Chronic Obstructive Pulmonary Disease (COPD) is nowadays the 4th cause of death in the world and it´s expected to become the 3rd cause of death in 2020 and the majority cause of morbidity. Besides that, in Portugal COPD patients become more dependents each day.

Acupuncture as a reflex therapy it´s carried out through a Traditional Chinese Medicine (TCM) diagnose that will allowed to identify the acupoints.

The investigators are interested in to assess acupuncture efficacy on physical exercise tolerance in COPD patients.An experimental, controlled, randomized, double blind study was done. Patients were recruited according TCM diagnose to optimize potential therapeutic effects.

Inclusion Criteria:

• COPD GOLD III,IV;
• able to walk;
• Informed consent signed;
• stable medication during last 3 days
• exacerbation during 3 months;
• Chinese diagnose opening principle;
• blood pressure "90"180 mmhg/ "100mmhg; respiratory rate "10"30 cpm

Exclusion Criteria:

• smoker;
• metastasis;
• hepatic,
• renal or cardiovascular disease;
• pulmonary hypertension;
• COPD symptoms exacerbation during the therapy;
• previous acupuncture treatments;
• unstable vital signs;
• pulmonary rehabilitation in the last 6 months;
• needle phobia.

Patients didn´t know what kind of therapy they were submitted The acupuncturist was a nurse, able to do invasive procedures with no knowledge of Chinese Medicine, and totally blind in terms of the verum or sham acupuncture.