Effectiveness and safety of traditional Chinese medicine on stable chronic obstructive pulmonary disease: A systematic review and meta-analysis

Abstract

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 PubMed、 the Cochrane Library、CNKI、CBM 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.

Keywords: Chronic obstructive pulmonary disease; Traditional Chinese medicine; randomized controlled trials; systematic review.