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Research on Chinese medicine and COPD

Last updated: 11 March, 2017
by Steven Clavey, Traditional Chinese Gynaecology

A systematic review and meta-analysis of the herbal formula Buzhong Yiqi Tang for stable chronic obstructive pulmonary disease.

This meta-analytic review of the use of a traditional Chinese medicine formula for the treatment in 1400 patients with chronic obstructive pulmonary disease found that Bu Zhong Yi Qi Tang (BZYQT) “improves clinically important outcomes for patients with stable COPD, such as improved clinical symptoms, exercise capacity, lung function and quality of life. Moreover, it has an excellent safety profile.

Complement Ther Med. 2016 Dec;29:94-108. Chen Y, Shergis JL, Wu L, Yu X, Zeng Q, Xu Y, Guo X, Zhang AL, Xue CC, Lin L.

OBJECTIVE: To systematically evaluate the efficacy and safety of Buzhong Yiqi Tang (BZYQT) for stable chronic obstructive pulmonary disease (COPD).

METHODS: Three electronic English databases (PubMed, EMBASE and CENTRAL) and four Chinese databases (CBM, CNKI, CQVIP and WFMO) were searched from their inceptions until 30th June 2016. Participants were diagnosed with COPD according to the Chinese Medical Association’s COPD diagnosis and treatment guidelines or Global Initiative for Chronic Obstructive Lung Disease (GOLD), and were in stable stage. Randomized controlled trials (RCTs) of oral BZYQT, alone or combined with conventional treatment, compared with conventional treatment alone or plus placebo were included in the review. Clinical improvement and the six-minute walking test (6MWT) were the primary outcome measures. The secondary outcome measures were defined as forced expiratory volume in one second (FEV1), forced vital capacity (FVC), respiratory muscle strength index with maximum inspiratory pressure (MIP), COPD Assessment Test (CAT), and frequency of acute exacerbations. To assess risk of bias the Cochrane, Risk of Bias tool was used, and statistical analysis was performed using RevMan 5.3.0 software.

RESULTS: Sixteen studies (1400 participants) were included. The results of meta-analysis indicated patients receiving BZYQT alone or BZYQT in combination with conventional treatment showed a significant increase in clinical improvement (RR 1.25, 95% CI 1.18 to 1.33, I2=0%), enhanced exercise capacity 6MWT (MD 51.22m, 95% CI 45.56 to 56.89, I2=44%), improved lung function FVC (L) (MD 0.26 liters, 95% CI 0.18 to 0.33, I2=37%), reduced respiratory muscle fatigue MIP (MD 0.46 liters, 95% CI 0.11 to 0.80, I2=0%), and improved quality of life CAT (MD -2.56 points, 95% CI -3.40 to -1.72, I2=0%) when compared with conventional treatment alone, or plus placebo. BZYQT also showed small but significant improvements in FEV1% and decreased acute exacerbations of COPD. Four studies reported that no adverse events occurred, other studies did not mention adverse events. The finding should be considered with caution because the included studies had methodological shortfalls.

CONCLUSIONS: BZYQT improves clinically important outcomes for patients with stable COPD, such as improved clinical symptoms, exercise capacity, lung function and quality of life. Moreover, it has an excellent safety profile. However further evaluation is needed to validate these preliminary findings in high quality RCTs.

 

Effectiveness and safety of traditional Chinese medicine on stable chronic obstructive pulmonary disease: A systematic review and meta-analysis.

“Among patients with stable COPD, TCM plus conventional medical treatment therapy might be associated with reduction risk of exacerbation, improvement of lung function, better quality of life and higher exercise capacity.”

Complement Ther Med. 2015 Aug;23(4):603-11. doi: 10.1016/j.ctim.2015.06.015. Epub 2015 Jun 27.

Haifeng W, Hailong Z, Jiansheng L, Xueqing Y1, Suyun L, Bin L, Yang X, Yunping B.

OBJECTIVE: This study was intended to evaluate the efficacy and safety of Traditional Chinese Medicine (TCM) on stable chronic obstructive pulmonary disease (COPD).

METHOD: A systematic review was conducted of clinical trials that compared TCM plus conventional medicine treatment versus conventional medicine treatment alone. Randomized controlled trials (RCTs) of clinical therapeutic studies on COPD by TCM were included. Searches were applied to the following electronic databases: The PubMed、 the Cochrane Library、CNKI、CBM and VIP. No blinding and language restriction was used. All trials included were analyzed according to the criteria of the Cochrane Handbook. Review Manager 5.2 software was used for data analysis.

RESULT: 37 randomized clinical trials enrolling 3212 patients were included. Follow-up duration ranged from 4 weeks to 1.5 years. Compared to conventional medicine treatment alone, TCM plus conventional medicine treatment showed improvement in forced expiratory volume in one second (FEV1) (MD 0.12 L; 95% CI 0.08 to 0.16), and less exacerbation (OR -0.86; 95% CI -1.13 to -0.60). TCM treatment also led to a statistically improvement in SGRQ score compared to placebo (MD -4.36; 95% CI -7.12 to -1.59). There was statistically significant difference in six-minute walk distance (MD 36.66 meters, 95% CI 24.57 to 48.74) found with TCM compared to placebo.

CONCLUSION:

Among patients with stable COPD, TCM plus conventional medical treatment therapy might be associated with reduction risk of exacerbation, improvement of lung function, better quality of life and higher exercise capacity. The results were limited by the methodological flaws of the studies. High quality studies are needed to provide clear evidence for the future use of TCM.

 

Chinese herbal medicine (weijing decoction) combined with pharmacotherapy for the treatment of acute exacerbations of chronic obstructive pulmonary disease.

In this 2014 review of 15 studies of a traditional formula designed for respiratory disorders, the authors found “Weijing decoction appeared to be beneficial for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and well-tolerated when taken concurrently with RP, such as antibiotics, bronchodilators (oral and inhaled), and mucolytics.”

Evid Based Complement Alternat Med. 2014;2014:257012. doi: 10.1155/2014/257012. Epub 2014 Aug 6.

Liu S, Shergis J, Chen X, Yu X, Guo X, Zhang AL, Lu C, Xue CC.

OBJECTIVE: To evaluate the efficacy and safety of Weijing decoction combined with routine pharmacotherapy (RP) for the treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD).

METHODS: Randomized controlled trials (RCT) evaluating Weijing decoction for AECOPD were included. English, Chinese, and Japanese databases were searched from their respective inceptions to June 2013. The methodological quality was assessed according to the Cochrane Collaboration’s risk of bias tool. All data were analyzed and synthesized using RevMan 5.2 software.

RESULTS: Fifteen (15) studies involving 986 participants were included. Participants were diagnosed with COPD in the acute exacerbation stage. In addition, most of studies reported that they included participants with the Chinese medicine syndrome, phlegm-heat obstructing the Lung. Weijing decoction combined with RP improved lung function (forced expiratory volume in one second; FEV1), arterial blood gases (PaO2 and PaCO2), clinical effective rate, and reduced inflammatory biomarkers (TNF-α and IL-8) when compared with RP alone. No severe adverse events were reported in these studies.

CONCLUSIONS: Weijing decoction appeared to be beneficial for AECOPD and well-tolerated when taken concurrently with RP, such as antibiotics, bronchodilators (oral and inhaled), and mucolytics.

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