COPD Stable Measure Of TCM Classification System Evaluation And Efficacy Of Timely Imperial Evil Scheme

Chronic obstructive pulmonary disease (COPD) is a common respiratory disease characterized by progressive, recurrent attacks and decreased lung function. It results in large economic losses; heavy burdens of society and families; high mutilation rate and high lethality rate. Intervention in stable phase of COPD is an important measure to reduce attacks. An obvious intervention of stable COPD is affected by measures of Traditional Chinese medicine such as traditional Chinese drugs, traditional sports and external therapies. The clinical treatment programs is directly affected by results of clinical trials. In this research,evaluate the quality by randomized controlled trials (RCTs) with interventions of Traditional Chinese medicine with patients in stable COPD from January2003to September2013. Besides, RCTs are divided into three classes by interventions:traditional Chinese drugs; traditional sports and Point therapies, to assess the clinical efficacy by systematic review/Meta-analysis to provide evidence for clinical application. In addition, clinical efficacies of stable COPD on therapeutic alliance of traditional Chinese medicine are evaluated.Object:1. Evaluate the quality of reporting studies of intervention in patients with stable COPD of RCTs on the efficacy of TCM published in journals. Improve the quality of literatures to increase the reliability of test results.2. In order to implement evidence-based treatment protocols to manage stable COPD, do systematic reviews of clinical efficacy by RCTs on interventions of Chinese medicine,acupuncture therapy,the traditional sports.3. Evaluate clinical efficacy of patients with stable COPD on therapeutic alliance of TCM based on theories of preventive treatment of disease.Method:1. Assessment of the quality literaturesTo retrieve five domestic and foreign literature databases from January2003to September2013, and evaluating the quality of reporting studies by using Jadad, CONSORT and Excel2010.2. Systematic reviewClinical efficacy is systematic evaluated by RCTs on traditional Chinese drugs, traditional sports and point therapies. Choose reporting studies of Chinese drug intervention on stable COPD (Jadad score>4) and the remaining two kinds (Jadad score>3). To extract Basic information, eligibility information and methods of reporting studies. The quality of reporting studies is evaluated by the Cochrane collaborations’tool for assessing risk of bias. RevMan5.2is used to analyze data.3. Clinical ResearchFour community health service stations are randomly divided into intervention group and controlgroup.Bailing Capsule combined with methods to resist pathogens are used in Intervention group, while control group uses basic treatment for6months. Observe symptom scores, CAT scores, mMRC scores, numbers of acute episode to evaluate efficacy.Result:1. Quality assessment of literaturesLiteratures describe in detail on the inclusion and exclusion criteria, interventions and outcome indicators. The overall quality of RCTs is not high; most of them are lack of content in CONSORT statement, especially experimental design, random method, calculation of sample capacity. Recommendations are made for improving the quality of reporting.(1)Standardize the literature title, so the report can be judged from the title of a RCT.(2)Make perfect abstract, and highlight the experimental design content.(3)Use flow diagram, and describe experimental design, random method, test result and method in detail.(4)Clinical trials should be registered.2. Systematic review2.1Systematic review on intervention of traditional Chinese drugs on stable COPDNine studies are included in the systematic review on intervention in traditional Chinese drugs. Intervention of traditional Chinese drugs on stable COPD is evaluated by distribution of outcomes, from clinical curative effect,lung function,exercise tolerance,life quality and immune function.The results show:(1)Treatment based on syndrome differentiation of western drugs combined with traditional Chinese drugs significantly maybe improve total effective rate, reduce inefficiency.(2) Intervention of traditional Chinese drugs on stable COPD maybe increase CD4+levels,lower CD8+levels, which suggest that traditional Chinese drugs can improve immune function in patients.(3)TCM Differential Treatment maybe lower the SGRQ score,and improve the quality of life, compared with western drugs alone.(4)Intervention of traditional Chinese drugs on stable COPD maybe increase FVC; Whether it is combined with traditional Chinese drugs or western drugs alone, have failed to significantly improve lung function in patients with FEVi/FVC, FEVi and exercise tolerance.2.2Systematic review on intervention of traditional sports on stable COPDFive studies are included in the systematic review on intervention in traditional sports on stable COPD. Intervention of Traditional sports on stable COPD patients are evaluated from exercise tolerance, life quality, pulmonary function and Clinical symptoms.The results show:(1)Tradition sports maybe improve exercise tolerance.(2)Treatment based on traditional sports maybe have no significant effect in improving the SGRQ score.(3)Whether it is combined with traditional sports or western drugs alone, have failed to significantly improve lung function in patients with FVC, FEV1, FEV1%. Only Wuqinxi maybe improve lung function in patients with FEV1,FEV1/FVC,FEV1%pre.2.3Systematic review on intervention of acupoint therapies on stable COPD Ten studies are included in the systematic evaluation on intervention in acupoint therapies. Intervention of acupoint therapies on stable COPD patients are evaluated from exercise tolerance, life quality, and pulmonary function.The results show:(1)Point application and moxibustion maybe improve exercise tolerance, and have obvious advantages compare with western medicine alone.(2) Acupoint application maybe lower the SGRQ score,and improve the quality of life.(3)Acupuncture or acupoint application maybe have no significant impact on lung function of the patients.Moxibustion maybe improve FEV1/FVC,FEV1%pre. According to system evaluation results, three kinds of measures has different efficacy on stable COPD patients. In summary, stable COPD patients should adopt comprehensive measures for treatment.3.Clinical researchBy applying bailing capsule treatment patients with lung and kidney qi deficiency syndrome, and using anti-viral traditional Chinese drugs at the time of infection, while with basis of preventive treatment of disease. The results suggest that:Compared with the control group, the number of acute episodes within6months of the observation group is significantly lower. And the total score of clinical symptoms of the two groups have a huge difference, which is statistically significant. Observation group is better than the control group, which is statistically significant. CAT score is no significant difference in the two groups, but the observation group has significantly improved quality of life compared with before. The mMRC dyspnea index, FEV1%, FEV1/FVC is no significant different of the two group.