Adjuvant Treatment with Xiaoqinglong Formula for Bronchial Asthma in Acute Attack: A Systematic Review of Randomized Controlled Trials

Abstract

Background. XQLF (Xiaoqinglong formula) is the most commonly used prescription of traditional Chinese medicine in the treatment of asthma. XQLF combined with western medicine has been used to treat bronchial asthma in more and more cases, and good results have been achieved. Therefore, this meta-analysis aimed to evaluate the adjuvant treatment of traditional Chinese medicine classic herbal formula XQLF with bronchial asthma in acute attack. Methods. The following electronic databases were systematically searched from inception to April 2019: PubMed, EMBASE database, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang, VIP Database for Chinese Technical Periodicals, and China Biology Medicine (CBM). Two reviewers searched these databases and independently evaluated all the eligible articles for inclusion. Stata 14.0 was used for data synthesis and analysis. Results. A total of 33 RCTs (randomized controlled trials) including 2176 patients were enrolled. All of the patients in these studies were in the acute attack stage of asthma. We conducted subgroup analysis according to the duration of treatment, which was 14 days, 10 days, and 7 days, respectively. The overall results show that adjuvant treatment with XQLF significantly improve CER (clinical efficacy rate) (RR = 1.17; 95% CI, 1.14 to 1.21; P<0.0001) and promote pulmonary function including FEV1 (WMD = 0.35; 95% CI, 0.27 to 0.43; P<0.0001), PEF (SMD = 1.02; 95% CI, 0.49 to 1.55; P<0.0001), and FVC (WMD = 0.51; 95% CI, 0.35 to 0.66; P<0.0001). The adjuvant treatment of XQLF can also reduce serum IgE concentration (SMD = −1.39; 95% CI, 1.92 to −0.85; P<0.0001) and serum EOS concentration at 14 days (WMD = −39.85; 95% CI, −56.20 to −23.49; P<0.0001). Conclusion. This study finally showed that XQLF has the auxiliary effect of improving the efficiency, promoting the lung function, and reducing the serum IgE in the treatment of acute attack asthma. This trial is registered with CRD42019133549.

Cang-ai volatile oil alleviates nasal inflammation via Th1/Th2 cell imbalance regulation in a rat model of ovalbumin-induced allergic rhinitis

“…Clinical studies have reported that YPFP appears to have an ameliorative effect on symptoms such as nasal itching and sneezing ( Cheong et al, 2022 ), and reduces the levels of interleukins like IgE and IL-4 in patients with AR ( Fang et al, 2014 ). Xiao-qing-long Tang (XQLT) (from the book Shang-Han-Lun by Zhongjing Zhang , who is regarded a medical genius by later generations), has the effect of warming the lung to dissipate cold, which can effectively treat respiratory diseases ( Wang et al, 2020 ). A systematic review and meta-analysis of randomized controlled trials demonstrated that oral XQLT can relieve AR symptoms and is effective and safe for clinical use ( Yan et al, 2022 ).…”

HDAC Downregulation of Xiaoqinglong Decoction in the Treatment of Allergic Rhinitis

“…As a classic Chinese medicine prescription, XQLD has been commonly used in the treatment of allergic diseases such as asthma and AR in clinical practice [6,17]. However, because its therapeutic mechanism has not been fully described, XQLD still lacks a sufficient theoretical basis for its further clinical promotion and application.…”

“…Type 2 inflammatory response and destruction of nasal epithelial function are key pathological changes in AR progression [18,19]. Previous studies have reported the therapeutic effect of XQLD on immune response [17], but the regulation mechanism still needs more ascertained proof. In our study, XQLD has been demonstrated to directly inhibit the expression of type 2 inflammatory cytokines (IL4, IL5, and IL13).…”

Investigating Xiaoqinglong Decoction in the Treatment of Allergic Rhinitis by Negatively Regulating HDAC in Mouse Model

“…In recent years, the effect of traditional Chinese medicine in treating AR has been gradually recognized [13], and the research on mechanism of TCM to treat AR has attracted a lot of attention. As a classic Chinese medicine prescription, XQLD has been commonly used in the treatment of allergic diseases such as asthma and AR in clinical practice [11,14].…”