Adjunctive Short-Wave Diathermy to High-Frequency Chest Wall Oscillation for Acute Exacerbation of COPD: A Randomized Controlled Trial.

OBJECTIVE: This study aimed to evaluate the efficacy and safety of combining short-wave diathermy (SWD) with high-frequency chest wall oscillation (HFCWO) compared with HFCWO alone and routine treatment in patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: This single-center, parallel-group randomized controlled trial enrolled 89 patients with AECOPD admitted to Yongkang First People's Hospital between March 2024 and March 2025. Participants were randomly assigned (1:1:1) to receive routine treatment alone (control group), routine treatment plus HFCWO (HFCWO group), or routine treatment plus combined SWD and HFCWO (combined group) for 72 h. Primary and secondary outcomes were assessed at baseline and after 72 h of intervention, with both within-group and between-group comparisons performed. Primary outcomes included changes in the COPD Assessment Test (CAT) and Breathlessness, Cough, and Sputum Scale (BCSS) scores. Secondary outcomes included lung function parameters (FEV1, FVC, and FEV1/FVC), arterial blood gas parameters (PaO2 and PaCO2), inflammatory markers (interleukin-6, C-reactive protein, and white blood cell count), and quantitative sputum indices (24-h sputum volume, total cell count, and differential counts). RESULTS: After the 72-h intervention, the combined therapy group demonstrated significantly greater reductions in CAT and BCSS scores compared with both the HFCWO group and the control group (p < 0.05). Combined therapy also achieved superior improvements in arterial blood gas parameters (PaO2 and PaCO2) and sputum clearance indices (24-h sputum volume and neutrophil and eosinophil percentages) compared with HFCWO alone or routine treatment. In contrast, no significant differences were observed in lung function parameters (FEV1 and FVC) or inflammatory markers (IL-6, CRP, and WBC). CONCLUSIONS: The combined intervention significantly improves respiratory symptoms, arterial oxygenation, and sputum clearance in patients with AECOPD compared with HFCWO alone or routine treatment. The addition of thermal therapy enhances the clinical efficacy of mechanical airway clearance, offering a feasible adjunctive strategy for acute-phase management of AECOPD.