This work was supported by the 2022 &#34;Tianfu Qingcheng Plan&#34; Tianfu Science and Technology Leading Talents Project (Chuan Qingcheng No. 1090), the National TCM Clinical Excellent Talents Training Program (National TCM Renjiao Letter [2022] No. 1), &#34;100 Talent Plan&#34; Project of Hospital of Chengdu University of Traditional Chinese Medicine (Hospital office [2021] 42), Special subject of scientific research of Sichuan Administration of Traditional Chinese Medicine (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. KY 2022010).
1. Equipment preparation
<ol>
	<li>Prepare disposable sterile acupuncture needles (size 0.25 mm x 40 mm), moxa sticks (size 1.2 cm x 1.2 cm), medical sterilization swabs, iodophor swabs, lighter, and several 60 mm x 60 mm cardboards (see Figure 1).</li>
</ol>
2. Doctor preparation
<ol>
	<li>Ensure that patients meet the diagnostic criteria for COPD in the Primary Care Guidelines for Chronic Obstructive Pulmonary Disease and have abdominal distension.</li>
	<li>Exclude patients with the following conditions:(1) those with skin ulceration, poor glycemic control, poor blood pressure control, and dizziness; (2) those with silicosis, tuberculosis, malignant tumors, asthma, coagulation disorders, and severe cardiac insufficiency; (3) those with rheumatic heart disease, congenital heart disease, renal failure, liver failure, and so on; (4) those with poor compliance.</li>
	<li>Wear a medical mask and hat.</li>
	<li>Wash the hands with soapy water, leave them dry, and use alcohol hand sanitizer before holding the needle to operate.</li>
</ol>
3. Patient preparation
<ol>
	<li>Ask the patient to empty the bladder.</li>
	<li>Measure the patient&#39;s blood pressure, heart rate, respiratory rate, and oxygen saturation.</li>
	<li>Make sure the skin is not damaged and festering.</li>
	<li>After the above basic signs are normal, instruct the patient to choose the supine or prone position to expose the acupuncture points.</li>
	<li>Advise the patient to inform the physician in case of discomfort during the procedure.</li>
</ol>
4. Acupoints selection
<ol>
	<li>Wipe the skin of the sites to be needled with Iodophor swabs.</li>
	<li>According to the standardized acupuncture points, choose Feishu (BL13), Taiyuan (LU9), Dingchuan (EX-B1), Zusanli (ST36), Zhongwan (RN12), Tianshu (ST25)24,25,26 (see Figure 2).</li>
</ol>
5. Acupuncture and needling manipulation
<ol>
	<li>Stretch out flat the five fingers of the left hand, and place apart the index and middle fingers at the place of stabbing.</li>
	<li>Hold the needle handle by the thumb and index finger of the right hand, the end of the middle finger is close to the point, and the finger belly is against the needle body.</li>
	<li>Press downward the thumb and index finger while the middle finger is flexed and insert the needle into the international standardized acupuncture angles and depths.</li>
	<li>Uniformly lift and thrust the needle handle along the acupuncture angle, the depth is about 3 mm, and the frequency is about 60 times/min27.</li>
	<li>Rotate the needle handle forward and backward at an angle of 180 degrees or less; the frequency is about 60 times/min until the patient feels De-qi27.</li>
</ol>
6. Place moxa sticks
<ol>
	<li>Lit the moxa sticks from the bottom 2-3 cm from the skin28 so that the patient has a warm sensation and redness on the body surface. Treatment takes about 30 min.</li>
</ol>
7. Place cardboards
<ol>
	<li>Place the 60 mm x 60 mm cardboard under the moxa sticks to prevent the ash from burning the skin until the moxa sticks burn out (see Figure 3).</li>
</ol>
8. Picking the needles
<ol>
	<li>Gently pick up the burned-out moxa sticks with the end of the bamboo swab.</li>
	<li>Gently apply pressure to the needle sites with medical sterilization swabs in the hand.</li>
	<li>Do a small twist with the needles and slowly lift them to the subcutaneous, leave them for a moment, and then remove them.</li>
	<li>After the needles come out, use medical sterilization swabs to lightly press the needle holes for a moment to prevent bleeding and reduce pain.</li>
	<li>After the needles are withdrawn, carefully check whether the needle holes are bleeding, ask the patient whether there is any discomfort, and check whether the number of needles is missing.</li>
</ol>

Warm Acupuncture and Moxibustion to Relieve COPD with Abdominal Distension

<ol>
	<li>Li, N., 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=Gut+microbiota+dysbiosis+contributes+to+the+development+of+chronic+obstructive+pulmonary+disease.">Gut microbiota dysbiosis contributes to the development of chronic obstructive pulmonary disease.</a> Respiratory Research. 22, 274 (2021).</li><li>Kirschner, S. K., 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=Intestinal+function+is+impaired+in+patients+with+chronic+obstructive+pulmonary+disease.">Intestinal function is impaired in patients with chronic obstructive pulmonary disease.</a> Clinical Nutrition. 40 (4), 2270-2277 (2021).</li><li>Sun, 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=Correlation+between+lower+gastrointestinal+tract+symptoms+and+quality+of+life+in+patients+with+stable+chronic+obstructive+pulmonary+disease.">Correlation between lower gastrointestinal tract symptoms and quality of life in patients with stable chronic obstructive pulmonary disease.</a> Journal of Traditional Chinese Medicine. 33 (5), 608-614 (2013).</li><li>Liu, J., Wu, G. <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+Da+Cheng+Qi+Tang+in+the+treatment+of+abdominal+distension+in+chronic+obstructive+pulmonary+disease.">Clinical observation of Da Cheng Qi Tang in the treatment of abdominal distension in chronic obstructive pulmonary disease.</a> Journal of Clinical Pulmonology. 11, 1188 (2007).</li><li>Kesten, S., Celli, B., Decramer, M., Leimer, I., Tashkin, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tiotropium+HandiHaler+in+the+treatment+of+COPD:+A+safety+review.">Tiotropium HandiHaler in the treatment of COPD: A safety review.</a> International Journal of Chronic Obstructive Pulmonary Disease. 4, 397-409 (2009).</li><li>Windisch, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Impact+of+home+mechanical+ventilation+on+health-related+quality+of+life.">Impact of home mechanical ventilation on health-related quality of life.</a> The European Respiratory Journal. 32 (5), 1328-1336 (2008).</li><li>Li, J. S., Li, S. Y., Wang, Z. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diagnostic+criteria+for+Chinese+medical+evidence+of+chronic+obstructive+pulmonary+disease+(2011+version).">Diagnostic criteria for Chinese medical evidence of chronic obstructive pulmonary disease (2011 version).</a> Journal of Chinese Medicine. 53 (02), 177-178 (2012).</li><li>Feng, Z., Xie, Y., Chun, L., He, W., Li, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+study+of+the+underlying+evidential+features+in+the+literature+of+stable+chronic+obstructive+pulmonary+disease+based+on+association+rules+combined+with+hidden+structure+models.">A study of the underlying evidential features in the literature of stable chronic obstructive pulmonary disease based on association rules combined with hidden structure models.</a> World Science and Technology - Modernization of Chinese Medicine. 23 (02), 552-559 (2021).</li><li>He, W., Li, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+efficacy+of+Shizi+heat+ironing+therapy+to+improve+gastrointestinal+function+in+patients+with+chronic+obstructive+pulmonary+disease.">The efficacy of Shizi heat ironing therapy to improve gastrointestinal function in patients with chronic obstructive pulmonary disease.</a> New Chinese Medicine. 44 (02), 31-32 (2012).</li><li>Commission Emergency Medical Quality Control C, Emergency Medical Branch Of Chinese Medical A, Chinese Medical Doctor Association Emergency Medical B, World Federation Of Chinese Medicine Societies Emergency Professional C, Pulmonary Disease Academy Of China Association Of Chinese M, Chinese Society For Integrated Chinese And Western Medicine Intensive Medicine Specialized C. Expert consensus of Chinese and Western medicine treatment on acute exacerbation of chronic obstructive pulmonary disease in China (2021). <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Chinese Critical Care Emergency Medicine. 33 (11), 1281-1290 (2021).</li><li>Zhong, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preliminary+study+on+the+mechanism+of+traditional+moxibustion.">Preliminary study on the mechanism of traditional moxibustion.</a> Chinese Journal of Basic Medicine of Traditional Chinese Medicine. 6, 47-48 (1999).</li><li>Liu, H. Y. T. <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+investigation+of+the+biophysical+mechanism+of+moxibustion+therapy.">A preliminary investigation of the biophysical mechanism of moxibustion therapy.</a> Chinese Acupuncture. 10, 17-59 (1996).</li><li>Sun, D. 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=Cervical+spondylosis+of+nerve+root+type+with+qi+stagnation+and+blood+stasis+treated+with+warming+needle+with+different+lengths+of+moxa+stick:+a+randomized+controlled+trial.">Cervical spondylosis of nerve root type with qi stagnation and blood stasis treated with warming needle with different lengths of moxa stick: a randomized controlled trial.</a> Chinese Acupuncture. 42 (8), 873-878 (2022).</li><li>Zhang, H., Liu, J., Wen, S., Tian, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+of+warm+acupuncture+in+treating+patients+with+gouty+arthritis+of+the+knee+joint+with+evidence+of+damp-heat+entrapment+and+its+effects+on+joint+pain,+joint+function+and+serum+inflammatory+indexes.">Efficacy of warm acupuncture in treating patients with gouty arthritis of the knee joint with evidence of damp-heat entrapment and its effects on joint pain, joint function and serum inflammatory indexes.</a> Hebei Chinese Medicine. 43 (07), 1170-1173 (2021).</li><li>Zhang, Y., Wang, S., Sun, Y., Yang, D., Sun, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+effects+of+warm+acupuncture+in+the+treatment+of+dysmenorrhea+secondary+to+cold+clotting+and+blood+stasis+type+of+adenomyosis.">Clinical effects of warm acupuncture in the treatment of dysmenorrhea secondary to cold clotting and blood stasis type of adenomyosis.</a> China Pharmaceutical Herald. 20 (05), 146-159 (2023).</li><li>Ma, Q., He, 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+Yang+deficiency+type+chronic+functional+constipation+with+warm+acupuncture+and+moxibustion+at+the+Baliao.">Clinical study on the treatment of Yang deficiency type chronic functional constipation with warm acupuncture and moxibustion at the Baliao.</a> Journal of Guangzhou University of Chinese Medicine. 40 (02), 363-367 (2023).</li><li>Wei, X., Jin, H., Yan, 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+diarrhea-type+irritable+bowel+syndrome+by+strengthening+the+spleen,+tonifying+the+spirit+and+warming+acupuncture.">Clinical study on the treatment of diarrhea-type irritable bowel syndrome by strengthening the spleen, tonifying the spirit and warming acupuncture.</a> Shanxi Traditional Chinese Medicine. 44 (02), 245-254 (2023).</li><li>Tan, L. H., 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+electroacupuncture+at+different+acupoints+on+the+expression+of+NMDA+receptors+in+ACC+and+colon+in+IBS+rats.">Effect of electroacupuncture at different acupoints on the expression of NMDA receptors in ACC and colon in IBS rats.</a> Evidence-Based Complementary and Alternative Medicine: eCAM. 2019, 4213928 (2019).</li><li>Anastasi, J. K., McMahon, D. J., Kim, G. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Symptom+management+for+irritable+bowel+syndrome:+A+pilot+randomized+controlled+trial+of+acupuncture/moxibustion.">Symptom management for irritable bowel syndrome: A pilot randomized controlled trial of acupuncture/moxibustion.</a> Gastroenterology Nursing. 32 (4), 243-255 (2009).</li><li>Wu, X., Guo, Y., Zheng, J., Liu, Z. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Protective+effect+of+warm-through+acupuncture+on+stress+gastric+mucosal+injury.">Protective effect of warm-through acupuncture on stress gastric mucosal injury.</a> Shanghai Acupuncture and Moxibustion Journal. 4, 40-41 (2001).</li><li>Zhang, 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=Efficacy+comparison+of+different+acupuncture+treatments+for+functional+dyspepsia:+A+systematic+review+with+network+meta-analysis.">Efficacy comparison of different acupuncture treatments for functional dyspepsia: A systematic review with network meta-analysis.</a> Evidence-Based Complementary and Alternative Medicine: eCAM. 2020, 3872919 (2020).</li><li>Liu, Q., 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=Rehabilitation+effects+of+acupuncture+on+the+diaphragm+dysfunction+in+chronic+obstructive+pulmonary+disease:+A+systematic+review.">Rehabilitation effects of acupuncture on the diaphragm dysfunction in chronic obstructive pulmonary disease: A systematic review.</a> International Journal of Chronic Obstructive Pulmonary Disease. 16, 2023-2037 (2021).</li><li>Xie, F., Wu, Y. P., Liu, L., Ren, J. G., Zhang, B. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Warm+acupuncture+on+chronic+obstructive+pulmonary+disease+with+phlegm-turbid+obstructing+of+the+lung:+a+randomized+controlled+trial.">Warm acupuncture on chronic obstructive pulmonary disease with phlegm-turbid obstructing of the lung: a randomized controlled trial.</a> Zhongguo Zhen Jiu. 39 (9), 918-922 (2019).</li><li>Gao, 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=A+comparative+study+of+the+effects+of+warm+acupuncture+on+lung+function+and+quality+of+life+in+patients+with+stable+COPD.">A comparative study of the effects of warm acupuncture on lung function and quality of life in patients with stable COPD.</a> Chinese Acupuncture. 31 (10), 893-897 (2011).</li><li>Shi, Z., Ni, T., Wang, 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+moxibustion+combined+with+salmeterol+xinafoate+and+fluticasone+propionate+powder+for+inhalation+for+COPD+in+stable+stage.">Clinical study on moxibustion combined with salmeterol xinafoate and fluticasone propionate powder for inhalation for COPD in stable stage.</a> Chinese Medicine. 53 (14), 150-153 (2021).</li><li>Yang, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+efficacy+of+warm+acupuncture+in+55+cases+of+functional+dyspepsia.">Clinical efficacy of warm acupuncture in 55 cases of functional dyspepsia.</a> Modern Wellness. 282 (18), 170 (2016).</li><li>Yuan, Y., Hai, Y., Gu, X., Wang, Z., Peng, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preliminary+study+on+the+standardization+of+acupuncture+techniques.">Preliminary study on the standardization of acupuncture techniques.</a> Journal of Traditional Chinese Medicine. 2, 230-231 (2002).</li><li>Zhou, H. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+moxa-stick+ignition+locations+on+temperature+of+needle+body+and+surrounding+environment+during+warm+needling.">Effects of moxa-stick ignition locations on temperature of needle body and surrounding environment during warm needling.</a> Zhongguo Zhen Jiu. 34 (7), 675-677 (2014).</li><li>Chinese Medical Association. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Primary+care+guidelines+for+chronic+obstructive+pulmonary+disease+(2018).">Primary care guidelines for chronic obstructive pulmonary disease (2018).</a> Chinese Journal of General Practitioners. 11, 856-870 (2018).</li><li>Geyer, M., Guller, U., Beglinger, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Carbon+dioxide+insufflation+in+routine+colonoscopy+is+safe+and+more+comfortable:+results+of+a+randomized+controlled+double-blinded+trial.">Carbon dioxide insufflation in routine colonoscopy is safe and more comfortable: results of a randomized controlled double-blinded trial.</a> Diagnostic and Therapeutic Endoscopy. 2011, 378906 (2011).</li><li>Chen, L., Jin, X., Li, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Analysis+of+the+current+situation+and+problems+in+the+development+of+warm+acupuncture+operation+technology.">Analysis of the current situation and problems in the development of warm acupuncture operation technology.</a> Chinese Journal of Traditional Chinese Medicine. 33 (09), 3768-3771 (2018).</li><li>Huang, K., Liang, S., Sun, Z., Zhang, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Startup+mechanism+of+moxibustion+warming+and+dredging+function.">Startup mechanism of moxibustion warming and dredging function.</a> Zhongguo Zhen Jiu. 37 (9), 1023-1026 (2017).</li><li>Gao, 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=Experimental+study+on+the+effect+of+acupuncture+on+gastric+mucosal+barrier+function.">Experimental study on the effect of acupuncture on gastric mucosal barrier function.</a> China Chinese Medicine Technology. 5, 277-278 (2001).</li><li>Liang, F., Wang, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Science+of+Acupuncture+and+Moxibustion.">Science of Acupuncture and Moxibustion.</a> China Press of Traditional Chinese Medicine. 133, (2016).</li><li>Liang, F., Wang, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Science+of+Acupuncture+and+Moxibustion.">Science of Acupuncture and Moxibustion.</a> China Press of Traditional Chinese Medicine. , 136-137 (2016).</li><li>Zheng, W., Zhang, J., Shang, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ancient+Chinese+medicine+practitioners'+understanding+of+the+contraindications+of+acupuncture.">Ancient Chinese medicine practitioners' understanding of the contraindications of acupuncture.</a> Chinese Journal of Traditional Chinese Medicine. 26 (09), 1928-1930 (2011).</li><li>Shi, 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+and+Moxibustion.">Acupuncture and Moxibustion.</a> Chinese Traditional Clinical Medicine Series. , (2004).</li><li>National Standard of the People's Republic of China. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Acupuncture+technical+practice+part+1:+Moxibustion.">Acupuncture technical practice part 1: Moxibustion.</a> Chinese Acupuncture. 30 (06), 501-504 (2010).</li><li>Zhang, M., Gao, X. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+clinical+application+of+warm+acupuncture+and+penetration+moxibustion+by+professor+GAO+Xiyan.">The clinical application of warm acupuncture and penetration moxibustion by professor GAO Xiyan.</a> Zhongguo Zhen Jiu. 38 (12), 1325-1328 (2018).</li></ol>

The authors have no conflicts of interest to declare.

It is well known that the pathogenesis of abdominal distension caused by COPD is not fully understood, which hinders the development of new therapies and drugs. In recent years, warm acupuncture and moxibustion have been widely applied to COPD combined with abdominal distention.The therapeutic mechanism of warm acupuncture and moxibustion is mainly the effect of acupuncture, the moxibustion warming effect, and the heat-conducting effect of the needle body31. Moxibustion focuses on the local warmin...

Chronic obstructive pulmonary disease (COPD) is a common chronic consumptive disease of the respiratory system. Patients with COPD mainly manifest in chronic cough and sputum, with the progressive development of the disease and gradual decline in lung function. The disease may be complicated by chronic pulmonary cardiac disease, respiratory failure, and heart failure in the later stages of the disease, which seriously affects the quality of life of patients. It is reported that alterations in gut microbiota are associated with disease progression in COPD1. In addition to pulmonary symptoms, 40.31% of patients with stable COPD reported abdominal distention. Abdominal distension can have a significant impact on worsening pulmonary symptoms, increasing the frequency of acute exacerbations of COPD, and impairing the quality of life of patients with stable COPD2,3. The causes of abdominal distension in COPD are considered to be multifactorial which may include as follows: (1) dysbiosis of bacteria; (2) ascites, which increases intra-abdominal pressure; (3) electrolyte disturbances; (4) right heart failure and congestion of the liver or digestive tract; (5) prolonged bed rest4; (6) medications5 and mechanical ventilation6.
Some Chinese medicine scholars have proposed that the development process of COPD is the process of four states:(1) lung qi deficiency; (2) spleen qi deficiency; (3) kidney qi deficiency; (4) Yin and yang deficiency7,8. If the spleen fails to transport and transform and the stomach is weak and unable to receive, abdominal distension may occur, which in turn can lead to muscle thinning and weakness due to the lack of chemical sources9. At present, the drugs commonly used in the clinical treatment of COPD include bronchodilators, glucocorticoids, antibiotics, and other drugs10. There are no guidelines specifying standardized treatment protocols for COPD combined with abdominal distention, which is often treated symptomatically.
Warm acupuncture and moxibustion in traditional Chinese medicine can guide Qi to dredge the meridians, invigorate blood circulation, remove blood stasis, replenish deficiency to warm yang, and dissipate cold. They can produce antioxidant substances and thus play a regulatory role, which can promote immune system stress response and improve blood circulation11,12. Warm acupuncture and moxibustion can be used to treat cervical spondylosis13, knee arthritis14, dysmenorrhea15, constipation16, irritable bowel syndrome17, and so on. Experimental studies have turned out that acupuncture can relieve abdominal distension by regulating the brain-gut axis18. Acupuncture combined with moxibustion significantly reduces abdominal distention19, which may be exerted through the regulation of plasma prostaglandin E2 and gastrin levels in plasma and gastric mucosal tissues20. Meanwhile, warm acupuncture and moxibustion are superior to prokinetics and sham acupuncture in terms of improving the symptoms of functional dyspepsia21. Acupuncture can strengthen the diaphragm and relieve respiratory muscle fatigue, as well as improve carbon dioxide retention, and hypoxia, and prevent and relieve respiratory failure22. Warm acupuncture and moxibustion improve lung function, clinical symptoms, and quality of life in patients with stable COPD23,24.
According to the theory of Chinese medicine that &#34;The lung stands in interior-exterior relationship with the large intestine&#34;, the warming acupuncture and moxibustion treatment used in this study aim to promote the recovery of gastrointestinal function and improve pulmonary function and quality of life. Warm acupuncture and moxibustion are highly effective, easy to perform, and inexpensive forms of traditional Chinese medicine treatments. In conclusion, it is necessary to propose a standard protocol on how to properly operate the use of warm acupuncture and moxibustion to relieve COPD with abdominal distension. This article describes how to properly manipulate the use of warm acupuncture and moxibustion treatment to relieve COPD with abdominal distension.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Moxa stick</td>
			<td>Dr. Moxi</td>
			<td>N/A</td>
			<td>size: 1.2 cm x 1.2 cm</td>
		</tr>
		<tr>
			<td>Disposable sterile acupuncture needle</td>
			<td>HWATO</td>
			<td>2001-0020</td>
			<td>size:&#160; 0.25 mm x 40 mm</td>
		</tr>
		<tr>
			<td>Iodophor swabs</td>
			<td>BEIJIAER</td>
			<td>20162140536</td>
			<td></td>
		</tr>
		<tr>
			<td>Cardboard</td>
			<td>In-house</td>
			<td>In-house</td>
			<td>size: 60 mm x 60 mm&#160;</td>
		</tr>
	</tbody>
</table>

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.

General conditions 
A total of 12 patients (Table 1) with COPD combined with abdominal distension were divided into observation and control groups, with 6 cases in each group, respectively. All met the diagnostic criteria of the &#39;&#39;Primary Care Guidelines for Chronic Obstructive Pulmonary Disease (2018)&#39;&#39;29 and had abdominal distension. The control group was given pseudo-needling. We chose the same acupoints as the observation group and inserte...

Watch this Scientific Journal Video about An Effective Traditional Chinese Medicinal Treatment for Chronic Obstructive Pulmonary Disease with Abdominal Distension at JoVE.com

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.

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 ...

a-preliminary-study-on-warm-acupuncture-moxibustion-for-treating

Research

JoVE Journal

Medicine

1.3K Views.  Hospital of Chengdu University of Traditional Chinese Medicine. Here, we present a protocol to properly manipulate warm acupuncture and moxibustion for treating chronic obstructive pulmonary disease (COPD) with abdominal distension. 

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

A Component-resolved Diagnostic Approach for a Study on Grass Pollen Allergens in Chinese Southerners with Allergic Rhinitis and/or Asthma

Sensitization to grass pollen imposes a global risk for allergic airway diseases. Although prevention relies on local investigation of the pollen allergens, data on this topic are limited in southern China. Any available data were obtained by self-report questionnaires, skin prick tests, and total or specific IgE tests using crude extracts. For many reasons, these methods are unreliable. Serum sIgE reactivity to Bermuda grass, Timothy grass, and Humulus scandens allergens in a cohort of patients from Greater Guangzhou (southern China&#39;s largest city and its outskirts) with allergic rhinitis and/or asthma were examined using a fully-automated immunoassay analyzer as a component-resolved diagnostics (CRD) tool.
For the first time, a considerably high prevalence of Bermuda grass sIgE positivity was demonstrated in Chinese southerners with allergic rhinitis and/or asthma. In these patients, a subtle prevalence of sensitization to Timothy grass and Humulus scandens was also noted, which may arise from cross-reactivity, as the latter two are not common in the region. This was also supported by the detection of allergen components.
Fully-automated immunoassay analyzers may offer satisfactory consistency between regions, laboratories, and institutions and over time. The automaticity of the instrument may enable a standardized detection that would not have been readily revealed before the advent of CRD.
This is a study that uses a CRD approach to investigate sensitization to grass pollen allergens in southern China. It adds to current evidence in the literature. Future studies are needed to validate these findings. However, although CRD is a useful tool, the findings made with the fully-automated immunoassay analyzer should not substitute for other laboratory investigations, clinical evaluations, and physician expertise.

This work describes a protocol that uses a component-resolved approach to study sensitization to grass pollen allergens in a cohort of patients from southern China with allergic rhinitis and/or asthma.

Sensitization to grass pollen imposes a global risk for allergic airway diseases. Although prevention relies on local investigation of the pollen ...

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 ...

Three-Dimensional Finger Motion Tracking during Needling: A Solution for the Kinematic Analysis of Acupuncture Manipulation

Three-dimensional (3D) motion tracking has been used in many fields, such as the researches of sport and medical skills. This experiment aimed to use 3D motion tracking technology to measure the kinematic parameters of the joints of fingers during acupuncture manipulation (AM) and establish three technical indicators "amplitude, velocity and time". This method can reflect the operation characteristics of AM and provide quantitative parameters along three axes of multiple finger joints. The current evidence shows that the method has great potential for future applications such as the study of the dose-effect relationship of acupuncture, teaching, and learning of AM, and the measurement and preservation of famous acupuncturists' AM.

This experimental method describes a solution for the kinematic analysis of acupuncture manipulation with three-dimensional finger motion tracking technology.

Three-dimensional (3D) motion tracking has been used in many fields, such as the researches of sport and medical skills. This experiment aimed to use 3D ...

Improving FSN Therapy in the Rat Model&#58; Minimizing Discomfort and Maximizing Efficiency

Efficacy of Fu's Subcutaneous Needling on Sciatic Nerve Pain: Behavioral and Electrophysiological Changes in a Chronic Constriction Injury Rat Model

Fu&#39;s subcutaneous needling (FSN), an invented acupuncture technique from traditional Chinese medicine, is used worldwide for pain relief. However, the mechanisms of action are still not fully understood. During FSN treatment, the FSN needle is inserted and retained in the subcutaneous tissues for a long duration with a swaying movement. However, challenges arise from maintaining a posture while manipulating FSN in animal models (e.g., rats) for researchers. Uncomfortable treatment can lead to fear and resistance to FSN needles, increasing the risk of injury and may even affect research data. Anesthesia may also affect the study results too. Hence, there is a need for strategies in FSN therapy on animals that minimize injury during the intervention. This study employs a chronic constriction injury model in Sprague-Dawley rats to induce neuropathic pain. This model replicates the pain induced by nerve injury observed in humans through surgical constriction of a peripheral nerve, mimicking the compression or entrapment seen in conditions such as nerve compression syndromes and peripheral neuropathies. We introduce an appropriate manipulation for easily inserting an FSN needle into the subcutaneous layer of the animal&#39;s body, including needle insertion and direction, needle retention, and swaying movement. Minimizing the rat&#39;s discomfort prevents the rat from being tense, which causes the muscle to contract and hinder the entry of the needle and improves the study efficiency.

Author Spotlight: Unveiling the Therapeutic Effects of FSN Treatment &#8211; Bridging Research and Clinical Applications in Neuropathic Pain

We present a protocol for using Fu's subcutaneous needling in a chronic constriction injury model to induce sciatic nerve pain in rats.

Fu&#39;s subcutaneous needling (FSN), an invented acupuncture technique from traditional Chinese medicine, is used worldwide for pain relief. However, the ...

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.

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. ...

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 ...

Establishment of the KOA Model in Rabbits Using the Modified Videman Method

Application of Acupotomy in a Knee Osteoarthritis Model in Rabbit

Knee osteoarthritis (KOA) is one of the most frequently encountered diseases in the orthopedic department, which seriously reduces the quality of life of people with KOA. Among several pathogenic factors, the biomechanical imbalance of the knee joint is one of the main causes of KOA. Acupotomology believes that restoring the mechanical balance of the knee joint is the key to treating KOA. Clinical studies have shown that acupotomy can effectively reduce pain and improve knee mobility by reducing adhesion, contracture of soft tissues, and stress concentration points in muscles and tendons around the knee joint. 
In this protocol, we used the modified Videman method to establish a KOA model by immobilizing the left hindlimb in a straight position. We have outlined the method of operation and the precautions related to acupotomy in detail and evaluated the efficacy of acupotomy in conjunction with the theory of "Modulating Muscles and Tendons to Treat Bone Disorders" through the detection of the mechanical properties of quadriceps femoris and tendon, as well as cartilage mechanics and morphology. The results show that acupotomy has a protective effect on cartilage by adjusting the mechanical properties of the soft tissues around the knee joint, improving the cartilage stress environment, and delaying cartilage degeneration.

Author Spotlight: Investigating the Mechanism of Action of Acupotomy in Treating Knee Osteoarthritis

In this protocol, a knee osteoarthritis model was prepared using the modified Videman method, and the operation procedures and precautions of acupotomy are detailed. The effectiveness of acupotomy has been demonstrated by testing the mechanical properties of quadriceps femoris and tendon and the mechanical and morphological properties of cartilage.

Knee osteoarthritis (KOA) is one of the most frequently encountered diseases in the orthopedic department, which seriously reduces the quality of life of ...

A Moxibustion Platform for Herbal Cake-Based Treatment of Rats with Renal Failure

Using Herbal-Cake-Separated Moxibustion for the Treatment of Rats with Chronic Renal Failure

In the process of moxibustion in clinical practice, subjects need to be in a stable mood and comfortable posture to avoid problems such as moxa ash falling, scalding skin, and poor curative effect. Such problems also exist in the rat moxibustion experiment. To simulate clinical practice, it is necessary to introduce an experimental instrument in animal experiments, that is, a moxibustion device with fixed rats and moxibustion treatment synchronization, which can make experimental rats receive moxibustion treatment quietly and comfortably under non-anesthesia.
Our research group designed a rat moxibustion experimental platform. The device was framed by a wooden board with a supporting base plate, multiple fixed components, and partitioned components. The device can achieve the operation mode of moxibustion in rats without binding, avoiding anesthesia and scalding and simultaneously exposing multiple acupoints on the back. This operation can avoid physical and mental injury to rats and operators, which improves the research efficiency and further promotes the development and research of moxibustion animal experiments.
The device has a simple structure, is easy to operate and popularize, is comprehensively and innovatively designed, reusable, and is suitable for rat experiments mainly based on moxibustion. This article mainly introduces the structure of the experimental platform device for rat moxibustion, the basic procedure of herbal-cake-separated-moxibustion in experimental rats using the device and describes the establishment of a rat model of chronic renal failure (CRF) and representative experimental results.

Author Spotlight: Understanding the Effect of Herbal-Cake-Separated Moxibustion in Rats with Renal Faliure

The moxibustion experimental platform can fix the rats without restriction, and the rats can undergo multi-acupoint moxibustion in the awake state, ensuring the welfare of the rats, protecting the safety of the operators, ensuring therapeutic efficacy, and improving the efficiency of the experiment.

In the process of moxibustion in clinical practice, subjects need to be in a stable mood and comfortable posture to avoid problems such as moxa ash ...

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 ...

Advanced Lung Imaging for Disease Detection and Monitoring

Phase-Resolved Functional Lung MRI for Pulmonary Ventilation and Perfusion (V/Q) Assessment

Fourier decomposition is a contrast agent-free 1H MRI method for lung perfusion (Q) and ventilation (V) assessment. After image registration, the time series of each voxel is analyzed with regard to the cardiac and breathing frequency components.
Using a standard 2D spoiled gradient-echo sequence with a temporal resolution of ~300 ms, an image-sorting algorithm was developed to produce phase-resolved functional lung imaging (PREFUL) with an increased temporal resolution. Thus, it is feasible to evaluate regional flow volume loops (FVL) during tidal volume breathing and depict the propagation of the pulse wave during the cardiac cycle. This method can be applied at 1.5T or 3T with standard MR hardware without the necessity for sequence programming, as the described protocol can be implemented with the default SPGRE sequence on most systems.
PREFUL ventilation MRI has been validated using 129Xe and 19F gas imaging with good regional agreement. Perfusion-weighted PREFUL MRI has been validated using SPECT as well as dynamic contrast enhanced (DCE) MRI. PREFUL has been tested in a dual center dual vendor setting and is currently applied in several ongoing multicenter trials. Furthermore, it is feasible across a range of field strengths (0.55T-3T) and different age groups, including newborns.
Quantitative V/Q PREFUL MRI has been used in patients with cystic fibrosis, chronic obstructive pulmonary disease, chronic thromboembolic pulmonary hypertension, and corona virus disease-2019 to quantify disease and monitor treatment change after therapy. Furthermore, PREFUL V/Q imaging has been shown to predict transplant loss due to chronic lung allograft dysfunction in patients after lung transplantation. In summary, PREFUL MRI is a validated technique for quantitative ventilation and pulmonary pulse wave/perfusion imaging for regional pulmonary disease detection, quantification, and treatment monitoring with potential added value to the current clinical routine.

Author Spotlight: Enhancing Diagnostic Strategies and Biomarker Development for Comprehensive Lung Function Analysis

Here, we describe the implementation of phase-resolved functional lung MRI as a contrast-agent-free proton MR technique for the assessment of pulmonary ventilation and perfusion dynamics. Validated and applicable across different field strengths and age groups, it could enhance clinical decision-making in the future by aiding in disease quantification and therapy monitoring.

Fourier decomposition is a contrast agent-free 1H MRI method for lung perfusion (Q) and ventilation (V) assessment. After image registration, the time ...