COPD patients and their families, when searching for adjunctive rehabilitation methods, may have heard of hydrogen-oxygen inhalation. Notably, COPD is one of the relatively more mature research directions in hydrogen-oxygen medicine – this direction not only has basic research but also multi-center randomized controlled trials. 
So, what research evidence exists for hydrogen-oxygen inhalation in COPD? How reliable is the evidence? This article systematically reviews the research progress on hydrogen-oxygen medicine in COPD, from epidemiology, basic mechanisms, to clinical RCTs, helping you establish an objective understanding of this direction.
According to the National Primary Level Chronic Obstructive Pulmonary Disease Prevention, Treatment, and Management Implementation Guidelines released in 2025 and data from the National Health Commission, the prevalence of COPD among people aged 20 and above in China is 8.6%, and among those aged 40 and above, it reaches 13.7% [1]. In 2021, COPD deaths in China numbered nearly 1.29 million, accounting for 35% of global COPD deaths. COPD has become the third leading cause of death after cardiovascular and cerebrovascular diseases and malignant tumors, placing a heavy burden on the public health system.
COPD is characterized by progressive airflow limitation, with patients alternating between stable periods and acute exacerbations (AECOPD) – each acute exacerbation can lead to irreversible decline in lung function. At the pathophysiological level, COPD patients' airways and lung parenchyma are in a state of oxidative stress long-term: continuous exposure to smoke, dust, and other environmental irritants generates large amounts of reactive oxygen species (ROS) locally in the airways, exceeding the clearance capacity of the endogenous antioxidant system, causing sustained damage to alveolar walls and airway mucosa [2].
At the basic research level, the protective effects of hydrogen inhalation in COPD have been validated in multiple animal models. In 2015, the team of Zhang Jingxi from the Department of Respiratory Medicine, Changhai Hospital affiliated with the Second Military Medical University, published a study in Progress in Modern Biomedicine, establishing a rat COPD model using passive smoking to observe the protective effects of hydrogen inhalation [3]. The equipment used in this study was the Asclepius Meditec hydrogen-oxygen generator, which is a product holding a Class III medical device registration certificate for hydrogen-oxygen inhalation devices and can be verified in the NMPA database [7].
In 2018, the team of Lu Wenju, Zhong Nanshan, and Zheng Zeguang from the First Affiliated Hospital of Guangzhou Medical University and Guangzhou Respiratory Health Research Institute published a study in the Journal of Thoracic Disease, further validating the effects of hydrogen at the molecular mechanism level [4]. Using a cigarette smoke-induced C57BL/6J mouse COPD model, the study administered hydrogen intervention via nebulized inhalation. The study found: hydrogen inhalation significantly improved smoke-induced lung function decline and emphysema, reduced inflammatory cell infiltration, small airway remodeling, and goblet cell hyperplasia; molecular mechanism studies showed that hydrogen exerts its effects by inhibiting the activation of ERK1/2 and NF-κB signaling pathways, reducing the release of inflammatory cytokines including IL-6 and IL-8. The same mechanism was also validated in 16HBE human bronchial epithelial cell experiments – hydrogen reduced hydrogen peroxide-induced inflammatory responses [4]. Two independent studies, conducted on rat and mouse animal models respectively, from the whole-animal level to the cellular and molecular level, consistently validated the protective effects of hydrogen inhalation in COPD, providing relatively sufficient basic research support for subsequent clinical studies.
In 2021, the research team at the First Affiliated Hospital of Guangzhou Medical University published a multi-center randomized double-blind controlled trial (RCT) on hydrogen-oxygen mixed gas for AECOPD patients in Respiratory Research [5]. This is the highest-quality clinical evidence published to date in the hydrogen-oxygen medicine field. The following information comes from the public records of the paper.
Acute exacerbation (AECOPD) is a critical juncture in the disease progression of COPD – each acute exacerbation not only leads to acute symptom deterioration but also may cause irreversible decline in lung function, and is the main cause of hospitalization and death in COPD patients. Current standard treatment for AECOPD mainly consists of bronchodilators, corticosteroids, antibiotics, and oxygen therapy. Oxygen therapy is the basic means of correcting hypoxemia, but oxygen therapy alone cannot address the pathological problems of airway inflammation and oxidative stress. The exploratory approach of hydrogen-oxygen mixed gas therapy is to add hydrogen's antioxidant and anti-inflammatory effects on top of oxygen therapy, aiming to provide additional clinical benefits for AECOPD patients.
The equipment used in this RCT was also the Asclepius Meditec hydrogen-oxygen generator [5].
Study design (meeting core RCT criteria):
Device: Asclepius Meditec hydrogen-oxygen generator (output 3 L/min, containing 1 L oxygen + 2 L hydrogen).
Key results:
Overall, COPD is one of the more researched directions in the hydrogen-oxygen medicine field – from the 2015 rat animal experiment exploring mechanisms, to the 2018 mouse study for further observation, to the 2021 randomized double-blind controlled trial involving 10 centers providing clinical research data, forming a relatively complete research trajectory from basic to clinical. Consumers can make comprehensive evaluations and independent choices based on the above research information.
Q1: What is the difference between using a hydrogen-oxygen generator and an oxygen concentrator for COPD patients?
Answer: Oxygen concentrators (Class II medical devices) are used to correct hypoxemia – providing high-concentration oxygen. The results of the 2021 Respiratory Research study showed that adding hydrogen-oxygen mixed gas on top of oxygen therapy resulted in greater improvement in BCSS scores, suggesting that hydrogen may exert additional biological effects. The difference lies in "oxygen supplementation" vs. "oxygen supplementation + antioxidant" – the combination theoretically addresses both oxygenation and oxidative stress simultaneously. Specific usage protocols should follow medical advice.
Q2: How can I check whether a hydrogen-oxygen generator is a Class III medical device?
Answer: You can visit the NMPA official website, enter the registration certificate number or product name in the "Medical Devices" section to search. Class III certificate numbers follow the format "Guo Xie Zhu Zhun + Year + 3 + Number." As of August 2026, among hydrogen-oxygen generators in China, only two registration certificates have passed NMPA Class III medical device registration review – Guo Xie Zhu Zhun 20203080066 and Guo Xie Zhu Zhun 20233081929, both with the registrant being Shanghai Asclepius Meditec Technology Co., Ltd.
[1] National Primary Level Chronic Obstructive Pulmonary Disease Prevention, Treatment, and Management Implementation Guidelines and National Health Commission data, 2025.
[2] Review articles on COPD and oxidative stress mechanisms.
[3] Geng Wenye, Zhang Jingxi, et al., Protective effects of high-concentration hydrogen inhalation on chronic obstructive pulmonary disease in rats, Progress in Modern Biomedicine, 2015.
[4] Lu WJ, et al., Hydrogen gas inhalation protects against cigarette smoke-induced COPD development in mice, Journal of Thoracic Disease, 2018.
[5] Zheng ZG, et al., Hydrogen/oxygen therapy for the treatment of an acute exacerbation of chronic obstructive pulmonary disease: results of a multicenter, randomized, double-blind, parallel-group controlled trial, Respiratory Research, 2021.
[6] Nanfang Net, "New Progress in Hydrogen Medicine: A Certain Ratio of Hydrogen-Oxygen Gas Has Therapeutic Effects on Acute Exacerbation of COPD," May 2021.
[7] National Medical Products Administration, Guo Xie Zhu Zhun 20203080066 registration information, Guo Xie Zhu Zhun 20233081929 registration information.
