Kwon Chan-Young, Lee Boram, Lee Beom-Joon, Kim Kwan-Il, Jung Hee-Jae
Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busan, South Korea.
Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea.
Front Pharmacol. 2021 Oct 20;12:717570. doi: 10.3389/fphar.2021.717570. eCollection 2021.
Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by irreversible airflow limitation. Many COPD patients use complementary and alternative modalities, including herbal medicines (HMs). This systematic review investigated the effectiveness and safety of HM in managing COPD symptoms compared to placebo. Nine electronic databases were searched to identify relevant randomized controlled trials (RCTs) up to February 12, 2021. The Cochrane risk of bias tool was used to assess the methodological qualities of the included studies. Primary outcomes were lung function parameters and exercise capacity. A meta-analysis was conducted to determine the effect size for homogeneous outcomes. Fourteen studies were included. There was low to very low quality evidence that HM significantly improved forced expiratory volume in 1 s (FEV1) (L), FEV1 (%) and 6-minute walk distance, as well as moderate quality evidence that HM significantly improved forced vital capacity (FVC) (L) compared to placebo. However, according to low quality evidence, there was no significant difference in FEV1/FVC (%) or vital capacity (L) between the groups. Low to moderate evidence suggests that HM has the potential to help improve some respiratory functions, COPD symptoms, and some aspects of quality of life in COPD patients compared to placebo. However, these findings are challenged by the poor methodological quality of the included studies, the heterogeneity of HMs used, and potential publication bias. Therefore, the findings could be significantly influenced by further larger, more rigorous RCTs on this topic. Moreover, it may also be recommended to develop standardized HMs focused on some individual herbs that are frequently used or expected to play an important role in patients with COPD, and to elucidate the underlying mechanisms.
慢性阻塞性肺疾病（COPD）是一种以不可逆气流受限为特征的呼吸系统疾病。许多COPD患者使用补充和替代疗法，包括草药（HMs）。本系统评价调查了与安慰剂相比，草药在管理COPD症状方面的有效性和安全性。检索了九个电子数据库，以识别截至2021年2月12日的相关随机对照试验（RCTs）。使用Cochrane偏倚风险工具评估纳入研究的方法学质量。主要结局是肺功能参数和运动能力。进行荟萃分析以确定同质结局的效应大小。纳入了十四项研究。有低至极低质量的证据表明，与安慰剂相比，草药显著改善了第1秒用力呼气量（FEV1）（升）、FEV1（%）和6分钟步行距离，以及中等质量的证据表明草药显著改善了用力肺活量（FVC）（升）。然而，根据低质量证据，两组之间的FEV1/FVC（%）或肺活量（升）没有显著差异。低至中等质量的证据表明，与安慰剂相比，草药有潜力帮助改善COPD患者的一些呼吸功能、COPD症状和生活质量的某些方面。然而，这些发现受到纳入研究方法学质量差、所用草药的异质性以及潜在发表偏倚的挑战。因此，这些发现可能会受到关于该主题的进一步更大、更严格的RCTs的显著影响。此外，还可能建议开发针对COPD患者中经常使用或预期发挥重要作用的某些个别草药的标准化草药，并阐明其潜在机制。
