1.
Effect of Statins on COPD: A Meta-Analysis of Randomized Controlled Trials.
Zhang, W, Zhang, Y, Li, CW, Jones, P, Wang, C, Fan, Y
Chest. 2017;(6):1159-1168
Abstract
BACKGROUND Much controversy persists regarding the place of statin drugs in the treatment of patients with COPD. This systematic review and meta-analysis sought to determine the clinical efficacy of statin therapy in COPD. METHODS We searched MEDLINE, EMBASE, the Cochrane Database, and PubMed for relevant clinical studies. Randomized controlled trials (RCTs) comparing the effects of statin drugs with placebo in COPD populations were included. Pooled estimates were calculated using a random-effects model. Heterogeneity was determined using the I2 statistic. RESULTS Ten trials with a total of 1,471 patients were included. Statin treatment was associated with a larger improvement in exercise capacity, lung function, and St. George's Respiratory Questionnaire score compared with placebo, but there were no statistically significant differences in inflammatory markers, all-cause mortality, and safety outcomes; however, subgroup analysis indicated that statin drugs improved clinical outcomes in the subjects from trials enrolling patients with overt cardiovascular disease (CVD), elevated baseline C-reactive protein levels, or a high cholesterol level. CONCLUSIONS The findings from this systematic review suggest a role for statin drugs in patients with COPD and coexisting CVD, evidence of increased systemic inflammation, or hyperlipidemia with respect to improving exercise tolerance and pulmonary function. These findings need to be confirmed by RCTs specifically designed to test this hypothesis and identify appropriate patients for statin use. TRIAL REGISTRY PROSPERO CRD42017060594; https://www.crd.york.ac.uk/PROSPERO/.
2.
[A study of the mechanism of Qingre Huatan therapy in treatment of acute exacerbation of chronic obstructive pulmonary disease by improving airway inflammation and mucus hypersecretion].
Li, W, Mao, B, Wang, G, Wang, L, Chang, J, Zhang, Y, Wan, MH, Guo, J
Zhong xi yi jie he xue bao = Journal of Chinese integrative medicine. 2008;(8):799-805
Abstract
OBJECTIVE To explore the effects of Tanreqing injection, a traditional Chinese herbal preparation for clearing heat and resolving phlegm, in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) by improving airway inflammation and airway mucus hypersecretion. METHODS A randomized controlled trial (RCT) was designed. Ninety AECOPD patients were randomly divided into Tanreqing group, ambroxol hydrochloride group and control group. The patients in the three groups were all treated with conventional therapy. Furthermore, intravenous drip infusion of 20 ml Tanreqing injection (once daily) and 15 mg ambroxol hydrochloride injection (twice daily) were administered respectively to the patients in the Tanreqing group and ambroxol hydrochloride group. They were all treated for 10 days. Symptom score of traditional Chinese medicine (TCM), plasma concentrations of interleukin-8 (IL-8), IL-10 and neutrophil elastase (NE) were detected before and after treatment. RESULTS Cough, sputum amount, expectoration, dyspnea, fever, coated tongue and pulse tracings were improved obviously in Tanreqing group (P<0.05), and the effects of Tanreqing on improving cough, sputum amount and expectoration were better than the conventional therapy (P<0.05), while there was no significant difference between Tanreqing group and ambroxol hydrochloride group (P>0.05). Compared with ambroxol hydrochloride group and the control group, the coated tongue was improved obviously in Tanreqing group (P>0.05). After treatment, plasma concentrations of IL-8, IL-10 and NE were decreased in Tanreqing group and ambroxol hydrochloride group (P<0.05), and the levels of IL-8 and IL-10 in the control group were decreased (P<0.05). The change of IL-8 level before and after treatment in Tanreqing group was greater than that in ambroxol hydrochloride group and the control group. The changes of IL-10 and NE levels in ambroxol hydrochloride group were greater than those in Tanreqing group and the control group, while there was no significant difference in the changes of serum levels of IL-8, IL-10 and NE among the three groups (P>0.05). Total response rates in Tanreqing group and ambroxol hydrochloride group were higher than that in the control group (P<0.05), while there was no significant difference in total response rate between Tanreqing group and ambroxol hydrochloride group (P>0.05). There was no significant difference in total response rate among the three groups (P>0.05). CONCLUSION Tanreqing injection can improve TCM signs and symptoms in AECOPD patients, and the mechanism maybe due to the decrease of serum levels of IL-8 and NE and improvement of IL-10 level.
3.
[Effects of shenmai injection on the clinical efficacy of noninvasive ventilation in patients with severe respiratory failure caused by chronic obstructive pulmonary disease].
Ouyang, XH, Yin, R, Zhang, Y
Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine. 2006;(7):608-11
Abstract
OBJECTIVE To study the effect of Shenmai Injection (SMI) on the clinical efficacy of noninvasive positive-pressure ventilation (NPPV) in treating patients with severe respiratory failure (RF) caused by chronic obstructive pulmonary disease (COPD). METHODS Patients in the control group (n=23) were treated with conventional therapy plus NPPV, and those in the treatment group (n=25) received the same treatment but with intravenous infusion of SMI 30 ml once a day additionally. The treatment lasted for 10 days. Arterial oxygen saturation (SaO2) was continuously monitored in all patients, arterial blood gas values was determined before treatment and at the 6th hour, the 24th hour, the 3rd day and the 7th day after treatment, and consciousness, breath, heart rate and severity of dyspnea were observed during the treating period. RESULTS All patients in the treatment group were markedly improved and discharged from hospital, while in the control group 20 were improved and discharged from hospital, but the other 3 failed to be remitted and received the conventional invasive mechanical ventilation. The duration of hospitalization and ventilation were 11.3 +/- 2.5 d and 5.8 +/- 2.8 d in the treatment group, and 13.2 +/- 2.7 d and 7.5 +/- 3.0 d in the control group, showing significant difference in the two indexes between the two groups (P < 0.05). The dyspnea score and the arterial blood gas values determined on the 3rd and 7th day were significantly improved in the treatment group than those in the control group (P < 0.05 or P < 0.01). The incidence of endotracheal intubation caused adverse reaction, such as facial-skin crush wound, abdominal distention and contaminated infection in the treatment group was obviously lessened as compared with the control group. CONCLUSION SMI could shorten the duration of hospitalization and mechanical ventilation, reduce trachea cannulation, and decrease the incidence of complications and adverse reactions in the patients with severe RF due to COPD treated with NPPV.