Chronic Obstructive Pulmonary Disease
Chronic obstructive pulmonary disease (COPD) is a lung disease that gets worse over time. It makes it hard to move air in and out of the lungs. This results in coughing, wheezing, and shortness of breath. Emphysema and chronic bronchitis are two forms of COPD. Emphysema is damage to tiny air sacs of the lungs. Chronic bronchitis is damage to airways. The damage may be due to cigarette smoking, toxins, irritants, or genetics.
Treatment includes medicine to improving breathing and oxygen. In some cases, surgery may be needed to partially remove or replace the lung. Natural therapies may help to ease symptoms. They should only be used along with medical treatment. Let your care team know about any herbs or treatments you are trying.
- Acupuncture is the insertion of fine needles for symptom relief. It is thought to be help improve breathing for those with COPD.C2-C4
- N-Acetyl Cysteine (NAC) is an amino acid. It is thought to reduce the risk of flare-ups.B1, B2, B11, B13, B15, B17-B19, B21, B22 (Note: NAC may slow blood clotting.)
- Traditional Chinese exercise, such as Qigong and Tai Chi . Use movement, breathing, and meditation to cultivate the life energy that is believed to flow through the body. It is thought to promote lung function and activity tolerance. May also improve quality of life.A1-A9
May Be Effective
- Chinese herbal formulas , such as Bushen Fangchuan or Bushen Yiqi. May reduce symptoms, exercise capacity, lung function, and quality of life.B12, B16, B20
- Cineole (the main part of eucalyptus oil) may reduce symptoms.B6
- Ginseng is an herb that may improve lung function and quality of life.B8
- Osteopathic Manipulation thought to improve exercise capacity.C1
- Pelargonium sidoides is a plant that grows in Africa. It may reduce flare up when used with standard treatment.B9
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.
Herbs and Supplements to Be Used With Caution
Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse, such as:
- Creatine causes the muscles to hold water. It can cause dehydration in the rest of the body. It is important to drink extra water. Talk to you doctor if you have bipolar disorder, kidney disease, or diabetes. It may make your condition worse.
- NAC may slow blood clotting. Talk to your doctor if you have a bleeding disorder.
A1. Chan AW, Lee A, et al. Tai chi Qigong improves lung functions and activity tolerance in COPD clients: a single blind, randomized controlled trial. Complement Ther Med. 2011 Feb;19(1):3-1.
A2. Ng BH, Tsang HW, et al. Functional and psychosocial effects of health qigong in patients with COPD: a randomized controlled trial. J Altern Complement Med. 2011 Mar;17(3):243-251.
A3. Leung RW, McKeough ZJ, et al. Short-form Sun-style t’ai chi as exercise training modality in people with COPD. Eur Respir J. 2013 May;41(5):1051-1057.
A4. Chan AW, Lee A, et al. The sustaining effects of Tai chi Qigong on physiological health for COPD patients: a randomized controlled trial. Complement Ther Med. 2013 Dec;21(6):585-594.
A5. Ding M, Zhang W, et al. Effectiveness of t’ai chi and qigong on chronic obstructive pulmonary disease: a systematic review and meta-analysis. J Altern Complement Med. 2014 Feb;20(2):79-86.
A6. Xiao CM, Zhuang YC. Efficacy of Liuzijue qigong in individuals with chronic obstructive pulmonary disease in remission. J Am Geriatr Soc. 2015 Jul;63(7):1420-1425.
A7. Ngai SP, Jones AY, et al. Tai Chi for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev. 2016 Jun 7;(6):CD009953.
A8. Guo JB, Chen BL, et al. Tai Chi for improving cardiopulmonary function and quality of life in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Clin Rehabil. 2016 Aug;30(8):750-764.
A9. Luo X, Zhang J, et al. The effects of traditional Chinese exercise in patients with chronic obstructive pulmonary disease: a meta-analysis. PLoS One. 2016 Sep 2;11(9):e0161564.
Herbs and Supplements
B1. Grandjean EM, Berthet P, Ruffmann R, et al. Efficacy of oral long-term N-acetylcysteine in chronic bronchopulmonary disease: a meta-analysis of published double-blind, placebo-controlled clinical trials. Clin Ther. 2000;22:209-221.
B2. Decramer M, Rutten-van Molken M, Dekhuijzen PN, et al. Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomized on NAC Cost-Utility Study, BRONCUS): a randomised placebo-controlled trial. Lancet. 2005;365:1552-1560.
B3. Fuld JP, Kilduff LP, Neder JA, et al. Creatine supplementation during pulmonary rehabilitation in chronic obstructive pulmonary disease. Thorax. 2005;60:531-537.
B4. Faager G, Soderlund K, Skold CM, et al. Creatine supplementation and physical training in patients with COPD: a double blind, placebo-controlled study. Int J Chron Obstruct Pulmon Dis. 2006;1:445-453.
B5. Deacon SJ, Vincent EE, Greenhaff PL, et al. Randomised controlled trial of dietary creatine as an adjunct therapy to physical training in COPD. Am J Respir Crit Care Med. 2008 Apr 17.
B6. Worth H, Schacher C, et al. Concomitant therapy with Cineole (Eucalyptole) reduces exacerbations in COPD: a placebo-controlled double-blind trial. Respir Res. 2009 Jul 22;10:69.
B7. Al-Ghimlas F, Todd DC. Creatine supplementation for patients with COPD receiving pulmonary rehabilitation: a systematic review and meta-analysis. Respirology. 2010 Jul;15(5):785-795.
B8. An X, Zhang AL, et al. Oral ginseng formulae for stable chronic obstructive pulmonary disease: a systematic review. Respir Med. 2011 Feb;105(2):165-176.
B9. Matthys H, Pliskevich DA, et al. Randomised, double-blind, placebo-controlled trial of Eps 7630 in adults with COPD. Respir Med. 2013; 107(5): 691-701.
B10. Edwards L, Shirtcliffe P, et al. Use of nebulised magnesium sulphate as an adjuvant in the treatment of acute exacerbations of COPD in adults: a randomised double-blind placebo-controlled trial. Thorax. 2013 Apr;68(4):338-343.
B11. Tse HN, Raiteri L, et al. High-dose N-acetylcysteine in stable COPD: the 1-year, double-blind, randomized, placebo-controlled HIACE study. Chest. 2013 Jul;144(1):106-118.
B12. Chen X, May B, et al. Oral Chinese herbal medicine combined with pharmacotherapy for stable COPD: a systematic review of effect on BODE index and six minute walk test. PLoS One. 2014 Mar 12;9(3):e91830.
B13. Zheng JP, Wen FQ, et al. Twice daily N-acetylcysteine 600 mg for exacerbations of chronic obstructive pulmonary disease (PANTHEON): a randomised, double-blind placebo-controlled trial. Lancet Respir Med. 2014 Mar;2(3):187-194.
B14. Nouira S, Bouida W, et al. Magnesium sulfate versus ipratropium bromide in chronic obstructive pulmonary disease exacerbation: a randomized trial. Am J Ther. 2014 May-Jun;21(3):152-158.
B15. Shen Y, Cai W, et al. Effect of high/low dose N-acetylcysteine on chronic obstructive pulmonary disease: a systematic review and meta-analysis. COPD. 2014 Jun;11(3):351-358.
B16. Wang G, Liu B, et al. Effects of two Chinese herbal formulae for the treatment of moderate to severe stable chronic obstructive pulmonary disease: a multi-center, double-blind, randomized controlled trial. PLoS One. 2014 Aug 13;9(8):e103168.
B17. Tse HN, Raiteri L, et al. Benefits of high-dose N-acetylcysteine to exacerbation-prone patients with COPD. Chest. 2014 Sep;146(3):611-623.
B18. Poole P, Chong J, et al. Mucolytic agents versus placebo for chronic bronchitis or chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015 Jul 29;(7):CD001287.
B19. Cazzola M, Calzetta, et al. Influence of N-acetylcysteine on chronic bronchitis or COPD exacerbations: a meta-analysis. Eur Respir Rev. 2015 Sep;24(137):451-461.
B20. Chen Y, Shergis JL, et al. A systematic review and meta-analysis of the herbal formula Buzhong Yiqi Tang for stable chronic obstructive pulmonary disease. Complement Ther Med. 2016 Dec;29:94-108.
B21. Fowdar K, Chen H, et al. The effect of N-acetylcysteine on exacerbations of chronic obstructive pulmonary disease: a meta-analysis and systematic review. Heart Lung. 2017 Mar-Apr;46(2):120-128.
B22. Cazzola M, Rogliani P, et al. Impact of mucolytic agents on COPD exacerbations: a pair-wise and network meta-analysis. COPD. 2017 Oct;14(5):552-563.
B23. De Benedetto F, Pastorelli R, et al. Supplementation with Qter(®) and Creatine improves functional performance in COPD patients on long term oxygen therapy. Respir Med. 2018 Sep;142:86-93.
C1. Zanotti E, Berardinelli P, et al. Osteopathic manipulative treatment effectiveness in severe chronic obstructive pulmonary disease: a pilot study. Complement Ther Med. 2012 Feb-Apr;20(1-2):16-22.
C2. Suzuki M, Muro S, et al. A randomized, placebo-controlled trial of acupuncture in patients with chronic obstructive pulmonary disease (COPD): the COPD-acupuncture trial (CAT). Arch Intern Med. 2012 Jun 11;172(11):878-886.
C3. Coyle ME, Shergis JL, et al. Acupuncture therapies for chronic obstructive pulmonary disease: a systematic review of randomized, controlled trials. Altern Ther Health med. 2014 Nov-Dec;20(6):10-23.
C4. Feng J, Wang X, et al. Acupuncture for chronic obstructive pulmonary disease (COPD): a multicenter, randomized, sham-controlled trial. Medicine (Baltimore). 2016 Oct;95(40):e4879.
Last reviewed May 2019 by EBSCO NAT Review Board Last Updated: 6/14/2019