Clinical Outcomes of High-Flow Nasal Cannula Combined with Standardized Acupoint Application in Acute Exacerbations of COPD: A Retrospective Study

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).