Analysis of animal models of stable chronic obstructive pulmonary disease based on clinical features of traditional Chinese medicine and western medicine / 中国中药杂志

This study analyzed the advantages and disadvantages of existing animal models in China and abroad and their goodness of fit based on the clinical characteristics and diagnostic criteria of stable chronic obstructive pulmonary disease(COPD) in traditional Chinese medicine(TCM) and western medicine, followed by the collation and summarization of model evaluation methodologies. The results showed that the existing animal models of stable COPD were mainly modeled via smoke exposure or the combination of multiple methods like smoke exposure plus lipopolysaccharide or protease or bacterial infection. These animal models generally failed to simulate the clinical characteristics of TCM, and their goodness of fit in western medicine was higher than that in TCM. There is a lack of research on the animal models of stable COPD and the disease-syndrome combination models. Although the modeling is guided by the pathogenesis or mechanism of diseased humans, the established models were still not identical with the actual clinical situations. In-depth research is needed to develop quantitative standards for stable COPD models.

Effect of Dialectical Therapy of Bufeitang Combined with Shengesan and Fujiu Application on COPD at Stable Period and Lung-kidney Qi Deficiency Syndrome / 中国实验方剂学杂志

Objective::To observe the clinical efficacy of dialectical therapy of Bufeitang combined with Shengesan and Fujiu application on chronic obstructive pulmonary disease (COPD) and lung-kidney Qi deficiency syndrome, and its effect on inflammatory damage and airway remodeling. Method::One hundred and thirty-four patients were randomly divided into control group (66 cases) and observation group (68 cases) by random number table. Patients in control group got spiriva by powder inhaler, 1 grain/time, 1 time/day, and salmeterol xinafoate and fluticasone propionate powder for inhalation for spray as appropriate, 1 suction/time, 1-2 times/days, for a continued 12 months. In addition to the therapy of control group, patients in observation group were also given Fujiu application at two-tailed acupoints of Feiyu, Piyu and Shenyu for the first day of the every San Fu and San Jiu, and dialectical therapy of Bufeitang combined with Shengesan were given at the first day of San Fu and San Jiu for 2 months. The course of treatment was 12 months. Before and after treatment, FEV1% of self-assessment questionnaire of patients with COPD (CAT), 6-min walking distance, St George's respiratory questionnaire (SGRQ), severity of dyspnea (mMRC) and index of BODE were assessed. And levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), matrix metalloproteinase-9 (MMP-9) and matrix metalloproteinase inhibitor-1 (TIMP-1) were detected. Result::After treatment, scores of CAT, the total score of SGRQ, scoring of each dimension and index of BODE in observation group were all lower than that in control group (P<0.01), while FEV1% was higher than that in control group (P<0.01). And 6-min walking distance was more than that in control group (P<0.01), and the numbers of acute exacerbations were less than that in control group (P<0.01). The severity of dyspnea was lighter than that in control group (Z=2.047, P<0.05). And levels of MMP-9, TNF-α, IL-6 and ratio of MMP-9/TIMP-1 were lower than those in control group (P<0.01), whereas the level of TIMP-1 was higher than that in control group (P<0.01). Conclusion::Dialectical therapy of Bufei decoction combined with Shenge powder and Fujiu application can alleviate the current symptoms of dyspnea, improve exercise tolerance, quality of life and pulmonary function, reduce the number of acute exacerbations, relieve inflammation damage and airway remodeling. The comprehensive clinical efficacy is better than that of conventional western medicine.

Clinical practice guideline for stable chronic obstructive pulmonary disease with traditional Chinese medicine (draft version for comments) / 中国中药杂志

By referring to the standards and procedures of WHQ Handbook for Guideline Development, under the guidance of relevant laws, regulations, and technical documents, in line with the principle of "evidence-based, consensus-based, experience-based", and based on the best available evidences, fully combined with expert experience and patient preferences, we summarized eight clinical questions in this paper: can traditional Chinese medicine(TCM) treatment improve the clinical symptoms and the degree of dyspnea in patients with stable chronic obstructive pulmonary disease(COPD) Can TCM treatment reduce the number of exacerbations in patients with stable COPD? Can TCM treatment improve the exercise tolerance of patients with stable COPD? Can TCM treatment improve the quality of life of patients with stable COPD? Can TCM treatment delay the decline of lung function in patients with stable COPD? Can TCM treatment improve anxiety and depression in patients with stable COPD? Does the point application therapy benefit patients with stable COPD? Can non-pharmacological treatment benefit patients with stable COPD? Based on these eight clinical problems, the cha-racteristics of TCM itself, and actual clinical situation, the recommendations of TCM to treat the stable COPD were formed in this guideline, with intention to provide advice and guidance to clinicians in the use of TCM to treat stable COPD, to relieve symptoms, improve exercise tolerance, improve health status, prevent disease progression, prevent and treat exacerbations, and improve clinical efficacy. Due to the influence of the user's region, nationality, race and other factors, the implementation of this guideline should be based on the actual situations.

Efficacy of Gushen Dingchuan Pills and Western Medicine in Treating Stable Chronic Obstructive Pulmonary Disease Patients with Syndrome of Lung and Kidney Qi Deficiency / 中国实验方剂学杂志

Objective: To observe the efficacy of Gushen Dingchuan pills combined with routine western medicine in treating stable chronic obstructive pulmonary disease (COPD) patients with syndrome of lung and kidney Qi yin deficiency, and investigate its effect on serum levels of S100 calcium binding protein A8/A9 complex (S100A8/A9), nuclear factor (NF) -κB, tumor necrosis factor (TNF) -α, interleukin (IL) -8 and IL-1β. Method:One hundred and ten stable chronic COPD patients were selected and randomly divided into control group (55 cases) and treatment group (55 cases) by the random number table. Cases of control group received routine therapy by reference to the Guidelines for Diagnosis and Treatment for Chronic Obstructive Pulmonary Disease (2013 Revision). In addition to the therapy of control group, cases of treatment group were orally given Gushen Dingchuan pills(1.5-2.0 g/time, tid). Both groups were treated for 12 weeks. Lung function, scores of symptoms of lung and kidney Qi Yin deficiency, life quality St. George's respiratory questionnaire (SGRQ) score, and the efficacy were compared between both groups. Serum levels of S100A8/A9, NF-κB, TNF-α, IL-8 and IL-1β were detected for two groups. Result:After treatment, FEV1% and FEV1/FVC of treatment group were obviously higher, while score of symptoms of lung and kidney Qi deficiency were lower than control group (Pχ2=4.777, PPκB of treatment group were obviously lower than those of control group (Pα, IL-8, IL-1β of treatment group were remarkably lower than control group after treatment (PConclusion:Gushen Dingchuan pills combined with western medicine can treat stable chronic COPD patients with syndrome of lung and kidney Qi Yin deficiency by improving lung function, alleviating symptoms of lung and kidney Qi deficiency, increasing life quality and efficacy and decreasing levels of S100A8/A9 and NF-κB inflammatory factors.

Comprehensive Optimization of Rehabilitation Measures of Traditional Chinese Medicine to Elderly Patients with COPD at Stable Period / 中国实验方剂学杂志

Objective:To discuss the clinical efficacy of comprehensive optimization of rehabilitation measures of traditional Chinese medicine(TCM) on elderly patients with COPD at stable period, in order to study its effect on immune function and inflammatory factors. Method:One hundred and forty-four patients were randomly divided into control group and observation group by random number table. Patients in control group got ipratropium bromide, 40-80 μg/time, 2-4 times/days, salmeterol roticasone powder, 1 suction/time, 2 times/days, as well as comprehensive western medical treatment measures of healthcare education, oxygen therapy and respiratory muscle exercise. In addition to the basic therapy of ipratropium bromide and salmeterol roticasone powder, patients in observation group was added with syndrome differentiation therapy of TCM, foot bath with TCM and respiratory function exercise with TCM. The course of treatment was 6 months, and 6-month follow-up were recorded. Comprehensive assessment of COPD was recorded. Before and after treatment, respiratory questionnaire (mMRC), self-assessment test for patients with chronic obstructive pulmonary disease (CAT), forced expiratory volume in the first second (FEV1), FEV1%, St George's respiratory questionnaire (SGRQ), 6-minute walking distance (6 MWD) were scored. And levels of CD3+, CD4+, CD8+, CD4+/CD8+, interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-alpha) and hypersensitive C-reactive protein (hs-CRP) were detected. Result:Comprehensive assessment of COPD in the two groups were better than those before treatment (PZ=2.066, Pα were lower than those in control group (P+ was lower than that in control group (P1 and FEV1% were higher than those in control group (P+, CD4+, CD4+/CD8+ and 6-minute walking distance were more than those in control group (PConclusion:Comprehensive optimization of rehabilitation measures in TCM can inhibit inflammatory factors, improve immune function, alleviate clinical symptoms, improve lung function, improve exercise endurance and quality of life of patients, and promote the lung rehabilitation.

Nursing intervention based on domiciliary oxygen therapy tracking tables quantitative classification for elderly patients with stable chronic obstructive pulmonary disease / 中华护理杂志

Objective To explore the effects of nursing intervention based on domiciliary oxygen therapy tracking tables (DOTT) quantitative classification on domiciliary oxygen in elderly patients with stable chronic obstructive pulmonary disease (COPD).Methods Forty-two cases of elderly patients with stable COPD treated by domiciliary oxygen therapy from January 2015 to March 2015 were selected as the experimental group,and were given bilateral nasal catheter domiciliary oxygen therapy,and were provided domiciliary oxygen therapy management,nursing education and intervention according to results of family oxygen therapy compliance,symptom identification and oxygen safety,and family oxygen therapy confidence evaluated by family oxygen therapy tracking table.Other 30 cases of patients with stable COPD treated by bilateral nasal catheter domiciliary oxygen therapy and routine nursing during the same period of time were selected as the control group.Both groups were provided nursing care for at least 6 months.Nursing adherence,acute episode,patient satisfaction,and quality of life score before and after nursing of two groups were compared.Results Compared with the control group,nursing adherence and patient satisfaction after 6 months in the experimental group were higher,while rate of patients with acute episodes ≥ 2 times in the experimental group was lower (P＜0.05).Compared with that before nursing intervention,quality of life scores of two groups after nursing intervention were lower(P＜0.05).Compared with the control group,quality of life scores of the experimental group were all decreased (P＜0.05).Conclusion Nursing intervention based on domiciliary oxygen therapy tracking tables quantitative classification can effectively reduce the incidence of acute episodes,improve patient's nursing compliance,patient satisfaction,and quality of life.

Clinical observation of tiotropium combined with large dose salmeterol/fluticasone in the treatment of severe bronchial asthma with COPD stabilization / 中国生化药物杂志

Objective To evaluate the clinical efficacy of tiotropium combined with large dose salmeterol/fluticasone in the treatment of severe bronchial asthma with chronic obstructive pulmonary disease (COPD). Methods 60 patients with severe bronchial asthma with COPD stabilization in Taizhou hospital of Zhejiang province from January 2015 to December 2016 were selected and divided into the control and the study group according to the time of visiting hospital,30 cases in each group. The control group were given large dose Salmeterol/fluticasone on the basis of conventional treatment, the study group were treated with tiotropium bromide on the basis of control group. Results FEV1、FVC、FEV1/FVC、PEF and pulmonary function index were compared before the treatment between two groups. After treatment,FEV1,FVC,FEV1/FVC、PEF and pulmonary function index in the study group were better than the control group (P<0.05). Conclusion The combination of tiotropium and large dose salmeterol/fluticasone can significantly improve the clinical efficacy in the treatment of severe bronchial asthma and chronic obstructive pulmonary disease.

Analysis of irrational drug use in patients with stable chronic obstructive pulmonary disease / 天津医药

Objective To investigate the standard prescription in patients with stable chronic obstructive pulmonary disease (COPD) and to provide a reference for rational drug use. Methods A total of 157 patients with COPD in our hospital were included into the study from June 2016 to January 2017. Of patients, there were 3 patients with mild airflow limitation, 18 patients with moderate airflow limitation, 39 patients with severe airflow limitation and 97 patients with extremely severe airflow limitation. The self-made questionnaire was used to understand the basic situation, complications and irrational drug use. Results Most severe and extremely severe COPD patients were male, and most of them combined with high blood pressure and cardiovascular disease. Of the 157 patients, 12 cases with moderate airflow limitation used inhaled therapy of corticosteroids/bronchodilator medications, 45 cases combined with pneumocardial disease used compound methoxyphenamine, 26 cases used leukotriene receptor antagonist, 14 cases used antibiotics for no obvious infection symptom and 11 cases used systemic corticosteroids in stable COPD. All of them belong to rational drug use. Conclusion There are some unreasonable situations of drug using in patients with stable COPD. The medical staff should strictly control indications, strengthen the education for drug use, guide rational drug use and avoid the occurrence of adverse consequences.

"Application of ""Preventive Treatment"" for Stable Bronchiectasis" / 中国中医药信息杂志

Although the symptom of stable bronchiectasis is not significant, the four pathological factors including qi stagnation, sputum obstruction, blood stasis and lung-spleen qi vacuity still exist inside patients' bodies, making them in the state of both healthy and ill. This article discussed the application of the idea of preventive treatment to intervene and treat, which could prevent the emergence of new diseases and the changing of existing diseases. It could prevent vacuity evil and bandit wind, depressed qi transforming into fire, phlegm depressed in the lung and channel obstruction caused by long-term diseases. It can effectively prevent the acute attack of bronchiectasis and improve the patients' lung function and life quality.

Clinical observation of tiotropium combined with large dose salmeterol/fluticasone in the treatment of severe bronchial asthma with COPD stabilization / 中国生化药物杂志

Objective To evaluate the clinical efficacy of tiotropium combined with large dose salmeterol/fluticasone in the treatment of severe bronchial asthma with chronic obstructive pulmonary disease (COPD). Methods 60 patients with severe bronchial asthma with COPD stabilization in Taizhou hospital of Zhejiang province from January 2015 to December 2016 were selected and divided into the control and the study group according to the time of visiting hospital,30 cases in each group. The control group were given large dose Salmeterol/fluticasone on the basis of conventional treatment, the study group were treated with tiotropium bromide on the basis of control group. Results FEV1、FVC、FEV1/FVC、PEF and pulmonary function index were compared before the treatment between two groups. After treatment,FEV1,FVC,FEV1/FVC、PEF and pulmonary function index in the study group were better than the control group (P<0.05). Conclusion The combination of tiotropium and large dose salmeterol/fluticasone can significantly improve the clinical efficacy in the treatment of severe bronchial asthma and chronic obstructive pulmonary disease.

Analysis of irrational drug use in patients with stable chronic obstructive pulmonary disease / 天津医药

Objective To investigate the standard prescription in patients with stable chronic obstructive pulmonary disease (COPD) and to provide a reference for rational drug use. Methods A total of 157 patients with COPD in our hospital were included into the study from June 2016 to January 2017. Of patients, there were 3 patients with mild airflow limitation, 18 patients with moderate airflow limitation, 39 patients with severe airflow limitation and 97 patients with extremely severe airflow limitation. The self-made questionnaire was used to understand the basic situation, complications and irrational drug use. Results Most severe and extremely severe COPD patients were male, and most of them combined with high blood pressure and cardiovascular disease. Of the 157 patients, 12 cases with moderate airflow limitation used inhaled therapy of corticosteroids/bronchodilator medications, 45 cases combined with pneumocardial disease used compound methoxyphenamine, 26 cases used leukotriene receptor antagonist, 14 cases used antibiotics for no obvious infection symptom and 11 cases used systemic corticosteroids in stable COPD. All of them belong to rational drug use. Conclusion There are some unreasonable situations of drug using in patients with stable COPD. The medical staff should strictly control indications, strengthen the education for drug use, guide rational drug use and avoid the occurrence of adverse consequences.

Effect of Roxithromycin on Airway Inflammation in Patients with Chronic Obstructive Pulmonary Disease at Stable Phase / 中国药师

Objective:To investigate the effect of roxithromycin on airway inflammation in chronic obstructive pulmonary disease ( COPD) patients at stable phase to provide evidence for the clinical diagnosis and treatment .Methods:Totally 46 cases of outpatients with stable COPD were divided into the observation group and the control group .The control group received the conventional treatment , while the observation group was treated with roxithromycin capsules 150mg.d-1 additionally, and the treatment course was 10 months. The sputum, serum cytokines γ-IFN, IL-8 and TNF-αlevels, sputum leukocyte , neutrophil count and adverse reactions were observed and compared between the groups .Results:After the 5-month treatment, the levels of γ-IFN, IL-8 and TNF-αcytokines in serum and sputum in the observation group were significantly lower than those before the treatment (P<0.05) and in the control group (P<0.05).After the 10-month treatment, the above indices in the observation were further decreased when compared with those after the 5-month treatment (P<0.05), which were notably lower than those in the control group (P<0.05).There was only one case of ad-verse drug reactions in the observation group , and the patient was out of the study .Conclusion:Long-term use of roxithromycin at low dose can reduce cytokines in serum and sputum and inflammatory cell count in sputum in stable COPD patients , which exhibits the effect on airway inflammation to some extent .

Clinical efficacy of additive LiuJunZi decoction in treatment of chronic obstructive pneumonia / 中国生化药物杂志

Objective To investigate clinical efficacy of additive LiuJunZi decoction in treatment of patients with chronic obstructive pneumonia ( COPD) of both lung and spleen deficiency in stable phase.Methods A total of 58 patients with deficiency of both lung and spleen type stable COPD patients were randomly divided into treatment group and control group by a random number table, 29 cases in each group, patients in two groups were treated with salmeterol and fluticasone propionate powder for inhalation.On this basis, the treatment group were given additive Liujunzi Decoction, orally, with 3 months treatment.The clinical signs and symptoms of patients, pulmonary function, index of sputumand acute attack proportion in a year were observed and compared.Results After different treatment, total efficiency was 93.1% in treatment group, which was obviously higher than 65.5%in control group (P<0.05).After treatment, the values of FEV1 and FEV1/FVC improved compared with before treatment, and the above indexes of treatment group significantly improved compared with control group (P<0.05).The HDACs activety, levels of TNF-αand IL-8 mproved compared with before treatment, and the above indexes of treatment group significantly improved compared with control group (P<0.05).The acute attack was two cases in treatment group(6.9%), seven cases in control group(24.1%), but the difference had no statistically significant.Conclusion The additive Liujunzi decoction in the treatment of both lung and spleen deficiency type chronic obstructive pulmonary disease ( COPD) in stable phase has exact clinical curative effect, can significantly improve clinical symptoms and laboratory indexes, control the progression of the disease, and improve life quality of the patients.

Therapeutic Effect Assessment Indexes of Randomized Controlled Trials on Traditional Chinese Medicine Syndrome Differentiation and Treatment of Chronic Obstructive Pulmonary Disease：A Systematic Review / 世界科学技术-中医药现代化

This study was aimed to review of the selection and use of the therapeutic effect assessment indexes of randomized controlled trials ( RCTs ) on traditional Chinese medicine ( TCM ) syndrome differentiation and treatment of chronic obstructive pulmonary disease ( COPD ) based on clinical efficacy . Published studies were searched in the CBM , CNKI , VIP , Wanfang database , Cochrane Library , PubMed and Embase to identity all RCTS on TCM treatment of COPD . Two researchers selected studies and extracted data independently using a designed extraction form . The Cochrane collaboration software RevMan 5 . 1 was used for meta-analysis . The re-sults showed that a total of 40 RCTs were included . Meta-analyses showed that TCM syndrome differentiation and treatment of COPD can improve the pulmonary function and life quality , improve the clinical effect and TCM syndrome effect , reduce the number of acute exacerbation of COPD and improve clinical symptoms . Some therapeutic effect assessment indexes , such as pulmonary function , life quality , clinical comprehensive effect , the number of acute exacerbation of COPD, clinical symptoms and signs, syndrome effect and the integral of syndrome were used more frequent . Other indexes such as 6-min walk distance , BODE Index and health eco-nomic evaluation were used less frequently . It was concluded that TCM syndrome differentiation and treatment of COPD had certain therapeutic efficacy. A large number of strictly-designed, multicenter, high-quality RCTs are required because of the low quality of the included studies. The selection of therapeutic effect assessment indexes is still not standardized . The therapeutic effect assessment indexes should be selected based on differ-ent purposes of clinical studies with the clinical characteristics of TCM .

Effect and safety of two treatment methods in patients with stable phase of chronic obstructive pulmonary disease / 中国基层医药

Objective To investigate the effect and safety of Compound codeine phosphate syrup with Ambroxol treatment in the stable phase of chronic obstructive pulmonary disease. Methods 100 patients with stable COPD were divided into Compound codeine phosphate syrup with Ambroxolt treatment group (Group A) 50 cases and Compound codeine phosphate syrup treatment group( Group B) 50 cases,drug were given for 3 ～ 7d. The symptom score and efficacy of two groups before treatment and after treatment were compared. Results The symptom score of cough,sputum volume,sputum viscosity ,wheeze,sleep after treatment 8th day were improved significantly ( χ2 = 3. 891 ,χ2 =3. 992, χ2 = 4. 198, χ2 = 3.981, χ2 = 3. 879, allP < 0. 05; Total effective rate of cough, sputum volume, sputum viscosity,wheeze in group A(92. 0% ,94. 0% ,90. 0% ,90. 0% ) higher than that in group B(80.0% ,86.0% ,80. 0%,78.0% ) ( χ2 = 3.991, χ2 = 4. 012, χ2 = 3. 998, χ2 = 3.971, allP < 0. 05); The adverse reactions of A、 B group were 12.0% and 14.0%(χ2 =1.971,P>0.05). Conclusion Compound codeine phosphate syrup with Ambroxol is an effective and safe antitussive in the stable phase of chronic obstructive pulmonary disease.