The Effects and Safety of Chinese Oral Herbal Paste on Stable Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta‐analysis of Randomized Controlled Trials

Abstract

Background. Chinese oral herbal paste has been widely used in the treatment of chronic obstructive pulmonary disease (COPD). However, the treatment effects of herbal paste were controversial and lack evidence to support its clinical use. This study aims to systematically assess the efficacy and safety of Chinese oral herbal paste for the treatment of stable COPD. Methods. PubMed, Web of Science, CENTRAL, EMBASE, CNKI, VIP, CBM, and WANFANG database in addition to two websites of clinical trial registry were searched from respective inception to August 2019. Only randomized controlled trials (RCTs) studying Chinese herbal paste for the treatment of stable COPD were included. Methodological quality was assessed based on Cochrane risk of bias and GRADE approach. Data were analyzed using RevMan 5.3. Results. A total of 19 RCTs with 1303 individuals compared Chinese oral herbal paste and Western medicine (WM) with WM alone were included for meta-analysis. The review showed compared with WM alone, the combination of herbal paste and WM reduced exacerbation frequency. Subgroup analyses showed that after two to three months of treatment, compared with WM alone, Chinese herbal paste plus WM significantly decreased the St George’s Respiratory Questionnaire (SGRQ) scores, COPD assessment test (CAT) scores, and scores of traditional Chinese medicine (TCM) syndrome, and improved clinical effective rates, lung function, and 6-minute walk distance. No serious adverse events related to herbal paste were reported. Conclusion. Current evidence showed that Chinese oral herbal paste may be an effective and well-tolerated adjuvant therapy for stable COPD. Considering the risks of bias and heterogeneity, more high-quality, well-designed RCTs are still needed.

The Clinical Efficiency and the Mechanism of Sanzi Yangqin Decoction for Chronic Obstructive Pulmonary Disease

“…TCM has focused on the treatment of COPD for thousands of years [ 60 ]. Large-scale clinical trials have confirmed that TCM has made progress in controlling COPD [ 61 , 62 ].…”

Information Survey on the Use of Complementary and Alternative Medicine

“…Respiratory system pathologies benefit from the integration between conventional and CAMs, particularly homeopathy, homotoxicology, phytotherapy, acupuncture, and traditional Chinese medicine. A recent systematic review shows that Chinese oral herbal therapies are effective in reducing exacerbations in chronic obstructive pulmonary diseases [32], and different cases of asthma, in which current evidence does not support the systematic use of CAM in adults and children [33].…”

Guidelines of integrated Chinese and western medicine for diagnosis and treatment of chronic obstructive pulmonary disease (2022)

“…It could also reduce the number of AEs, and improve the efficiency of clinical treatment 24 . Another systematic review within 19 RCTs showed that the integration of Chinese medicine ointment and conventional Western medicine treatment could reduce the number of AEs and improve scores of SGRQ and CAT 25 . One more systematic review covering 100 RCTs showed that, on the basis of the conventional Western medicine treatment, giving TCM treatment based on syndrome differentiation combined acupuncture and moxibustion treatment could improve patients’ lung function, reduce the number of AEs, and improve scores of CAT, etc 26 .…”