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Hung JH, Chen WC, Lin MC, Chuang HM, Wang JL, Fu PK, Lin CP, Huang ST. Associations of Chinese Herbal Medicine Use with the Risks of Acute Exacerbation and Mortality in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Cohort Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:77-86. [PMID: 35085024 DOI: 10.1089/jicm.2021.0103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objectives: This study aimed to assess the correlation of exacerbation and the mortality rate in patients with chronic obstructive pulmonary disease (COPD) between biomedical treatments with or without Chinese herbal medicine (CHM) as an adjunct. Design: A total of 81,261 COPD patients were identified from the National Health Insurance Research Database in Taiwan between 2001 and 2012. After screening and matching, 3176 COPD patients were included in the study. Statistical analyses were performed to assess the differences in the baseline characteristics. The authors used the Cox proportional hazard regression analysis to calculate the risks of mortality and hospitalization due to acute exacerbation of COPD within 1 year between a CHM user cohort and non-CHM user cohort. The cumulative incidence of mortality in COPD patients with or without CHM treatment was calculated by the Kaplan-Meier method. Results: COPD patients in the CHM user cohort demonstrated a significantly lower risk of mortality (p < 0.001) and acute exacerbation (p < 0.05), compared with the non-CHM user cohort. In addition, the CHM users exhibited a reduced cumulative incidence of mortality compared with the non-CHM user cohort (p < 0.001). Xiao Qing Long Tang and Fritillariae thunbergii were the most common Chinese herbal formula and single Chinese herb prescribed for COPD patients. Conclusion: Combining CHM with biomedical treatment might reduce the risk of acute exacerbation and incidence of mortality in patients with COPD.
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Affiliation(s)
- Jui-Hung Hung
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wei-Chieh Chen
- Department of Chinese Medicine, An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Mei-Chen Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Hsiao-Mei Chuang
- Department of Chinese Medicine, An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Jiun-Long Wang
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Pin-Kuei Fu
- Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chun-Pang Lin
- Department of Chinese Medicine, An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Sheng-Teng Huang
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Chinese Medicine, An-Nan Hospital, China Medical University, Tainan, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Cancer Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
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Yang L, Zhu Z, Qi Z, Fan X, Qian D, Zhang J, Duan J. Comparative Analysis of the Chemical Consistency Between the Traditional and Mixed Decoction of Maimendong Decoction by Ultra-Performance Liquid Chromatography Coupled to Quadrupole with Time-of-Flight Mass Spectrometry (UPLC-QTOF-MS)-Based Chemical Profiling Approach. J Chromatogr Sci 2020; 58:549-561. [PMID: 32378713 DOI: 10.1093/chromsci/bmz104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 08/30/2019] [Accepted: 10/31/2019] [Indexed: 01/22/2023]
Abstract
Take Maimendong Decoction (MMDD), one of the Chinese classic herbal formulas, as an object to evaluate the chemical consistency between traditional decoction and mixed decoction. The ultra-performance liquid chromatography coupled to quadrupole with time-of-flight mass spectrometry-based chemical profiling approach has been utilized. A total of 48 major peaks are detected from these two decoctions under the present chromatographic and mass spectrometry conditions. The results of negative ion mode show nine significant inconsistencies. Liquiritin, ginsenoside Ro and ginsenoside Rg5/Rk1 are detected with higher intensity in traditional preparation sample than the mixed decoction, while licoisoflavone A is higher in mixed decoction samples than the traditional one. The mechanisms involved in the chemical changes were assumed to be anti-inflammation, anti-oxidative stress and so on, suggesting these two different preparation approaches of MMDD may lead to a possibility of discrepant clinical outcomes.
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Affiliation(s)
- Lan Yang
- School of Chinese Medicine, School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Zhenhua Zhu
- Jiangsu Key Laboratory for High Technology Research of Traditional Chinese Medicine Formulae Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing 210023, China.,Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu 215100, China
| | - Zhonghua Qi
- School of Chinese Medicine, School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Xinsheng Fan
- School of Chinese Medicine, School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Dawei Qian
- Jiangsu Key Laboratory for High Technology Research of Traditional Chinese Medicine Formulae Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing 210023, China.,Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Jingjing Zhang
- Department of Respiratory, Nantong Hospital of Traditional Chinese Medicine, Nantong 226001, China
| | - JinAo Duan
- Jiangsu Key Laboratory for High Technology Research of Traditional Chinese Medicine Formulae Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing 210023, China.,Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing 210023, China
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Lin TH, Chen SI, Su YC, Lin MC, Lin HJ, Huang ST. Conventional Western Treatment Combined With Chinese Herbal Medicine Alleviates the Progressive Risk of Lung Cancer in Patients With Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Cohort Study. Front Pharmacol 2019; 10:987. [PMID: 31572178 PMCID: PMC6753872 DOI: 10.3389/fphar.2019.00987] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/31/2019] [Indexed: 12/24/2022] Open
Abstract
Background and purpose: Lung cancer has high global incidence and mortality rates. Chronic obstructive pulmonary disease (COPD) is strongly associated with lung cancer and is an independent risk factor for lung cancer with or without smoking. Chinese herbal medicines (CHMs) are used to treat COPD. This study sought to determine whether CHM treatment effectively decreases the incidence of lung cancer in COPD patients receiving conventional Western medical treatment. Methods: Records obtained from the National Health Insurance Research Database (NHIRD) were used to identify 81,780 adults aged ≥18 years newly diagnosed with COPD in Taiwan between 2000 and 2010. Among them, 11,180 received CHMs after COPD diagnosis and 23,319 did not (non-CHM). After excluding patients with missing basic demographic information, each group consisted of 2,682 patients. Statistical methods analyzed the baseline characteristics for both groups and we performed a Cox proportional hazard regression analysis to examine the incidence of lung cancer. The cumulative incidence of lung cancer in COPD patients with or without CHM treatment was calculated by the Kaplan-Meier method. The association between herbs and formulas was examined by NodeXL to perform a network analysis of CHM. Results: COPD patients using CHM had a lower risk for lung cancer (adjusted hazards ratio [aHR] = 0.36, 95% confidence interval [CI] = 0.24–0.53, p < 0.001). Older age was associated with a higher risk of lung cancer: patients aged 40–59 years (aHR = 5.32, 95% CI = 2.19–12.94, p < 0.001) and those aged ≥60 years (aHR = 16.75, 95% CI = 7.54–37.23, p < 0.001) were at significantly greater risk compared with patients aged 18–39 years. CHM use was associated with a trend for a lower cumulative incidence of lung cancer compared with non-CHM use (p < 0.001). Among the 10 most commonly used single herbs and formulas used to decrease the risk of lung cancer in COPD patients, Fritillariae thunbergii was the most commonly used single herb and Xiao Qing Long Tang the most commonly used formula. Conclusion: The findings from this nationwide retrospective cohort study indicate that CHM as adjunctive therapy in COPD treatment regimens may reduce the risk of lung cancer in this vulnerable patient population.
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Affiliation(s)
- Tsai-Hui Lin
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Shu-I Chen
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yuan-Chih Su
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Mei-Chen Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Hung-Jen Lin
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Sheng-Teng Huang
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Chinese Medicine, China Medical University, Taichung, Taiwan.,An-Nan Hospital, China Medical University, Tainan, Taiwan.,Chinese Medicine Research Center, China Medical University, Taichung, Taiwan.,Research Center for Chinese Herbal Medicine, China Medical University, Taichung, Taiwan.,Cancer Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
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Kim KI, Shin S, Lee N, Lee BJ, Lee J, Lee H. A traditional herbal medication, Maekmoondong-tang, for cough: A systematic review and meta-analysis. JOURNAL OF ETHNOPHARMACOLOGY 2016; 178:144-154. [PMID: 26666732 DOI: 10.1016/j.jep.2015.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 11/26/2015] [Accepted: 12/04/2015] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Maekmoondong-tang (MMDT) is a traditional herbal medication widely used to improve cough in Korea, Japan, and China. It is composed of six herbs (Ophiopogonis Tuber, Pinelliae Tuber, Glycyrrhizae Radix, Zizyphi Fructus, Ginseng Radix, and Oryzae Semen). AIM OF THE STUDY This study is aimed to systematically review the relevant randomised controlled trials (RCTs) to determine the effectiveness and safety of MMDT for cough. MATERIALS AND METHODS Electronic and hand-searching of 7 databases (Cochrane Library, MEDLINE, EMBASE, OASIS, RISS, CNKI and CiNii) was systematically conducted up to February 2015 for RCTs testing MMDT in patients with cough. The primary outcome was cough symptom improvement using cough diary, visual analog scale, or response rate. Risk of bias of the included trials was evaluated with the Cochrane risk of bias assessment tool. The dichotomous data were pooled to obtain a risk ratio (RR) of cough persisting after treatment, with 95% confidence intervals (CI). RESULTS Nine RCTs involving 2453 participants were included. The methodological quality was largely poor for a majority of the studies. MMDT reduced the severity of cough by 74% compared with the conventional antitussive medications in various conditions (n=1145; RR of cough persisting after treatment=0.26; 95% CI, 0.19-0.34, I(2)=0%). The addition of MMDT to conventional medication in patients with postinfectious cough significantly alleviated symptoms up to day 5 but the effect was not maintained one week afterwards. For other diseases/conditions including chronic obstructive pulmonary disease, lung cancer surgery, and asthma, the evidence is inconsistent for MMDT/mMMDT for cough. Adverse events appear to be rare but the reporting was poor. CONCLUSIONS The current evidence from our systematic review and meta-analysis on MMDT for cough is inconclusive and we propose that rigorously designed, placebo-controlled trials of MMDT should be conducted to establish its place in management of cough.
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Affiliation(s)
- Kwan-Il Kim
- Department of Clinical Korean Medicine, College of Korean Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-872, Republic of Korea.
| | - Seungwon Shin
- College of Korean Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-872, Republic of Korea.
| | - Nara Lee
- Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea.
| | - Beom-Joon Lee
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-872, Republic of Korea.
| | - Junhee Lee
- College of Korean Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-872, Republic of Korea.
| | - Hyangsook Lee
- Acupuncture & Meridian Science Research Centre, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-701, Republic of Korea.
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Mukaida K, Hattori N, Kondo K, Morita N, Murakami I, Haruta Y, Yokoyama A, Kohno N. A pilot study of the multiherb Kampo medicine bakumondoto for cough in patients with chronic obstructive pulmonary disease. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2011; 18:625-629. [PMID: 21177084 DOI: 10.1016/j.phymed.2010.11.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Revised: 09/28/2010] [Accepted: 11/07/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To evaluate the effect of bakumondoto, Kampo medicine, on cough in patients with chronic obstructive pulmonary disease (COPD). DESIGN A 16-week, randomized, open-labeled, cross-over design. SETTING Outpatient clinics at one university hospital and two general hospitals in Japan from May 2007 to March 2009. PARTICIPANTS Twenty-four elderly patients (14 men and 9 women aged over 65) with COPD. INTERVENTION Treatment with or without bakumondoto for 8 weeks in a cross-over design. MEASUREMENTS The primary outcome measurements were the frequency and intensity of cough assessed by a visual analogue scale (VAS) and a daily cough diary. Secondary outcome measurements were quality of life (QOL) assessed using St. George's Respiratory Questionnaire (SGRQ) and lung functions measured using spirometry. RESULTS Treatment with bakumondoto significantly improved cough severity during the first treatment period (week 0 vs. week 8, p=0.004) and showed a trend to decrease during the second treatment period (week 8 vs. week 16, p=0.129) assessed by the VAS. Neither QOL nor lung function was affected by the treatment with bakumondoto. CONCLUSION Bakumondoto may be effective in suppressing cough in elderly patients with COPD. To further confirm the efficacy, a larger and placebo-controlled study with objective cough assessment is necessary.
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Affiliation(s)
- Kenichi Mukaida
- Department of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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Saruwatari J, Hisaeda S, Higa Y, Tomiyasu Y, Nakagawa K, Ishizaki T. The in-vivo effect of bakumondo-to (TJ-29), a traditional Japanese medicine used for treatment of chronic airway disease, on cytochrome P450 1A2, xanthine oxidase and N-acetyltransferase 2 activity in man. J Pharm Pharmacol 2010; 56:1171-7. [PMID: 15324486 DOI: 10.1211/0022357044094] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
In Japan, patients with chronic airway disease are administered bakumondo-to (TJ-29), a mixture of six herbal components. We have assessed the effects of TJ-29 on the activities of cytochrome P450 (CYP) 1A2, xanthine oxidase and N-acetyltransferase 2 in 26 healthy subjects under a double-blind, randomized, placebo-controlled cross-over study design. The baseline activities of the three enzymes were assessed by the respective urinary metabolic ratios of an 8-h urine sample after an oral 150-mg dose of caffeine. Thereafter, the subjects received a thrice-daily 3.0-g dose of TJ-29 or placebo for seven days, and underwent the same caffeine test on the post-dose days 1 and 7. No statistically significant difference was observed in the activity of the three enzymes between those at baseline, and on day 1 after dosing with TJ-29 or placebo. The mean activity of CYP1A2, xanthine oxidase and N-acetyltransferase 2 tended to be lower on day 7 after dosing with TJ-29 compared with those at baseline and on day 7 after dosing with placebo. However, these changes were not statistically significant in CYP1A2 (P=0.120), xanthine oxidase (P=0.123) or N-acetyltransferase 2 (P=0.056). In conclusion, TJ-29 did not appear to substantially affect the activity of CYP1A2, xanthine oxidase or N-acetyltransferase 2 in man.
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Affiliation(s)
- Junji Saruwatari
- Division of Pharmacology and Therapeutics, Graduate School of Medical and Pharmaceutical Sciences, Kumamoto University, Oe-honmachi 5-1, Kumamoto 862-0973, Japan
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