Meta AnalysisID 365
黄芪作为慢性阻塞性肺疾病辅助治疗的系统评价和随机对照试验Meta分析
CRD42020188443
How is the clinical efficacy and safety of Astragalus for the treatment of people with COPD?
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Record Fields
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- Meta Analysis Id
- 365
- Evidence Id
- 8923
- Core Evidence Id
- 8923
- Source Meta Analysis Id
- 344
- Herb2 Meta Analysis Id
- HBMA000344
- Crd Id
- CRD42020188443
- Title
- Astragalus(a traditional Chinese medicine) as an Adjuvant Treatment for COPD: A Systematic Review and Meta-analysis for Randomized Controlled Trials
- Review Question
- How is the clinical efficacy and safety of Astragalus for the treatment of people with COPD?
- Study Type Included
- Inclusion criteria: Randomized controlled trial (RCTs) of Astragalus in the treatment of people diagnosed with COPD. Exclusion criteria: (1)Repeatedly published literatures. (2)Literatures that are review, animal experiments, case reports and other types.
- Condition Being Studied
- Lung Diseases, Obstructive
- Participant
- Inclusion criteria: Patients diagnosed as COPD, diagnostic criteria according to Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2019 Report Exclusion criteria: (1)Pregnant or diagnosed with other major diseases, such as chronic kidney failure, acute heart failure, severe liver or kidney dysfunction.(2)Intolerant to traditional Chinese medicine therapy
- Animal
- Human Disease Modelled
- Intervention
- Astragalus (Radix Astragali), known as huang qi in Chinese, is the dried root of Astragalus membranaceus (Fisch.) Bge. var. mongholi- cus (Bge.) Hsiao or Astragalus membranaceus (Fisch.) Bge. (Family Leguminosae). It is one of the most commonly prescribed herbs in traditional Chinese medicine.The flavonoids, cyclolanostane-type saponins and polysaccharides are the main bioactive compounds in Astragalus. Astragaloside IV, one of the cyclolanos- tane-type saponins, is used as a marker compound for quality control in the manufacture of Astragalus and its preparations. In modern Chinese medicine, Astragalus is used either alone or in combination with other herbs in oral decoction, pill or capsule forms. It is also manufactured in injectable form for intravenous and intramuscular administration. In this systematic review, Treatment group participants needed to have received Astragalus or its extract as the treatment drug, regardless of formulation or route of administration.
- Comparator Control
- Inclusion criteria: (1)Control group participants received placebo, no treatment, or conventional treatment. (2)Co-interventions will be included where all randomized study arm participants received the same co-intervention. Exclusion criteria: (1)Other herbal or complementary medicines lacking validated efficacy were not accepted as control interventions. (2)Studies involving Astragalus as one of multiple active components in a compound preparation or as a part of a combined treatment regimen will not be included in the review.
- Main Outcome
- Lung functions including forced expiratory volume in one second (FEV₁), ratio of forced expiratory volume in the first second to predicted value (FEV1%), forced vital capacity (FVC), ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC) Measures of effect Our main outcome results are continuous variables, which will be expressed as mean differences (MDs) using a fixed‐effect or standardized mean difference (SMD), with 95% CI. We considered a P value less than 0.05 statistically significant. We will present the data as forest plots when possible to show size and direction of effect for treatments with 95% CIs (certainty) using Review Manager 5 (RevMan 2014).
- Outcome Measure
- Additional Outcome
- (1)The rate of clinical efficacy and traditional Chinese medicine symptomatic score. The rate of clinical efficacy= (number of total patients - number of invalid patients)/number of total patients∗100%. Effectiveness status was classified as effective, valid, and invalid according to clinical symptoms and objective indicators. When clinical symptoms and objective indictors were unchanged or aggravated, patients were regarded as an invalid effectiveness status. (2)Quality of life (e.g. total score on St George's Respiratory Questionnaire (SGRQ)) (3)Symptoms (breathlessness on Borg and other scales and Shortness of Breath Questionnaire; composite measures (summary symptom score)) (4)Exercise tolerance (six‐minute walk test) (5)Inflammatory markers [C-reaction protein (CRP), white blood cell count (WBCC), and neutrophil percentage (N%) (6)Incidence of COPD exacerbations(if the disease stage of the included participants is stable) (7)Adverse events (number of participants experiencing one or more adverse event, e.g. gastrointestinal, central nervous system (CNS), and cardiovascular adverse events; change in weight; withdrawal rates) Measures of effect The additional outcomes are either dichotomous or continuous. For dichotomous outcomes, we will record the number of participants with one or more outcome events by allocated treatment group. We will undertake meta‐analyses only when this was meaningful, that is, when treatments, participants, and the underlying clinical question were similar enough for pooling to make sense. We will express results for pooled outcomes with dichotomous variables using a fixed‐effect odds ratio (OR) with 95% confidence interval (CI). Results for continuous variables will be expressed as mean differences (MDs) using a fixed‐effect or standardized mean difference (SMD), with 95% CI. We will consider a P value less than 0.05 statistically significant. We will combine rate ratios on a natural logarithm scale and weighted them by the inverse of the variance of the log rate ratio. We will present the data as forest plots when possible to show size and direction of effect for treatments with 95% CIs (certainty) using Review Manager 5 (RevMan 2014).
- Study Method
- Intervention, Systematic review
- Keyword
- Drugs, Chinese Herbal; Humans; Medicine, Chinese Traditional; Pulmonary Disease, Chronic Obstructive; Randomized Controlled Trials as Topic
- Contact
- YunRu Chen [email protected]
- Organisational Affiliation
- China-Japan Friendship Hospital
- Funding Source
- National Science and Technology Major Projects of Sudden Severe Acute Respiratory Infectious Diseases Treatment New Technology research and the New Scheme (2017ZX10204401) Grant number(s) <span style=font-size: 14px>State the funder, grant or award number and the date of award</span> 2017ZX10204401
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- China
- Review Stage
- Review Ongoing
- First Submission Date
- 2020-05-26
- Registration Date
- 2020-07-05
- Anticipated Start Date
- 2020-04-25
- Anticipated Completion Date
- 2020-12-31
- Title Cn
- 黄芪作为慢性阻塞性肺疾病辅助治疗的系统评价和随机对照试验Meta分析
- Title En
- Astragalus(a traditional Chinese medicine) as an Adjuvant Treatment for COPD: A Systematic Review and Meta-analysis for Randomized Controlled Trials
- Bilingual Status
- complete