Department of Respiratory Medicine, the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei 230031, Anhui Province, China.
Graduate School, Anhui University of Traditional Chinese Medicine, Hefei 230012, Anhui Province, China.
J Integr Med. 2024 Sep;22(5):561-569. doi: 10.1016/j.joim.2024.07.003. Epub 2024 Jul 9.
Chronic obstructive pulmonary disease (COPD), a common respiratory disease, can be effectively treated by traditional Chinese medicine (TCM). Qingfei Huatan, a TCM formula, has been reported to effectively alleviate the clinical symptoms of COPD patients. However, there is a lack of multi-centre, randomised, double-blind, controlled clinical trials documenting the clinical efficacy and safety of this formula in the treatment of acute exacerbation of COPD (AECOPD).
This study evaluated the efficacy and safety of Qingfei Huatan formula in the treatment of AECOPD, thereby providing high-quality clinical evidence.
DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: A total of 276 patients with AECOPD were included in this multi-centre, randomised, double-blind, placebo-controlled trial and were randomised into treatment and control groups at a ratio of 1:1. Patients in the treatment and control groups took Qingfei Huatan granules or simulated Qingfei Huatan granules twice a day, for 14 days, in addition to Western medicine treatment. All patients were followed up for 3 months.
The primary outcome was time taken to symptom stabilisation. The secondary outcomes included duration of antibiotic use, clinical symptom and sign score, TCM syndrome score, dyspnoea score, and quality of life (QOL) score. Meanwhile, the safety of the formula was assessed through routine urine and stool tests, electrocardiograms, liver and kidney function tests, and the observation of adverse events throughout the trial.
The time taken for effective stabilisation (P < 0.05) and obvious stabilisation (P < 0.01), and the duration of antibiotic use (P < 0.05) were significantly shorter in the treatment group than in the control group. On days 6, 9, 12 and 14 of treatment, clinical symptom and sign score decreased in both groups, particularly in the treatment group (P < 0.01). On days 9, 12 and 14 of treatment, the TCM syndrome scores of both groups were reduced (P < 0.01), with more significant reductions in the treatment group. At 3 months after the end of treatment, the treatment group continued to have lower clinical symptom and sign score and TCM syndrome score than the control group (P < 0.01). On days 6, 9, 12 and 14 of treatment, dyspnoea and QOL scores were markedly reduced in the two groups (P < 0.05 and P < 0.01, respectively), especially in the treatment group. At 3 months after the end of treatment, dyspnoea and QOL scores were lower in the treatment group than those in the control group (P < 0.01). No serious adverse events were observed in either group.
The Qingfei Huatan formula can effectively shorten the duration of AECOPD and antibiotic use, significantly relieve clinical symptoms, and increase QOL for AECOPD patients, with a favourable safety profile. These results suggest that this formula can be used as a complementary treatment for AECOPD patients.
The protocol was registered at the Chinese Clinical Trial Registry (ChiCTR1900026576). Please cite this article as: Zhu HZ, Li CY, Liu LJ, Tong JB, Lan ZH, Tian SG, Li Q, Tong XL, Wu JF, Zhu ZG, Li SY, Li JS. Efficacy and safety of Qingfei Huatan formula in the treatment of acute exacerbation of chronic obstructive pulmonary disease: A multi-centre, randomised, double-blind, placebo-controlled trial. J Integr Med. 2024; 22(5): 561-569.
慢性阻塞性肺疾病(COPD)是一种常见的呼吸系统疾病,可通过中医(TCM)进行有效治疗。清肺化痰汤是一种 TCM 配方,据报道可有效缓解 COPD 患者的临床症状。然而,缺乏多中心、随机、双盲、对照临床试验来记录该配方在治疗 COPD 急性加重(AECOPD)中的临床疗效和安全性。
本研究评估清肺化痰汤治疗 AECOPD 的疗效和安全性,从而提供高质量的临床证据。
设计、地点、参与者和干预措施:这项多中心、随机、双盲、安慰剂对照试验共纳入 276 例 AECOPD 患者,按 1:1 的比例随机分为治疗组和对照组。治疗组和对照组患者均在接受西药治疗的基础上,每天服用两次清肺化痰汤颗粒或模拟的清肺化痰汤颗粒,疗程为 14 天。所有患者均随访 3 个月。
主要结局是症状稳定所需的时间。次要结局包括抗生素使用时间、临床症状和体征评分、中医证候评分、呼吸困难评分和生活质量(QOL)评分。同时,通过常规尿液和粪便检查、心电图、肝肾功能检查以及整个试验期间观察不良事件来评估配方的安全性。
治疗组有效稳定(P<0.05)和明显稳定(P<0.01)时间以及抗生素使用时间(P<0.05)均显著短于对照组。治疗第 6、9、12 和 14 天,两组临床症状和体征评分均下降,尤其是治疗组(P<0.01)。治疗第 9、12 和 14 天,两组中医证候评分均降低(P<0.01),治疗组降低更为明显。治疗结束后 3 个月,治疗组的临床症状和体征评分及中医证候评分仍低于对照组(P<0.01)。治疗第 6、9、12 和 14 天,两组呼吸困难和 QOL 评分均显著降低(P<0.05 和 P<0.01),尤其是治疗组。治疗结束后 3 个月,治疗组呼吸困难和 QOL 评分仍低于对照组(P<0.01)。两组均未观察到严重不良事件。
清肺化痰汤可有效缩短 AECOPD 病程和抗生素使用时间,显著缓解临床症状,提高 AECOPD 患者的生活质量,安全性良好。这些结果表明,该配方可作为 AECOPD 患者的辅助治疗。
该方案在中国临床试验注册中心(ChiCTR1900026576)注册。请引用本文作为:朱慧志,李传应,刘立军,佟佳宾,兰智慧,田思胜,李强,佟秀莲,吴金峰,朱志刚,李双燕,李军,李建生。清肺化痰汤治疗慢性阻塞性肺疾病急性加重症的疗效和安全性:多中心、随机、双盲、安慰剂对照试验。解放军医学杂志。2024;22(5):561-569.