Effect of Jianpi therapy in treatment of chronic obstructive pulmonary disease: a systematic review

OBJECTIVE: To evaluate the efficacy of Jianpi therapy in Traditional Chinese Medicine (TCM) for treatment of chronic obstructive pulmonary disease (COPD) in stable phase by performing a systematic review and meta-analysis. METHODS: The literatures concerning randomized controlled trials (RCTs) and quasi-RCTs comparing TCM treatment plus Western Medicine (WM) treatment with TCM alone, or TCM treatment vs no treatment, placebo for stable phase of COPD were searched in PubMed (1990-December 2010), in English and using Chinese National Knowledge Infrastructure (CNKI, 1990-December 2010), Chinese Biomedical Database (1990-December 2010), Wangfang Database (1990-December 2010), and Weipu (VIP) Database in Chinese. The quality assessment and data extraction for RCTs were conducted by two reviewers independently. Jadad scale and allocation concealment were used to assess the quality of the included studies, and meta-analyses were conducted with the Collaboration's Revman 5.0 software. RESULTS: Seventeen RCTs or quasi-RCTs involving 1269 patients were included. The methodological quality was poor in all trials except one trial (Jadad score=4). In the meta-analysis, TCM-WM treatment was significantly superior to WM treatment in cure rate [OR=3.82, 95%CI (2.45, 5.95)], and the effective rate between TCM treatment and placebo also had significant difference [OR=4.31, 95%CI (2.35, 7.91)]. Moreover, pulmonary function of the patients in TCM-WM group and TCM group was significantly improved [forced vital capacity (FVC), P=0.01, quality of life, P<0.001]. CONCLUSION: The experience in TCM-WM treatment of COPD in stable phase, was encouraging. The current evidence shows that TCM-WM treatment might be more efficient in effective rate, quality of life, and FVC than WM treatment alone. But for forced expiratory volume in one second (FEV1) and FEV1/FVC, no matter TCM-WM treatment compared with WM treatment alone or TCM treatment compared with placebo, there was no significant difference, with no obvious adverse reactions. Due to the low methodological quality of trials included, more RCTs of high quality in large scale are required. (C) 2013 JTCM. All rights reserved.