Chinese herbal medicine for chronic obstructive pulmonary disease (COPD): systematic analyses of modern and classical approaches.

An, X 2012, Chinese herbal medicine for chronic obstructive pulmonary disease (COPD): systematic analyses of modern and classical approaches., Doctor of Philosophy (PhD), Health Sciences, RMIT University.


Document type: Thesis
Collection: Theses

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Title Chinese herbal medicine for chronic obstructive pulmonary disease (COPD): systematic analyses of modern and classical approaches.
Author(s) An, X
Year 2012
Abstract Chronic obstructive pulmonary disease (COPD) is a lung disorder characterised by irreversible airflow limitation with symptoms such as chronic cough, sputum production, dyspnea and chest tightness. It is divided into stable and exacerbation phases. Exacerbations of COPD involving deterioration of symptoms are major causes of morbidity, hospitalization and mortality and affect health-related quality of life (HRQoL).

Conventional pharmacotherapy involving bronchodilators and corticosteroids has side effects and provides only temporary relief. Therefore, Chinese herbal medicines are increasingly being used internationally following recent publications and reviews of randomised controlled trials (RCTs) that evaluated the benefits of oral CHM formulae and herbal extracts for stable COPD and experimental studies demonstrating anti-inflammatory and immune effects relevant to COPD of some Chinese herbs and formulae. These reviews, however, did not adequately represent the large volume of non-English studies despite the fact that in China. CHMs have been used to treat COPD-like lung diseases since ancient times and in the contemporarily management of COPD along with conventional pharmacotherapy. Therefore, this study aims to review English and Chinese databases to assess potentially efficacious and safe CHMs in the treatment of COPD.

The study (1) reviewed current concepts and treatment of COPD in both conventional and Chinese medicines, (2) analysed COPD-like disorders in classical Chinese medicine books, (3) identified main herbal formulae and individual herbs used for COPD-like disorders, (4) conducted systematic searches of RCTs on CHM for COPD, meta-analyzed results of each main outcome measure and calculated usage frequencies of each herbal formulae and individual herbs, and (5) identified the likely mechanisms of action of the shortlisted herbs.

English and Chinese databases were searched in three separate systematic reviews (SRs) based on Cochrane Handbook for Systematic Reviews of Interventions. Findings of reviews and meta-analysis supported the effectiveness of CHM either used independently or as an adjunct to routine pharmacotherapy in preventing decline of FEV1% predicted of stable COPD patients, improving QoL and exercise tolerance, reducing COPD exacerbation frequency and relieving a range of COPD symptoms. Other RCTs found that CHMs lower levels of TNF-α and IL-8 in sputum and serum, and regulate levels of T lymphocyte subsets and immunoglobulins. These effects were confirmed in some experimental studies.

The Classical Chinese literature and modern RCTs identified several promising herbal formulae including Liu Jun Zi Tang (Six Gentleman Decoction), Bu Fei Tang (Tonify Lungs Decoction) and Shen Ge San (Ginseng and Gecko Powder) and a number of frequently used individual herbs for COPD including Ren shen (Panax ginseng), Dang shen (Codonopsis pilosula), Huang qi (Astragalus membranaceus), Bai zhu.
Degree Doctor of Philosophy (PhD)
Institution RMIT University
School, Department or Centre Health Sciences
Keyword(s) chronic obstructive pulmonary disease
chinese herbal medicine
randomised controlled trials
chinese medicine
herbal medicine
systematic review
meta-analysis
forced expiratory volume in one second
health-related quality of life
quality of life
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