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A systematic review and meta-analysis of the herbal formula Buzhong Yiqi Tang for stable chronic obstructive pulmonary disease.
Complement Ther Med 2016; 29:94-108CT

Abstract

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.

Authors+Show Affiliations

Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong Province, China; Department of Respiratory Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong Province, China.China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong Province, China; Department of Respiratory Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong Province, China.Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong Province, China; Department of Respiratory Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong Province, China.Department of Respiratory Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong Province, China.Department of Respiratory Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong Province, China.Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong Province, China.China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong Province, China; China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia. Electronic address: charlie.xue@rmit.edu.au.Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong Province, China; Department of Respiratory Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong Province, China; Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, Guangdong Province, China. Electronic address: drlinlin620@163.com.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

27912964

Citation

Chen, Yuanbin, et al. "A Systematic Review and Meta-analysis of the Herbal Formula Buzhong Yiqi Tang for Stable Chronic Obstructive Pulmonary Disease." Complementary Therapies in Medicine, vol. 29, 2016, pp. 94-108.
Chen Y, Shergis JL, Wu L, et al. A systematic review and meta-analysis of the herbal formula Buzhong Yiqi Tang for stable chronic obstructive pulmonary disease. Complement Ther Med. 2016;29:94-108.
Chen, Y., Shergis, J. L., Wu, L., Yu, X., Zeng, Q., Xu, Y., ... Lin, L. (2016). A systematic review and meta-analysis of the herbal formula Buzhong Yiqi Tang for stable chronic obstructive pulmonary disease. Complementary Therapies in Medicine, 29, pp. 94-108. doi:10.1016/j.ctim.2016.09.017.
Chen Y, et al. A Systematic Review and Meta-analysis of the Herbal Formula Buzhong Yiqi Tang for Stable Chronic Obstructive Pulmonary Disease. Complement Ther Med. 2016;29:94-108. PubMed PMID: 27912964.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A systematic review and meta-analysis of the herbal formula Buzhong Yiqi Tang for stable chronic obstructive pulmonary disease. AU - Chen,Yuanbin, AU - Shergis,Johannah Linda, AU - Wu,Lei, AU - Yu,Xuhua, AU - Zeng,Qigang, AU - Xu,Yinji, AU - Guo,Xinfeng, AU - Zhang,Anthony Lin, AU - Xue,Charlie Changli, AU - Lin,Lin, Y1 - 2016/09/15/ PY - 2015/08/10/received PY - 2016/07/27/revised PY - 2016/09/14/accepted PY - 2016/12/4/entrez PY - 2016/12/4/pubmed PY - 2017/4/5/medline KW - Buzhong Yiqi Tang (BZYQT) KW - Chronic obstructive pulmonary disease (COPD) KW - Meta-analysis KW - Systematic review SP - 94 EP - 108 JF - Complementary therapies in medicine JO - Complement Ther Med VL - 29 N2 - 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. SN - 1873-6963 UR - https://www.unboundmedicine.com/medline/citation/27912964/A_systematic_review_and_meta_analysis_of_the_herbal_formula_Buzhong_Yiqi_Tang_for_stable_chronic_obstructive_pulmonary_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0965-2299(16)30178-9 DB - PRIME DP - Unbound Medicine ER -