Please wait a minute...
Shopping Cart Email List Chinese
Advanced Search Fig/Tab
Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Featured Articles  |  Most Downloaded  |  Most Reading
Online Submission Subscribe to Our RSS Content Feed
Front. Med.    2014, Vol. 8 Issue (3) : 368-375    https://doi.org/10.1007/s11684-014-0360-0
RESEARCH ARTICLE
Effects of comprehensive therapy based on traditional Chinese medicine patterns on older patients with chronic obstructive pulmonary disease: a subgroup analysis from a four-center, randomized, controlled study
Minghang Wang1,3, Jiansheng Li2,3(), Suyun Li1,3, Yang Xie1,3
1. Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, China
2. The Geriatric Department, Henan University of Traditional Chinese Medicine, Zhengzhou 450046, China
3. Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment and Chinese Medicine Development of Henan Province, Zhengzhou 450046, China
 Download: PDF(202 KB)   HTML
 Export: BibTeX | EndNote | Reference Manager | ProCite | RefWorks
Abstract

This study aimed to evaluate the efficacy of comprehensive therapy based on traditional Chinese medicine (TCM) patterns on older patients with chronic obstructive pulmonary disease (COPD) through a four-center, open-label, randomized controlled trial. Patients were divided into the trial group treated using conventional western medicine and Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules, and Yi-Qi Zi-Shen granules based on TCM patterns respectively; and the control group treated using conventional western medicine. A total of 136 patients≥65 years completed the study, with 63 patients comprising the trial group and 73 comprising the control group. After the six-month treatment and the 12-month follow-up period, significant differences were observed between the trial and control groups in the following aspects: frequency of acute exacerbation (P≤0.040), duration of acute exacerbation (P = 0.034), symptoms (P≤0.034), 6-min walking distance (6MWD) (P≤0.039), dyspnea scale (P≤0.036); physical domain (P≤0.019), psychological domain (P≤0.033), social domain (P≤0.020), and environmental domain (P≤0.044) of the WHOQOL-BREF questionnaire; and daily living ability domain (P≤0.007), social activity domain (P≤0.018), depression symptoms domain (P≤0.025), and anxiety symptoms domain (P≤0.037) of the COPD-QOL. No differences were observed between the trial and control groups with regard to FVC, FEV1, and FEV1%.
Keywords chronic obstructive pulmonary disease      older adult      clinical trial      Bu-Fei Jian-Pi granules      Bu-Fei Yi-Shen granules      Yi-Qi Zi-Shen granules     
Corresponding Author(s): Jiansheng Li   
Online First Date: 09 September 2014    Issue Date: 09 October 2014
 Cite this article:   
Minghang Wang,Jiansheng Li,Suyun Li, et al. Effects of comprehensive therapy based on traditional Chinese medicine patterns on older patients with chronic obstructive pulmonary disease: a subgroup analysis from a four-center, randomized, controlled study[J]. Front. Med., 2014, 8(3): 368-375.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-014-0360-0
https://academic.hep.com.cn/fmd/EN/Y2014/V8/I3/368
Fig.1  Enrollment of patients and completion of the subgroup analysis.
Characteristics Trial group (n= 63) Control group (n= 73) t/χ2/Z P
Age (year) 72.48±3.91 71.92±3.89 0.833 0.406
Course of disease△ 222.75±455.50 182.92±130.73 0.714 0.476
BMI▲ 23.16±10.79 22.55±3.54 0.634 0.478
Exacerbation□
Frequency (times) 3.10±2.04 3.05±2.03 0.116 0.908
Duration (day) 10.67±7.17 10.64±6.48 0.020 0.984
Lung function
FVC (L) 2.83±0.99 2.78±0.97 0.287 0.775
FEV1 (L) 1.32±0.50 1.34±0.49 −0.156 0.876
FEV1% 47.60±10.68 49.95±13.81 −1.093 0.276
Gender
Male 49 65 3.164 0.075
Female 14 8
Smoking status
Currently smoking 41 56 2.237 0.135
Not smoking 22 17
Number of packs smoked per month 21.49±12.15 19.78±11.02 0.718 0.475
GOLD classification
GOLD 1 4 5
GOLD 2 23 31 0.578 0.749
GOLD 3 36 37
Tab.1  Baseline characteristics of the patients
Variable Trial group (n = 63) Control group (n = 73) t/χ2/Z P
Frequency (times)
?Month 0 3.10±2.04 3.05±2.03 0.116 0.908
?Month 6 0.46±0.59 0.73±0.85 −2.077 0.040
?Month 18 0.94±0.98 1.45±1.71 −3.833 0.000
?Average frequency 0.62±0.65 1.18±0.97 −3.941 0.000
Frequency (constituent ratio)
?With exacerbation 37 60
?Without exacerbation 26 13 9.101 0.003
Duration (days)
?Average duration 4.08±5.52 6.62±4.80 −2.523 0.034
Tab.2  Comparison of the frequency and duration of AECOPD
Fig.2  Change in and comparison of the results of FVC, FEV1, FEV1%, total scores of symptoms, dyspnea scale, and 6MWD.
Fig.3  Change in quality of life and comparison of the physical, psychological, environmental, social domain, and total scores of the WHOQOL-BREF questionnaire and that of the results of COPD-QOL for daily living ability, social activity, depression symptoms, anxiety symptoms domain, and total scores at baseline for months 3, 6, and 18.
1 E Diaz-Guzman, DM Mannino. Epidemiology and prevalence of chronic obstructive pulmonary disease. Clin Chest Med 2014; 35(1): 7–16
https://doi.org/10.1016/j.ccm.2013.10.002 pmid: 24507833
2 World Health Organization. World Health Statistics 2013.
3 CE Rycroft, A Heyes, L Lanza, K Becker. Epidemiology of chronic obstructive pulmonary disease: a literature review. Int J Chron Obstruct Pulmon Dis 2012; 7: 457–494
https://doi.org/10.2147/COPD.S32330 pmid: 22927753
4 A Kaplan, P Hernandez, D O’Donnell. Less smoke, more fire: what’s new for you in the latest COPD guidelines? Can Fam Physician 2008; 54(5): 737–739
pmid: 18474708
5 Centers for Disease Control and Prevention (CDC). Chronic obstructive pulmonary disease among adults—United States, 2011. Morb Mortal Wkly Rep 2012; 61(46): 938–943
pmid: 23169314
6 China National Committee on Ageing. China’s Aged Population to More than Double by 2053.
7 N Zhong, C Wang, W Yao, P Chen, J Kang, S Huang, B Chen, C Wang, D Ni, Y Zhou, S Liu, X Wang, D Wang, J Lu, J Zheng, P Ran. Prevalence of chronic obstructive pulmonary disease in China: a large, population-based survey. Am J Respir Crit Care Med 2007; 176(8): 753–760
https://doi.org/10.1164/rccm.200612-1749OC pmid: 17575095
8 J Gelberg, RA McIvor. Overcoming gaps in the management of chronic obstructive pulmonary disease in older patients: new insights. Drugs Aging 2010; 27(5): 367–375
https://doi.org/10.2165/11535220-000000000-00000 pmid: 20450235
9 A Qaseem, TJ Wilt, SE Weinberger, NA Hanania, G Criner, T van der Molen, DD Marciniuk, T Denberg, H Schünemann, W Wedzicha, R MacDonald, P Shekelle; American College of Physicians; American College of Chest Physicians; American Thoracic Society; European Respiratory Society. Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Ann Intern Med 2011; 155(3): 179–191
https://doi.org/10.7326/0003-4819-155-3-201108020-00008 pmid: 21810710
10 NA Hanania, G Sharma, A Sharafkhaneh. COPD in the elderly patient. Semin Respir Crit Care Med 2010; 31(5): 596–606
https://doi.org/10.1055/s-0030-1265900 pmid: 20941660
11 JS Li, SY Li, ZW Wang, XQ Yu, MH Wang, YY Wang. TCM Diagnosis and treatment guidelines for chronic obstructive pulmonary disease (2011 Edition). J Tradit Chin Med (Zhong Yi Za Zhi) 2012; 53: 80–84 (in Chinese)
12 SY Li, JS Li, MH Wang, Y Xie, XQ Yu, ZK Sun, LJ Ma, W Zhang, HL Zhang, F Cao, YC Pan. Effects of comprehensive therapy based on traditional Chinese medicine patterns in stable chronic obstructive pulmonary disease: a four-center, open-label, randomized, controlled study. BMC Complement Altern Med 2012; 12(1): 197
https://doi.org/10.1186/1472-6882-12-197 pmid: 23107470
13 JS Li, SY Li, XQ Yu, Y Xie, MH Wang, ZG Li, NZ Zhang, SJ Shao, YJ Zhang, L Zhu, LX Guo, YP Bai, YF Wang. Bu-Fei Yi-Shen granule combined with acupoint sticking therapy in patients with stable chronic obstructive pulmonary disease: a randomized, double-blind, double-dummy, active-controlled, 4-center study. J Ethnopharmacol 2012; 141(2): 584–591
https://doi.org/10.1016/j.jep.2011.08.060 pmid: 21911051
14 Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease (Revised 2006).
15 COPD Study Group of Chinese Society of Respiratory Disease. Treatment guidelines of Chronic Obstructive Pulmonary Disease (Revised 2007). Chin J Tuberc Respir Dis (Zhonghua Jie He He Hu Xi Za Zhi) 2007; 30(1): 8–17 (in Chinese)
16 S Burge, JA Wedzicha. COPD exacerbations: definitions and classifications. Eur Respir J 2003; 21(41): 46–53
https://doi.org/10.1183/09031936.03.00078002 pmid: 12795331
17 BR Celli, W MacNee; ATS/ERS Task Force. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004; 23(6): 932–946
https://doi.org/10.1183/09031936.04.00014304 pmid: 15219010
18 DA Mahler, CK Wells. Evaluation of clinical methods for rating dyspnea. Chest 1988; 93(3): 580–586
https://doi.org/10.1378/chest.93.3.580 pmid: 3342669
19 WHO. The World Health Organization Quality of Life (WHOQOL-BREF). Geneva: World Health Organization. 2004
20 YY Cai, ZZ Li, ZJ Fang. The evaluation of the quality of life of chronic obstructive pulmonary disease. Chin J Gen Pract (Zhonghua Quan Ke Yi Shi) 2004; 3(4): 225–227 (in Chinese)
21 R Pistelli, L Ferrara, C Misuraca, S Bustacchini. Practical management problems of stable chronic obstructive pulmonary disease in the elderly. Curr Opin Pulm Med 2011; 17(Suppl 1): S43–S48
https://doi.org/10.1097/01.mcp.0000410747.20958.39 pmid: 22209930
22 CM Blanchette, SR Berry, SJ Lane. Advances in chronic obstructive pulmonary disease among older adults. Curr Opin Pulm Med 2011; 17(2): 84–89
https://doi.org/10.1097/MCP.0b013e32834316ff pmid: 21178625
23 NS Gooneratne, NP Patel, A Corcoran. Chronic obstructive pulmonary disease diagnosis and management in older adults. J Am Geriatr Soc 2010; 58(6): 1153–1162
https://doi.org/10.1111/j.1532-5415.2010.02875.x pmid: 20936735
24 J Bourbeau, G Ford, H Zackon, N Pinsky, J Lee, G Ruberto. Impact on patients’ health status following early identification of a COPD exacerbation. Eur Respir J 2007; 30(5): 907–913
https://doi.org/10.1183/09031936.00166606 pmid: 17715163
25 JA Wedzicha, TA Seemungal. COPD exacerbations: defining their cause and prevention. Lancet 2007; 370(9589): 786–796
https://doi.org/10.1016/S0140-6736(07)61382-8 pmid: 17765528
26 V Bellia, C Sorino, F Catalano, G Augugliaro, N Scichilone, R Pistelli, C Pedone, R Antonelli-Incalzi. Validation of FEV6 in the elderly: correlates of performance and repeatability. Thorax 2008; 63(1): 60–66
https://doi.org/10.1136/thx.2007.080572 pmid: 17702791
27 Lung Health Study Research Group. Effect of inhaled triamcinolone on the decline in pulmonary function in chronic obstructive pulmonary disease. N Engl J Med 2000; 343(26): 1902–1909
https://doi.org/10.1056/NEJM200012283432601 pmid: 11136260
28 DP Tashkin, B Celli, S Senn, D Burkhart, S Kesten, S Menjoge, M Decramer; UPLIFT Study Investigators. A 4-year trial of tiotropium in chronic obstructive pulmonary disease. N Engl J Med 2008; 359(15): 1543–1554
https://doi.org/10.1056/NEJMoa0805800 pmid: 18836213
29 LA Camargo, CA Pereira. Dyspnea in COPD: beyond the modified Medical Research Council scale. J Bras Pneumol 2010; 36(5): 571–578
pmid: 21085822
30 JE Morales-Blanhir, CD Palafox Vidal, MJ Rosas Romero, MM García Castro, A Londoño Villegas, M Zamboni. Six-minute walk test: a valuable tool for assessing pulmonary impairment. J Bras Pneumol 2011; 37(1): 110–117
https://doi.org/10.1590/S1806-37132011000100016 pmid: 21390439
31 AE Holland, CJ Hill, T Rasekaba, A Lee, MT Naughton, CF McDonald. Updating the minimal important difference for six-minute walk distance in patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil 2010; 91(2): 221–225
https://doi.org/10.1016/j.apmr.2009.10.017 pmid: 20159125
32 W Xu, JP Collet, S Shapiro, Y Lin, T Yang, RW Platt, C Wang, J Bourbeau. Independent effect of depression and anxiety on chronic obstructive pulmonary disease exacerbations and hospitalizations. Am J Respir Crit Care Med 2008; 178(9): 913–920
https://doi.org/10.1164/rccm.200804-619OC pmid: 18755925
33 S Al Aqqad, IA Hyder Ali, RM Md Kassim, A Sarriff, B Tangiisuran. Evaluation of the characteristics, anxiety, and depression among older patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease. Chest 2014; 145(Suppl 3): 393A
https://doi.org/10.1378/chest.1823747
34 JS Li, SY Li, MH Wang. Functional status and living quality change of chronic obstructive pulmonary diseases. J Henan Univ Chin Med (Henan Zhong Yi Xue Yuan Xue Bao) 2007; 22(1): 19–22 (in Chinese)
[1] Li Ni, Zheng Wen, Xiaowen Hu, Wei Tang, Haisheng Wang, Ling Zhou, Lujin Wu, Hong Wang, Chang Xu, Xizhen Xu, Zhichao Xiao, Zongzhe Li, Chene Li, Yujian Liu, Jialin Duan, Chen Chen, Dan Li, Runhua Zhang, Jinliang Li, Yongxiang Yi, Wei Huang, Yanyan Chen, Jianping Zhao, Jianping Zuo, Jianping Weng, Hualiang Jiang, Dao Wen Wang. Effects of Shuanghuanglian oral liquids on patients with COVID-19: a randomized, open-label, parallel-controlled, multicenter clinical trial[J]. Front. Med., 2021, 15(5): 704-717.
[2] Wenjie Zhu, Binghe Xu. Overcoming resistance to endocrine therapy in hormone receptor-positive human epidermal growth factor receptor 2-negative (HR+/HER2--) advanced breast cancer: a meta-analysis and systemic review of randomized clinical trials[J]. Front. Med., 2021, 15(2): 208-220.
[3] Shuyang Sun,Zhiyuan Zhang. Patient-derived xenograft platform of OSCC: a renewable human bio-bank for preclinical cancer research and a new co-clinical model for treatment optimization[J]. Front. Med., 2016, 10(1): 104-110.
[4] Xu Chen, Xiaomao Xu, Fei Xiao. Heterogeneity of chronic obstructive pulmonary disease: from phenotype to genotype[J]. Front Med, 2013, 7(4): 425-432.
[5] Sowmya Viswanathan, Armand Keating. Overcoming the challenges of conducting translational research in cell therapy[J]. Front Med, 2011, 5(4): 333-335.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed