Table 1 Details from all trials

  Lau, 2008 [9]

RCT

46 (31:15)

Mild to moderate

75 (7.0)

AcuTENS at Ding Chuan (EX-B1). Frequency of 4 Hz and pulse width 200 μs. Intensity at the highest tolerable by the participant.

Placebo TENS with no electrical output at same point as treatment group

45 min

Single session

Dyspnoea (SOB VAS)

Lung Function (FEV₁, FVC)

  Liu, 2015 [10]

RCT

50 (25:25)

Moderate to very severe

66.3 (9.0)

AcuTENS at Ding Chuan (EX-B1), BL13, BL23, ST36

Frequency of 2 Hz

+ Usual treatment

Placebo TENS with no electrical output at same points as treatment group

+ Usual treatment

40 min

Every 2 days for 4 weeks (14 sessions)

Dyspnoea (DVAS after 6mwd), QoL (CAT), Exercise capacity (6mwd), Lung function (FEV₁, FVC)

  Ngai, 2010 [11]

RCT

18

Not mentioned

71.8 (1.2)

AcuTENS at Ding Chuan (EX-B1).

Frequency of 2 Hz, pulse width of 200 μs.

Placebo TENS with no electrical output at same point as treatment group

45 min

20 sessions. 5 sessions per week for 4 weeks

QoL (SGRQ)

Exercise capacity (6mwd)

Lung function (FEV₁, FVC)

  Jones, 2011 [12]

RCT

44 (25:19)

Not mentioned

69.1 (1.6)

AcuTENS at Ding Chuan (EX-B1).

Frequency of 2 Hz, pulse width of 200 μs

Placebo TENS with no electrical output at same point as treatment group

45 min

Single session

Dyspnoea (VAS)

Lung function (FEV₁, FVC,)

  Shou, 2014 [14]

RCT

30 (10:20)

Mild to moderate

I: 68.3 (10.2)

C: 70.0 (9.2)

TENS at bilateral BL13

Frequency of 4 Hz, pulse width of 200 μs

Placebo TENS with no electrical output at same point as treatment group

40 min

20 sessions. Five times a week for 4 weeks

Lung Function (FVC, FEV₁,)

  Wen, 2011 [15]

RCT

40 (14:26)

Not mentioned

I: 69.7 (8.09)

C: 66.9 (6.71)

TENS at Ding Chuan (EX-B1)

Frequency of 4 Hz, pulse width of 200 μs.

+ conventional treatment

Placebo TENS with no electrical output at same point as treatment group

+ conventional treatment

40 min

Once a day for 10 days

Lung function (FEV1, FVC)

  Öncü, 2017 [13]

RCT

70 (54:16)

Not mentioned

Not mentioned

AcuTENS at Ding Chuan (EX-B1) and LU7.

Frequency 4 Hz, pulse width of 200 μs

+Conventional treatment

Placebo TENS with no electrical output at same point as treatment group

+Conventional treatment

45 min

20 sessions. Daily at hospital and 3 times a week at home

Dyspnoea (mMRC, Borg), QoL (SGRQ)

Exercise capacity (6mwd)

  Bai, 2018 [26]

RCT

80 (44: 36)

Mild to severe

I: 64.6 (5.0)

C: 63.7 (5.2)

Moxibustion with a moxa stick at GV14 and CV17

+ Routine treatment

Routine treatment

5 min per point

Once a day for 30 days

QoL (SGRQ)

Lung Function (FEV₁,)

  Cheng, 2011 [23]

RCT

60 (42:18)

Not mentioned

I1: 65.07

I2: 68.15

C: 69. 21

I1: Heat-sensitive point’s moxibustion (gentle moxibustion at heat-sensitive points)

I2: Moxa stick. 3–5 points selected depending on symptom. BL12, BL13, BL20, BL23, LU7, LU9, CV12, ST36, SP6, KI3, ST40

+ Western medicine standard therapy

Western medicine standard therapy (Anti-inflammatory, relieve panting, eliminating phlegm to stop cough)

I1: Until diathermy disappeared and patients felt burning pain.

I2: 30 min

Once daily. 30 days

Lung function (FEV₁, FEV₁/FVC)

  Cui, 2015 [22]

RCT

60 (34:26)

Not mentioned

56 ± 8.1

Moxa sticks at GV14 and GV2

+ Routine treatment

Routine treatment

(theophylline sustained-release capsules and ambroxol tablets)

Not mentioned

Once a month for 3 months

Lung function (FEV₁, FEV₁/FVC,)

  Guang, 2017 [25]

RCT

60 (31:29)

Not mentioned

I: 56 (1)

C: 55 (2)

Moxibustion with 3 moxibustion boxes from GV14 to GV2

+ Tiotropium bromide inhalation powder spray

Tiotropium bromide inhalation powder spray

20 min

5 time per week for 12 weeks

Dyspnoea (mMRC)

QoL (CAT)

  He, 2013 [21]

RCT

93 (63:30)

Not mentioned

I: 66.11 (9.34)

C: 67.25 (8.75)

Ginger moxibustion at BL13 bilateral. Each time 3 / 5 wicks

+ Compound methoxamine capsule

Compound methoxamine capsule

Not mentioned

Once every 3 days, a total of 14 times

Oral treatment: 3 times a day for 6 weeks

Lung function (FEV₁, FEV₁/FVC, FVC)

  Liang, 2018 [27]

RCT

88 (51:37)

Moderate to severe

I: 65. 69 (7.22)

C: 65. 96 (7.19)

Heat sensitivity moxibustion between BL13 and BL17 points

+Routine treatment

Routine treatment

5 min per point

5 times a week for 8 weeks

Lung function (FEV₁, FEV₁/FVC)

  Liu, 2015 [20]

RCT

100 (61:39)

Not mentioned

67.5 (9.2)

Moxibustion therapy with moxa stick at GV14, BL13, Ding Chuan (EX-B1), ST40, ST36

+Routine treatment

Routine treatment (low flow oxygen therapy and bronchodilator and antibiotic)

30 min

Once a day for 14 days

QoL (SGRQ),

Exercise capacity (6mwd), Lung function (FEV₁, FVC, FEV₁/FVC)

  Tang, 2012 [19]

RCT

40 (29:11)

Not mentioned

I: 75.5 (13)

C: 77.8 (2.3)

Moxibustion at BL12, BL20, KI1, ST36, ST40

+ Western medicine treatment

Western medicine treatment (continuous low-flow oxygen inhalation, anti-inflammatory, relieving asthma, eliminating phlegm, stopping cough and immune support)

10-15 min

Once a day for 4 weeks

TCM syndrome (cough, phlegm, asthma, full attack time)

  Wang, 2016 [18]

RCT

70 (56:14)

Not mentioned

I: 65.2 (6.1)

C: 66.3 (6.3)

Moxibustion with moxa stick and moxibustion box at RN8, RN6, RN4, BL12, CV12, ST36

+Routine treatment

Routine treatment (oxygen therapy, nutrition support, respiratory rehabilitation)

10–15 min per point

3 treatment courses. Each course consisted in 14 daily consecutive sessions.

Lung function (FEV₁, FVC)

  Wen, 2013 [8]

RCT

108 (67:41)

Not mentioned

Not mentioned

Cone Moxibustion at BL13, BL15, BL18, BL20, BL23

Patients feel burning sensation, intolerance, to remove residual wick, replace with a new wick.

+Western medicine treatment

Western medicine treatment (spasmolytic, relieving asthma, eliminating phlegm, stopping cough drug treatment)

Not mentioned

5 times a week for 4 weeks

QoL (SGRQ)

  Yang, 2016 [17]

RCT

60 (42:18)

Not mentioned

54.1 (9.75)

Moxibustion with cones from GV3 to GV14

+Routine treatment

Routine treatment (oxygen inhalation, thiamethoxam bromide, budesonide)

2 h

9 sessions, once every 10 days for 3 months

Lung function (FEV₁, FEV₁/FVC)

  Zhang, 2016 [16]

RCT

510 (308:202)

Not mentioned

62 (9)

Moxibustion with moxa stick at BL13, BL20, GV12, LU1, CV6, ST36, ST40, KI3

+Montelukast

Montelukast (10 mg/day, oral)

5–10 min per point

4 to 6 courses during a year. Each course consisted in 10 daily sessions

Lung function (FEV₁, FEV₁/FVC)

  Zhe, 2017 [24]

RCT

80 (44:36)

Mild to severe

I: 58.2 (11.7)

C: 57.5 (12.3)

Moxibustion to 6 to 7 heat sensitive points found between the horizontal lines of BL13 and BL17

+ Conventional treatment

Conventional treatment (bronchodilators, glucocorticoids, expectorant cough and respiratory exercises)

30 to 40 min

5 times a week for 3 months

QoL (SGRQ)

Lung function (FEV₁, FEV₁/FVC)

  Wu, 2004^a [31]

  2007^b [29]

RCT

44 (36:8)

Not mentioned

Effleurage: hold, rub and press the neck and each shoulder

Press and rub GV14 3 min.

Press the CV22 for 1.5 min.

Press and rub the BL13 for 3 min.

Press and rub the BL23 for 1.5 min.

Press and rub LU10 for 3 min

Effleurage: hold, rub and press the neck and each shoulder

Rub and press Sp5 for 4 min.

Rub and press Sp3 for 4 min.

Point (using finger-tip pressure only) and press

Liv1 for 4 min.

16 min

20 sessions. Five times a week for 4 weeks.

Dyspnoea (PFSDQ-M)^a, (VAS)^b

Exercise capacity (6mwd)^a

Anxiety (SSAI)^a, Depression (GDS)^b

  Maa, 1997 [30]

CRCT

31 (19;12)

Not mentioned

67.32 (8.17)

Acupressure at LU1, LU2, LU10, PC8, ST36, LI4, GV14

+Pulmonary rehabilitation

Sham acupressure:

pressure to no specified sham points

+Pulmonary rehabilitation

1 or 2 min per acupoint

at least once a day for 6 weeks

Pulmonary rehabilitation: 21–36 sessions

Dyspnoea (mBorg and VAS)

Exercise capacity (6mwd)

Anxiety (BESC)

  Guo, 2017 [32]

RCT

200 (not mentioned)

Not mentioned

Not mentioned

Acupressure at GV14, Ding Chuan (EX-B1), BL23, BL13, BL17, CV12 and CV17

+Regular treatment

Regular treatment (drug treatment and respiratory exercises)

2–3 min per point

Once a day for 6 months

QoL (SGRQ),

Anxiety (HAM-A), Depression (HAM-D)

Pulmonary function (FEV₁, FEV₁/FVC)

  Huang, 2018 [33]

RCT

68 (not mentioned)

Not mentioned

I: 52.4 (3.9)

C: 54.4 (1.2)

Acupressure at BL13, BL20 and GV14

+ Routine drug treatment

Routine drug treatment

2 min per point

Twice a day for 3 months

Exercise capacity (6mwd),

QoL (CAT),

Pulmonary function (FEV₁, FVC, FEV₁/FVC)

  Wu, 2017 [34]

64 (38:26)

Not mentioned

73.6 (6.7)

Acupressure at GV20, GB20, Taiyang, ST36, PC6 and LI11

+ Regular treatment

Regular treatment (drug treatment, psychological nursing, health guidance and diet adjustment)

5–10 min per point

Twice a day for 4 weeks

QoL (GQOL - 74)

  Xu, 2018 [35]

RCT

98 (51:47)

Not mentioned

63.1 (15.2)

Acupressure at CV12, CV4, CV6

+ Regular treatment

Regular treatment

10 min per point

Not mentioned

Anxiety (HAM-A, SCL-90)

  Tsay, 2005 [28]

RCT

52 (25:27)

Not mentioned

73.88 (7.19)

Acupressure at LI4, PC6 and Ear ShenMen

+  3 min shoulders massage

+ Regular treatment

3 min shoulders massage + Regular treatment (inhaled bronchodilators and mechanical ventilation)

15 min

Once a day for 10 days

Dyspnoea (VAS)

Anxiety (SSAI)

  Cao L, 2012 [36]

RCT

30

Not mentioned

I: 76.9 (5.84)

C: 77.6 (5.70)

Ear acupressure with seeds at:

Shenmen, Lung, Trachea, Throat, Inter-tragus

+ Sham acupuncture

+ Usual treatment

Sham auricular therapy at irrelevant acupoint

+ Sham acupuncture

+ Usual treatment (bronchodilator, anti-inflammatory, anti-choline drug)

Pressing the seeds: 3–5 times a day

20 days

Dyspnoea (mMRC)

QoL (CAT)

Lung Function (FEV₁, FEV₁/FVC)

  Jin RF 2009 [37]

RCT

60 (39:21)

Not mentioned

Not mentioned

Ear acupressure with seed at:

Lung, Spleen, Kidney, Trachea, Under sebum, Sympathetic

+ Regular treatment

Regular treatment (eliminating phlegm, bronchodilator, regular nursing)

Not mentioned

Once a day for 12 days

Lung Function (FVC, FEV₁, FEV₁/FVC)

  Li 2017 [40]

RCT

82 (not mentioned)

Not mentioned

Not mentioned

Acupressure using magnets at: Anti-asthmatic point, Trachea, Lung, Shenmen, Occiput, Adrenal gland

+Regular treatment

Regular treatment

Press 1020 times per point

I1: once every 6 h, (at least 3 times a day) for 6 months.

I2: at least 3 times a day from 3 am to 5 am and 3 pm to 5 pm for 6 months.

Dyspnea (mMRC)

Lung function (FEV₁, FVC, FEV₁/FVC)

  Pang CL, 2014 [39]

RCT

52 (31:21)

Not mentioned

I: 62.5 (6.4)

C: 68.2(6.0)

Ear acupressure with seeds at:

Spleen, Kidney, Lung and Sanjiao

+ Inhaled Seretide

Inhaled Seretide.

Not mentioned

Press seeds 3 times a day for 3 months

Lung Function (FEV₁, FEV₁/FVC)

  Pang CL, 2016 [38]

RCT

38 (25:13)

Severe and very severe

I: 65.5 (6.4)

C: 67.2(6.3)

Ear acupressure at:

Spleen, Kidney, Lung, Sanjiao and Relieving asthma

+ Salmeterol inhalation powder

Salmeterol inhalation powder

2 min

Massage 3 times a day for 3 months

Lung Function (FEV₁, FEV₁/FVC)

  Hu ZH, 1997 [41]

RCT

32 (19:13)

Not mentioned

I: 63.5 (12.06)

C: 60.33 (12.45)

Ear acupuncture with manual needle stimulation at: Lung, Trachea and Inter-tragus

Inhaled salbutamol

30 min

1 session

Lung function (FEV₁, FVC,)

  Xiao W, 2009 [43]

RCT

60 (33:27)

Not mentioned

I: 72 (51–81)

C: 70 (48–85)

Flash Fire Cupping therapy at BL13, BL20 and BL23 + Western medicine treatment

Western medicine treatment (oxygen inhalation, spasmolytic, relieving asthma, eliminating phlegm, stopping cough treatment)

Not mentioned

28 sessions, once a day for 4 weeks

TCM syndrome integral (cough, expectoration, dyspnoea, wheezing)