Clinical Observation of Bufei Huoxue Capsules Combined with Azithr omycin Tablets in the Treatment of Patients with Stable COPD / 中国药房

OBJECTIVE： To observe the efficacy and safety of Bufei huoxue capsules combined with Azithromycin tablets in the treatment of patients with stable COPD. METHODS： Totally 140 patients with stable COPD were collected from Anhui Chest Hospital during Jun. 2014-Feb. 2018， and then divided into control group and observation group according to random number table， with 70 cases in each group. Both groups received smoking cessation intervention and symptomatic treatment. Control group was additionally given Tiotropium bromide powder for inhalation， once a day+Azithromycin tablets 0.25 g， twice a week. Observation group were additionally given Bufei huoxue capsules 4 pills， 3 times a day， on the basis of control group. Both groups were treated for 180 d continuously. The clinical efficacies of 2 groups were observed， and the levels of serum inflammatory factors （CRP， IL-6 and TNF-α）， lung function related indexes （PEF， FEV1 and FEV1/FVC） and COPD related symptoms （time of AECOPD attack and 6MWT） were observed before and after treatment. The occurrence of ADR was recorded. RESULTS： Totally 9 cases withdrew from the study in control group， and 3 cases in observation group. A total of 128 cases （61 cases in control group， 67 cases in observation group） completed the study. Total response rate was 92.54％ in observation group， which was significantly higher than 80.33％ in control group（P＜0.05）. Before treatment， there was no statistical significance in the levels of serum inflammatory factors， lung function related indexes or COPD related symptoms （P＞0.05）. After treatment， the levels of CRP， IL-6 and TNF-α in 2 groups were decreased significantly， and the times of AECOPD attack were decreased significantly； observation group was significantly lower or less than control group. PEF， FEV1 and FEV1/FVC were increased significantly in 2 groups and 6MWT was prolonged significantly； observation group was significantly higher or longer than control group （P＜0.05）. One case suffered from skin rash in control group， and two cases had mild nausea in observation group； no severe ADR was found in both groups. CONCLUSIONS： Bufei huoxue capsules combined with Azithromycin tablets can significantly reduce the level of serum inflammatory factors of stable COPD patients， improve their lung function， and relieve clinical symptoms with good safety.

Comparison of the efficacy of high dose and conventional dose of budesonide/formoterol inhalation in stable COPD / 中国生化药物杂志

Objective To compare large dose or conventional dose of budesonide/formoterol fumarate powder in treatment of stable chronic obstructive pulmonary disease(COPD).Methods 120 patients with stable COPD from March 2015 to March 2016 in Jiaxing Second hospital were selected,were treated with budesonide/formoterol,and were divided into the conventional dose group and high dose groupaccording to different doses,60 cases in each group.Pulmonary function tests,CAT Chinese version scale assessment and 6 min walking distance(6MWD)test were performed before and after treatment,and adverse reactions and acute attack were observed.Results FEV1/FVC and FEV1％were significantly improved after treatment in the two groups,and those in the high dose group were significantly better than those in the conventional dose group,the difference was statistically significant(P<0.05),CAT score and 6MWD were significantly improved after treatment in the two groups,and those in the high dose group were significantly higher than those in the conventional dose group,the difference was statistically significant(P<0.05),adverse reactions such as palpitations,tachycardiain the high dose group were significantly higher than those in the conventional dose group,while the acute attack rate was significantly lower than that of the conventional dose group,the difference was statistically significant(P<0.05).Conclusion High dose of budesonide/formoterol inhalation in the treatment of patients with stable COPD powder can improve the pulmonary function and health status,but adverse reactions increase.

Cai Wanru’s Experience on the Treatment of Stable Chronic Obstructive Pulmonary Disease / 浙江中医药大学学报

Objective] To research professor Cai’s experience in treating stable chronic obstructive pulmonary disease(COPD). [Method] The paper expounds Professor Cai’s experience in treating stable chronic obstructive pulmonary disease by analyzing the etiology, pathology, summarizing the clinical thoughts and citing the typical case. [Result] Professor Cai emphasized therapies of strengthening body resistance,replenishing Qi,treating zang and fu together,activating blood,dredging collaterals, treating disease with the theory of Chinese medicine and modern medicine as well as applying the theory of preventive treatment of disease on preventing the exacerbation of COPD. Better clinical effects were acquired. [Conclusion] Professor Cai Wanru always grabs for the treatment of qi deficiency and phlegm, blood stasis of the disease.She is good at prescribing formula. Therefore the treating method has clinical value.

Clinical Efficacy and Related Influencing Factors of Jianpi Huatan Decoction Plus Zhongwan Moxibustion in Patients with Mild to Moderate Stable COPD / 中国中医药信息杂志

Objective To observe the clinical efficacy of Jianpi Huatan Decoction plus Zhongwan (RN12) moxibustion on patients of mild to moderate stable chronic obstructive pulmonary disease (COPD) with syndrome of qi deficiency of lung and spleen, and analyze the related influencing factors. Methods With prospective randomized clinical trial, 140 cases of mild to moderate stable COPD were randomized into two groups (70 cases for each group). Treatment group was treated by Jianpi Huatan Decoction plus Zhongwan moxibustion based on western medicine, and control group was only treated by western medicine. Both groups were treated for 12 weeks and followed up for 12 weeks. Scores of clinical symptoms and quality of life questionnaire were examined, and multiple logistic regression analysis was used to find possible impacting factors on the effect. Results Symptoms were significantly alleviated after treatment (P0.05). Multiple logistic regression analysis showed that different therapies and severity of COPD were the major influencing factors of clinical effect (P<0.05, P<0.01). Conclusion Jianpi Huatan Decoction plus Zhongwan moxibustion had significant therapeutic effect on mild to moderate stable COPD patients with syndrome of qi deficiency of lung and spleen by alleviating symptoms and improving quality of life. Treatment style and severity of COPD are the main influencing factors.

Pharmacotherapy in Stable Chronic Obstructive Pulmonary Disease

The general approach to manage stable COPD is characterized by a stepwise increase in treatment, depending on the severity of the disease. None of the existing medications for COPD have been shown to modify the long-term decline in lung function that is the hallmark of the disease. Therefore, pharmacotherapy in COPD is used to decrease symptoms and /or complications. Bronchodilator medications are central to the symptomatic management of COPD. They are given on an as-needed basis or on a regular basis to prevent or reduce symptoms. The principal bronchodilator treatments are beta2-agonists, anticholinergics, theophylline, and a combination of these drugs. Regular treatment with long-acting bronchodilators is more effective and convenient than treatment with short-acting bronchodilators, but more expensive. The addition of regular treatment with inhaled steroids to bronchodilator treatment is appropriate for symptomatic COPD patients with an FEV1<50% predicted (Stage III: Severe COPD and Stage IV: Very Severe COPD) or repeated exacerbations (for example, more than 3 times during the last 3 years). Chronic treatment with systemic steroids should be avoided, if possible.