Synergistic Effects of Integrating Fire Dragon Cupping with Non-Invasive Ventilation on Lung Function and Inflammatory Response in COPD Patients with Hypoxemia: A Single-Center Retrospective Study

Purpose: Chronic obstructive pulmonary disease (COPD) with hypoxemia is associated with high morbidity and mortality. Fire dragon jar moxibustion, a Traditional Chinese Medicine(TCM) therapy, may complement non-invasive ventilation (NIV). Methods: In this single-center retrospective study, 100 hospitalized COPD patients with hypoxemia (PaO 2 < 60 mmHg) received NIV alone (control, n=50) or NIV plus moxibustion (treatment, n=50). Outcomes included FEV1, PaO 2 , inflammatory markers (PCT, CRP), dyspnea (mMRC), exacerbation frequency, TCM tongue-pulse scores, 30-day readmission, oxygen dependency, and glucocorticoid use. Primary endpoints were FEV1 improvement and PaO 2 change at 12 weeks. Results: At 12 weeks, the treatment group showed greater improvement in FEV1 (17.4% vs 8.7%, P < 0.01) and PaO 2 (+6.4 mmHg vs − 1.2 mmHg, P < 0.001). PCT and CRP decreased more markedly in the treatment group (P < 0.05). Dyspnea (mMRC) decreased by 1.3 points vs 0.4 points in controls, and annual exacerbation frequency reduced by 1.8 vs 0.6 (P < 0.001). TCM tongue and pulse scores improved, with a trend from phlegm-dampness to lung qi deficiency (P < 0.05). 30-day readmission (8% vs 12%), oxygen therapy dependency (22% vs 30%), and glucocorticoid dosage (850 mg vs 1200 mg) were lower in the treatment group (P < 0.05). No serious adverse events attributable to the procedure were observed. Conclusion: Combining fire dragon jar moxibustion with NIV significantly improves lung function, oxygenation, dyspnea, inflammatory markers, and TCM syndrome in COPD patients with hypoxemia, with a favorable safety profile. Keywords: TCM, external therapy, dyspnea, acute exacerbation, oxygenation, safety