Syndrome and Treatment Rules of Traditional Chinese Medicine in Treating Chronic Obstructive Pulmonary Disease Based on Modern Medical Cases / 中国实验方剂学杂志

ObjectiveTo explore the syndrome and treatment rules of traditional Chinese medicine （TCM） in treating chronic obstructive pulmonary disease （COPD） based on the medical literature and cases with the help of TCM inheritance support system platform （V2.5）， thus providing new ideas for TCM to treat COPD. MethodThe medical cases of TCM treating COPD were retrieved from China national knowledge infrastructure （CNKI）， Wanfang Database， and VIP China Science and Technology Journal Database. The medical cases that met the inclusion literature were collected in a new Word document， and then input into the TCM inheritance support system platform （V2.5） after data standardization. With the help of the algorithm carried by this software， the frequency statistics of "symptoms， syndrome types of TCM， Chinese medicine， and meridians of Chinese medicine" in the included COPD medical cases were performed， and the correlation analysis of the "prescription rules" in the included medical cases was carried out， thus excavating the potential core drug pairs and new prescriptions for the treatment of COPD. ResultA total of 103 articles were included with 126 medical cases and 131 diagnoses and treatments. According to statistics， the common symptoms of COPD were cough， expectoration， chest tightness， and asthma， and the common TCM syndromes included phlegm-heat obstructing lung， phlegm and blood stasis blocking lung， and lung-spleen Qi deficiency. The common TCM treatment methods included clearing heat and resolving phlegm， banking up earth to generate metal， and descending adverse and relieving dyspnea， among which the high-frequency Chinese medicines for the treatment of COPD were Pinelliae Rhizoma， Armeniacae Semen Amarum， Ephedrae Herba， Citri Reticulatae Pericarpium， and so on. The commonly used drug pairs included Asari Radix et Rhizoma-Pinelliae Rhizoma， Pinelliae Rhizoma-Schisandrae Chinensis Fructus-Glycyrrhizae Radix et Rhizoma， etc. Twelve new prescriptions for the treatment of COPD were found. ConclusionTCM believes that COPD is a lung disease formed by external evil， phlegm， blood stasis， and other pathological factors， with cough， phlegm， and asthma as the main symptoms. The main syndromes of COPD are phlegm-heat obstructing lung， phlegm and blood stasis blocking lung， and lung-spleen qi deficiency. "Strengthening the upright and dispelling evil" is the basic principle of the treatment COPD. In clinical， TCM methods with dispelling phlegm and removing blood stasis， and tonifying lung， spleen， and kidney should be adopted to treat COPD.

Meta-analysis of the Effectiveness of Inhaled Corticosteroids Combined with Tiotropium Bromide versus Inhaled Corticosteroids Alone in the Treatment of Asthmatic-COPD Overlap Syndrome / 中国药房

OBJECTIVE：To systematically e valuate the effectiveness of inhaled corticosteroids combined with tiotropium bromide versus inhaled corticosteroids alone in the treatment of asthmatic-COPD overlap syndrome ，and to provide evidence-based reference for clinical use. METHODS ：Retrieved from PubMed ，Web of Science ，Embase，Cochrane Library ，CBM，CNKI， VIP，Wanfang database ，during the establishment of the database to Nov. 2019，randomized controlled trials （RCT）about inhaled corticosteroids combined with tiotropium bromide （trial group ）versus inhaled corticosteroids alone （control group ）in the treatment of asthmatic-COPD overlap syndrome were collected. After data extraction of included literatures met inclusion criteria ，quality evaluation with modified Jadad scale ，Meta-analysis was performed for response rate ，forced expiratory volume in the first second （FEV1），forced vital capacity （FVC），FEV1/FVC，inspiratory fraction （IC/TLC），residual to total ratio （RV/TLC），asthma symptom（ACT）score，chronic obstructive pulmonary symptom （CAT）score，the times of acute exacerbations by Rev Man 5.3.0 software. RESULTS ：A total of 25 RCTs were included ，involving 2 828 patients. The results of Meta-analysis showed that the response rate [RR ＝1.16，95％CI（1.10，1.22），P＜0.001]，FEV1[MD＝0.44，95％CI（0.35，0.54），P＜0.001]，FVC [MD ＝0.70， 95％CI（0.46，0.95），P＜0.001]，FEV1/FVC [MD= 8.79，95％CI（6.22，11.37），P＜0.001]，IC/TLC [MD ＝4.93，95％CI（3.01， 6.85），P＜0.001]，RV/TLC [MD ＝－9.22，95％CI（－9.79，－8.66），P＜0.001]，ACT score [MD ＝5.38，95％CI（4.30，6.47）， P＜0.001]，CAT score [MD ＝－3.67，95％CI（－4.89，－2.45），P＜0.001] and the times of acute exacerbations [MD ＝－1.49， 95％CI（－2.82，－0.17），P＝0.03] in trial group were significantly higher than control group ，with statistical significance. CONCLUSIONS：Compared with inhaled corticosteroids alone ，inhaled hormone combined with tiotropium bromide can improve the response rate and pulmonary function ，but increase the times of acute exacerbation of patients with asthmatic-COPD overlap syndrome.