Clinical Study Of Xiaotan Fangfu Decoction To Improve Symptom Control Level Of Asthma Patients After Inhaled Corticosteroid Reduction

Objectives:To evaluate the impact of traditional Chinese medicine(TCM)on inhaled corticosteroid(ICS)reduction process through treatment intervention with Xiaotan Fangfu decoction in patients with asthma remission,and with lung and spleen qi deficiency syndrome.To provide a TCM treatment plan which reduces the recurrence rate of asthma and helps to complete the stepwise ICS reduction process smoothly.Methods:From January 2019 to December 2019,76 eligible cases of bronchial asthmatic patients in remission,with lung and spleen qi deficiency,were recruited from the respiratory clinics of Dongzhimen Hospital and Hospital Of Traditional Chinese Medicine Chaoyang District.Using the random number table method,they were divided into treatment group and control group,with 38 cases in each group.After the two groups were enrolled,the ICS being used was reduced.The treatment group was given Xiaotan Fangfu decoction while blank control was given to the control group,and the course of treatment was three months.The differences in stepwise ICS reduction success rate,clinical symptoms,pulmonary function and ACT score between the two groups were observed before and after treatment.Results:1.A total of 76 patients were enrolled,including 38 cases in the treatment group and 38 cases in the control group.During the clinical intervention,ICS dose was increased in 8 and 9 patients from the treatment group and control group respectively.59 patients reduced their ICS dose successfully,with 30 from the treatment group and 29 from the control group.The success rate of stepwise ICS reduction in the treatment group was 78.9%,and that in the control group was 76.3%.2.After treatment,the total score of the ACT and its individual component scores were compared within the two groups.The scores of daily activities,dyspnea,sleep disturbance,disease control and total scores in the treatment group were significantly higher than before treatment(P<0.05).After treatment,the score of rescue medication in the treatment group was higher;the scores of daily activities,rescue medication,disease control and total scores in the control group were higher;the scores of dyspnea and sleep disturbance in the control group were lower;however,these differences were not statistically significant(P>0.05).After treatment,the individual component scores and total score of the treatment group were statistically better than the control group(P<0.05).3.After treatment,the FEV1%,PEF%pred,FEV1/FVC%and FVC%were compared within the two groups.After treatment,FEV1%,PEF%pred and FEV1/FVC%were significantly higher in the treatment group(P<0.05)while the increase in FVC%in the treatment group and the increase in FEV1%,PEF%pred and FEV1/FVC%in the control group were not statistically significant(P>0.05).After treatment,there was no significant difference in the FEV1%,PEF%pred,FEV1/FVC%and FVC%between the two groups(P>0.05).4.After treatment,the primary symptom score,secondary symptom score and total score were compared within the two group,and the scores of the two groups were significantly lower than before treatment(P<0.05).When compared between the two groups,the treatment group was significantly lower than the control group(P<0.05).After treatment,the scores of wheezing,coughing,shortness of breath,asthenia,self perspiration,loss of appetite,and loose stool in the two groups were significantly lower than before treatment(P<0.05);the score of flu in the two groups was lower after treatment but the difference was not statistically significant(P>0.05).There was no significant difference between the two groups in wheezing and coughing scores(P>0.05).The scores of shortness of breath,asthenia,flu,self perspiration,loss of appetite,and loose stool in the treatment group were significantly lower than the control group(P<0.05).Conclusions:1.Both groups showed similar stepwise ICS reduction success rate,but the treatment group showed a trend towards increment in absolute value.2.During stepwise ICS reduction,combining treatment with Xiaotan Fufang decoction improves ACT score,especially in terms of daily activities,dyspnea,sleep disturbance and disease control.3.There was no significant difference in pulmonary function between the two groups after treatment,but the treatment group showed a trend towards improvement.4.During stepwise ICS reduction,combining treatment with Xiaotan Fufang decoction improves traditional Chinese medicine symptoms in patients with asthma,especially shortness of breath,asthenia,flu,self perspiration,loss of appetite,and loose stool.