Modified Weijing formula for the treatment of acute exacerbations of chronic obstructive pulmonary disease: A systematic review of randomized controlled trials

Introduction: Chronic obstructive pulmonary disease (COPD) is a very common disease of the respiratory system. An increasing number of clinical trials on Weijing formula in the management of acute exacerbations of COPD have been performed, but the evidence base remains unknown. However, the evidence base for it remains unknown. This review aimed to evaluate the efficacy and safety of Weijing formula in the treatment of COPD exacerbations by systematically summing up the evidence from all available trials. Methods: Four English language databases and 4 Chinese databases were searched to identify relevant randomized controlled trials from their respective inception up to June 2013. The electronic search was supplemented with a manual search. The Cochrane tool was used for the assessment of risk of bias in the included trials. The following outcomes were evaluated: (1) lung function; (2) arterial blood gases; (3) serum levels of inflammatory mediators; and (4) adverse events. Data were analyzed using STATA 12.0 software. Results: A total of 11 studies that compared Weijing formula combined with conventional Western medications with the same conventional Western medications alone were included. In general, the methodological quality of the included trials was relatively poor. Due to the poor quality of the available studies and obvious heterogeneity across studies, we did not perform any pooled analysis. The results of this systematic review indicate that, in general, the effects of Weijing formula combined with conventional Western medications were no worse than those of the same conventional Western medications alone. In most cases, compared with Western medications alone, the combined use of Weijing formula and Western medications could significantly improve PaO2, and lung function measured as FEV1, FEV1% predicted and FEV1/FVC ratio, and reduce PaCO2 and the serum levels of TNF-alpha. and IL-8. No adverse events were reported in all included studies except one study. Conclusions: Within the limitations of this systematic review, we may conclude that compared with Western medications alone, the addition of Weijing formula seems to provide more benefits for patients with COPD exacerbations, without any serious adverse reactions being identified. There is encouraging evidence suggesting that Weijing formula in conjunction with Western medications may be a safe and effective treatment option for patients experiencing COPD exacerbations. However, further rigorously designed studies are warranted. (C) 2013 Elsevier GmbH. All rights reserved.