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Shufeng Jiedu capsules for treating acute exacerbations of chronic obstructive pulmonary disease: a systematic review and meta-analysis

Shufeng Jiedu capsules for treating acute exacerbations of chronic obstructive pulmonary disease: a systematic review and meta-analysis
Shufeng Jiedu capsules for treating acute exacerbations of chronic obstructive pulmonary disease: a systematic review and meta-analysis
Background: Chinese herbal medicine is widely used in combination with usual care for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in China. Shufeng Jiedu capsule (SFJD) is a Chinese patent medicine. The effectiveness and safety of SFJD for AECOPD remains uncertain.

Methods: A systematic review of randomized control trials was performed. We included trials in patients diagnosed with AECOPD, who received SFJD as a single intervention or in combination with usual treatment. PubMed, Cochrane Library, EMBASE, CINAHL and four Chinese databases were searched from inception to April 2019. Two reviewers independently screened studies, extracted study data and assessed risk of bias. Meta-analysis was performed using RevMan 5.3 software. We performed subgroup analyses and sensitivity analyses according to the predefined protocol. Quality of evidence was assessed using GRADE.

Results: 13 RCTs (1,036 patients, of which 936 were inpatients) were included. The mean age ranged from 52 to 67 and approximately 60% of patients were male. These RCTs had a high risk of bias due to lack of blinding and other factors. SFJD combined with usual care (including antimicrobials) compared to usual care alone was associated with a significant reduction in treatment failure, from 20.1% to 8.3% (11 trials; 815 patients; relative risk 0.43, 95% confidence interval [CI] 0.30 to 0.62) and duration of hospital admission (2 trials; 79 patients; mean difference -4.35 days, 95% CI -5.28 to -3.43 days; low certainty ). Low or very low certainty evidence suggested benefit from SFJD compared to controls in terms of PaCO2, PaO2, FEV1/FVC ratio, clinical symptoms, white cell counts, inflammatory markers and health related quality of life. No significant difference in adverse events was found in a pooled analysis.

Conclusion: For hospitalized adults with AECOPD, SFJD may reduce treatment failure, shorten hospital stay, and improve symptoms and signs. However, the quality of the evidence is very low to low due to the potential risk of bias and inconsistency among included trials. Further large, high quality RCTs are needed.
COPD, Chinese herbal medicine, Exacerbation, Meta-analysis, Randomised controlled trial, Shufeng Jiedu, Systematic review
1472-6882
Xia, Ruyu
394737f7-9ef2-4036-970e-a47eb559b737
Hu, Xiaoyang
65904b24-3775-4b14-9532-eb703a056655
Fei, Yutong
38d05d9e-30d7-48b4-b86d-768abefede0c
Willcox, Merlin
dad5b622-9ac2-417d-9b2e-aad41b64ffea
Lingzi, Wen
68cc2043-145e-4088-9182-b01577147308
Yu, Ming-Kun
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Lishan, Zhang
fef99d72-4c05-4e9b-a2e7-26d5d3f60dd2
Dai, Meng-Yuan
b99d8335-7c45-490a-ae0c-e7161642f3d2
Fei, Guang-He
fb569fe1-9db1-44e8-91b6-a56c7efde2d9
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Francis, NA
9b610883-605c-4fee-871d-defaa86ccf8e
Wilkinson, Thomas
8c55ebbb-e547-445c-95a1-c8bed02dd652
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Liu, Jianping
4699004b-2872-49f2-b2f9-f90a061a29db
Xia, Ruyu
394737f7-9ef2-4036-970e-a47eb559b737
Hu, Xiaoyang
65904b24-3775-4b14-9532-eb703a056655
Fei, Yutong
38d05d9e-30d7-48b4-b86d-768abefede0c
Willcox, Merlin
dad5b622-9ac2-417d-9b2e-aad41b64ffea
Lingzi, Wen
68cc2043-145e-4088-9182-b01577147308
Yu, Ming-Kun
2d737e60-76c3-462b-9439-f38b76e4073f
Lishan, Zhang
fef99d72-4c05-4e9b-a2e7-26d5d3f60dd2
Dai, Meng-Yuan
b99d8335-7c45-490a-ae0c-e7161642f3d2
Fei, Guang-He
fb569fe1-9db1-44e8-91b6-a56c7efde2d9
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Francis, NA
9b610883-605c-4fee-871d-defaa86ccf8e
Wilkinson, Thomas
8c55ebbb-e547-445c-95a1-c8bed02dd652
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Liu, Jianping
4699004b-2872-49f2-b2f9-f90a061a29db

Xia, Ruyu, Hu, Xiaoyang, Fei, Yutong, Willcox, Merlin, Lingzi, Wen, Yu, Ming-Kun, Lishan, Zhang, Dai, Meng-Yuan, Fei, Guang-He, Thomas, Mike, Francis, NA, Wilkinson, Thomas, Moore, Michael and Liu, Jianping (2020) Shufeng Jiedu capsules for treating acute exacerbations of chronic obstructive pulmonary disease: a systematic review and meta-analysis. BMC Complementary and Alternative Medicine, 20 (151), [151]. (doi:10.1186/s12906-020-02924-5).

Record type: Article

Abstract

Background: Chinese herbal medicine is widely used in combination with usual care for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in China. Shufeng Jiedu capsule (SFJD) is a Chinese patent medicine. The effectiveness and safety of SFJD for AECOPD remains uncertain.

Methods: A systematic review of randomized control trials was performed. We included trials in patients diagnosed with AECOPD, who received SFJD as a single intervention or in combination with usual treatment. PubMed, Cochrane Library, EMBASE, CINAHL and four Chinese databases were searched from inception to April 2019. Two reviewers independently screened studies, extracted study data and assessed risk of bias. Meta-analysis was performed using RevMan 5.3 software. We performed subgroup analyses and sensitivity analyses according to the predefined protocol. Quality of evidence was assessed using GRADE.

Results: 13 RCTs (1,036 patients, of which 936 were inpatients) were included. The mean age ranged from 52 to 67 and approximately 60% of patients were male. These RCTs had a high risk of bias due to lack of blinding and other factors. SFJD combined with usual care (including antimicrobials) compared to usual care alone was associated with a significant reduction in treatment failure, from 20.1% to 8.3% (11 trials; 815 patients; relative risk 0.43, 95% confidence interval [CI] 0.30 to 0.62) and duration of hospital admission (2 trials; 79 patients; mean difference -4.35 days, 95% CI -5.28 to -3.43 days; low certainty ). Low or very low certainty evidence suggested benefit from SFJD compared to controls in terms of PaCO2, PaO2, FEV1/FVC ratio, clinical symptoms, white cell counts, inflammatory markers and health related quality of life. No significant difference in adverse events was found in a pooled analysis.

Conclusion: For hospitalized adults with AECOPD, SFJD may reduce treatment failure, shorten hospital stay, and improve symptoms and signs. However, the quality of the evidence is very low to low due to the potential risk of bias and inconsistency among included trials. Further large, high quality RCTs are needed.

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More information

Accepted/In Press date: 14 April 2020
Published date: 24 May 2020
Keywords: COPD, Chinese herbal medicine, Exacerbation, Meta-analysis, Randomised controlled trial, Shufeng Jiedu, Systematic review

Identifiers

Local EPrints ID: 441290
URI: http://eprints.soton.ac.uk/id/eprint/441290
ISSN: 1472-6882
PURE UUID: 02ad6ad1-b58f-46eb-be2a-c7d728e4c5de
ORCID for Xiaoyang Hu: ORCID iD orcid.org/0000-0002-3143-7999
ORCID for Merlin Willcox: ORCID iD orcid.org/0000-0002-5227-3444
ORCID for NA Francis: ORCID iD orcid.org/0000-0001-8939-7312
ORCID for Michael Moore: ORCID iD orcid.org/0000-0002-5127-4509

Catalogue record

Date deposited: 08 Jun 2020 16:32
Last modified: 10 Jan 2022 03:19

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Contributors

Author: Ruyu Xia
Author: Xiaoyang Hu ORCID iD
Author: Yutong Fei
Author: Merlin Willcox ORCID iD
Author: Wen Lingzi
Author: Ming-Kun Yu
Author: Zhang Lishan
Author: Meng-Yuan Dai
Author: Guang-He Fei
Author: Mike Thomas
Author: NA Francis ORCID iD
Author: Michael Moore ORCID iD
Author: Jianping Liu

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