Institutional Use of Tuina Therapy in the Management of Chronic Obstructive Pulmonary Disease in China and Its Policy Implications: A Comparison with the Korean Chuna Manual Therapy System

Objectives: Chronic obstructive pulmonary disease (COPD) is a major chronic respiratory disease that requires long-term, community-based management. China has designated COPD as a target condition within its national basic public health service system and has incorporated traditional Chinese medicine (TCM), including non-pharmacological therapies. This study aimed to examine the institutional use of Tuina therapy for COPD management in China and to compare it with the application of Chuna manual therapy in the Korean national health insurance system.Methods: A policy-oriented literature review was conducted using Chinese government documents, clinical guidelines, and health insurance regulations related to COPD and TCM published between 2019 and 2025. Relevant Korean policy documents, insurance regulations, and clinical guidelines were also reviewed. A qualitative comparative analysis focused on policy positioning, insurance coverage, and integration with community-based chronic disease management.Results: In China, COPD is positioned as a basic public health service target disease, and TCM is integrated into long-term disease management. Tuina therapy is recognized in clinical guidelines and, in some regions, included in medical service pricing and insurance reimbursement. In contrast, although Chuna manual therapy has been covered by the Korean national health insurance system since 2019, its use is largely limited to musculoskeletal disorders. COPD management in Korea remains centered on Western medicine–based guidelines.Conclusions: China applies a disease-centered approach integrating Tuina therapy into COPD care, whereas Korea adopts a technology-centered regulatory framework that restricts the scope of Chuna manual therapy. These differences indicate a need to reconsider the role of Korean medicine–based non-pharmacological therapies in community-based respiratory care.