ObjectiveTo evaluate the efficacy and safety of Fugui ostealgia particles for cervical spondylosis (Yang-asthenia and cold-damp type). MethodsFrom December 2010 to July 2011, we carried out a multi-centered, randomized, double-blind and double-simulation clinical observation study based on the Guiding Principles for the Clinical Research on New Chinese Traditional Medicine (TCM). A total of 240 patients were divided into experimental group and control group with the number of patients at a ratio of 3:1. The treatment group (n=180) was treated by Fugui ostealgia particles, while patients in the control group (n=60) received Kangguzengsheng capsules. The treatment course lasted for 90 days. ResultsThe total effective rate in the experimental group was 92.44%, and was 75.47% in the control group, with a significant difference between the two groups (P<0.05). The total effective rate for TCM syndromes was significantly different between the two groups (P<0.05). The effect on main symptoms such as nuchal pain, aversion to cold, and cold hands and feet, was significantly different between the two groups (P<0.05). Laboratory test results showed no abnormality before and after treatment, and no drug-related adverse reactions occurred. ConclusionFugui ostealgia particles are safe and effective for the treatment of Yang-asthenia and cold-damp type cervical spondylosis, especially for the treatment of nuchal pain, aversion to cold, and cold hands and feet.
ObjectiveTo systematically review the clinical efficacy of low molecular weight heparin (LMWH) in treating patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). MethodsDatabases including PubMed, The Cochrane Library (Issue 10, 2013), EMbase, CBM, CNKI, VIP and WanFang Data were searched for the randomized controlled trials (RCTs) about LMWH in treating acute exacerbation of COPD from the establishment to October 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of the included studies. Meta-analysis was then performed using RevMan 5.2 software. ResultsA total of 6 RCTs involving 501 patients were finally included. The results of meta-analysis showed that:compared with the control group, LMWH significantly improved levels of D-dimmer (MD=-0.28, 95%CI-0.50 to-0.05, P=0.02), reduced carbon dioxide partial pressure (PaCO2) (MD=-3.42, 95%CI-6.66 to-0.18, P=0.04), improved coagulation (PT) (MD=1.85, 95%CI 1.29 to 2.42, P < 0.000 01), and improved clinical symptoms and signs (RR=1.33, 95%CI 1.12 to 1.58, P=0.001), but it did not improve oxygen partial pressure (PaO2) (MD=0.28, 95%CI-3.04 to 3.61, P=0.87). During treatment, no severe adverse reaction occurred in both groups. ConclusionLMWH could significantly improve symptoms caused by acute exacerbation of COPD. Due to limited quantity and quality of the included studies, the above conclusion needs to be confirmed by conducting more high quality RCTs with larger sample size.
ObjectiveTo systematically evaluate the efficacy and safety of procalcitonin guided algorithms of antibiotic therapy in acute exacerbation chronic obstructive pulmonary disease (AECOPD). MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 6, 2016), CBM, CNKI, VIP, and WanFang Data from the date of their establishment to July 2016, to collect randomized controlled trials (RCTs) about procalcitonin guided antibiotics therapy in patients with AECOPD. References of the included literature were also searched manually for additional studies. The literature screening, data extraction and bias risk assessment of the included studies were completed by two reviewers independently. Statistical analysis was conducted using RevMan 5.2 software. ResultsA total of ten RCTs involving 1 071 patients were included. The results of meta-analysis indicated that compared with the standard treatment group, the antibiotic prescription rate (RR=0.70, 95% CI 0.55 to 0.89, P=0.004), the rate of duration of antibiotic >10 days (RR=0.38, 95% CI 0.26 to 0.56, P<0.000 01) and the superinfection rate (RR=0.23, 95% CI 0.09 to 0.58, P=0.002) were significantly lower in the procalcitonin-guided treatment group. There were no statistical differences in clinical effective rate (RR=0.98, 95% CI 0.91 to 1.06, P=0.61), hospital mortality (RR=0.84, 95% CI 0.52 to 1.73, P=0.43), and the rate of need for intensive care (RR=0.77, 95% CI 0.40 to 1.47, P=0.43). ConclusionProcalcitonin guided antibiotics therapy may reduce antibiotic exposure and superinfection rate in patients with AECOPD. In addition, due to the low methodological quality and limited quantity of the included studies, larger sample-size, and high quality RCTs are needed to verify the above conclusion.
ObjectiveTo systematically review the clinical efficacy of low-dose erythromycin in patients with stable chronic obstructive pulmonary disease (COPD). MethodsRandomized controlled trials (RCTs) about low-dose erythromycin plus routine treatment versus routine treatment/placebo plus routine treatment in treating stable COPD was electronically searched in PubMed, EMbase, CBM, The Cochrane Library (Issue 4, 2013), CNKI, VIP and WanFang Data from the their establishment dates to May 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality. The results of meta-analysis was performed using RevMan 5.2 software. ResultsA total of eight RCTs involving 526 patients were finally included. The results of metaanalysis showed that:a) compared with the control group, low-dose erythromycin significantly improved six-minute walk distance (SMD=0.30, 95%CI 0.05 to 0.55, P=0.02), reduced the frequency of acute exacerbation (RR=0.44, 95%CI 0.25 to 0.78, P=0.005), and decreased the concentrations of IL-8 (SMD=-1.63, 95%CI-2.17 to-1.09, P < 0.000 01), TNF-α (SMD=-1.49, 95%CI-2.36 to-0.62, P=0.000 8), and neutrophil elastase (NE) (SMD=-0.94, 95%CI-1.36 to-0.51, P < 0.000 1) in sputum. b) the erythromycin therapy could improve forced expiratory volume in one second (FEV1) (SMD=0.19, 95%CI-0.19 to 0.58, P=0.32) but without significant differences compared with the control group. ConclusionLow-dose erythromycin could improve exercise tolerance, reduce the frequency of acute exacerbation, and help relieve airway inflammation, but in the improvement of FEV1, low-dose erythromycin is not better than routine treatment. Due to limited quantity and quality of the included studies, larger scale, multicenter, high quality RCTs are needed to verify the aforementioned conclusion.