Respiratory Tract Infections and Acupuncture Treatment in Tokyo

Understanding Respiratory Tract Infections

What Are Respiratory Tract Infections?

Respiratory tract infections are infectious diseases affecting the respiratory system, divided into upper respiratory tract infections (URTIs) and lower respiratory tract infections (LRTIs). URTIs include the common cold, sinusitis, pharyngitis, and tonsillitis, while LRTIs encompass bronchitis, bronchiolitis, and pneumonia. RTIs can be acute (short-term) or chronic, with acute infections being more common.

The respiratory tract serves as a primary entry point for pathogens, making it vulnerable to infections. Inflammation caused by these pathogens leads to symptoms like nasal congestion, sore throat, cough, and difficulty breathing. While most RTIs are self-limiting, severe cases, particularly in vulnerable populations like children, the elderly, or those with compromised immunity, can lead to hospitalization or long-term complications.

Causes and Risk Factors

RTIs are caused by a variety of pathogens:

• Viruses: Responsible for most RTIs, including rhinoviruses (common cold), influenza viruses, respiratory syncytial virus (RSV), and coronaviruses (e.g., SARS-CoV-2).
• Bacteria: Common bacterial causes include Streptococcus pneumoniae (pneumonia), Haemophilus influenzae, and Mycoplasma pneumoniae.
• Fungi: Less common, but can cause infections like aspergillosis in immunocompromised individuals.

Risk factors for RTIs include:

• Age: Young children and older adults are more susceptible due to weaker immune systems.
• Seasonal Factors: RTIs peak in colder months due to increased indoor crowding and viral stability in low temperatures.
• Environmental Exposure: Air pollution, smoking, or secondhand smoke irritates the respiratory tract, increasing infection risk.
• Immune Status: Conditions like HIV, diabetes, or chemotherapy weaken immunity, heightening susceptibility.
• Crowded Settings: Schools, daycare centers, and public transportation facilitate pathogen spread.
• Poor Hygiene: Inadequate handwashing or respiratory etiquette increases transmission.

Symptoms and Complications

Symptoms of RTIs vary depending on the affected area and severity:

• Upper Respiratory Tract Infections:
  • Nasal congestion or runny nose
  • Sore throat
  • Cough (dry or productive)
  • Sneezing
  • Headache or sinus pressure
  • Mild fever or fatigue
• Lower Respiratory Tract Infections:
  • Persistent cough with mucus
  • Shortness of breath or wheezing
  • Chest pain
  • High fever or chills
  • Severe fatigue

Complications of RTIs include:

• Pneumonia: A severe LRTI that can be life-threatening, especially in the elderly or immunocompromised.
• Bronchitis: Chronic inflammation of the bronchi, leading to persistent cough.
• Sinusitis: Secondary bacterial infections of the sinuses following a viral URTI.
• Otitis Media: Ear infections, common in children with URTIs.
• Exacerbation of Chronic Conditions: RTIs can worsen asthma, chronic obstructive pulmonary disease (COPD), or heart failure.

Diagnosis

Diagnosing RTIs involves:

• Clinical Evaluation: Assessing symptoms, medical history, and physical signs like fever or lung sounds.
• Laboratory Tests: Swabs for viral or bacterial identification, or blood tests for infection markers (e.g., white blood cell count).
• Imaging: Chest X-rays or CT scans for LRTIs like pneumonia.
• Pulse Oximetry: Measures oxygen levels in severe cases.

Accurate diagnosis helps distinguish viral from bacterial infections, guiding appropriate treatment.

Conventional Treatments

Treatment for RTIs depends on the cause and severity:

• Supportive Care: Rest, hydration, and humidified air for viral URTIs. Over-the-counter medications like decongestants, antihistamines, or cough suppressants provide symptom relief.
• Antibiotics: Prescribed for bacterial RTIs, such as streptococcal pharyngitis or bacterial pneumonia. However, they are ineffective against viruses.
• Antivirals: Used for specific viral infections, like oseltamivir for influenza or remdesivir for severe COVID-19.
• Hospitalization: Required for severe LRTIs, involving oxygen therapy, intravenous fluids, or mechanical ventilation.

Limitations of conventional treatments include antibiotic resistance, side effects of medications, and lack of specific therapies for many viral RTIs. This has spurred interest in acupuncture as a complementary approach.

How Acupuncture Eases Respiratory Symptoms

What Is Acupuncture?

Acupuncture is a TOM practice that involves inserting thin, sterile needles into specific acupoints to regulate the flow of energy and blood through meridians. In TOM, health depends on the balanced flow of energy, and disruptions lead to illness. Acupuncture aims to restore this balance, promoting the body’s natural healing processes. Modern research suggests acupuncture modulates the nervous system, releases anti-inflammatory mediators, and enhances immune function, making it relevant for respiratory conditions.

For RTIs, acupuncture offers a non-invasive, drug-free option to alleviate symptoms, strengthen immunity, and reduce infection frequency. It is particularly valuable for patients seeking to complement conventional treatments or manage chronic respiratory symptoms.

Mechanisms of Acupuncture for RTIs

Acupuncture may ease respiratory symptoms through several mechanisms:

1. Immune System Enhancement: Acupuncture stimulates the production of immune cells, such as T-lymphocytes and natural killer cells, boosting resistance to pathogens. Studies show it increases immunoglobulin levels, enhancing mucosal immunity in the respiratory tract.
2. Anti-Inflammatory Effects: RTIs involve inflammation of the respiratory mucosa. Acupuncture reduces pro-inflammatory cytokines (e.g., IL-6, TNF-α) and promotes anti-inflammatory mediators (e.g., IL-10), alleviating symptoms like sore throat or cough.
3. Improved Airway Function: Acupuncture may relax bronchial smooth muscles, reducing wheezing and shortness of breath in LRTIs. It also promotes mucus clearance, easing congestion.
4. Symptom Relief: By stimulating endorphin release, acupuncture reduces pain (e.g., sore throat, headache) and improves sleep, aiding recovery.
5. Stress Reduction: Stress weakens immunity, increasing RTI susceptibility. Acupuncture activates the parasympathetic nervous system, lowering stress hormones like cortisol.
6. Prevention of Recurrence: Regular acupuncture may strengthen the body’s “wei energy” (defensive energy in TOM), reducing the frequency and severity of RTIs, especially in children or those with recurrent infections.

Evidence Supporting Acupuncture for RTIs

Research on acupuncture for RTIs, particularly URTIs, shows promising results:

• Common Cold: A 2015 systematic review in Complementary Therapies in Medicine found acupuncture reduced the duration and severity of cold symptoms compared to sham acupuncture. Electroacupuncture was particularly effective.
• Recurrent URTIs in Children: A 2020 randomized controlled trial (RCT) in Pediatrics reported that acupuncture reduced the frequency of URTIs in children by 30% over six months, with improvements in immune markers.
• Chronic Rhinitis and Sinusitis: Studies in The American Journal of Rhinology & Allergy (2018) showed acupuncture alleviated nasal congestion and improved quality of life in patients with allergic or non-allergic rhinitis.
• COPD and Bronchitis: A 2022 meta-analysis in Evidence-Based Complementary and Alternative Medicine found acupuncture improved lung function and reduced exacerbations in COPD patients, suggesting benefits for LRTIs.
• COVID-19: Preliminary studies from 2020–2021 indicated acupuncture, combined with TOM herbs, reduced respiratory symptoms and hospital stay duration in mild-to-moderate COVID-19 cases.

While these findings are encouraging, limitations include small sample sizes, variability in acupuncture protocols, and the need for larger RCTs. Acupuncture’s role in severe LRTIs like pneumonia requires further investigation.

Safety and Considerations

Acupuncture is safe when performed by licensed practitioners using sterile, single-use needles. Side effects, such as mild bruising or soreness, are rare. For RTI patients, considerations include:

• Infection Control: Practitioners must follow strict hygiene protocols to prevent cross-infection, especially during active RTIs.
• Severity Assessment: Acupuncture should not replace urgent medical care for severe LRTIs or complications like pneumonia.
• Contraindications: Patients with high fever, severe dyspnea, or bleeding disorders may require modified protocols or medical clearance.

Key Acupoints for Treating Respiratory Tract Infections

Acupoint selection is tailored to the patient’s symptoms, TOM diagnosis, and the stage of infection (acute vs. chronic). Below are key acupoints commonly used for RTIs, based on clinical studies and TOM principles:

1. Yingxiang (LI20)

• Location: In the nasolabial groove, at the midpoint of the lateral border of the ala nasi (nostril).
• Meridian: Large Intestine
• Function: Opens nasal passages, relieves congestion, and expels “wind” (TOM term for external pathogens).
• Clinical Use: Effective for nasal congestion, runny nose, and sinusitis in URTIs.

2. Fengchi (GB20)

• Location: At the base of the skull, in the depression between the sternocleidomastoid and trapezius muscles.
• Meridian: Gallbladder
• Function: Expels wind, clears heat, and promotes circulation to the head and neck.
• Clinical Use: Used for headache, sore throat, and early-stage RTIs to prevent pathogen penetration.

3. Dazhui (DU14)

• Location: On the midline of the back, below the spinous process of the seventh cervical vertebra.
• Meridian: Governor Vessel (Du Mai)
• Function: Strengthens wei energy, regulates immune function, and clears heat.
• Clinical Use: Boosts immunity and reduces fever in acute RTIs.

4. Feishu (BL13)

• Location: On the back, 1.5 finger-widths lateral to the lower border of the third thoracic vertebra.
• Meridian: Bladder
• Function: Regulates lung energy, promotes mucus clearance, and strengthens respiratory function.
• Clinical Use: Effective for cough, wheezing, and chest congestion in LRTIs.

5. Lieque (LU7)

• Location: On the radial aspect of the forearm, 1.5 finger-widths above the wrist crease, in the depression proximal to the styloid process.
• Meridian: Lung
• Function: Regulates lung energy, relieves cough, and opens the exterior (expels pathogens).
• Clinical Use: Widely used for cough, sore throat, and nasal congestion in RTIs.

6. Hegu (LI4)

• Location: On the hand, in the web between the thumb and index finger.
• Meridian: Large Intestine
• Function: Expels wind, relieves pain, and boosts immunity.
• Clinical Use: Addresses headache, fever, and sore throat while enhancing overall resistance.

7. Zusanli (ST36)

• Location: On the anterior aspect of the leg, four finger-widths below the knee, lateral to the tibia.
• Meridian: Stomach
• Function: Strengthens energy, boosts immunity, and reduces inflammation.
• Clinical Use: Supports recovery and prevents recurrent RTIs by enhancing systemic health.

8. Quchi (LI11)

• Location: At the lateral end of the elbow crease when the arm is flexed.
• Meridian: Large Intestine
• Function: Clears heat, reduces inflammation, and regulates immune function.
• Clinical Use: Used for fever, sore throat, and systemic inflammation in RTIs.

TOM Perspective on Acupoint Selection

In TOM, RTIs are often attributed to “external pathogenic invasions” (e.g., wind-cold or wind-heat) that disrupt lung energy and wei energy. Acupoints like LI20 and LU7 target local respiratory symptoms, while DU14 and ST36 strengthen systemic defenses. Practitioners may adjust selections based on the TOM pattern (e.g., wind-cold with chills vs. wind-heat with fever) and the patient’s constitution, using pulse and tongue diagnosis to guide treatment.

Acupuncture Techniques

• Manual Acupuncture: Needles are inserted and manipulated for 20–30 minutes to stimulate energy flow.
• Electroacupuncture (EA): Low-frequency stimulation at points like BL13 or LU7 enhances effects on cough and congestion.
• Moxibustion: Applying heat near points like DU14 or ST36 boosts immunity, especially for chronic or recurrent RTIs.
• Cupping Therapy: Often combined with acupuncture on the back (e.g., BL13) to promote lung energy circulation and relieve congestion.

Integrating Acupuncture with Conventional Treatments

Acupuncture complements conventional RTI management:

• With Medications: Acupuncture may reduce reliance on decongestants or cough suppressants by alleviating symptoms naturally.
• With Antibiotics: For bacterial RTIs, acupuncture supports recovery without interfering with antibiotics.
• With Preventive Measures: Acupuncture enhances immunity, complementing vaccination (e.g., influenza or pneumococcal vaccines) and hygiene practices.
• With Chronic Conditions: For patients with asthma or COPD, acupuncture reduces RTI-triggered exacerbations.

Patients should inform their healthcare providers about acupuncture to ensure coordinated care, especially in severe cases.

Practical Considerations for Patients

Finding a Qualified Acupuncturist

• Certification: Choose a practitioner licensed by a recognized body, such as the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).
• Experience: Seek acupuncturists with expertise in respiratory or immune-related conditions.
• Hygiene: Ensure sterile, single-use needles and strict infection control measures, critical during active RTIs.

Treatment Frequency and Duration

Acute RTIs may require 1–3 sessions per week for 1–2 weeks, while chronic or recurrent cases benefit from weekly sessions over 8–12 weeks, followed by maintenance treatments. Protocols vary based on symptom severity and patient response.

Future Directions and Research Needs

Acupuncture’s potential for RTIs is promising, but further research is needed to:

• Conduct large-scale RCTs to confirm efficacy across different RTI types and populations.
• Explore mechanisms, such as acupuncture’s effects on mucosal immunity or cytokine regulation.
• Standardize acupoint protocols for reproducibility.
• Evaluate cost-effectiveness compared to conventional treatments.

Ongoing studies, including those on acupuncture for post-COVID-19 respiratory symptoms, may provide further insights.

Conclusion

Respiratory tract infections are a significant public health burden, ranging from mild colds to severe pneumonias. While conventional treatments like antibiotics and supportive care are essential, acupuncture offers a complementary approach to ease symptoms, boost immunity, and prevent recurrence. Key acupoints like LI20, LU7, DU14, and ST36 target respiratory and immune functions, aligning with TOM principles of restoring balance.

For individuals seeking holistic care, acupuncture provides a safe, non-invasive option when integrated with conventional therapies. Patients with frequent RTIs, chronic respiratory conditions, or those concerned about medication side effects may find acupuncture particularly beneficial. As research continues to validate its effects, acupuncture may become a standard adjunctive therapy for respiratory health.

If you’re struggling with respiratory tract infections or seeking to strengthen your immunity, consult a healthcare provider to explore acupuncture as part of your care plan. Visit our licensed acupuncturist with experience in respiratory conditions and take a proactive step toward better breathing. Share this article to raise awareness about acupuncture’s role in managing RTIs.

Fuji Wellness:

• Address: 132-0031 Matsushima 1-chome, 21-14, Tokyo, Japan
• Chat with us: Click here
• Email: sunnyphamsensei@gmail.com