8⁺, CD4⁺/CD8⁺ ratio), and patient-centered outcomes (CAT, mMRC, 6MWD, SGRQ).Results
The HFNC plus AA group showed a higher clinical response rate (88.76% vs 70.79%; adjusted risk difference, 17.98%; relative risk, 1.25; 95% CI, 1.08-1.46; P=0.003). The combination group demonstrated greater improvements in FEV₁ (mean difference [MD] 0.07 L), FVC (MD 0.20 L), PaO₂ (MD 5.03 mmHg), and PaCO₂ (MD -1.93 mmHg) (all P<0.05). Reductions in inflammatory markers (IL-8, IL-17, TNF-α, hs-CRP, PCT) and favorable immune modulation (increased CD4⁺/CD8⁺ ratio) were more pronounced in the HFNC plus AA group (all P<0.01). Patient-centered outcomes also favored the combination: CAT (MD -2.59), 6MWD (MD 28.53 m), and SGRQ (MD -5.76) (all P≤0.01). Adverse events were higher in the combination group (47.67% vs 32.18%; RR 1.48; 95% CI 1.02-2.16), driven primarily by local skin reactions.Conclusion
In this observational study, adding standardized AA to HFNC was associated with improved clinical outcomes and a generally manageable safety profile. However, these findings are exploratory and require prospective validation.
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BibTeX
@article{li2026clinical,
title = {{Clinical Outcomes of High-Flow Nasal Cannula Combined with Standardized Acupoint Application in Acute Exacerbations of COPD: A Retrospective Study.}},
author = {Binbin Li and Yamin Lu and Lei Pan and Xiaoyong Xu and Wengui Zhu and Dan Zhang and Shidong Zhang and Baoyi Zhang},
journal = {International journal of chronic obstructive pulmonary disease},
year = {2026},
month = oct,
doi = {10.2147/copd.s632735},
url = {https://europepmc.org/article/MED/42904141},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Clinical Outcomes of High-Flow Nasal Cannula Combined with Standardized Acupoint Application in Acute Exacerbations of COPD: A Retrospective Study.
AU - Binbin Li
AU - Yamin Lu
AU - Lei Pan
AU - Xiaoyong Xu
AU - Wengui Zhu
AU - Dan Zhang
AU - Shidong Zhang
AU - Baoyi Zhang
PY - 2026
DA - 2026/10/16
JO - International journal of chronic obstructive pulmonary disease
DO - 10.2147/copd.s632735
UR - https://europepmc.org/article/MED/42904141
AB - Purpose To evaluate the clinical outcomes associated with adding standardized acupoint application (AA) to high-flow nasal cannula (HFNC) in hospitalized patients with acute exacerbation of COPD (AECOPD).Patients and methods This retrospective comparative effectiveness study included 178 consecutive AECOPD patients treated between February 2024 and April 2025 who received either HFNC alone (n=89) or HFNC plus AA (n=89). All patients received guideline-based conventional care. Propensity score matching was used to adjust for baseline differences. Clinical outcomes were assessed at day 10, including a validated Traditional Chinese Medicine (TCM) syndrome-scoring scale (primary outcome), selected to holistically capture the multi-symptom response targeted by the integrative intervention, pulmonary function (FEV₁, FVC), arterial blood gases (PaO₂, PaCO₂, SaO₂), inflammatory biomarkers (IL-8, IL-17, TNF-α, hs-CRP, PCT), immune subsets (CD4⁺, CD8⁺, CD4⁺/CD8⁺ ratio), and patient-centered outcomes (CAT, mMRC, 6MWD, SGRQ).Results The HFNC plus AA group showed a higher clinical response rate (88.76% vs 70.79%; adjusted risk difference, 17.98%; relative risk, 1.25; 95% CI, 1.08-1.46; P=0.003). The combination group demonstrated greater improvements in FEV₁ (mean difference [MD] 0.07 L), FVC (MD 0.20 L), PaO₂ (MD 5.03 mmHg), and PaCO₂ (MD -1.93 mmHg) (all P<0.05). Reductions in inflammatory markers (IL-8, IL-17, TNF-α, hs-CRP, PCT) and favorable immune modulation (increased CD4⁺/CD8⁺ ratio) were more pronounced in the HFNC plus AA group (all P<0.01). Patient-centered outcomes also favored the combination: CAT (MD -2.59), 6MWD (MD 28.53 m), and SGRQ (MD -5.76) (all P≤0.01). Adverse events were higher in the combination group (47.67% vs 32.18%; RR 1.48; 95% CI 1.02-2.16), driven primarily by local skin reactions.Conclusion In this observational study, adding standardized AA to HFNC was associated with improved clinical outcomes and a generally manageable safety profile. However, these findings are exploratory and require prospective validation.
SN - 1176-9106
SN - 1178-2005
ER -