An evaluation of activity tolerance, patient-reported outcomes and satisfaction with the effectiveness of pulmonary daoyin on patients with chronic obstructive pulmonary disease.

BACKGROUND AND OBJECTIVE: Pulmonary Daoyin (PD) (evolved from ancient Chinese daoyin skills), is a rehabilitation technology that combines specially designed movements of the arms and body and controlled breathing exercises, to improve the physiological and psychological status of patients with chronic respiratory disease. Pulmonary rehabilitation is effective for patients with chronic obstructive pulmonary disease (COPD), and the efficacy of PD is unknown. The aim of this study is to investigate the effect of a PD program in enhancing activity tolerance, patient-reported outcomes and satisfaction with the effectiveness on patients with COPD. MATERIALS AND METHODS: The multi-center, randomized controlled trial was conducted from November 2011 to June 2012 in local communities in cities of the 11 research centers in China. It included COPD patients (moderate to very severe) who were recruited from an outpatient clinic. A randomized controlled study included 464 COPD patients who were randomly allocated either to the PD group, participating in a 3-month, ten times-weekly supervised PD-based pulmonary rehabilitation program, or to a control group continuing with regular medical treatment alone. Data were gathered using the 6-minute walking distance (6MWD) test, COPD patient-reported outcomes (COPD-PRO) and Effectiveness Satisfaction Questionnaire for COPD (ESQ-COPD), which was filled out at baseline and 3 months post-intervention. SAS 9.2 was used for statistical analysis. RESULTS: Of the 464 patients in the study, 461 were included in the full analysis set (FAS); 429 were in the per-protocol analysis set (PPS). After 3-month intervention, there was a significant difference between the two groups in 6MWD (FAS; P=0.049; PPS; P=0.041), total score and all domains of COPD-PRO (FAS; P=0.014; PPS; P=0.003) and ESQ-COPD (FAS; P=0.038; PPS; P<0.001). CONCLUSIONS: The PD program was able to improve the activity tolerance level and satisfaction of COPD patients because of its effectiveness.

Randomized, double-blind, placebo-controlled superiority trial of the Yiqigubiao pill for the treatment of patients with chronic obstructive pulmonary disease at a stable stage.

In traditional Chinese medicine (TCM), the Yiqigubiao pill is commonly used to enhance physical fitness. The current clinical trial was designed to evaluate the efficacy and safety of the Yiqigubiao pill as an adjuvant therapy for patients with stable chronic obstructive pulmonary disease (COPD). The current trial was a randomized, double-blind, placebo-controlled superiority trial. The participants were recruited from outpatients at the Traditional Chinese Medicine Hospital affiliated with Xinjiang Medical University (Ürümqi, China) between February and September 2012. All participants were patients with stable COPD that were randomized to the Yiqigubiao pill (YQGB; n=84) or placebo (Pb; n=87) groups. The occurrences of acute exacerbation (AE) of COPD during the trial were recorded. Lung function value assessments, scoring of life quality and exercise endurance, arterial blood gas analysis and serum inflammatory cytokines level determination were performed prior to and throughout the study. A total of 139 participants completed the intervention and 132 participants completed the study. The interval between the initial intervention and the first AECOPD was greater in the YQGB group compared with the Pb group (P<0.01). The incidence rate of AECOPD was lower in the YQGB group than in the Pb group (P<0.01). Subsequent to the intervention or at the end of the study, the 6-min walking distance difference was longer in the YQGB group compared with the Pb group (P<0.01). The scores reflecting life quality decline became lower in the YQGB group (P<0.01). The serum levels of proinflammatory factors were downregulated to a greater extent in the YQGB group compared with the Pb group. Thus, the Yiqigubiao pill is an efficient and safe adjuvant therapy for the treatment of stable patients with COPD.

Inhibition of Asthma in OVA Sensitized Mice Model by a Traditional Uygur Herb Nepeta bracteata Benth.

Asthma is a chronic lung inflammation which affects many people. As current therapies for asthma mainly rely on administration of glucocorticoids and have many side effects, new therapy is needed. In this study, we investigated Nepeta bracteata Benth., a traditional Uygur Herb, for its therapeutics effect in OVA induced asthmatic mice model. Treatment of OVA sensitized asthma mice with extract from Nepeta bracteata Benth. demonstrated improved lung pathology, as well as reduced infiltration of eosinophil and neutrophil. Nepeta bracteata Benth. extract also contributed to the rebalance of Th17/Treg cell via decreasing the Th17 cell and increasing the Treg, which was corresponding with the inhibited Th17 cytokine response and increased IL-10 level. Moreover, the reduced TGF-ß level and Smad2/3 protein level also suggested that Nepeta bracteata Benth. extract could inhibit TGF-ß mediated airway remodelling as well. Taken together, these data suggested that Nepeta bracteata Benth. may be a novel candidate for future antiasthma drug development.

[Effect of Modified Zhisou Powder on the lung function of chronic obstructive pulmonary disease model rats of northwest China cold dryness syndrome].

OBJECTIVE: To observe Modified Zhisou Powder (MZP) on the lung function of chronic obstructive pulmonary disease (COPD) model rats of northwest China cold dryness syndrome (NCCDS). METHODS: Totally 90 male Wistar rats were randomly divided into three groups, i.e., the normal control group (n =20), the COPD model group (n =35), and the COPD of NCCDS group (n =35). The COPD model was established by tracheal dripping porcine pancreatic elastase (PEE) in combination with fumigation for 90 days. The COPD of NCCDS model was set up by tracheal dripping PEE +fumigation + cold and dry environmental stress for 90 days. Then rats in the COPD of NCCDS were randomly divided into the MZP intervention group (n =11 )and the normal saline intervention group (n =10).All intervention lasted for 15 successive days. The lung function was detected using Small Animal Lung Function Device at day 90 and day 105. And the lung pathology was also observed. RESULTS: Little amount of sputum sound could be heard in the airway of the COPD model group and the COPD of NCCDS group. Pathological section showed alveolar ectasia, narrowed and broken alveolar septa, forming larger capsular space with infiltration of inflammatory cells. Rats in the COPD of NCCDS group showed chills, increased amount of drinking water, and loose stool. MZP could improve their symptoms. As for lung function test, compared with the normal control group, Te increased in the COPD model group (P <0.01), and EF50 decreased (P<0.05). PEF and EF50 decreased (P <0.01), Ti and Te increased (P <0.01, P <0.05) in the COPD of NCCDS group. Compared with the normal saline intervention group, PEF and EF50 increased (P < 0.01), Ti and Te decreased (P <0.01) in the MZP intervention group. CONCLUSION: MZP could improve the symptoms of COPD rats of NCCDS, and delay the velocity of decreased lung function.

[The expressions of TNF-alpha and MMP-9 in serum and MMP-1 mRNA in the bone tissue in chronic obstructive pulmonary disease patients of cold dryness syndrome in northwest China].

OBJECTIVE: To observe the expressions of tumor necrosis factor a (TNF-alpha) and matrix metalloproteinase (MMP-9) in serum and matrix metalloproteinase 1 (MMP-1) mRNA in the bone tissue in chronic obstructive pulmonary disease (COPD) patients of cold dryness syndrome (CDS) in northwest China, thus providing reference for wholism treating COPD of CDS. METHODS: Twenty-one male Wistar rats were randomly divided into three groups, i.e., the normal control group, the COPD model group, and the COPD of CDS group, 7 in each group. The COPD model was established by dripping porcine pancreatic elastase (PEE) in trachea combination with cigarette smoking, and the COPD of CDS model was also set up by dripping PEE in trachea in combination with cigarette smoking and cold-dry environmental stress. Serum contents of TNF-alpha and MMP-9 were determined using ELISA. The MMP-1 mRNA expression in rats' bone tissue was detected using fluorescent quantitative PCR. RESULTS: Compared with the normal control group, the serum MMP-9 level obviously increased in the COPD of CDS group (P < 0.05). The MMP-1 mRNA expression level in the bone tissue of the COPD of CDS group and the COPD model group also obviously increased (P < 0.01, P < 0.05). The MMP-1 mRNA expression level was obviously higher in the COPD of CDS group than in the COPD model group (P < 0.01). There was no statistical difference in the serum TNF-alpha level among the three groups (P > 0.05). CONCLUSION: CDS could increase the serum MMP-9 level and the MMP-1 mRNA expression in the bone tissue, which might be one of reasons for the fact that cold and dry environment causes more bone resorption and bone degradation in COPD.

Inflammatory responses of the rat lungs in cold-dryness syndrome in the northwest of China.

OBJECTIVE: To examine changes in body weight and the lung inflammation factors interleukin-1beta (IL-1beta), interleukin-8 (IL-8), IL-10 and tumor necrosis factor-alpha (TNF-alpha) in a rat model of cold-dryness syndrome in Northwest (Xinjiang) China to provide a reference for treating chronic obstructive pulmonary disease (COPD) with local peculiarities. METHODS: The rat COPD model was established by intratracheal instillation of porcine pancreatic elastase (PPE) in combination with cigarette smoking (CS). The rat model of cold-dryness syndrome of COPD in the northwest of China was set up by intratracheal instillation of PPE in combination with CS and environmental cold-dryness stress. The level of IL-1beta, IL-8, IL-10 and TNF-alpha in bronchoalveolar lavage fluid (BALF) were measured by enzyme-linked immunosorbent assay (ELISA). The data were analyzed using the software SPSS 11.5. RESULTS: (1) Body weight was less in the two model groups than that of control group (P < 0.01), PPE plus CS cold-dryness group was less than that of PPE plus CS group (P < 0.01). (2) IL-1beta in BALF significantly increased in PPE plus CS and cold-dryness group than that of control group (P < 0.01). (3) IL-8 and TNF-alpha in BALF significantly increased in PPE plus CS and cold-dryness group and PPE plus CS group than that of control group (P < 0.01). CONCLUSION: Body weight in COPD model rats was reduced compared with controls. Cold-dryness may aggravate such a condition lung inflammation in the model was mainly manifested by an increase in IL-1beta, IL-8 and TNF-alpha levels, with no change in IL-10 levels. Cold-dryness may aggravate lung inflammation of COPD.

A study of the law of herbal administration in treating lung-distension by TCM physicians through history using cluster analysis.

OBJECTIVE: To review the herbal drugs used most often for treating lung-distension by determining those used by physicians throughout history; to study their property, taste, and channel tropism; and to explore their compatibility. METHODS: Historical prescriptions for treating lung-distension were collected and sorted. Property, taste and channel tropism were determined, and the law of herbal administration was determined by cluster analysis. RESULTS: One hundred and ninety five prescriptions were found, involving 166 herbal drugs, with a total appearance frequency of 1296 drugs. The herbs involved 8 properties (total appearance frequency, 1296), 7 forms of taste (total appearance frequency, 1991) and involved all 12 regular channels (total appearance frequency, 3382). Sixteen herbal drugs were used most often and formed 4 cluster prescriptions: C1: Xing Ren (Semen Armeniacae Amarum), Gan Cao (Radix Glycyrrhizae), and Ban Xia (Rhizoma Pinelliae); C2: Gui Zhi (Ramulus Cinnamomi), Wu Wei Zi (Fructus Schisandrae), and Sheng Jiang (Rhizoma Zingiberis Recens); C3: Da Zao (Fructus Jujubae), Ma Huang (Herba Ephedrae), and Shi Gao (Gypsum Fibrosum); and C4: Chen Pi (Pericarpium Citri Reticulatae), Jie Geng (Radix Platycodi), Fu Ling (Poria), Sang Bai Pi (Cortex Mori), Xi Xin (Herba Asari), Gan Jiang (Rhizoma Zingiberis), and Bai Shao (Radix Paeoniae Alba). CONCLUSION: In treating lung-distension, phlegm retention has been traditionally considered the underlying pathology, emphasizing regulation of the lung and spleen as key and stressing patient nourishment and mental improvement. Prescriptions for lung-distension should be made with reference to the property, taste, channel tropism, and effectiveness of the chosen herbal drugs.

Chinese herbs in treatment of influenza: a randomized, double-blind, placebo-controlled trial.

OBJECTIVE: To investigate the efficacy and safety of Antiwei, a traditional Chinese prescription, in the treatment of influenza. METHODS: In a multi-center, randomized, double-blind, placebo-controlled trial, we recruited 480 adults aged 18 to 65 years within 36 h of onset of influenza-like symptoms. There were 225 patients with confirmed influenza. Eligible patients were randomly assigned 6 g of Antiwei (n = 360) or placebo (n = 120) twice daily for three days. All patients recorded their temperature and symptoms on diary cards during treatment. Analyses were performed in both the influenza-like population and the influenza-confirmed population. RESULTS: Antiwei increased patients' recovery by 17% (P < 0.001), and reduced the severity of illness measured by the median symptom score by 50% (P < 0.001) in both the influenza-like and the influenza-confirmed populations, compared to placebo. The influenza-confirmed patients reported reductions in the severity of fever (P = 0.002), cough (P = 0.023) and expectoration (P = 0.004) after one-day of treatment with Antiwei, compared to placebo. The adverse event profiles were similar for Antiwei and placebo. CONCLUSION: Antiwei was effective and well tolerated in treatment of natural influenza infection in adults. Antiwei represents a clinically valuable intervention in the management of influenza.

[Mahuang Zhisou Capsule in treatment of acute upper respiratory tract infection of external wind-cold syndrome: a multi-center, randomized controlled, and double-blind trial].

OBJECTIVE: To evaluate the efficacy and safety of Mahuang Zhisou Capsule (MHZSC), a compound traditional Chinese herbal medicine, in treatment of acute upper respiratory tract infection of wind-cold syndrome. METHODS: A multi-center, double-blind, double dummy, randomized controlled trial was conducted. A total of 240 patients were randomized into treatment group (120 cases, treated with MHZSC) and control group (120 cases, treated with Mahuang Zhisou Pill). The therapeutic course was 3 days. RESULTS: Seven cases were excluded and three cases lost to follow-up. Two hundred and thirty-three cases entered intention-to-treat (ITT) analysis and 230 cases fitted in per-protocol population set (PPS) analysis. After treatment, the therapeutic effect of upper respiratory tract infection was calculated by ITT and PPS analysis respectively. The significant response rate and total response rate in the treatment group were 78.07% and 98.25% (ITT and PPS), while the significant response rates in the control group were 70.59% (ITT) and 70.69%(PPS), and the total response rates were 95.80% (ITT) and 95.69% (PPS) respectively. There were no significant differences in clinical efficacy between the two groups (P>0.05). CONCLUSION: MHZSC is effective and safe in treatment of acute upper respiratory tract infection of external wind-cold syndrome.