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Modified Yupinfeng formula for the traetment of stable chronic obstructive pulmonary disease: a systematic review of randomized controlled trials

机译：改良玉屏风配方治疗稳定型慢性阻塞性肺疾病：随机对照试验的系统评价

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Background: Chronic obstructive pulmonary disease (COPD), is a very common disease of respiratory system. An increasing number of clinical trials on Yupingfeng formula in the management of stable COPD have been performed. However, the evidence base for it remains unknown. This review aims at assessing the efficacy, and safety of modified Yupingfeng formula in the treatment of stable COPD through a systematic review of all available randomized controlled trials. Materials and Methods: Literature retrieval was conducted using four English databases (CENTRAL, PubMed, BASEMAN, and ISI Web of Science), and four Chinese databases (CBM, CNKI, VIP, and WANFANG), from respective inception to January 2013, and supplemented with a manual search. Review authors independently extracted the trial data, and assessed the quality of each trial. Methodological quality was assessed by Cochrane risk of bias and Jadad’s scale. The following outcomes were evaluated: (1) lung function; (2) 6-minute walk distance (6MWD); (3) effective rate; (4) serum levels of IgA, IgG and IgE; and (5) adverse events. Data were analyzed using STATA 12.0 software. Results: A total of nine studies involving 660, stable COPD patients were identified. Patients from all studies included in this review were randomized to receive Yupingfeng formula combined with Western medications in comparison with Western medications. In general, the methodological quality of the included trials was poor. The results of this systematic review indicates that, compared with Western medications alone, the use of Yupingfeng formula, if combined with Western medications could significantly improve FEV1 (WMD = 0.30L; 95%CI: 0.19, 0.42), FEV1/FVC ratio (SMD = 0.69; 95%CI: 0.48, 0.91), 6MWD (WMD = 31.73m; 95% CI: 19.29, 44.17), and effective rate (RR = 1.24; 95% CI: 1.10, 1.41), and increase the serum levels of IgA (WMD = 0.25; 95%CI: 0.16, 0.34) and IgG (WMD = 1.10; 95%CI: 0.53, 1.68), but no difference was found in the serum IgE levels (WMD = 0.47; 95%CI: －0.32, 1.27) between the two groups. No serious adverse events were reported. Conclusions: Within the limitations of this systematic review, we may conclude that compared with Western medications alone, Yupingfeng formula, when combined with Western medications can provide more benefits for patients with stable COPD, without any serious adverse reactions being identified. However, these benefits need to be further confirmed through high-quality prospective placebo-controlled trials that should be strictly conducted in accordance with methodological principles and procedures.
机译：背景：慢性阻塞性肺疾病（COPD）是一种非常常见的呼吸系统疾病。玉屏风配方治疗稳定型COPD的临床试验越来越多。但是，其证据基础仍然未知。这篇综述旨在通过对所有可用的随机对照试验的系统评价，评估改良的玉屏风配方治疗稳定型COPD的疗效和安全性。资料和方法：从开始到2013年1月，使用四个英文数据库（CENTRAL，PubMed，BASEMAN和ISI Web of Science）和四个中文数据库（CBM，CNKI，VIP和WANFANG）进行文献检索，并进行了补充手动搜索。评论作者独立提取试验数据，并评估每个试验的质量。方法学质量通过Cochrane偏倚风险和Jadad量表进行评估。评价了以下结果：（1）肺功能； （2）步行6分钟（6MWD）； （3）有效率； （4）血清IgA，IgG和IgE水平； （5）不良事件。使用STATA 12.0软件分析数据。结果：共鉴定了9项研究，涉及660名稳定的COPD患者。本研究纳入的所有研究患者均被随机分配接受玉屏风配方与西药相结合的治疗。通常，纳入试验的方法学质量较差。该系统评价的结果表明，与单独使用西药相比，使用玉屏风配方与西药联合使用可显着改善FEV1（WMD = 0.30L; 95％CI：0.19，0.42），FEV1 / FVC比（ SMD = 0.69; 95％CI：0.48，0.91），6MWD（WMD = 31.73m; 95％CI：19.29，44.17），有效率（RR = 1.24; 95％CI：1.10，1.41），并增加血清IgA（WMD = 0.25; 95％CI：0.16，0.34）和IgG（WMD = 1.10; 95％CI：0.53，1.68）水平，但血清IgE水平无差异（WMD = 0.47; 95％CI ：－0.32，1.27）在两组之间。没有严重不良反应的报道。结论：在本系统评价的范围内，我们可以得出的结论是，与单纯的西药相比，玉屏风配方与西药联用可以为稳定的COPD患者提供更多益处，而未发现任何严重的不良反应。但是，这些益处需要通过高质量的前瞻性安慰剂对照试验进一步证实，这些试验应严格按照方法学原则和程序进行。

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