Tesis

Keamanan dan Efektivitas Akupunktur Tanam Benang dalam Meningkatkan Kapasitas Fungsional dan Kualitas Hidup Pasien Penyakit Paru Obstruktif Kronis = Safety and Effectiveness of Thread-Embedding Acupuncture in Improving Functional Capacity and Quality of Life in Patients With Chronic Obstructive Pulmonary Disease.

Pendahuluan: Penyakit paru obstruktif kronis (PPOK) merupakan penyakit progresif yang ditandai oleh sesak, batuk, dan produksi sputum kronis, yang berdampak pada penurunan kapasitas fungsional dan kualitas hidup. Terapi farmakologis seringkali belum mengatasi seluruh gejala, sehingga diperlukan pilihan terapi nonfarmakologis yang efektif dan aman. Akupunktur tanam benang (ATB) telah terbukti mengurangi gejala dan meningkatkan kualitas hidup pasien PPOK, namun belum ada penelitian yang menilai efek jangka menengahnya. Metode: Uji klinis acak tersamar ganda terkontrol dilakukan pada 34 pasien PPOK stabil berusia 18-70 tahun dengan indeks massa tubuh ≥18,5 kg/m2, yang dibagi secara acak menjadi dua kelompok (17 perlakuan, 17 kontrol). Kelompok perlakuan mendapatkan ATB dengan benang polidioksanon (PDO) menggunakan jarum 30G x 38mm pada titik BL13 ke EX-B1 dan ST36 bilateral sebanyak satu kali. Pada kelompok kontrol, dilakukan prosedur tiruan tanpa penetrasi kulit. Luaran meliputi six-minute walking test (6MWT), modified Medical Research Council (mMRC), COPD Assessment Test (CAT), dan St. George’s Respiratory Questionnaire (SGRQ), dinilai sebelum serta 1, 2, dan 3 bulan setelah intervensi. Semua subjek melanjutkan terapi standar masing-masing. Hasil: Dibandingkan dengan kelompok kontrol, kelompok perlakuan menunjukkan peningkatan jarak 6MWT serta perbaikan skor mMRC, CAT, dan SGRQ yang bermakna secara statistik hingga bulan ketiga. Tingkat keberhasilan terapi lebih tinggi pada kelompok perlakuan (RR=3,33; 95%CI=1,11–10,03; p=0,013) pada bulan ketiga. Kejadian eksaserbasi akut dan hospitalisasi lebih rendah pada kelompok perlakuan, sementara efek samping ringan dan serupa pada kedua kelompok. Kesimpulan: ATB dengan benang PDO efektif dan aman sebagai tambahan terhadap terapi standar dalam meningkatkan kapasitas fungsional dan kualitas hidup pasien PPOK.
Kata kunci: penyakit paru obstruktif kronis, akupunktur tanam benang, kapasitas fungsional, kualitas hidup, keamanan


Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by chronic dyspnea, cough and sputum production, leading to reduced functional capacity and quality of life. Pharmacological therapy often fails to fully control symptoms; therefore, effective and safe non-pharmacological options are needed. Threadembedding acupuncture (TEA) has been reported relieving symptoms and improving quality of life in COPD, but its medium-term effects remain unclear. Methods: A double-blind randomized controlled trial was conducted on 34 patients with stable COPD aged 18-70 years old and body mass index ≥18.5 kg/m 2, randomly assigned to an intervention (n=17) and a control group (n=17). The intervention group received one session of TEA using polydioxanone (PDO) thread with 30G x 38mm needle at BL13 to EX-B1 and ST36 bilaterally. The control group underwent a sham procedure without skin penetration. Outcomes included the six-minute walking test (6MWT), modified Medical Research Council (mMRC), COPD Assessment Test (CAT), and St. George’s Respiratory Questionnaire (SGRQ), assessed at baseline and 1, 2 and 3 months postintervention. All participants continued their standard treatment. Result: Compared with control, the intervention group showed significant improvement in 6MWT distance and in mMRC, CAT and SGRQ scores through the third month. The effective rate was higher in the intervention group (RR=3,33; 95%CI=1,11–10,03; p=0,013) at third month. Exacerbation and hospitalization rates were lower, while mild adverse events were comparable. Conclusion: TEA with PDO thread is effective and safe as an adjunct to standard treatment in improving functional capacity and quality of life in patients with COPD.
Keywords: chronic obstructive pulmonary disease, thread-embedding acupuncture, functional capacity, quality of life, safety