Evidence-based Clinical Chinese Medicine - Volume 1: Chronic Obstructive Pulmonary Disease

by Charlie Changli Xue, Chuanjian Lu, Johannah Shergis, Lei Wu

Overview

Evidence-based Clinical Chinese Medicine: Vol. 1 Chronic Obstructive Pulmonary Disease provides a 'whole evidence' analysis of the Chinese medicine management of chronic obstructive pulmonary disease (COPD). Evidence from the classical Chinese medicine literature, contemporary clinical literature, and the outcomes of clinical trials and experimental studies are reviewed, analysed and synthesised. The data from all these sources are condensed to provide evidence-based statements which will inform clinical practice and guide future research.This book has been designed to be an easy reference at the point of care. During a patient consultation, Chinese medicine practitioners can refer to this book for guidance on which Chinese herbal medicine formulas, specific herbs, or acupuncture points, can best treat their patient, and be confident there is evidence which supports its use.Currently, Chinese medicine practitioners who develop a special interest in a particular health condition such as COPD have to consult a variety of sources to further their knowledge. Typically, they use the contemporary clinical literature to understand the theory, aetiology, pathogenesis and obtain expert opinions on the Chinese medicine management of COPD. They search the electronic literature to identify systematic reviews of clinical trials, if any exists, to obtain assessments of the current state of the clinical evidence for particular interventions. If they have the skills and resources, they may search the classical Chinese medicine literature for an historical perspective on treatments that have stood the test of time.This book provides all of this information for practitioners in one handy, easy to use reference. This allows practitioners to focus on their job of providing high quality healthcare, with the knowledge it is based on the best available evidence.

Product Details

ISBN-13:	9789814723091
Publisher:	World Scientific Publishing Company, Incorporated
Publication date:	06/14/2016
Series:	Evidence-based Clinical Chinese Medicine , #1
Pages:	336
Product dimensions:	6.00(w) x 9.00(h) x 0.70(d)

Table of Contents

Disclaimer v

Foreword vii

Related Publications x

Authors and Contributors xiii

Members of Advisory Committee and Panel xv

Acknowledgments xxi

List of Figures xxxiii

List of Tables xxxv

1 Introduction to Chronic Obstructive

Pulmonary Disease 1

Risk Factors 2

Pathological Processes 3

Diagnosis 4

Symptoms 4

Testing 4

Differential Diagnosis 6

Acute Exacerbations of COPD 6

Management 8

Pharmacological Interventions 8

Non-Pharmacological Interventions 9

Management of Acute Exacerbations of COPD 9

Therapeutic Outcomes 10

References 11

2 COPD in Chinese Medicine 13

Aetiology and Pathogenesis 15

Syndrome Differentiation and Treatments 16

Stable COPD 17

Lung qi deficiency 17

Lung and Spleen qi deficiency 17

Lung and Kidney qi deficiency 18

Lung and Kidney qi and Yin deficiency 19

Acute Exacerbations of COPD 19

External cold and internal phlegm-yin 19

Phlegm-heat obstructing the Lung 20

Turbid phlegm obstructing the Lung 20

Phlegm and blood stasis in the Lung 21

Yang deficiency with excess fluid 21

Phlegm clouding the Heart orifice 22

Single-Herb Formulae 22

Acupuncture and Related Therapies 23

Other Therapies 24

Other Strategies 24

References 25

3 Classical Chinese Medicine Literature 27

Classical Literature Search 28

Classical Literature Citations 29

Results 30

Common Formulae 31

Common Herbs 31

Common Acupuncture Points 33

Selected Quotations 35

Classical Literature in Perspective 36

References 37

4 Methods for Evaluating Clinical Evidence 39

Search Strategy 40

Inclusion Criteria 42

Exclusion Criteria 42

Methodological Quality Assessment 42

Statistical Analyses 43

Summary of Findings 43

References 44

5 Clinical Evidence for Chinese Herbal Medicine 47

Previous Systematic Reviews 47

Stable COPD 48

Acute Exacerbations of COPD 48

Clinical Evidence: Characteristics 49

Clinical Evidence from Randomised Controlled Trials 50

Methodological Quality 53

Stable COPD 56

Oral CHM 56

Lung function 56

Health-related quality of life 56

Dyspnoea scales 58

Exercise capacity 58

COPD exacerbations 60

BODE index 60

Effective rate 60

Intravenous CHM 62

Lung function 62

Summary of Findings for Main Chinese Herbal Medicine Comparisons 62

Individual Formulae 62

Lung function 62

Exercise capacity 67

Effective rate 67

Summary of Findings for Individual Formulae 67

Safety of Chinese Herbal Medicine for Stable COPD 71

Frequently Reported Herbs 71

Acute Exacerbations of COPD 74

Oral CHM 74

Lung function 74

Health-related quality of life 74

Dyspnoea 74

Exercise capacity 74

Arterial blood gases 76

Effective rate 76

Intravenous CHM 79

Lung function 79

Arterial blood gases 79

Effective rate 79

Intramuscular CHM 79

Lung function 79

Arterial blood gases 83

Summary of Findings for Main Comparisons 83

Individual Formulae 83

Lung function 83

Effective rate 83

Summary of Findings for Individual Formulae 83

Safety of CHM during Acute Exacerbations of COPD 90

Frequently Reported Herbs 97

Clinical Evidence from Commonly Used Formulae in Clinical Practice 97

Clinical Evidence from Non-Randomised Controlled Trials 97

Results 102

Clinical Evidence from Non-Controlled Studies 102

Summary of Main Findings: Chinese Herbal Medicine for COPD 106

Overall Evidence 107

Implications for Practice 107

References 108

6 Pharmacological Actions of Common Herbs 109

Experimental Studies of huang qi 109

Experimental Studies of dang shen and ren shen 110

Experimental Studies of bai zhu 110

Experimental Studies of xing ren 110

Experimental Studies of ban xia 111

Experimental Studies of huang qin 111

Experimental Studies of chen pi 112

Experimental Studies of dan shen 112

Experimental Studies of gan cao 112

Experimental Studies of fu ling 113

Experimental Studies of Herbal Formulae 113

Summary of Pharmacological Actions of Common Herbs 114

References 114

7 Clinical Evidence for Acupuncture and Related Therapies 119

Previous Systematic Reviews 120

Clinical Evidence: Characteristics 121

Clinical Evidence from Randomised Controlled Trials 123

Methodological Quality 125

Acupuncture 125

Effects of Intervention: Acupuncture 126

Acupuncture alone 126

Stable COPD 126

Acute exacerbations of COPD 127

Acupuncture plus Pulmonary Rehabilitation 127

Acupuncture plus Other Acupuncture Therapies 127

Acupuncture plus Moxibustion 127

Acupuncture plus Point Application Therapy 128

Summary of Findings for Main Comparisons 128

Acupressure 128

Effects of Intervention: Acupressure 131

Acupressure alone 131

Stable COPD 131

Acupressure plus Pharmacotherapy 131

Stable COPD 131

Acute exacerbations of COPD 132

Point Application Therapy 132

Effects of Intervention: Point Application Therapy 132

Point Application Therapy alone 132

Stable COPD 132

Point Application Therapy plus Pharmacotherapy 134

Stable COPD 134

Acute exacerbations of COPD 136

Acupuncture Points with Evidence of Clinical Effect- Point Application Therapy 136

Summary of Findings for the Main Comparisons 137

Acupuncture Point Injection Therapy 137

Effects of Intervention: Acupuncture Point Injection Therapy 137

Stable COPD 137

Acute exacerbations of COPD 141

Acupuncture Point Injection plus Other Acupuncture Therapies 142

Acupuncture Point Injection Therapy plus Point Application Therapy 142

Acupuncture Points with Evidence of Clinical Effect: Acupuncture Point Injection Therapy 142

Moxibustion 143

Effects of Intervention: Moxibustion 143

Moxibustion plus Pharmacotherapy 143

Acupuncture Points with Evidence of Clinical Effect: Moxibustion 145

Catgut Embedding 146

Effects of Intervention: Catgut Embedding 146

Catgut Embedding plus Pharmacotherapy 146

Stable COPD " 146

Acute exacerbations of COPD 148

Transcutaneous Electrical Nerve Stimulation (TENS) 148

Effects of Intervention: TENS 148

TENS alone 148

Stable COPD 148

TENS plus pharmacotherapy 149

Acute exacerbations of COPD 149

Other Acupuncture-Related Therapies 149

Percutaneous Iontophoresis of Chinese herbal medicine plus pharmacotherapy 149

Topical patch plus pharmacotherapy 150

Clinical Evidence from Non-Randomised Controlled Trials 150

Results 150

Clinical Evidence from Non-Controlled Studies 151

Summary of Main Findings: Acupuncture and Related Therapies for COPD 151

Overall Evidence 153

Implications for Practice 153

References 154

8 Clinical Evidence for Other Chinese Medicine Therapies 155

Previous Systematic Reviews 156

Clinical Evidence: Other Chinese Medicine Therapies 157

Clinical Evidence from Randomised Controlled Trials 158

Characteristics 158

Methodological Quality 159

Effects of Intervention: Qigong 159

Qigong alone 159

Qigong plus pharmacotherapy, health education and/or breathing exercises 160

Effects of Intervention: Taichi 161

Taichi alone 161

Taichi plus pulmonary rehabilitation and respiratory exercise 162

Summary of Findings for Main Comparisons 163

Effects of Intervention: Chinese Pulmonary Rehabilitation 163

Chinese Pulmonary Rehabilitation Alone 163

Chinese Pulmonary Rehabilitation plus Pharmacotherapy 163

Effects of Intervention: Tuina 166

Tuina Alone 166

Tuina plus Pharmacotherapy 166

Effects of the Intervention: Cupping 166

Clinical Evidence from Non-Randomised Controlled Trials 166

Clinical Evidence from Non-Controlled Studies 167

Summary of Main Findings: Other Chinese Medicine

Therapies for COPD 167

Overall Evidence 168

Implications for Practice 168

References 169

9 Clinical Evidence for Combination Therapies 171

Methodological Quality 173

Clinical Evidence from Randomised Controlled Trials 173

Stable COPD 173

Acute Exacerbations of COPD 176

Combination Therapies for Stable COPD 176

Summary of Main Findings: Combination Therapies for COPD 178

Overall Evidence 178

Implications for Practice 178

10 Summary of All Evidence 179

Chinese Herbal Medicine 179

Stable COPD 180

Acute Exacerbations of COPD 183

Acupuncture and Related Therapies 183

Summary of Acupuncture Therapies Across Evidence Types 184

Other Chinese Medicine Therapies 185

Implications for Practice 185

Implications for Research 188

Methods 188

Intervention 189

Appendix 1 All Included Clinical Studies 191

Appendix 2 List of Formulae Cited in the Monograph 265

Appendix 3 List of Herbs Cited in the Monograph 267

Glossary 271

Index 285