A systematic review and meta-analysis of the herbal formula Buzhong Yiqi Tang for stable chronic obstructive pulmonary disease |
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| Institution: | 1. Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong Province, China;2. Department of Respiratory Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong Province, China;3. Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, Guangdong Province, China;4. China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia;1. College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China;2. College of Pharmaceutical Science, Zhejiang University of Technology, Hangzhou 310014, China;3. Children''s Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China;1. Advanced Algorithm & Systems Co., Ltd., 7F Ebisu-IS Building, 1-13-6 Ebisu, Shibuya-ku, Tokyo 150-0013, Japan;2. Graduate School of Humanities and Sciences, Ochanomizu University, 2-1-1 Ohtsuka, Bunkyo-ku, Tokyo 112-8610, Japan;1. Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University Seoul, Republic of Korea;2. Hwapyeong Institute of Integrative Medicine, Incheon, Republic of Korea;3. Korean Medicine Hospital of Pusan National University, Gyeongsangnam-do, Republic of Korea;4. School of Korean Medicine, Pusan National University, Yangsan, Republic of Korea;1. Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, and National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, and Jiangsu Key Laboratory for High Technology Research of TCM Formulae, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China;2. Jiangsu Revolence Pharmaceutical Co., Ltd., Huaian 223200, Jiangsu Province, China;1. Department of Plant Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan;2. Department of Geology University of Malaya, Malaysia;3. Department of Chemistry, University of Nizwa, Oman |
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| Abstract: | ObjectiveTo systematically evaluate the efficacy and safety of Buzhong Yiqi Tang (BZYQT) for stable chronic obstructive pulmonary disease (COPD).MethodsThree 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.ResultsSixteen 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 51.22 m, 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.ConclusionsBZYQT 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. |
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| Keywords: | Buzhong Yiqi Tang (BZYQT) Chronic obstructive pulmonary disease (COPD) Systematic review Meta-analysis |
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