Effects of the Chinese herb formula Yufeining on stable chronic obstructive pulmonary disease: A randomized, double-blind, placebo-controlled trial.

BACKGROUND: A Chinese herb formula Yufeining (YFN) has showed promise in the treatment of stable chronic obstructive pulmonary disease (COPD), less is known that the impact of YFN in combination with standard Western treatments on lung inflammation. This study evaluated the safety and efficacy of YFN as a treatment for stable COPD and as an anti-inflammatory agent. METHODS: Sixty patients with stable COPD were randomly assigned to two treatment groups (YFN treatment, N = 30; placebo treatment, N = 30). Both groups received inhaled steroids and bronchodilators during an 8-week intervention, and patient status was assessed at 8 weeks later and 4 months after treatment. The primary outcome included clinical efficacy. The secondary outcomes involved CAT score, mMRC grade, six-minute walking distance (6MWD). IL-8, TNF-α, IL-17A, LTB4, TGF-ß1 and CRP were also detection in peripheral serum, as well as adverse reaction conditions. RESULTS: The YFN group demonstrated a significant improvement in clinical efficacy (compare 89.3% to 63.3% in the placebo group; P < 0.05). CAT scores and mMRC grades significantly decreased (P < 0.05, P < 0.01), and 6MWD significantly increased (P<0.05), after YFN treatment. The levels of IL-8, TNF-α, LTB4 and CRP decreased significantly after 8 weeks of treatment compared to baseline levels in both groups. Only in the YFN treatment group, the levels of IL-17A decreased significantly after treatment compared to baseline levels (P < 0.05). No changes were observed inTGF-ß1 from pre-to post-treatment in either group (P > 0.05). Serum levels of IL-8, TNF-α, IL-17A, LTB4 and CRP decreased significantly after YFN treatment compared to the placebo group (P < 0.05). CONCLUSION: A combinatorial treatment approach with YFN, inhaled steroids and bronchodilators produced a clinically effective treatment for stable COPD, leading to a significant decrease in circulating inflammatory mediators. The study appeared YFN was safety. CLINICAL TRIAL REGISTRATION NUMBER: No. ChiCTR-IOR-17013577.

Diagnostic value of fractional exhaled nitric oxide for asthma-chronic obstructive pulmonary disease overlap syndrome.

To examine the difference in the fractional exhaled nitric oxide (FeNO) between chronic obstructive pulmonary disease (COPD) patients with asthma-COPD overlap syndrome (ACOS) and patients with Non-ACOS COPD (Non-ACOS) and to investigate the correlation between FeNO levels and the differential cell counts of eosinophils in induced sputum, in order to explore the diagnostic value of FeNO in ACOS.A prospective, case-control study was performed on 53 cases of ACOS group and 53 cases of Non-ACOS group in the Respiratory Medicine Outpatient of Zhangzhou Municipal TCM Hospital, Affiliated to Fujian University of Traditional Chinese Medicine. The FeNO levels and induced sputum cell counts were determined and the correlation between FeNO levels and eosinophile percentage was analyzed by Pearson linear correlation analysis.The FeNO levels in patients with ACOS (37[24.5-53.0]) ppb were significantly higher than those of patients with Non-ACOS (20 [15.5-24.5] ppb) (P < .01). Also, the percentage of eosinophils in induced sputum in the ACOS group (5.70 [1.50-17.62]%) were significantly higher than those of the Non-ACOS group (0.50 [0.00-1.00]%) (P < .01). FeNO in both groups correlated positively with the percentage of eosinophils in induced sputum (P < .01), with a correlation coefficient r of 0.521. The area under the receiver operating curve of FeNO for the diagnosis of ACOS phenotype was 0.815 (P < .01), the sensitivity and specificity reach highest when the cut off value was 25.50 ppb.The FeNO in patients from the ACOS group were significantly higher than those in Non-ACOS group and were moderately correlated with the percentage of eosinophils in induced sputum. The results indicated that FeNO may be used as a diagnostic index for ACOS, in addition to the induced sputum.

Efficacy of Chaihu Jisang decoction on post-infection cough and its effect on cough reflex sensitivity.

OBJECTIVE: To investigate the efficacy of Chaihu Ji Sang Decoction (CJSD), (a modification of Xiao Chaihu Tang (Minor Decoction of Bupleurum) was evaluated in patients with post-infection cough (PIC). Its effect on cough reflex sensitivity (CRS) was also described. METHODS: One hundred and eighteen patients with PIC were enrolled and randomly divided into an experimental group and control group (54 patients in each group). The experimental group was given CJSD orally, and the control group was given cetirizine hydrochloride for 7 d. Cough symptom scores and TCM symptom scores were compared before and after treatment. Efficacy, cough onset time, recurrence, and adverse drug reactions were additionally evaluated. Finally, CRS was evaluated before and after treatment of PIC patients in the experimental group. RESULTS: Fifty-two patients in the experimental group and fifty control patients completed the study. Cough symptom scores and the TCM symptom scores of the two groups were significantly improved after treatment, however cough symptoms in the experimental group 1 (0, 2) were significantly lower than the control group 2 (1, 2) after treatment (P < 0.05). Similarly, TCM symptom scores 4 (0, 7) in the experimental group were significantly lower than the control group 6 (3, 12) (P < 0.01). Overall, the effective rate of the experimental treatment (84.60%) was significantly higher than that of the control treatment (68.00%) (P < 0.01). The onset time of efficacy of the experimental treatment was one day faster than the control treatment [2 (2,3) d vs 3 (2,3) d, P < 0.01]. The relapse rate in the experimental group (9.09%) was lower than that of the control group (29.41%) (P < 0.05). 39 PIC patients in the experimental group completed a capsaicin cough challenge test before treatment. The lgC2 and lgC5 of the experimental group prior to treatment was 1.19 (0.59, 1.49) and 1.80 (1.49, 2.10), respectively. The lgC2, lgC5 of the healthy control group was 1.49 (0.89, 2.40) and 2.70 (2.40, 3.00), respectively. The differences in lgC2 and lgC5 between experimental group and healthy groups were significant at this time point (both P < 0.01). After treatment, 34 patients in the experimental group received re-examination. lgC5 increased from 1.80 (1.49, 2.10) to 2.10 (1.49, 3.00). CRS after treatment/re-examination was significantly lower than those of baseline in the experimental group (P < 0.05). CONCLUSION: CJSD could effectively improve the clinical symptoms of PIC patients, with demonstrable low recurrence and safety. CJSD also significantly decreased the CRS in patients with PIC.