Search

OBJECTIVE: To systematically evaluate the efficacy and safety of Chinese herbal medicine (CHM) combined with conventional Western Medicine (CWM) on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) based on high-quality randomized placebo-controlled trials. METHODS: We searched PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, China Science and Technology Journal Database, and Wanfang databases for randomized placebo-controlled trials of CHM treatment for AECOPD from inception to June 4, 2021. The Cochrane Collaboration’s tool and the Grading of Recommendations, Assessment, Development and Evaluation were used to assess the risk of bias and the evidence quality of the included studies. Revman 5.3 software was used for Meta-analysis. RESULTS: A total of 9 trials involving 1591 patients were included. The Meta-analysis showed that based on CWM treatment, CHM group had significant advantages over the placebo group in ameliorating clinical total effective rate [RR = 1.29, 95% CI (1.07, 1.56), P = 0.007, low quality] and TCM symptom scores [MD = -2.99, 95% CI (-4.46, -1.53), P < 0.0001, moderate quality], improving arterial blood gas results [PaO(2): MD = 4.51, 95% CI (1.97, 7.04), P = 0.0005, moderate quality; PaCO(2): MD = -2.87, 95% CI (-4.28, -1.46), P < 0.0001, moderate quality], reducing CAT scores [MD = -2.08, 95% CI (-2.85, -1.31), P < 0.000 01, moderate quality]，length of hospitalization [MD = -1.87, 95% CI (-3.33, -0.42), P = 0.01, moderate quality], and acute exacerbation rate [RR = 0.60, 95% CI (0.43, 0.83), P = 0.002, moderate quality]. No serious CHM-related adverse events were reported. CONCLUSIONS: The current evidence indicates that CHM is an effective and well-tolerated adjunct therapy for AECOPD patients receiving CWM. However, considering the high heterogeneity, this conclusion requires confirmation.

Supplemental material, sj-docx-3-cre-10.1177_02692155221095481 for Clinical evidence for improving exercise tolerance and quality of life with pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis: A systematic review and meta-analysis by Siyuan Lei, Xuanlin Li, Yang Xie, and Jiansheng Li in Clinical Rehabilitation

Supplemental material, sj-doc-1-cre-10.1177_02692155221095481 for Clinical evidence for improving exercise tolerance and quality of life with pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis: A systematic review and meta-analysis by Siyuan Lei, Xuanlin Li, Yang Xie, and Jiansheng Li in Clinical Rehabilitation

Supplemental material, sj-doc-2-cre-10.1177_02692155221095481 for Clinical evidence for improving exercise tolerance and quality of life with pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis: A systematic review and meta-analysis by Siyuan Lei, Xuanlin Li, Yang Xie, and Jiansheng Li in Clinical Rehabilitation

Dong Zhang,1– 3 Hailong Zhang,1– 3 Xuanlin Li,1– 3 Siyuan Lei,1– 3 Lu Wang,1– 3 Wen Guo,1– 3 Jiansheng Li1– 3 1Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, 450046, People’s Republic of China; 2Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, 450046, People’s Republic of China; 3Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, 450003, People’s Republic of ChinaCorrespondence: Jiansheng Li Tel/Fax +86-371-65676568Email li_js8@163.comObjective: To evaluate the efficacy and safety of early pulmonary rehabilitation (PR) (ie, < 3 days of hospitalization) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods: Embase, Web of Science, PubMed and Cochrane Library were searched from their inception to 1 April 2021. Randomized controlled trials were included if they observed the efficacy of early PR in AECOPD patients. Study selection, data extraction, risk of bias and quality of evidence were assessed by two researchers independently. Assessment of the risk of bias and eidence quality were evaluated by the Cochrane Collaboration’s tool and Grading of Recommendations, Assessment, Development and Evaluation system, respectively.Results: Fourteen trials (829 participants) were identified. Significant improvement was found in the 6-minute walk distance (6MWD; mean difference (MD): 69.64; 95% CI: 40.26 to 99.01; Z = 4.65, P < 0.0001, low quality). In the subgroup analysis, the exercise-training group showed marked improvement (MD: 96.14; 95% CI: 20.24 to 172.04; Z = 2.48, P = 0.001). The Saint George’s Respiratory Questionnaire (SGRQ) total score was low (MD: − 12.77; 95% CI: − 16.03 to − 9.50; Z = 7.67, P < 0.0001, moderate quality). Significant effects were not found for the duration of hospital stay, quadriceps muscle strength or five times sit to stand test. Only one serious adverse event was reported in experimental group, which was not associated with early PR.Conclusion: PR initiated < 3 days of hospitalization may increase exercise capacity and improve quality of life, but the results should be interpreted prudently and dialectically, and the role of early PR in AECOPD needs further exploration.Keywords: chronic obstructive pulmonary disease, acute exacerbation, pulmonary rehabilitation, meta-analysis