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ObjectiveTo analyze the development status and quality of clinical practice guidelines for the treatment of dominant diseases with Chinese patent medicines (CPMs). MethodsDatabases were searched from Jan. 2019 to Dec.2023 to collect the published clinical practice guidelines of CPMs for the treatment of dominant diseases. The information about the title, the participants, clinical problems, outcomes, evidence grade, recommendations, and recommendation strength in the included clinical practice guidelines were collected, for which the development status was analyzed, and the quality was evaluated with the Scientific, Transparent and Applicable Rankings (STAR) tool for clinical practice guidelines. ResultsTotally, 34 guidelines were included, involving 273 kinds of CPMs. One to ten (with the medium five) clinical problems were proposed from 29 clinical practice guidelines respectively. All the guidelines divided the evidence into four grades according to Grade of Recommendation Assessment, Deve-lopement an Evaluation. And 28 guidelines had five levels of recommendation strength. A total of 344 recommendations were extracted, including 86 strong-recommendations, 191 weak-recommendations (including 36 weak recommendations only based on expert consensus) and 67 recommendations with unclear recommendation strength. All guidelines had high scores in the three areas of “clinical questions (94.20%)”, “evidence (91.45%)” and “recommendations (89.06%)”, while the scores in the three areas of “registry (22.06%)”, “protocol (19.00%)” and “accessibility (31.51%)” were low. The STAR recommended stars of 8 guidelines were 5.0~4.0 stars, while that of 18 guidelines were 3.5~2.5 stars, and 8 guidelines were 2.0~1.0 stars. The three guidelines with the highest recommended stars were depressive disorder, community-acquired pneumonia, and influenza in adult. ConclusionThere is a certain gap in the quality of the published clinical practice guidelines of CPMs, and the quality of the guidelines could be further improved in registry, protocols, funds, and accessibility.
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Chronic obstructive pulmonary disease (COPD) has a high global morbidity and mortality and a severe disease burden, yet progress in treatment and prevention has been slow in recent decades. Early COPD has few symptoms and is severely underdiagnosed and undertreated; it is crucial to search for effective clues of early COPD and provide management interventions. By reviewing the definition, risk factors, diagnosis and management interventions, this study explores the disease evolution of early-stage COPD, which can help clinical practice to develop more effective preventive and therapeutic strategies for stopping or slowing down the natural progression of the disease, improving the long-term prognosis, and reducing the disease burden.
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Humans , Pulmonary Disease, Chronic Obstructive/drug therapy , Prognosis , Risk FactorsABSTRACT
Chronic obstructive pneumonia cancer transformation refers to the malignant transformation of long-term repeated chronic inflammation of the lung. Traditional Chinese Medicine believes that the etiology and pathogenesis of chronic obstructive pneumonia cancer transformation always belong to the deficiency of origin and excess of signs. Chronic obstructive pulmonary disease causes damage to the qi of the lung, spleen and kidney. Qi is yang, and qi deficiency leads to yang deficiency. Yang deficiency and abnormal warm would result in qi stagnation, phlegm coagulation and blood stasis. It is the key to the transformation of chronic obstructive pneumonia cancer. Kidney yang is the root of yang qi. Deficiency of kidney yang is the initiating factor for the transformation of chronic obstructive pneumonia cancer. Deficiency of lung yang is the fundamental factor for the transformation of chronic obstructive pneumonia cancer. Deficiency of kidney yang and deficiency of spleen yang are the driving factors for the transformation of chronic obstructive pneumonia cancer. Therefore, this article discussed the role of kidney yang in the transformation of chronic obstructive pneumonia cancer from the theory of "Qi Zhu Xu Zhi", in order to broaden the thinking of clinical diagnosis and treatment of the disease.
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Patients in the perioperative period are often at risk of malnutrition due to the disease itself, surgical trauma, stress, and fasting. Oral nutritional supplementation is widely used in the perioperative period as the first choice for nutritional therapy. This article summarizes the effects, usage, adverse reactions and coping methods of oral nutritional supplementation during perioperative period, aiming to understand the current status of oral nutritional supplementation in perioperative period, and provide reference for subsequent application research of oral nutritional supplementation in perioperative period.
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Objective:To analyze the current hotspots of international research on patient safety in recent 10 years, and to provide reference for the scientific research and practical management of patient safety in China.Methods:Based on Web of Science database, CiteSpace visual analysis software was used to analyze the related literature on patient safety collected from January 2009 to December 2018. Word frequency analysis and Co-word clustering were performed on research institutions, authors, countries, journals, cited literature and high frequency keywords.Results:At present, the international research on patient safety is mainly concentrated in European and American higher educational institution with Harvard University as the core; the core journals are The Journal of the American Medical Association, New England Journal of Medicine, Lancet and other journals with the highest international academic influence; the patient safety phase is excavated through keyword co-occurrence cluster analysis. There are 9 international research hotspots, such as safety practice management, safety index research, safety education and safety culture construction. Conclusion:The relevant research background and current situation in the international field of patient safety are in a mature and stable stage. The research team is mainly concentrated in developed areas such as Europe and the United States, and a more closely cooperative and shared research model has been formed. The research hotspot and focus are closely around the multi-disciplinary and multi-field research theme of "patient-centered" advocated by the World Health Organization, which is worthy of domestic researchers' reference and learning. Also, the research and exploration work cored on patient safety domestically needed to be further structured and promoted.
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Objective:To establish a risk prediction model for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) using regression analysis and verify the model.Methods:The risk factors and acute exacerbation of 1 326 patients with chronic obstructive pulmonary disease (COPD) who entered the stable phase and followed up for 6 months in the four completed multi-center large-sample randomized controlled trials were retrospectively analyzed. Using the conversion-random number generator, about 80% of the 1 326 cases were randomly selected as the model group ( n = 1 074), and about 20% were the verification group ( n = 252). The data from the model group were selected, and Logistic regression analysis was used to screen independent risk factors for AECOPD, and an AECOPD risk prediction model was established; the model group and validation group data were substituted into the model, respectively, and the receiver operating characteristic (ROC) curve was drawn to verify the effectiveness of the risk prediction model in predicting AECOPD. Results:There were no statistically significant differences in general information (gender, smoking status, comorbidities, education level, etc.), body mass index (BMI) classification, lung function [forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), etc.], disease status (the number and duration of acute exacerbation in the past year, duration of disease, etc.), quality of life scale [COPD assessment test (CAT), etc.] and clinical symptoms (cough, chest tightness, etc.) between the model group and the validation group. It showed that the two sets of data had good homogeneity, and the cases in the validation group could be used to verify the effectiveness of the risk prediction model established through the model group data to predict AECOPD. Logistic regression analysis showed that gender [odds ratio ( OR) = 1.679, 95% confidence interval (95% CI) was 1.221-2.308, P = 0.001], BMI classification ( OR = 0.576, 95% CI was 0.331-1.000, P = 0.050), FEV1 ( OR = 0.551, 95% CI was 0.352-0.863, P = 0.009), number of acute exacerbation ( OR = 1.344, 95% CI was 1.245-1.451, P = 0.000) and duration of acute exacerbation ( OR = 1.018, 95% CI was 1.002-1.034, P = 0.024) were independent risk factors for AECOPD. A risk prediction model for AECOPD was constructed based on the results of regression analysis: probability of acute exacerbation ( P) = 1/(1+ e- x), x = -3.274 + 0.518×gender-0.552×BMI classification + 0.296×number of acute exacerbation + 0.018×duration of acute exacerbation-0.596×FEV1. The ROC curve analysis verified that the area under ROC curve (AUC) of the model group was 0.740, the AUC of the verification group was 0.688; the maximum Youden index of the model was 0.371, the corresponding best cut-off value of prediction probability was 0.197, the sensitivity was 80.1%, and the specificity was 57.0%. Conclusion:The AECOPD risk prediction model based on the regression analysis method had a moderate predictive power for the acute exacerbation risk of COPD patients, and could assist clinical diagnosis and treatment decision in a certain degree.
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Objective:To understand the preparation of evidence-based nursing practice for postoperative venous thrombosis in the department of spine and orthopedics in our hospital, and to identify the obstacle factors in the process of evidence-based nursing practice so as to promote the successful transformation and application of evidence.Methods:A questionnaire survey was conducted among 164 nurses in Department of Orthopedics of Wuhan Union Hospital in Hubei Province by using self-made general data questionnaire and Clinic Readiness of Evidence-Based Nursing Assessment (CREBNA).Results:The total score of CREBNA was (135.99 ±14.52) points, accounting for 87.10% of the full score. The average score of each subscale item was from high to low: organization environment subscale (4.44±0.67) points, evidence subscale (4.41±0.60) points and promotion factor subscale (4.31±0.69) points. Multiple stepwise regression analysis showed that different levels of understanding of evidence-based nursing practice was the main influencing factor of spine orthopedic nurses′ evidence-based practice readiness ( P<0.05). Conclusion:In this study, there were good level of readiness for evidence-based nursing practice and the current environment is conducive to the development of evidence-based practice programs. Before the application of evidence, managers should clarify the obstacles to change and formulate individual intervention measures to promote the clinical application of evidence.
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Objective:To evaluate the clinical effect of integrated traditional Chinese and Western medicine on common type of coronavirus disease 2019 (COVID -19) in Henan Province. Methods:A prospective single arm clinical study was performed. Patients with common type of COVID -19 admitted to seven designated hospitals for COVID -19 in Henan Province from January 25th to February 26th, 2020 were enrolled, and treated with integrated traditional Chinese and Western medicine. The negative transformation of 2019 novel coronavirus (2019 -nCoV) nucleic acid, disease outcome, hospital stay, clinical symptoms and signs scores, and chest imaging performance were observed. Results:Totally 86 cases were included in the analysis, including 48 males (55.8%), aged 43.5 (35.0, 53.3) years old, 24 patients (27.9%) with previous medical history. Fifty-eight patients were primarily diagnosed COVID -19 and 28 patients were transferred. The 2019 -nCoV nucleic acid of 86 cases (100%) turned negative, and the median time of turning negative was 10 (7, 14) days. Eighty-six cases (100%) were discharged from hospital, and none turned into the severe type; the average length of hospital stay was (13.8±5.6) days. The scores of fever, cough, chest tightness, shortness of breath, and fatigue decreased with the treatment time, and the scores of 7 days and 14 days after treatment were significantly lower than those before treatment [fever (points): 0 (0, 0), 0 (0, 0) vs. 1 (0, 1); cough (points): 1 (0, 1), 0 (0, 1) vs. 1 (0, 2); chest tightness (points): 0 (0, 0), 0 (0, 0) vs. 0 (0, 1); shortness of breath (points): 0 (0, 0), 0 (0, 0) vs. 0 (0, 1); fatigue (points): 0 (0, 1), 0 (0, 1) vs. 1 (0, 1); all P < 0.05]. The improvement rate of X ray and CT image was 42.9% (12/28) and 81.0% (64/79), respectively. Conclusions:The treatment with integrated traditional Chinese and Western medicine has good curative effect on common type of COVID -19 in 7 designated hospitals of Henan Province. It can improve the clinical symptoms, promote the absorption of pulmonary inflammation, and to some extent control the progress of disease and shorten the time of turning negative of virus nucleic acid and hospital stay.
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Objective:To discuss the emergency nursing management procedure in Department of Microsurgery during novel coronavirus pneumonia(COVID-19) and evaluate the effect of the prevention and control procedures.Methods:From January, 20- February 20, 2020, in order to prevent the medical staff and patients from infection of COVID-19, prevention and control measures were put in place which included screening and diagnosis of emergency pa- tients at the Department of Emergency through check body temperature and lung CT scan, monitoring body temperature and finger blood oxygen saturation on all inpatients and their accompanies, confirming the diagnosis and quarantine the patients who were in high temperature with abnormal lung CT scans, disinfecting and summary disinfection of the quaran- tine wards where suspected patients stayed, training medical staff for personal protections, standardizing the use and man- agement of personal protection equipment (PPE), managing medical staff in wards, educating patient about the COVID-19 to relive their nervousness, etc.Results:Of the 4 patients with persistent fever, 2 were diagnosed as new coronavirus infection. Of the 2 COVID-19 patients, 1 had confirmed diagnosis and transferred, the other who with highly suspected COVID-19 was quarantined at home. All medical staffs were trained with COVID-19 prevention and control proce- dures, with a qualification rate at 100%. Fourty-eight medical staffs were put on front-line duty and the rest of 17 were put on standby. Apart from one medical staff had been infected at the early phase of COVID-19, no one was in- fected after the emergency management and protective measures were implemented. All medical devices were used strictly to follow the controlled procedures. All patient wore masks.Conclusion:During the COVID-19 epidemic, emergency management measures were taken to avoid cross infection in hospital, which ensured the safety of medical staff and patients. The COVID-19 prevention and control measures were practical, in time and effective.
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Objective@#To understand the preparation of evidence-based nursing practice for postoperative venous thrombosis in the department of spine and orthopedics in our hospital, and to identify the obstacle factors in the process of evidence-based nursing practice so as to promote the successful transformation and application of evidence.@*Methods@#A questionnaire survey was conducted among 164 nurses in Department of Orthopedics of Wuhan Union Hospital in Hubei Province by using self-made general data questionnaire and Clinic Readiness of Evidence-Based Nursing Assessment (CREBNA).@*Results@#The total score of CREBNA was (135.99 ±14.52) points, accounting for 87.10% of the full score. The average score of each subscale item was from high to low: organization environment subscale (4.44±0.67) points, evidence subscale (4.41±0.60) points and promotion factor subscale (4.31±0.69) points. Multiple stepwise regression analysis showed that different levels of understanding of evidence-based nursing practice was the main influencing factor of spine orthopedic nurses′ evidence-based practice readiness (P<0.05).@*Conclusion@#In this study, there were good level of readiness for evidence-based nursing practice and the current environment is conducive to the development of evidence-based practice programs. Before the application of evidence, managers should clarify the obstacles to change and formulate individual intervention measures to promote the clinical application of evidence.
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Analogy is the significant thinking method in TCM and it has been recorded abundantly in ancient literature of TCM. The analogy idea had been adopted in the connotation of the reinforcing and reducing principle and method of traditional acupuncture, such as the reinforcing and reducing manipulation techniques, the timing of the reinforcing and reducing method and the effects of . In view of the analogy idea, the relevant reinforcing and reducing principles andmethods of traditional acupuncture were collated and analyzed in the article. It is anticipated that the origin and essence of reinforcing and reducing principles and methods can be better identified and this thinking characteristic of ancient acupuncture theory be widely understood and fully emphasized.
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Acupuncture TherapyABSTRACT
Objective To evaluate the effectiveness of nutritional support in the treatment of primary chylous reflux obstacle caused by primary lymphatic dysplasia among infants and investigate the effects of the essential components of therapeutic formula milk in treating this disease.Methods Seven infants,who were diagnosed at Beijing Shijitan Hospital between 2012 and 2014 with primary chylous reflux obstacle and aged (8.9±4.6) months at the onset,were retrospectively analyzed to evaluate effectiveness of the nutrition support and prognosis of the disease.Results After personalized enteral nutrition support (using proteins,short peptides and medium-chain triglyceride) of (8.3±2.8) months,heights and weights of all the seven infants were kept between the 3rd and 97th percentile lines,and the growth curve showed onward and upward trend.Their plasma albumin levels reached (43.7±4.4) g/L.The infants defecated 1-2 times a day and the texture of feces was formed and soft with yellow color.Conclusion Clinical symptoms and physical signs of the seven infants were improved after nutrition support,which contributed to the recovery.
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There are connotations on regulating deficiency and excess by acupuncture reinforcing and reducing in (), including regulating and , regulating blood and , regulating weakened body resistance and state of evil domination, regulating the deficiency and excess of syndrome. The deficiency and excess usually mean the objects received reinforcing and reducing, such as tangible blood stasis, pus, water, etc, and invisible . The deficiency and excess had always mean the symptoms of diseases since (), and the reinforcing and reducing of acupuncture was regulating . Therefore the connotations of reinforcing and reducing of acupuncture changed and there were complex acupuncture reinforcing and reducing manipulations. The various deficiency and excess connotations and stressing on acupuncture regulating made important changes for the theories and methods of acupuncture reinforcing and reducing which showed the profound impacts of the philosophical thought of monism in ancient China on acupuncture and moxibustion science.
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Humans , Acupuncture , China , MoxibustionABSTRACT
The reinforcing and reducing technique based on the speed of needle insertion and withdrawal is the important acupuncture technique recorded in(). Regarding the speed of needle insertion and withdrawal, the timing of needle insertion and withdrawal is one of the key factors to judge the therapeutic effects. In the paper, the origin was studied on the two methods of waiting forrecorded in(), e.g. "waiting for respiratory" and "waiting forbeneath needle"; and its application progression and clinical significance were explained. Of them, the "waiting forbeneath needle" is mostly used to decide the timing of needle withdrawal and closely related to the therapeutic effects of reinforcing and reducing technique; and its application is fully developed in later generations. In(), it stresses the needle insertion after waiting forwith the assistant hand, lifting and thrusting manipulation is followed after arrival ofbeneath needle. This technique brings the impacts on the reinforcing and reducing technique of acupuncture in later generations.
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<p><b>OBJECTIVE</b>To explore the effect of scalp acupuncture for children with cerebral palsy whose video-electroencephalogram(VEEG) showed epileptiform discharges.</p><p><b>METHODS</b>A total of 184 children with cerebral palsy whose VEEG showed epileptiform discharges or those combined with epilepsy were randomly assigned into a combination group (99 cases) and a rehabilitation group (85 cases). All the cases were treated with the original antiepileptic drugs. The conventional physical training and massage were applied in the rehabilitation group for 3 courses with 20 d at the interval, once a day, 5 times a week and 15 times as one course. Based on the treatment as the rehabilitation group, scalp acupuncture was used in the combination group for 3 courses with 15 d at the interval, once the other day and 10 times as one course. Shenting (GV 24), Benshen (GB 13), Sishencong (EX-HN 1) were selected as the main acupoints, combined with motor zone, foot motor-sensory area, balance zone,and temple-three-needle etc. Clinical onset and VEEG results were observed before and after treatment.</p><p><b>RESULTS</b>After treatment in the combination group, 27 cases improved; 47 cases had no effect; 25 cases aggravated. While in the rehabilitation group, 11 cases improved; 46 cases had no effect; 28 cases aggravated. There was no statistically significance between the two groups (>0.05). As for the cases with epilepsy onset in the combination group, 8 cases improved; 4 cases had no effect; 4 cases aggravated. In the rehabilitation group, 4 cases had no effect; 7 cases aggravated. The result in the combination group was better than that in the rehabilitation group (<0.05). As for the cases with epileptiform discharges in the combination group, 19 cases improved; 43 cases had no effect; 21 cases aggravated. In the rehabilitation group, 11 cases improved; 42 cases had no effect; 21 cases aggravated. There was no significance between the two groups (>0.05).</p><p><b>CONCLUSIONS</b>Scalp acupuncture therapy does not increase the risk of onset or epileptiform discharges in the children with cerebral palsy combined with epilepsy or epileptiform discharges. Scalp acupuncture combined with rehabilitation is better than simple rehabilitation for thosewith cerebral palsy and epilepsy onset.</p>
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The forming and development of traditional reinforcing and reducing method of acupuncture was rooted in traditional culture of China, and was based on the ancients' special understanding of nature, life and diseases, therefore its principle and methods were inevitably influenced by philosophy culture and medicine concept at that time. With deep study onand representative reinforcing and reducing method of acupuncture, the implied ideological concept, including contradiction view and profit-loss view in ancient dialectic,balance theory, concept of life flow, monophyletic theory of, theory of existence of disease-evil,-astrology theory, theory of inter-promotion of five elements, were summarized and analyzed. The clarified and systematic understanding on guiding ideology of reinforcing and reducing method of acupuncture could significantly promote the understanding on principle, method, content and manipulation.
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OBJECTIVE: To evaluate the efficacy and safety of the comprehensive interventions based on three Traditional Chinese medicine (TCM) patterns therapy in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and AECOPD risk window. METHODS: A prospective, multi-center, single-blinded, double-dummy and randomized controlled clinical trial is being conducted to test the therapeutic effects of a sequential two stage treatment. A total of 364 patients were enrolled into this study with 182 in each treatment group (TCM and conventional). Patients received medication (or control) according to their assigned group. TCM treatment according to syndrome differentiation for AECOPD were administered twice daily to patients with AECOPD over 7-21days, followed by TCM for AECOPD risk window (RW) over 28days. All patients were followed up for 6 months. Exacerbations were used as the primary outcome measures. Forced expiratory volume in the first second (FEV1) and the modified medical research council dyspnea (MMRC) scale, quality of life and mortality rate were used as secondary outcome measures. RESULTS: Of 364 randomized patients, 353 were included in the intention-to-treat analysis and 290 in the per-protocol analysis. In the TCM group, 16 patients (10.4%) reached the primary end point; 24 (17.7%) in the conventional group (RR 0.59, 95% CI 0.33-1.06; p=0.074). Among patients with a re-exacerbation, the median time to event was 107.5days (interquartile range [IQR], 39.5-129.0) in the TCM and 50days (IQR, 31-130.5) in the conventional group (P=0.011). After exacerbation therapy and a further 180-days follow-up, patients in the TCM group had significant improvements in dyspnea, as measured by MMRC (P=0.003), Patients in the TCM group also had improvements in health-related quality of life (P=0.002), as measured COPD Assessment Test (CAT). There was no difference between groups in death, and recovery of lung function. There were no differences between the TCM and conventional treatment group in adverse events. CONCLUSIONS: In patients presenting to the respiratory department with acute exacerbations of COPD, TCM treatments with syndrome differentiation will have beneficial effects with regard to re-exacerbation, relieving symptoms, improving quality of life for COPD patients.
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Drugs, Chinese Herbal/therapeutic use , Pulmonary Disease, Chronic Obstructive/drug therapy , Aged , Female , Humans , Male , Medicine, Chinese Traditional/methods , Prospective Studies , Risk , Single-Blind MethodABSTRACT
There are the obvious differences in the framework and structure between the teaching materials of acupuncture and moxibustion in the Republic of China and the traditional works, in which, the importance to the techniques is very clear. ①Attaching the great importance to the manipulation elements of acupuncture-moxibustion techniques:explaining clearly the preparation and the storage of the device of acupuncture and moxibustion, as well as the manipulation procedures and methods. ②Attaching the great importance to the localization of acupoint and decreasing the consideration to the theory of meridians and collaterals. ③Connecting the principles of acupuncture and moxibustion with the operation procedures and emphasizing the scientific evidences. The changes mentioned above originate from the following profound social and historical factors. ①Influences from the western culture and advanced science and technology, in which, pursuit of scientific and practical value is the mainstream in the time of Republic of China. ②Attaching the great importance to the specific characteristics of acupuncture and moxibustion and the training to the technical personnel, by which, the medical scholars of acupuncture and moxibustion in the Republic of China could enable the science of acupuncture and moxibustion to be survived and then developed in adverse situation. ③The scientific elaboration of the principle of acupuncture and moxibustion is a kind of academic adjustment on the influence of western learning.
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OBJECTIVE: This study was intended to evaluate the efficacy and safety of Traditional Chinese Medicine (TCM) on stable chronic obstructive pulmonary disease (COPD). METHOD: A systematic review was conducted of clinical trials that compared TCM plus conventional medicine treatment versus conventional medicine treatment alone. Randomized controlled trials (RCTs) of clinical therapeutic studies on COPD by TCM were included. Searches were applied to the following electronic databases: The PubMedã the Cochrane LibraryãCNKIãCBM and VIP. No blinding and language restriction was used. All trials included were analyzed according to the criteria of the Cochrane Handbook. Review Manager 5.2 software was used for data analysis. RESULT: 37 randomized clinical trials enrolling 3212 patients were included. Follow-up duration ranged from 4 weeks to 1.5 years. Compared to conventional medicine treatment alone, TCM plus conventional medicine treatment showed improvement in forced expiratory volume in one second (FEV1) (MD 0.12 L; 95% CI 0.08 to 0.16), and less exacerbation (OR -0.86; 95% CI -1.13 to -0.60). TCM treatment also led to a statistically improvement in SGRQ score compared to placebo (MD -4.36; 95% CI -7.12 to -1.59). There was statistically significant difference in six-minute walk distance (MD 36.66 meters, 95% CI 24.57 to 48.74) found with TCM compared to placebo. CONCLUSION: Among patients with stable COPD, TCM plus conventional medical treatment therapy might be associated with reduction risk of exacerbation, improvement of lung function, better quality of life and higher exercise capacity. The results were limited by the methodological flaws of the studies. High quality studies are needed to provide clear evidence for the future use of TCM.
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Drugs, Chinese Herbal/therapeutic use , Medicine, Chinese Traditional , Pulmonary Disease, Chronic Obstructive/drug therapy , Humans , Randomized Controlled Trials as Topic , Respiratory Function Tests , Treatment OutcomeABSTRACT
OBJECTIVE: To evaluate the efficacy and long-term effects of the three therapies for regulating and reinforcing lung and kidney (reinforcing lung and invigorating spleen, reinforcing lung and replenishing kidney, and supplementing Qi and nourishing kidney) in Traditional Chinese Medicine (TCM) on osteoporosis in rats with chronic obstructive pulmonary disease. METHODS: Totally 120 rats were randomly divided into control, model, Bufeijianpi, Bufeiyishen, Yiqizishen, aminophyline groups. Repeated smoke inhalations and bacterial infections were used to duplicate the stable Chronic obstructive pulmonary disease rat model. Normal saline was given to the air control and model groups, while Bufeijianpi granule, Bufeiyishen granule, and Yiqizishen granule, and aminophylline were administrated to rats in the Bufeijianpi, Bufeiyishen, Yiqizishen, and aminophylline groups respectively from weeks 9 through 20. Another 12 weeks without medicines to observe the long-term effect. Rats were sacrificed at week 20 and week 32. Bone mass density (BMD), bone mineral content (BMC), morphology of the femoral head, lung function, and levels of serum interleukin (IL)-1ß, IL-6, and tumor necrosis factor-α were detected. RESULTS: At weeks 20 and 32, tidal volume, peak expiratory flow and expiratory flow at 50% tidal volume in the three TCM-treated groups were higher than those in the model group (P < 0.05). Femur weight, BMD, and BMC were significantly higher in the three TCM-treated groups and the aminophylline-treated group compared with the model group (P < 0.01), except for BMC in the Yiqizishen-treated group at week 20. CONCLUSION: Bufeijianpi, Bufeiyishen, and Yiqizishen granules show good effects in the prevention and treatment of osteoporosis, which can alleviate airflow limitations and inflammation, improve BMD and BMC of the femur, and have favorable long-term effects.