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Review Article
Modified Dachengqi Decoction Combined with
Conventional Treatment for Treating Acute Exacerbation of
Chronic Obstructive Pulmonary Disease: A Systematic Review
Based on Randomized Controlled Trials
Ruohan Wu, Zheng Fengjie, Yuhang Li, Sun Yan, Liu Miao, Wang Tan, and Zhang Jinchao
School of Preclinical Medicine, Beijing University of Chinese Medicine, 11 North Sanhuan East Road, Chaoyang District,
Beijing 100029, China
Correspondence should be addressed to Yuhang Li; liyuhang@bucm.edu.cn
Received January ; Revised February ; Accepted February
Academic Editor: Zhaoxiang Bian
Copyright © Ruohan Wu et al. is is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective. is study intended to systematically evaluate the eectiveness and safety of modied Dachengqi Decoction (MDD)
combined with conventional treatment for treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
Method. An extensive search was performed within English and Chinese electronic databases from inception to April .
Methodological quality was assessed according to Cochrane risk of bias assessment. Data were analyzed using Review Manager ..
Results. A total of studies (involving patients) were included. e result showed that MDD and its modication combined
with routine treatment were more eective in improving FEV1%pred, enhancing the signicant eectiveness, reducing PCO2,
and shortening duration of mechanical ventilation. Adverse events were reported in two trials with symptom of diarrhea, while
no serious adverse eect was reported. Conclusion. Modied Dachengqi Decoction appears to be eective for treating AECOPD.
However, more regular designed RCTs are needed because of insucient methodological problems.
1. Introduction
Global strategy for the diagnosis, management, and preven-
tion of chronic obstructive pulmonary disease (COPD) []for
the rst time revised the goal of the treatment of COPD into
relief symptoms rapidly, and reduces risk of patients’ health,
such as recurrent episodes or rapid decrease of pulmonary
function []. erefore, how to control the symptoms and
reduce the frequency of disease onset became the research
emphasis in academic eld.
COPD belongs to the category of “lung distention” in
Chinese medicine. Syndrome of phlegm-heat obstructing
in the lung is one of the most common syndromes in the
acutestage.emainclinicalfeaturesincludeyellowsputum,
dyspnea, thirsty, and constipation []. “Interior and Exterior
Relationship between the Lung and Large Intestine” is one
of the most typical viscera correlation theories. It describes
the corelationship of viscera, meridian, physiological relation,
and pathological changes, which is the foundation for
further clinical treatment of AECOPD by using purgative
drugs. Many domestic and foreign researches [,]found
that COPD patients have digestive tract symptom such as
abdominal distension, constipation besides cough, wheezing,
phlegm, and dyspnea. So, it is viable to do research on using
purgativedecoctioninthetreatmentofAECOPD.
Dachengqi decoction, a representative recipe of dredging
intestines in Treatise on Febrile Diseases (Shang Han Lun),
hasbeenwidelyusedtotreatYangmingFushiSyndrome.
It is composed by Rheum, Magnolia ocinalis,immature
bitter orange, and Mirabilite. In a recent study, it eectively
treated critical patients with gastroenteric function disorder,
andreducetheincidenceandfatalityofMODS[].
is study aimed to determine the eects and safety of
purgative decoction on pulmonary function, artery blood gas
analysis, ventilator weaning time in patients with AECOPD
by systematically evaluating the eectiveness of oral
Evidence-Based Complementary and Alternative Medicine
decoctions, or Chinese patent medicine based on Dachengqi
Decoction plus conventional treatment compared with
western medicine alone in the treatment of AECOPD.
2. Materials and Methods
2.1. Search Strategy. We searched the Chinese literature from
CNKI,CBM,VIP,WANFANG,andforeignliteraturefrom
PubMedandCochranelibrary.esearchingwasfromthe
inception of the databases to April . We utilized the
medical subject headings “COPD” or “chronic obstructive
pulmonary disease” and “Chinese medicine” in PubMed,
Cochrane, while we use “COPD” or “chronic obstructive
pulmonary disease” and “Dachengqi Decoction” or “Radix et
Rhizoma Rhei” or “Natrii Sulfas” or “Fructus Aurantii Immat-
urus” or “Cortex Magnoliae ocinalis” in Chinese database.
2.2. Inclusion Criteria. Inclusion criteria were the following:
() RCTs in English or Chinese involving decoctions based on
Dachengqi Decotion compared with placebo, no treatment,
or conventional treatment without Chinese medicine as
controls. () Patients must be aged years or over and of any
gender or ethnic origin. Patients are diagnosed with COPD
in the severe stage with or without respiratory failure. COPD
is dened as “e Global Initiative for Chronic Obstruc-
tive Lung Disease (GOLD)” which is pulmonary function
includes FEV1%pred <% and FEV1/FVC% <% aer
using bronchodilator. () Primary outcome measures were
pulmonary function (FEV1%pred, FEV1/FVC%), safety, and
signicant eectiveness based on clinical symptoms relief.
e signicant eectiveness was dened as the symptoms
scores improvement rate ≥% according to “the guide for
clinical trials of new drugs” []. Clinical symptoms involved
cough, cough-up phlegm, dyspnea, constipation, and wheeze.
Secondary outcome measures were artery blood gas analysis
(PO2,PCO
2) and duration of mechanical ventilation.
2.3. Data Extraction. Study characteristics included trial
design, sample size, mean and standard deviation of partic-
ipants’ age, and history of COPD; severity of COPD dier-
entiation of syndrome, methodological quality, intervention,
outcome measures, treatment duration and follow-up period,
and adverse events were extracted to a predened form and
checked by a second reviewer.
2.4. Risk of Bias. e methodological quality of the included
studies was independently assessed by authors using
theCochraneriskofbiasassessment[]. Assessment of
Cochrane risk of bias consists of seven domains: () random
sequence generation () allocation concealment () blinding
of participants and personnel () blinding of outcome assess-
ment () incomplete outcome data () selective reporting and
() other bias. For each domain, evaluation was by denoting
“yes”-adequate (low risk of bias); “no”: inadequate (high risk
of bias); or “unclear”: unclear or not used (uncertain risk of
bias) according to the descriptions of the method in each
study. Any disagreement was resolved by discussion with a
third reviewer.
2.5. Data Analysis. Meta-analysis was performed using Rev-
Man .. For categorical data, we used risk ratios (RR),
while for continuous data, mean dierences (MD) were
calculated and expressed in eect value and % condence
(CI). Heterogeneity was calculated by 𝑋2and 𝐼2statistics.
When heterogeneity inspection result showed signicant
heterogeneity (𝑃 < 0.05), we used random eects model,
otherwise we applied xed eects model.
3. Results
3.1. Overview of Included Studies. We initially identied
citations, aer screening for potential relevance, full papers
[–] were assessed for possible inclusion (Figure ). All
studies were conducted in China. e characteristics of the
included studies are summarized in Tab l e . e dierent
compositions of Chinese herbal formula MDD are presented
in Table . e studies involved a total of acute COPD
patients, and studies were included in meta-analysis. All
studies reported diagnosis standard. All studies were about
Chinese medicine combined with western medicine rou-
tine treatment compared with conventional treatment alone
(Table ). Fieen studies [–,–,–]wereabout
oral decoction combined with western medicine routine
treatment. Two [,] studies used Chinese patent medicine
based on MDD.
3.2.AssessmentofRiskofBias. Information of sequence gen-
eration was adequate for ve studies at low risk of bias [,,
,,] and inadequate for seventeen studies with unclear
risk of bias [–,–,–,]. All the ve studies
reported that they used random number table for sequence
generation. Allocation concealment was not reported in all
studies (no). Blinding of participants, physicians, and study
personnel was not reported in these studies, but all studies
were carried without placebo, so they were of high risk of
bias.Noneofthestudiesreportedlosttofollowup,withdraw
and dropo; thus, the risk of bias of incomplete outcome
data over all studies was graded as unclear. As far as selective
reporting was concerned, for we could not nd any pre-
dened outcome measurements in all the included studies
we classied them as unclear risk of bias. Due to the limited
number of included studies, we were not able to implement
funnel plot.
3.3. Outcome Measure
3.3.1. Pulmonary Function. FEV1%pred was reported in
articles [,,,,](Figure )andFEV
1/FVC% was
reported in studies, respectively [,,,,](Figure ).
Signicant dierences showed in FEV1%pred. Decoction
group concludes ve trials (MD ., %CI . to .).
SimilarchangeswereshowninFEV
1/FVC% (MD ., %CI
. to .).
3.3.2. Signicant Eectiveness. MDD group showed higher
percentage of eectiveness when compared with non-MDD
Evidence-Based Complementary and Alternative Medicine
T : Characteristics of included trials.
Study ID Sample CM
syndrome Intervention Controlled Couse Adverse event Outcome measures
Fang and Shi,
[]
T: /
C: / NS MDD
Aminophylline . g qd,
Methylprednisolone mg
qh, Cefoperazone and
Sulbact am g qh,
Mucosolvan mg qh
D NS BGA, DMV
Fu, []T: /
C: / SPHOL MDD Conventional treatment D NS PF
Guo and Liang,
[]
T: /
C: / SPHOL MDD Mucosolvan mg and
conventional treatment D NS ER
Guo and Zhang ,
[]
T: /
C: / NS MDD Conventional treatment D NS PF, BGA, ER
Li,[]T: /
C: / SPHOL Tongsai g r a nu l e
gtid
Aminophylline . g,
antibacterial D NS Inammation
factor
Li et al.,
[]
T: /
C: / SPHOL MDD Conventional treatment D NS ER
Li,[]T: /
C: / SPHOL MDD
Cefaclor capsules . g tid,
Azithromycin tablets . g ,
Mucosolvan mg tid.
D YSE PF, BGA, ER
Liang, []T: /
C: / NS MDD Conventional treatment D NS PF, ER
Liu et al.,
[]
T: /
C: / NS MDD Conventional treatment D NS Oine success rate
Lu, []T: / C:
/ SPHOL MDD Conventional treatment D NS PF, BGA, ER
Mao, []T: /
C: / NS Tongfupaiqi
mixture Conventional treatment D YES PF
Meng, []T: /
C: / SPHOL MDD Conventional treatment D NS PF, ER
Pang,[]T: /
C: / SPHOL MDD Conventional treatment D NS BGA
Peng and Li,
[]
T: /
C: / SPHOL MDD Conventional treatment D NS ER
Shi et al.,
[]
T: /
C: / NS MDD Conventional treatment D NS DMV
Zhang, []T: /
C: / SPHOL MDD Conventional treatment D NS PF, ER
T: treatment; C: control; NS: not specied; conventional treatment: antibiotics, antispasmodic, expectorant (the drug is unknown); SPHOL: syndrome of
phlegm-heat obstructing lung; BGA: blood gas analysis. PF: pulmonary function; ER: eective rate; DMV: duration of mechanical ventilation.
formula group (RR ., %CI . to .) [,,,,]
(Figure ).
3.3.3. Blood Gas Analysis. PO2was reported in studies
[,,,,,](Table )andPCO
2was predicted in
studies [,,,,](Table ). ere was an improvement
in PO2and a reduction in PCO2when comparing modied
Dachengqi Decoction plus conventional treatment to con-
ventional treatment alone.
3.3.4. Duration of Mechanical Ventilation. Duration of
mechanical ventilation (days) was reported in studies
[,]. Recovery time of MDD group was shorter than that
of the conventional treatment group (MD −.d, %CI
−.d to −.d).
3.3.5. Safety. Two studies [,] reported adverse events.
Both trials reported adverse reaction as diarrhea. Other trials
did not report it.
4. Discussion
isstudyfocusesonevaluatingtheeectivenessandsafety
of modied Dachengqi Decoction for AECOPD based on
pulmonary function, blood gas analysis, and eective rates
when compared with conventional treatment group. Based
on the study of the sixteen studies, DMM may have positive
eect on improving patients pulmonary function, improving
thesymptoms,enhancingthepartialpressureofoxygen,
decreasing the partial pressure of carbon dioxide, and
shortening the duration of mechanical ventilation. As with
Evidence-Based Complementary and Alternative Medicine
T : e compositions of MDD.
Study ID Composition of formula
Fang and Shi, []MDD (Radix et Rhizoma Rhei, Fructus Aurantii Immaturus, Cortex Magnoliae ocinalis,Trichosanthis,
Semen Armeniacae Amarum, Radix Glycytthizae, Semen Raphani.) mL bid
Fu, [] MDD (Radix et Rhizoma Rhei, Fructus Aurantii Immaturus, Cortex Magnoliae ocinalis)qd
Guo and Liang, []MDD (Radix et Rhizoma Rhei, Fructus Aurantii Immaturus, Cortex Magnoliae ocinalis, Rhizoma Pinelliae,
Semen R aphani, Radix Astragali) mL bid
Guo and Zhang , []MDD (Gypsum Fibrosum, Radix Scutellariae, Semen Armeniacae Amarum, Fructrs Trichosanthis), mL
bid
Li,[] Tongsai granule (Radix et Rhizoma Rhei, Herba Ephedrae, Semen Lepidii, Bulbus Fritillariae Cirrhosae) g tid
Li et al., []MDD (Radix et Rhizoma Rhei, Fructus Aurantii Immaturus, Natrii Sulfas, Fructrs Trichosanthis, Semen
Raphani, Semen Lepidii) mL bid
Li,[]
MDD (Radix et Rhizoma Rhei g , Gypsum Fibrosum g , Fructrs Trichosanthis g, Semen Armeniacae
Amarum g, Radix Scutellariae g, Semen Lepidii g, Herba Houttuyniae g, Bulbus Fritillariae
unbergii g, Radix Glycytthizae g) mL tid
Liang, []MDD (Radix et Rhizoma Rhei g, Fructus Aurantii Immaturus g, Cortex Magnoliae ocinalis g , Radix
Scutellariae g, Rhizoma Pinelliae g, Pericarpium Citri Reticulatae g, Radix Glycytthizae g) mL bid
Liu et al., []MDD (Radix et Rhizoma Rhei, Fructus Aurantii Immaturus, Cortex Magnoliae ocinalis,Fructrs
Trichosanthis, Semen Armeniacae Amarum, Poria, Radix Glycytthizae) mL bid
Lu, []MDD (Radix et Rhizoma Rhei g, Fructrs Trichosanthis g, Semen Armeniacae Amarum g, Semen
Cannabis g, Radix Scutellariae g , Herba Houttuyniae g, R adix Glycytthizae g) mL bid
Mao, []TongFuPaiQi mixture (Radix et Rhizoma Rhei, Semen Raphani, Semen Persicae, Radix Paeoniae Rubra) mL
tid
Meng, []MDD (Radix et Rhizoma Rhei, Fructrs Trichosanthis, Semen Armeniacae Amarum Gypsum Fibrosum),
mL bid
Pang,[]MDD (Radix et Rhizoma Rhei, Cortex Magnoliae ocinalis, Fructrs Trichosanthis, Semen Armeniacae
Amarum, Rhizoma Pinelliae, Gypsum Fibrosum, Radix Astragali, Radix Glycytthizae) mL bid
Peng and Li, [] MDD (Radix et Rhizoma Rhei g, Natrii Sulfas g, Semen Lepidii g, Radix Scutellariae g) qd
Shietal.,[]MDD (Radix et Rhizoma Rhei, Fructus Aurantii Immaturus, Fructrs Trichosanthis, Semen Armeniacae
Amarum, Semen Raphani, Radix Glycytthizae) mL bid
Zhang, []MDD (Radix et Rhizoma Rhei, Cortex Magnoliae ocinalis, Fructrs Trichosanthis, Semen Armeniacae
Amarum, Rhizoma Pinelliae, Gypsum Fibrosum, Radix Scutellariae) mL bid
T : Outcome measures for PO(mmHg).
Study Treatment (m ±s) Control (m ±s) Mean dierence (% CI) 𝑃value
Fang and Shi, []± ± . (., .) 𝑃 = 0.0004
Guo and Liang, [].±. . ±. . (., .) 𝑃 = 0.0007
Li,[] . ±. . ±. . ( −., .) 𝑃 = 0.5452
Lu, [].±. . ±. . (−., .) 𝑃 = 0.34
Meng, [].±. . ±. . (., .) 𝑃 < 0.0001
Pang,[].±. . ±. . (., .) 𝑃 < 0.0001
Meta . (., .) 𝑃 < 0.00001
any meta-analysis, heterogeneity must be considered. We
found signicant heterogeneity in the outcome measure for
FEV1%pred, but the heterogeneity in the outcome measure
for FEV1/FVC and clinical symptom relief was very low.
Only two studies [,] reported a total of three adverse
events of diarrhea,which suggests that the MDD for COPD
is well tolerated. However due to the incomplete evaluation,
safetyofDMMshouldbeacceptedmorecautiously.e
results need to be monitored rigorously in the future.
Some systematic review [,]hasindicatedabenet
of using Chinese herb such as oral ginseng formulae for the
management of stable COPD which belongs to deciency
syndrome according to TCM (traditional Chinese medicine)
theory. Also, there were many studies showing that Chinese
medicine had become more and more important in treating
COPD/AECOPD []. ere have been many randomized
controlled trials indicating that herbs can release clinical
symptoms and improve quality of life.
MDDisnotavailableforitisnotwidelyusedintreating
COPD/AECOPD, but some studies []foundthatCOPD
patients have digestive tract symptom such as abdominal
distension, constipation besides cough, phlegm, and dyspnea.
us,itispracticaltouseMDDintreatingCOPDwhich
belongs to excess syndrome especially with constipation
Evidence-Based Complementary and Alternative Medicine
T : Outcome measures for PCO(mmHg).
Study Treatment (m ±s) Control (m ±s) Mean dierence (% CI) 𝑃value
Fang and Shi, []67 ± 11 74 ± 13 −. (−14.78,0.78) 𝑃 = 0.0852
Guo and Liang, []41.3 ± 5.13 48.26 ± 5.34 −. (−9.61, −4.31) 𝑃 < 0.0001
Lu, []41.76 ± 2.1 42.76 ± 2.39 −. (−2.56,0.56) 𝑃 = 0.2184
Meng, []65.7 ± 6.3 81.7 ± 8.1 −. (−19.67, −12.33) 𝑃 < 0.0001
Pang,[]57.54 ± 6.9 62.36 ± 5.76 −. (−7.57, −2.07) 𝑃 = 0.001
Meta −. (−5.44, −3.17) 𝑃 < 0.00001
622 of records were identied through
database searching
377 of records aer duplicates were
removed 91 full-text articles were excluded with
reason:
286 of full-text articles were assessed for
eligibility
16 of RCTS were included
qualitative synthesis
12 RCTS were included in quantitative
synthesis (meta-analysis)
270 of full-text articles were excluded,
with reasons
(1)eory contents (𝑛= 57)
(2) Reviews (𝑛= 58)
(3) Case experience (𝑛= 44)
(4) No Dachengqi Decoction (𝑛= 73)
(5) External therapy (𝑛= 33)
(6) COPD with other diseases (𝑛= 5)
Duplicated papers (𝑛 = 23)
F : Study selection process.
symptoms in TCM. e theory of “Interior and Exterior
Relationship between the Lung and Large Intestine” is one of
the most important theories in traditional Chinese Medicine
which is of great value in the clinical practice. Also some
studies found that “catharsis large intestine” can decrease T
cells and enhance the number of serum T cells and aect the
balance of CD+and CD+and can have eects on airway
remodeling of lung in rats with COPD [].
Also, there are several methodological limitations. First,
all trials involved were of low quality. No study applied
placebo as control; thus, the patients and physicians were
not blinded. Although all the trials reported randomization,
only studies reported sequence generation and no study
addressed the issue of allocation concealment. e quality
of studies published in Chinese is majorly poor, and some
scholars indicated that China generated virtually no negative
studies at all []. erefore, the ndings of the meta-
analyses should be interpreted with caution. Due to the
time limitation, we did not contact the original authors, and
furtherinformationforbetterevaluationofriskofbiaswas
inadequate.
Second,alltheincludedstudieswerepublishedinChi-
nese journals, and all the results were positive. What is more,
study number was not enough to implement funnel plot,
Evidence-Based Complementary and Alternative Medicine
Study or subgroup MDD Control Wei g h t Mean dierence Mean dierence
Mean SD Total Mean SD Total IV, random, 95%CI IV, random, 95%CI
Fu, 2010 50.3 9.69 30 44.26 10.88 30 16.9%6.04 [0.83, 11.25]
Li, 2009 76.23 5.32 30 74.45 5.25 30 22.1%178 [−0.89, 4.45]
Liang, 2011 50.3 9.69 30 41.95 10.89 30 16.9%8.35 [3.13, 13.57]
Lu, 2010 63.53 3.83 16 62.02 4.08 16 21.9%1.51 [−1.23, 4.25]
Mao, 2010 74.61 6.68 52 64.95 6.63 48 22.2%9.66 [7.05, 12.27]
Total (95%CI) 158 154 100.0%5.30 [1.48, 9.12]
Heterogeneity: Tau2= 15.36, Chi2= 25.73, df=4( ), and I2=84%
Test for overall eect: ( )
0 10 20
−20 −10
Control Experimental
F : Forest plot of comparison: FEV1%pred (%).
Study or subgroup MDD Control Wei g h t Mean dierence Mean dierence
Mean SD Total Mean SD Total IV, random, 95 %CI IV, random, 95 %
Fu, 2010 58.81 9.6 30 56.3 6.81 30 9.8%2.51 [−1.70, 6.72]
Li, 2009 72.27 5.13 30 70.98 5.18 30 25.7%1.29 [−1.32, 3.90]
Liang, 2011 58.92 9.42 30 57.3 7.52 30 9.4%1.62 [−2.69, 5.93]
Lu, 2010 65.17 2.4 16 64.09 2.9 16 51.3%1.08 [−0.76, 2.92J
Zhang, 2011 58.9 13.1 32 51.8 14.1 30 3.8%7.10 [0.31, 13.89]
Total (95%CI) 138 136 100.0%1.55 [0.23, 2.87]
Heterogeneity: Tau2= 0.00, Chi2= 3.06, df=4(
Test for overall eect: ( )
024
Favours control Favours MDD
−4−2
), and I2=0%
F : Forest plot of comparison: FEV1/FVC% (%).
so there might be a potential publication bias. We could
notruleoutthesystematicerrorbecausethesamplesize
of all studies was limited. So the clinical eect might be
exaggerated. Larger sample RCTs are needed in the future for
accurate results.
ird,allthedecoctionsincludedintheresearchwere
based on Dachengqi Decoction, but the herbs and the
dosages were dierent in each study. is might be the
main reason leading to the signicant heterogeneity. We can
see in the research that all the studies except six pointed
out that the syndrome of phlegm-heat obstructing lung is
appropriate for MDD. Determination of treatment based on
pathogenesis obtained through dierentiation of symptoms
is one of the most important characteristics in Chinese
Medicine, so modication according to symptoms is needed
during the treatment. Herbs of cold nature such as Gypsum
Fibrosum or Radix Scutellariae are used to clear heat while
diminishing sputum herbs such as Fructrs Trichosanthis,
Semen Lepidii, and Herba Houttuyniae are commonly used
in patients with abundance phlegm on the basic of Dachengqi
Decoction.
Despite of the methodological weakness and potential
risk of bias, the data from the included studies illustrated
that MDD combined with conventional treatment may
have better eectiveness than conventional treatment alone,
especially in improving FEV1%pred, enhancing signicant
eectiveness, reducing PCO2, and shortening duration of
mechanical ventilation. e study suggests that MDD could
improve airway obstruction and relieve respiratory failure so
as to improve prognosis.
5. Conclusion
Modied Dachengqi Decoction appears to be eective for
treating AECOPD. However, more well-designed and large
sample RCTs are needed in the future due to the insucient
methodological problems of existing studies.
Conflict of Interests
e authors declare that there is no conict of interests.
Evidence-Based Complementary and Alternative Medicine
Study or subgroup MDD Control Weight Risk ratio Risk ratio
Events Total Events Total M-H, random, 95%CI M-H, random, 95%CI
Fu, 2010 21 30 12 30 20.0%1.75 [1.06, 2.88]
Guo and Liang,
2011 28 30 16 30 40.7%1.75 [1.24, 2.48]
Li, 2009 22 30 15 30 28.3%1.47 [0.97, 2.23]
Lu, 2010 5 21 3 21 2.9%1.67 [0.46, 6.10]
Peng and Li, 2009 10 30 8 30 8.1%1.25 [0.57, 2.73]
Total (95%CI) 141 141 100.0%1.62 [1.30, 2.02]
Total events 86 54
Heterogeneity: Tau2= 0.00, Chi2= 0.94, df = 4 ( ), and I2=0%
Test for overall eect: ( )
0.5 0.7 1 1.5 2
Control Experimental
F : Forest plot of comparison: therapeutic eect of syndrome.
Authors’ Contribution
R.WuandY.Liequallycontributedtothispaper.
Acknowledgments
e authors particularly thank Professor J. P. Liu and Asso-
ciated Professor Y. T. Fei from the Centre for Evidence-
based Chinese Medicine, Beijing University of Chinese
Medicine, for their great supports in this study. is study was
funded by the China National Key Basic Research Plan (no.
CB).
References
[] GOLD Executive Committee, “Global strategy for the diagnosis,
management, and prevention of chronic obstructive pulmonary
disease,” http://www.goldcopd.org/.
[]J.Rizkallah,S.F.P.Man,andD.D.Sin,“Prevalenceof
pulmonary embolism in acute exacerbations of COPD,” Chest,
vol. , no. , pp. –, .
[] Professional Committee of Pulmonary Disease of Internal
Medicine Branch, China Association of Chinese Medicine,
“Syndromediagnosticcriteriaof traditional Chinese medicine
for chronic obstructive pulmonary disease,” Zhong Yi Za Zhi,
vol. , no. , pp. –, (Chinese).
[] F.J.ZhengandY.H.Li,“DiscussiononpathogenesisofCOPD
and treatment based on intestine,” China Journal of Traditional
Chinese Medicine and Pharmacy, no. , pp. –, .
[] J. F. Ludvigsson, M. Inghammar, M. Ekberg, and A. Egesten, “A
nationwide cohort study of the risk of chronic obstructive pul-
monary disease in coeliac disease,” JournalofInternalMedicine,
vol.,no.,pp.–,.
[] S. L. Yang and D. B. Li, “Clinical study on therapy of clearing
hallow viscera in treating critical patients with gastro-enteric
function disorder,” Chinese Journal of Integrative Medicine,vol.
,no.,pp.–,.
[]X.Y.Zheng⋅,Guidelines of Clinical Research of New Drugs
of Traditional Chinese Medicine, Medical Press Science of
Technology of China, Beijing, China, st edition, .
[]J.P.T.HigginsandS.Green,“CochraneHandbookfor
Systematic Reviews of Interventions (Version ..),” ,
http://handbook.cochrane.org/.
[] K. Fang and Z. L. Shi, “Observation on clinical eects of Tongfu
Pingchuan decoction combined with mechanical ventilation on
patients with respiratory failure induced by chronic obstructive
pulmonary disease,” Chinese Journal of Integrated Traditional
and Western Medicine in Intensive and Critical Care,vol.,no.
,pp.–,.
[] J. Y. Fu, e Study of the Application of the Method of Purging
to Relax the Bowels in the Treatment of Acute Exacerbations of
Chronic Obstructive Pulmonary Disease, Guangzhou University
of Chinese Medicine, .
[] J. H. Guo and D. Liang, “Clinical research of Acute Exacerbation
ofChronicObstructivePulmonaryDisease(AECOPD)treated
by tonifying Qi and unblocking Fu,” China Journal of Chinese
Medicine,vol.,no.,pp.–,.
[] W. X. Guo and F. Y. Zhang, “Clinical observation of xuan-
baichengqitang with mucosolvan in the treatment of Acute
Exacerbation of Chronic Obstructive Pulmonary Disease,”
Hebei Journal of Traditional Chinese Medicine,vol.,no.,pp.
–, .
[] D. L. Li, “e clinical study of Xuanbaichengqitang in the treat-
ment of Chronic Obstructive Pulmonary Disease,” Liaoning
University of Chinese Medicine, .
[]S.Y.Li,X.K.Cheng,J.S.Li,L.J.Ma,andC.H.Li,
“Eect of tongse grain of TCM on cytokine in patients with
chronic Obstructive Pulmonary Disease,” Liaoning Journal of
Traditional Chinese Medicine,vol.,no.,pp.–,.
[] X. Y. Li, “rough experiments of tong drop turbidity method
in the treatment of chronic obstructive pulmonary disease
curative eect observation of respiratory failure,” Journal of
Traditional Chinese Medicine,vol.,no.,pp.–,.
[] W. X. Liang, “e application of purgative method in treating
the Acute Exacerbation of Chronic Obstructive Pulmonary
Disease,” Guide of China Medicine,vol.,no.,pp.–,
.
Evidence-Based Complementary and Alternative Medicine
[] Y. Liu, X. Y. Jin, B. Huo et al., “Clinical study on Yiqi Tongfu
decoction for dicult to weaning patients with COPD from
mechanical ventilation,” AcademicJournalofKaifengMedical
College,vol.,no.,pp.–,.
[] J. Y. Lu, e Clinical Research on the Eect of Qingre Xiefu
Chinese Traditional Medicine in the Treatment of Acute Exacer-
bations of Chronic Obstructive Pulmonary Disease (AECOPD),
Hebei Medical University, .
[] L. N. Mao, “e treatment of TongFuPaiQi for AECOPD
patients,” Yunnan Journal of Traditional Chinese Medicine and
Materia Medica,vol.,no.,p.,.
[] F. S. Meng, “Clinical study on xuanbaichengqi decoction for
acute exacerbation of chronic obstructive pulmonary disease,”
Journal of New Chinese Medicine,vol.,no.,pp.–,.
[] K. Pang, “Treatment Combine traditional Chinese and western
medicine for COPD patients,” Traditional Chinese Medicinal
Research,vol.,no.,pp.–,.
[] W. B. Peng and S. F. Li, “Clinical observation of lung-
purging, blood-activating and fu-unblocking herbs with west-
ern medicine in treating acute exacerbation of chronic obstruc-
tive pulmonary disease,” Shanghai Journal of Traditional Chines e
Medicine,vol.,no.,pp.–,.
[] Z.-L. Shi, K. Fang, G.-H. Li, M.-J Mao, and Z.-H Li, “Eect of
catharsis method on breathing mechanics and airway inam-
matory factors of patients with respiratory failure induced
by chronic obstructive pulmonary disease,” China Journal of
Traditional Chinese Medicine and Pharmacy,vol.,no.,pp.
–, .
[] X. W. Zhang, “Clinical analysis of cases COPD treated with
traditional Chinese and western medicine,” Hebei Medicine,vol.
, no. , pp. –, .
[] W.Zhou,Y.Q.Zhong,H.M.Yangetal.,“Traditionalchinese
medicine in the treatment of chronic obstructive pulmonary
disease in stable stage: a systematic review of randomized
controlled trials,” Chinese Journal of Evidence-Based Medicine,
vol. , no. , pp. –, .
[] X.D.An,A.L.Zhang,A.W.Yangetal.,“Oralginsengformulae
for stable chronic obstructive pulmonary disease: a systematic
review,” Respiratory Medicine,vol.,pp.–,.
[]W.Li,B.Mao,G.Wangetal.,“EectofTanreqinginjection
on treatment of acute exacerbation of chronic obstructive pul-
monary disease with Chinese medicine syndrome of retention
of phlegm and heat in Fei,” Chinese Journal of Integrative
Medicine,vol.,no.,pp.–,.
[] Z.X.Quan,X.G.Zhong,G.Pengetal.,“Eectsofcatharsislarge
intestine on T lymphocyte subsets in peripheral blood from rats
with COPD,” China Journal of Traditional Chinese Medicine and
Pharmacy,vol.,no.,pp.–,.
[] A. Vickers, N. Goyal, R. Harland, and R. Rees, “Do certain
countries produce only positive results? A systematic review of
controlled trials,” Controlled Clinical Trials,vol.,no.,pp.
–, .
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