---
title: "Chronic cough"
url: "https://acuiq.com/wiki/evidence/chronic-cough"
updated: 2026-10-14
last_verified: 2026-10-14
license: CC-BY-4.0
license_url: "https://creativecommons.org/licenses/by/4.0/"
section: "evidence"
basis: "Modern research"
audience: "Anyone"
published: "2026-10-14"
reading_minutes: 9
sources: 18
---

# Chronic cough

_What Cochrane, four later reviews, the sham-controlled trials of electrical acupoint stimulation around lung surgery and bronchoscopy, and the ERS, CHEST, Chinese Thoracic Society and NICE guidelines report on acupuncture and acupoint application for chronic cough._

The European Respiratory Society (ERS) [2020 guideline](https://doi.org/10.1183/13993003.01136-2019) counts a cough as chronic once it has lasted eight weeks in an adult or four weeks in a child. A [2025 review](https://doi.org/10.1016/j.imr.2025.101121) lists its common causes as upper airway cough syndrome, from the nose and sinuses, cough-variant asthma, gastro-oesophageal reflux and respiratory infections, and notes that one person can have more than one. Cough-variant asthma was first described, the ERS guideline records, as asthma in which cough is the only symptom. The trials measure cough on symptom scores rated separately for day and night, and quality of life on the Leicester Cough Questionnaire (LCQ), 19 questions in which a higher score is better. Many also report a total effective rate, the share of patients each trial judged improved by its own criteria.

## No Cochrane review

Cochrane has published no review of acupuncture, acupressure or acupoint application for cough. Its reviews of other treatments contain no acupuncture trial: the [2019 review](https://doi.org/10.1002/14651858.CD013067.pub2) by Slinger and colleagues of speech and language therapy for unexplained chronic cough found two trials with 162 adults, and the [2015 review](https://doi.org/10.1002/14651858.CD007881.pub3) by Molassiotis and colleagues of cough in cancer included 17 studies of brachytherapy, laser or photodynamic therapy and drugs, and drew no practice recommendations from them.

## Later reviews

The first three reviews below compare acupuncture or a related method with drugs, or add it to drugs and compare the result with the same drugs alone. None of their trials used sham acupuncture, a control procedure made to look like the real one ([Sham acupuncture](/wiki/research/sham-acupuncture) covers the kinds in use), so none can separate the needling from the attention that comes with it. The fourth, of cough in lung cancer, takes in the sham-controlled trial of electrical stimulation described below. A mean difference (MD) is the gap between groups in the units of the scale; I² is the share of the variation between trials that chance does not explain.

| Review | Trials | Comparison | Main finding |
| --- | --- | --- | --- |
| [Lee and colleagues 2025](https://doi.org/10.1016/j.imr.2025.101121), chronic cough of any cause, searched to February 2024 | 30, with 2,835 people | Added to conventional treatment in 23 trials; against conventional treatment or no treatment in the rest | Added to treatment: cough score 0.85 points lower (3 trials, I² 86%) and LCQ 0.88 points higher (4 trials, I² 76%) |
| [Choi, Ang and Lee 2026](https://doi.org/10.3389/fmed.2026.1712003), cough from gastro-oesophageal reflux, searched to June 2025 | 5, with 390 people | Alone or added to drugs, against drugs | Daytime cough score 0.41 points lower and nighttime 0.38 lower; LCQ 2.29 points higher |
| [Xiong and colleagues 2021](https://doi.org/10.1155/2021/6694936), cough-variant asthma | 11, with 929 people aged 1 to 82 | Alone or added to Western or Chinese medicine, against those treatments | Cough symptoms and relapse after stopping drugs better with acupuncture |
| [Cao and colleagues 2026](https://doi.org/10.1111/jocn.70289), cough in lung cancer, searched to December 2024 | 38, with 2,995 people, 22 of them testing acupuncture, moxibustion or both | Usual care, drugs, sham or no treatment | Non-drug treatments as a group improved cough severity; pulmonary rehabilitation more than the others |

The review by Lee and colleagues, from the Korea Institute of Oriental Medicine and Kyung Hee University, is the only one to take chronic cough whatever its cause. Twelve tested acupoint herbal patching, a herbal medicine patch stuck on the points; eight tested needle acupuncture, three moxibustion (heat from burning moxa held over the points), and the rest patching with acupressure, hot compresses, bloodletting or herbal injection at points. All the control groups had conventional treatment except one, which had none. The authors judged every trial at high risk of bias because neither patients nor practitioners were blinded, rated the certainty of the evidence generally moderate, and noted that no trial counted coughs. None of its trials was restricted to cough after an infection. The trials most often used [`BL13`](/points/bl13) (Feishu), in 25 of them, then [`GV14`](/points/gv14) (Dazhui), [`CV17`](/points/cv17) (Danzhong) and Dingchuan ([`XB01B`](/points/xb01b), which the review writes EX-B1).

Choi’s review, from the same institute, rated its findings moderate certainty for the cough scores and the LCQ and low for the total effective rate, downgrading for unclear blinding and small trials. Xiong’s review, from Chengdu University of Traditional Chinese Medicine, found that none of its 11 trials described how anyone was blinded or how allocation was concealed, and called their quality low. A [2022 review of acupoint application](https://doi.org/10.1155/2022/4168308) for cough-variant asthma, 13 trials with 1,237 people, was [retracted by the journal](https://doi.org/10.1155/2024/9856747) in March 2024 and is not used here. [Asthma](/wiki/evidence/asthma) reports the trials in asthma generally, [Gastro-oesophageal reflux](/wiki/evidence/gastro-oesophageal-reflux) those in reflux itself, and [COPD](/wiki/evidence/copd) those in chronic obstructive pulmonary disease.

## Trials against sham

In a [2024 trial](https://pubmed.ncbi.nlm.nih.gov/38764101/) in Shandong, Wang and colleagues randomised 110 people having keyhole lung cancer surgery to transcutaneous electrical acupoint stimulation (TEAS), current passed through pads on the skin, or to the same pads with no current. Stimulation ran for 30 minutes before anaesthesia and daily for four days afterwards at `BL13`, [`BL20`](/points/bl20) (Pishu), [`BL23`](/points/bl23) (Shenshu), [`LI04`](/points/li04) (Hegu), [`LU07`](/points/lu07) (Lieque) and [`KD03`](/points/kd03) (Taixi). The trial reported lower cough scores with TEAS from the first day to three months after surgery, and LCQ scores higher at one and three months.

In Harbin, Zhang and colleagues gave 100 people sedated for [flexible bronchoscopy](https://doi.org/10.1155/2019/5650413), a camera passed into the airways, 30 minutes of TEAS at `LI04`, [`PC06`](/points/pc06) (Neiguan) and `LU07` beforehand, or the same electrodes with the stimulator off. Patients and the bronchoscopist did not know which they had. The bronchoscopist scored cough lower in the TEAS group, which also needed less lidocaine and fentanyl; patients’ own discomfort scores did not differ.

## Added to usual care, without a sham

A [2024 trial](https://doi.org/10.1016/j.ejon.2024.102598) at Southern Medical University in Guangzhou randomised 130 people with lung cancer to routine nursing or routine nursing with seven days of acupuncture at `LU07`, [`LU09`](/points/lu09) (Taiyuan), `BL13` and `BL20`. The trial reported cough 0.32 points better on a symptom inventory with acupuncture, and no difference in sputum or breathlessness. In children, a [Guangzhou trial](https://doi.org/10.3389/fmed.2025.1580229) published in 2026 added two weeks of acupoint application to bronchodilator and inhaled steroid treatment in 50 of 100 children with chronic cough, and reported lower daytime and nighttime cough scores than in the 50 who had the drugs alone, with no adverse reactions.

At a cancer hospital in Mumbai, Solanki and colleagues tested acupressure against the cough that an intravenous dose of fentanyl, an opioid painkiller, can set off within seconds. Among [225 women](https://doi.org/10.4097/kjae.2016.69.3.234), those given finger pressure at [`KD27`](/points/kd27) (Shufu) on both sides, below the inner ends of the collarbones, coughed in 1.3% of cases, against 12.7% with undiluted fentanyl alone and 6.8% with diluted fentanyl; the severity of cough did not differ. There was no sham pressure.

## What guidelines say

The [ERS guideline](https://doi.org/10.1183/13993003.01136-2019) for adults and children, published in January 2020, does not mention acupuncture. For refractory chronic cough in adults it recommends a trial of low-dose morphine and suggests a trial of gabapentin or pregabalin, and it suggests cough control therapy, physiotherapy and speech and language therapy, as a conditional recommendation on moderate-quality evidence. The American College of Chest Physicians (CHEST) guideline on [unexplained chronic cough](https://doi.org/10.1378/chest.15-1496), published in January 2016, does not mention it either; it suggests gabapentin and multimodality speech pathology therapy.

The Chinese Thoracic Society’s English-language [guideline](https://doi.org/10.21037/jtd.2018.09.153), published in 2018 from a literature search that ended in June 2015, added a section on traditional Chinese medicine. It covers herbal prescriptions by syndrome, calls their evidence level low, and does not mention acupuncture. The society’s [2021 revision](https://pubmed.ncbi.nlm.nih.gov/35000304/), published in Chinese in January 2022, was drafted with experts in traditional Chinese medicine among other fields, according to its abstract; its full text could not be checked for acupuncture. NICE’s [NG120](https://www.nice.org.uk/guidance/ng120), published on 7 February 2019, covers antibiotics and self-care for acute cough in England and does not mention acupuncture.

## What the reviews could not settle

The reviews could not say whether any effect comes from the points stimulated. Only Cao’s review took in a sham-controlled trial, and it pooled acupuncture with rehabilitation, exercise and other non-drug treatments; Lee’s found no trial that counted coughs, so its results rest on symptom scores and questionnaires collected without blinding. They could not say how large an effect is: the 0.85-point fall in Lee’s pooled cough score comes from three trials whose I² of 86% shows them disagreeing. Every trial in Lee’s and Choi’s reviews was run in China, against drugs that differed from one trial to the next, and the sham-controlled trials above treated cough around surgery and bronchoscopy rather than a cough of months.

AcuiQ’s [chronic cough](/symptoms/cough-chronic), [cough-variant asthma](/symptoms/asthma-cough-variant), [postoperative cough](/symptoms/cough-postoperative) and [cough](/symptoms/cough) pages list the protocols individual studies prescribed, each with its citation.

### Sources

1. Morice AH, Millqvist E, Bieksiene K, et al., ERS guidelines on the diagnosis and treatment of chronic cough in adults and children, European Respiratory Journal 2020 — https://doi.org/10.1183/13993003.01136-2019
2. Lee B, Kwon CY, Jeong YK, et al., Acupuncture-related therapy for chronic cough: a systematic review and meta-analysis, Integrative Medicine Research 2025 — https://doi.org/10.1016/j.imr.2025.101121
3. Slinger C, Mehdi SB, Milan SJ, et al., Speech and language therapy for management of chronic cough, Cochrane Database of Systematic Reviews 2019 — https://doi.org/10.1002/14651858.CD013067.pub2
4. Molassiotis A, Bailey C, Caress A, Tan JY, Interventions for cough in cancer, Cochrane Database of Systematic Reviews 2015 — https://doi.org/10.1002/14651858.CD007881.pub3
5. Choi TY, Ang L, Lee MS, Efficacy of acupuncture-related therapies for gastroesophageal reflux-related chronic cough: a systematic review and meta-analysis, Frontiers in Medicine 2026 — https://doi.org/10.3389/fmed.2026.1712003
6. Xiong J, Qi W, Yang H, et al., Acupuncture treatment for cough-variant asthma: a meta-analysis, Evidence-Based Complementary and Alternative Medicine 2021 — https://doi.org/10.1155/2021/6694936
7. Cao M, Cheng X, Lee VH, Lin CC, Cheung DST, Non-pharmacological interventions for cough in patients with lung cancer: a systematic review and meta-analysis, Journal of Clinical Nursing 2026 — https://doi.org/10.1111/jocn.70289
8. Tu H, Zhang Q, Assessment of acupoint therapy of traditional Chinese medicine on cough variant asthma: a meta-analysis, BioMed Research International 2022 (retracted) — https://doi.org/10.1155/2022/4168308
9. BioMed Research International, Retracted: Assessment of acupoint therapy of traditional Chinese medicine on cough variant asthma: a meta-analysis, BioMed Research International 2024 — https://doi.org/10.1155/2024/9856747
10. Wang P, Huang M, Xu H, Liu Y, Jia S, Effect of transcutaneous electrical acupoint stimulation on postoperative cough in lung cancer patients undergoing video-assisted thoracoscopic surgery, Zhongguo Zhen Jiu 2024 (in Chinese) — https://pubmed.ncbi.nlm.nih.gov/38764101/
11. Zhang W, Yang YX, Yu W, Qi SH, Cough suppression during flexible bronchoscopy using transcutaneous electric acupoint stimulation: a randomized controlled study, Evidence-Based Complementary and Alternative Medicine 2019 — https://doi.org/10.1155/2019/5650413
12. Zhang CX, Bu MR, Wu XM, et al., Efficacy of acupuncture for a cough-related symptom cluster in patients with lung cancer: a randomized controlled trial, European Journal of Oncology Nursing 2024 — https://doi.org/10.1016/j.ejon.2024.102598
13. Ni D, Zhong L, Liu X, et al., Stratified analysis based on VAS scores to assess the effect of acupoint application therapy in children with chronic coughs of varying severity: a randomized controlled study, Frontiers in Medicine 2026 — https://doi.org/10.3389/fmed.2025.1580229
14. Solanki SL, Doctor JR, Kapila SJ, Gehdoo RP, Divatia JV, Acupressure versus dilution of fentanyl to reduce incidence of fentanyl-induced cough in female cancer patients: a prospective randomized controlled study, Korean Journal of Anesthesiology 2016 — https://doi.org/10.4097/kjae.2016.69.3.234
15. Gibson P, Wang G, McGarvey L, et al., Treatment of unexplained chronic cough: CHEST guideline and expert panel report, Chest 2016 — https://doi.org/10.1378/chest.15-1496
16. Lai K, Shen H, Zhou X, et al., Clinical practice guidelines for diagnosis and management of cough: Chinese Thoracic Society (CTS) Asthma Consortium, Journal of Thoracic Disease 2018 — https://doi.org/10.21037/jtd.2018.09.153
17. Asthma Group of Chinese Thoracic Society, Chinese national guideline on diagnosis and management of cough (2021), Zhonghua Jie He He Hu Xi Za Zhi 2022 (in Chinese) — https://pubmed.ncbi.nlm.nih.gov/35000304/
18. National Institute for Health and Care Excellence, Cough (acute): antimicrobial prescribing (NG120), published 7 February 2019 — https://www.nice.org.uk/guidance/ng120