Efficacy and Safety of Chinese Medicine Resuscitation Pack for Enhanced Recovery after Bronchoscopy: A Randomized, Single-Blind, Placebo-Controlled Clinical Trial.

OBJECTIVE: To evaluate the efficacy and safety of a hospital-made resuscitation pack, a Chinese medicinal herbal compound formula designed to enhance recovery in post-bronchoscopy patients. METHODS: In this randomized, single-blind, placebo-controlled clinical trial, eligible patients were randomly assigned 1:1 to either the treatment or control groups. The patients in the treatment group applied the resuscitation pack, which contained aromatic compounded Chinese herbs. The patients in the control group applied a hospital-made, single herb placebo pack. Packs were placed on the Tiantu (CV 22) acupuncture point for 4 h as soon as the bronchoscopy finished. Efficacy indicators, such as recovery time, patients' symptoms including nausea and dizziness, and adverse events (AEs) were observed and compared. The outcome indices were evaluated at baseline, 1 and 24 h after the bronchoscopy. Subgroup analysis was further performed by patients' age and depth of sedation. RESULTS: When applying generalized estimating equations (GEE) to evaluate the intensity of post-bronchoscopy nausea and vomiting, the intensity was lower in the treatment group (163 cases) compared with the control group (162 cases; 95% CI: 0.004, 0.099, P=0.03]. Also, significantly lower intensity of nausea was observed in the 60-70 years of age subgroup (95% CI: 0.029, 0.169, P=0.006) and deep sedation subgroup (95% CI: 0.002, 0.124; P=0.04). There was no significant difference in dizziness between two groups by GEE (95% CI: -0.134, 0.297; P=0.459). In addition, no serious AEs were observed in either group. CONCLUSIONS: Our study found that the resuscitation pack markedly improved patients' symptoms by reducing nausea and vomiting after bronchoscopy without AEs, compared with placebo in the perioperative period. (Trial registration No. ChiCTR2000038299).

Effects of Dingchuan Decoction on Lung Function and Clinical Effectiveness Rate in Children with Asthma: A Systematic Review and Meta-Analysis.

Dingchuan decoction (DCD) is a traditional Chinese prescription for asthma that remains popular today. To systematically evaluate the effect of DCD on lung function, clinical effectiveness rate, and safety in children with asthma, significant databases were searched for randomized controlled trials from their inception to September 9, 2019. Randomized controlled trials assessing the effect of DCD on lung function and clinical effectiveness rate in children with asthma were included in this meta-analysis. The methodological quality of the included trials was assessed using the Cochrane risk of bias tool. RevMan 5.3 was used for data analysis. Fourteen studies with 1,384 children were reviewed. FEV1 improvement rate (mean difference [MD] 12.50, 95% confidence interval [CI] 8.72-16.29), PEF improvement rate (MD 14.28, 95% CI 11.08-17.49), and clinical effectiveness rate (relative risk 1.19, 95% CI 1.14-1.25) significantly increased in the DCD group when compared to simple conventional medication. Four trials suggest that DCD is safe for children. In conclusion, the use of DCD combined with conventional medication improves lung function and clinical effectiveness rate better than simple conventional medication. However, the selected trials lack blinding and large-scale studies. Therefore, to better manage DCD in clinical practice, more randomized controlled trials and large-scale studies are required for further evaluation.

Herbal Medicine for Adult Patients with Cough Variant Asthma: A Systematic Review and Meta-Analysis.

INTRODUCTION: Herbal medicine is commonly used by patients with chronic cough, but the role of herbal medicine for cough variant asthma (CVA) has not yet been clearly defined. For the first time, we performed a meta-analysis to integrate the current evidence of randomized controlled trials (RCTs) on this topic and assess the efficacy of herbal medicine in adults with CVA. METHODS: A comprehensive search was conducted in electronic databases to identify RCTs of herbal medicine for adult CVA. Cochrane systematic review methods were followed, and the Grading of Recommendations Assessment, Development, and Evaluation was performed to evaluate the quality of evidence. RESULTS: Twenty-eight RCTs were included. Compared with placebo, moderate-quality evidence from two studies showed that herbal medicine was associated with reduced cough symptom score (CSS) (MD -1.15 points; 95% CI, -1.67 to -0.63) and visual analogue scale (VAS) (MD -1.76 points; 95% CI, -2.66 to -0.86). Compared with montelukast, low- to moderate-quality evidence from 11 studies indicated that herbal medicine was associated with improved Leicester Cough Questionnaire (LCQ) (MD 2.38 points; 95% CI, 1.32 to 3.44), reduced CSS (SMD -0.81 points; 95% CI, -1.09 to -0.53), and VAS (MD -1.34 points; 95% CI, -1.82 to -0.86). There were no significant differences between herbal medicine and ICS plus bronchodilator. CONCLUSIONS: In adults with CVA, herbal medicine may result in improved quality of life and reduced cough frequency and severity scores compared with placebo or montelukast. Herbal medicine was not better than ICS plus a bronchodilator but the evidence is very uncertain.

[Effect of Nervilla fordii on lung aquaporin 1 and 5 expression in endotoxin-induced acute lung injury rat].

OBJECTIVE: To explore the protective mechanism of Nervilia fordii (NF) by observing the effect of its pretreatment on lung aquaporin 1 and 5 (AQP-1, AQP-5) expression in rats with endotoxin-induced acute lung injury (ALI). METHODS: Twenty-four SD rats were randomly divided into 3 groups, the normal group (A), the NF pre-intervention group (B) and the endotoxin model group (C). Rats in Group B and C were made into ALI by endotoxin (5 mg/kg) injection via sublingual vein, and NF pretreatment was applied to Group B. Animals were sacrificed at the 8 h after modeling, their lung were taken for observing the water permeability change by wet/dry weight ratio (W/D) measuring, pathological feature by HE staining, and the expression of AQP-1, AQP-5 was detected by immunohistochemistry and RT-PCR. RESULTS: The W/D ratio of lung was higher in model rats than in normal rats, but as compared with Group C, it was significantly lower (P < 0.05) in Group B. The pulmonary edematous change was significantly mild and the AQP-1 and AQP-5 protein expressions were significantly higher in Group B than in Group C (P < 0.05). CONCLUSION: NF pretreatment can promote lung AQP-1 and AQP-5 expression up-regulation, increase lung water clearance and transportation to improve the water balance and eliminate pulmonary edema, so as to effectively protect lung from acute injury.

A retrospective study on clinical features of and treatment methods for 77 severe cases of SARS.

In this retrospective study, clinical data including clinical manifestations, routine blood tests, chest radiographic imaging from 77 severe cases of SARS treated with integrated Chinese and Western medicine were collected and statistically analyzed. Twenty-nine (37.6%) patients were admitted to the intensive care unit, non-invasive ventilation was used in 40 (51.9%) cases, and invasive ventilatory procedure was performed in eight (10.3%) cases. Seventy (90.9%) patients were clinically cured and seven (9.0%) died. The duration of defervescence was 8.3 +/- 5.0 days after admission. In the early stage, normal leucocyte count was seen in 46 (75.4%) of the 61 patients tested, decreased leucocyte count in 13 (21.3%) and elevated leucocyte count in only two (3.2%) cases. A decreased lymphocyte count was also seen in 23 (37.7%) cases of the 61 patients tested on admission, and by day 14, the number of patients with decreased lymphocyte count (1.11 +/- 0.66 x 10(9)) increased to 32 (47.7%) in 67 cases examined. Neutral granulocyte count was normal or decreased in 58 (95.0%) patients on admission, but elevated from the 7th day onward and peaked on day 21 in 32 (65.3%) of the 49 cases tested. All of the blood abnormalities returned to normal in the convalescent stage. Twenty-nine (37.6%) of the 77 severe cases of SARS patients demonstrated an extensive lung involvement. In comparison with the non-severe SARS cases, this group of patients showed significantly more pneumonic air-space opacities and ground glass-like changes on the chest radiographs (p < 0.05, chi2 test). The role Chinese medicine played in the treatment of SARS was discussed.