Comparative effectiveness of six Chinese herb formulas for acute exacerbation of chronic obstructive pulmonary disease: a systematic review and network meta-analysis

Abstract

Background: Six Chinese herb formulas, namely, the Weijing decoction (WJ), the Maxingshigan decoction (MXSG), the Yuebijiabanxia decoction (YBBX), the Qingqihuatan decoction (QQHT), the Dingchuan decoction (DC) and the Sangbaipi decoction (SBP), are commonly used, along with routine pharmacotherapy, to manage the acute exacerbation of chronic obstructive pulmonary disease (AECOPD). In this study, we conducted a systematic review to summarize the efficacy of these six formulas, and we also conducted a network meta-analysis (NMA) to rank these formulas. Methods: We searched five English databases and four Chinese databases, with dates ranging from the starting dates of these databases to December 2016. Randomized controlled trials that evaluated any of the six Chinese herb formulas combined with the use of pharmacotherapy for AECOPD were identified. Results: Fifty-five studies involving 4560 participants were included. The pairwise meta-analyses showed that WJ and QQHT had superior effects on the improvement of lung function (forced expiratory volume in 1 seconds; FEV1) (mean difference (MD): 0.25, 95% confidence interval (CI): 0.19-0.30 and 0.34, 95%CI: 0.10-0.58). MXSG, WJ and QQHT were found to be more effective for improving arterial blood gases (PaO2 and PaCO2). In terms of effective rates, all of these formulas had additional favourable effects compared to routine pharmacotherapy. The results of the NMA analyses indicated that only MXSG showed superior add-on effects for the improvement of FEV1 (MD: 0.37, 95% credible interval (CrI): 0.03-0.72). Most of the formulas combined with routine pharmacotherapy were superior to pharmacotherapy alone for the improvement of arterial blood gases and effective rates. The ranking tests suggested that QQHT and MXSG combined with routine pharmacotherapy might be optimal options for the treatment of AECOPD. Conclusions: This NMA indicated that QQHT and MXSG might be more effective treatment regimens for AECOPD. Further well-designed studies that specifically examine the direct comparisons of these formulas are needed to support our conclusions.

Efficacy of Qingfei Paidu Decoction on Patients with COVID-19 Pneumonia in Wuhan, China: A Propensity Score Matching Study

“…MSD has been widely used in the prevention and treatment of respiratory diseases. Several studies had verified its antiviral effects mediated by regulating immune function, suppressing inflammatory cytokine storm, and improving oxygenation and forced expiratory volume/second (FEV1) [ 13 , 14 ]. SMD has been shown to alleviate pathological lung damage and inflammation in rats with asthmatic pneumonia by enhancing immune activity and downregulating the expression of thymic stromal lymphopoietin (TSLP), toll-like receptor 4 (TLR4), and nuclear factor- κ B (NF- κ B) in lung tissue [ 15 ].…”

The Effectiveness of Traditional Chinese Medicine (TCM) as an Adjunct Treatment on Stable COPD Patients: A Systematic Review and Meta-Analysis

“…Eight studies report adverse events of any cause and data are summarized in Table 5. Of these, four studies have no adverse events throughout the study period [28,[66][67][68]. Wang reports 2 cases of nausea, Liu reports 1 case of mouth dryness, and Huang reports 3 cases of acute exacerbation with hospitalization.…”

“…Of these, nine studies used St. George's Respiratory Questionnaire (SGRQ) [69][70][71][72][73][74][75][76][77]. Eight studies used COPD-Quality of Life (COPD-QoL) questionnaire [54,67,[78][79][80][81][82][83].…”

“…is review does not include studies where participants have both acute exacerbated and stable chronic obstructive pulmonary disease and any complicated diseases. Previous systematic reviews report either one single herb extract or formulae, or one specific TCM syndrome-related treatment method [32,67,[84][85][86][87][88][89][90][91]. However, this is not the usual practice of traditional Chinese medicine.…”

Efficacy and safety of Sangbaipi Decoction in patients with acute exacerbation of chronic obstructive pulmonary disease

“…In recent years, clinical studies have also shown that Sangbaipi Decoction combined with conventional Western medicine treatment of AECOPD can improve the clinical efficacy, [ 5 ] but there are some limitations, such as single reports, scattered research, small sample size. With the development of evidence-based medicine, it has opened up new research fields in the clinical efficacy evaluation of Chinese medicine, produced new research ideas and methods, and promoted the progress of clinical research in Chinese medicine.…”