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Published in: BMC Complementary Medicine and Therapies 1/2024

Open Access 01-12-2024 | Chronic Obstructive Lung Disease | Study Protocol

Effect of YuPingFeng granules on clinical symptoms of stable COPD: study protocol for a multicenter, double-blind, and randomized controlled trial

Authors: Ruifeng Chen, Yangqing Zhan, Zhengshi Lin, Xiao Wu, Jinchao Zhou, Zifeng Yang, Jinping Zheng

Published in: BMC Complementary Medicine and Therapies | Issue 1/2024

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Abstract

Background

Reducing current clinical symptoms and the risks of future exacerbations is the main goal of stable COPD management. Traditional Chinese medicine has unique advantages in chronic disease management. YuPingFeng (YPF), as a classical prescription, has been proven to reduce the risk of exacerbations, but there is a lack of high-quality evidence for the assessment of clinical symptoms and quality of life, particularly for the assessment of treatment response of microecology and immunity.

Methods/design

This is a prospective, multicentre, randomized, double-blind, placebo-controlled clinical trial. A total of 316 eligible subjects with moderate to severe COPD will be randomized 1:1 to receive YPF or placebo. Participants will receive either YPF or a placebo at 5 g three times daily for 52 weeks. The primary outcome will be the change in the COPD Assessment Test (CAT) score after 52 weeks of treatment. Secondary outcomes will include changes in the St George's Respiratory Questionnaire (SGRQ) score and clinical symptom score, among others. Outcomes will be measured at each visit. The study will continue for 52 weeks and will include six visits to each subject (at day 0 and weeks 4,12,24,36 and 52). In the event of exacerbations, subjects will be required to go back to the hospital once on the first day of exacerbation or when their condition permits.

Discussion

This trial will provide research methods to evaluate the clinical efficacy, safety, and the possible mechanism of YPF in the treatment of stable moderate-to-severe COPD patients. In addition, we hope to provide more possibilities for TCM to participate in the management of stable COPD.

Trial registration

The trial was registered at the Chinese Clinical Trials Registry on 3 June 2022 (ChiCTR2200060476; date recorded: 3/6/2022, https://​www.​chictr.​org.​cn/​).
Literature
3.
go back to reference Wang C, Xu J, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet. 2018;391(10131):1706–17.CrossRefPubMed Wang C, Xu J, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet. 2018;391(10131):1706–17.CrossRefPubMed
4.
go back to reference Yin P, Wang H, Vos T, et al. A subnational analysis of mortality and prevalence of COPD in China from 1990 to 2013: findings from the global burden of disease study 2013. Chest. 2016;150(6):1269–80.CrossRefPubMed Yin P, Wang H, Vos T, et al. A subnational analysis of mortality and prevalence of COPD in China from 1990 to 2013: findings from the global burden of disease study 2013. Chest. 2016;150(6):1269–80.CrossRefPubMed
5.
go back to reference Yang G, Wang Y, Zeng Y, et al. Rapid health transition in China, 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet. 2013;381(9882):1987–2015.CrossRefPubMedPubMedCentral Yang G, Wang Y, Zeng Y, et al. Rapid health transition in China, 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet. 2013;381(9882):1987–2015.CrossRefPubMedPubMedCentral
6.
go back to reference Barnes PJ. Targeting cytokines to treat asthma and chronic obstructive pulmonary disease. Nat Rev Immunol. 2018;18(7):454–66.CrossRefPubMed Barnes PJ. Targeting cytokines to treat asthma and chronic obstructive pulmonary disease. Nat Rev Immunol. 2018;18(7):454–66.CrossRefPubMed
7.
go back to reference Chang TY, Chien JY, Wu CH, Dong YH, Lin FJ. Comparative safety and effectiveness of inhaled corticosteroid and long-acting beta2-Agonist combinations in patients with COPD. Chest. 2020;157(5):1117–29.CrossRefPubMed Chang TY, Chien JY, Wu CH, Dong YH, Lin FJ. Comparative safety and effectiveness of inhaled corticosteroid and long-acting beta2-Agonist combinations in patients with COPD. Chest. 2020;157(5):1117–29.CrossRefPubMed
8.
go back to reference Leitao Filho FS, Takiguchi H, Akata K, et al. Effects of Inhaled Corticosteroid/Long-Acting beta2-Agonist Combination on the Airway Microbiome of Patients with Chronic Obstructive Pulmonary Disease: a randomized controlled clinical trial (DISARM). Am J Respir Crit Care Med. 2021;204(10):1143–52.CrossRefPubMed Leitao Filho FS, Takiguchi H, Akata K, et al. Effects of Inhaled Corticosteroid/Long-Acting beta2-Agonist Combination on the Airway Microbiome of Patients with Chronic Obstructive Pulmonary Disease: a randomized controlled clinical trial (DISARM). Am J Respir Crit Care Med. 2021;204(10):1143–52.CrossRefPubMed
9.
go back to reference Yang IA, Clarke MS, Sim EH, Fong KM. Inhaled corticosteroids for stable chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2012;7:CD002991. Yang IA, Clarke MS, Sim EH, Fong KM. Inhaled corticosteroids for stable chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2012;7:CD002991.
10.
go back to reference Crim C, Calverley PMA, Anderson JA, et al. Pneumonia risk with inhaled fluticasone furoate and vilanterol in COPD patients with moderate airflow limitation: the SUMMIT trial. Respir Med. 2017;131:27–34.CrossRefPubMed Crim C, Calverley PMA, Anderson JA, et al. Pneumonia risk with inhaled fluticasone furoate and vilanterol in COPD patients with moderate airflow limitation: the SUMMIT trial. Respir Med. 2017;131:27–34.CrossRefPubMed
11.
go back to reference Chen YW, Ramsook AH, Coxson HO, Bon J, Reid WD. Prevalence and risk factors for osteoporosis in individuals with COPD: a systematic review and meta-analysis. Chest. 2019;156(6):1092–110.CrossRefPubMed Chen YW, Ramsook AH, Coxson HO, Bon J, Reid WD. Prevalence and risk factors for osteoporosis in individuals with COPD: a systematic review and meta-analysis. Chest. 2019;156(6):1092–110.CrossRefPubMed
12.
go back to reference Wang CY, Lin YS, Wang YH, et al. Risk of sepsis among patients with COPD treated with fixed combinations of inhaled corticosteroids and long-acting Beta2 agonists. Aging-Us. 2019;11(17):6863–71.CrossRef Wang CY, Lin YS, Wang YH, et al. Risk of sepsis among patients with COPD treated with fixed combinations of inhaled corticosteroids and long-acting Beta2 agonists. Aging-Us. 2019;11(17):6863–71.CrossRef
13.
go back to reference Professional Committee of Pulmonary Diseases IMB, China Association of Chinese Medicine. Guidelines for TCM diagnosis and treatment of chronic obstructive pulmonary disease (2011 edition). J Trad Chin Med. 2012;53(01):80–4. Professional Committee of Pulmonary Diseases IMB, China Association of Chinese Medicine. Guidelines for TCM diagnosis and treatment of chronic obstructive pulmonary disease (2011 edition). J Trad Chin Med. 2012;53(01):80–4.
14.
go back to reference Liao C, Liu T, Zeng Z, et al. Efficacy and safety of modified Yupingfeng formula in treating allergic rhinitis: a protocol for systematic review and meta analysis. Medicine (Baltimore). 2020;99(51):e23698.CrossRefPubMed Liao C, Liu T, Zeng Z, et al. Efficacy and safety of modified Yupingfeng formula in treating allergic rhinitis: a protocol for systematic review and meta analysis. Medicine (Baltimore). 2020;99(51):e23698.CrossRefPubMed
15.
go back to reference Ma J, Zheng J, Zhong N, et al. Effects of YuPingFeng granules on acute exacerbations of COPD: a randomized, placebo-controlled study. Int J Chron Obstruct Pulmon Dis. 2018;13:3107–14.CrossRefPubMedPubMedCentral Ma J, Zheng J, Zhong N, et al. Effects of YuPingFeng granules on acute exacerbations of COPD: a randomized, placebo-controlled study. Int J Chron Obstruct Pulmon Dis. 2018;13:3107–14.CrossRefPubMedPubMedCentral
16.
go back to reference Chan RY, Chien WT. The effects of two Chinese herbal medicinal formulae vs. placebo controls for treatment of allergic rhinitis: a randomised controlled trial. Trials. 2014;15:261.CrossRefPubMedPubMedCentral Chan RY, Chien WT. The effects of two Chinese herbal medicinal formulae vs. placebo controls for treatment of allergic rhinitis: a randomised controlled trial. Trials. 2014;15:261.CrossRefPubMedPubMedCentral
17.
go back to reference Chen Y, Long S, Yang D, et al. Systematic review and meta analysis of additional Yupingfeng powder combined with western medicine treatment at stable period of chronic obstructive pulmonary disease. J Hainan Med Univ. 2020;26(23):1814-1821+1825. Chen Y, Long S, Yang D, et al. Systematic review and meta analysis of additional Yupingfeng powder combined with western medicine treatment at stable period of chronic obstructive pulmonary disease. J Hainan Med Univ. 2020;26(23):1814-1821+1825.
18.
go back to reference Luo Q, Zhang CS, Yang L, et al. Potential effectiveness of Chinese herbal medicine Yu ping feng san for adult allergic rhinitis: a systematic review and meta-analysis of randomized controlled trials. BMC Complement Altern Med. 2017;17(1):485.CrossRefPubMedPubMedCentral Luo Q, Zhang CS, Yang L, et al. Potential effectiveness of Chinese herbal medicine Yu ping feng san for adult allergic rhinitis: a systematic review and meta-analysis of randomized controlled trials. BMC Complement Altern Med. 2017;17(1):485.CrossRefPubMedPubMedCentral
19.
go back to reference Liao C, Liu T, Zeng Z, et al. Efficacy and safety of modified Yupingfeng formula in treating allergic rhinitis: a protocol for systematic review and meta analysis. Medicine. 2020;99(51):e23698.CrossRefPubMedPubMedCentral Liao C, Liu T, Zeng Z, et al. Efficacy and safety of modified Yupingfeng formula in treating allergic rhinitis: a protocol for systematic review and meta analysis. Medicine. 2020;99(51):e23698.CrossRefPubMedPubMedCentral
20.
go back to reference Wang R, Wang J, Shu J, et al. Efficacy and safety of Yu-Ping-Feng powder for asthma in children: a protocol of systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2020;99(1):e18551.CrossRefPubMed Wang R, Wang J, Shu J, et al. Efficacy and safety of Yu-Ping-Feng powder for asthma in children: a protocol of systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2020;99(1):e18551.CrossRefPubMed
21.
go back to reference Zhao S, Xie J, Liu G, et al. Study on the effect of Yupingfeng on allergic rhinitis in rats. Chin J Otorhinolaryngol-skull Base Surg. 2017;23(01):39–42+48. Zhao S, Xie J, Liu G, et al. Study on the effect of Yupingfeng on allergic rhinitis in rats. Chin J Otorhinolaryngol-skull Base Surg. 2017;23(01):39–42+48.
22.
go back to reference Wei Q, Zhang X, Pang Y, et al. Effects of Yupingfeng granules on eosinophils in mice with chronic urticaria. Lishizhen Medi Materia Medica Res. 2021;32(07):1542–6. Wei Q, Zhang X, Pang Y, et al. Effects of Yupingfeng granules on eosinophils in mice with chronic urticaria. Lishizhen Medi Materia Medica Res. 2021;32(07):1542–6.
23.
go back to reference Wang Q. Classification of the nine basic TCM constitutional type and based expression and diagnosis. J Beijing Unive Tradit Chin Med. 2005;04:1–8. Wang Q. Classification of the nine basic TCM constitutional type and based expression and diagnosis. J Beijing Unive Tradit Chin Med. 2005;04:1–8.
24.
go back to reference Chronic obstructive pulmonary disease group CTS, Chronic obstructive pulmonary disease working committee Tcaocp. Guidelines for the diagnosis and management of chronic obstructive pulmonary disease (revised version 2021). Chin J Tuberculosis Respir Dis. 2021;44(3):36. Chronic obstructive pulmonary disease group CTS, Chronic obstructive pulmonary disease working committee Tcaocp. Guidelines for the diagnosis and management of chronic obstructive pulmonary disease (revised version 2021). Chin J Tuberculosis Respir Dis. 2021;44(3):36.
25.
go back to reference Lim KE, Kim SR, Kim HK, Kim SR. Symptom Clusters and Quality of Life in Subjects With COPD. Respir Care. 2017;62(9):1203–11.CrossRefPubMed Lim KE, Kim SR, Kim HK, Kim SR. Symptom Clusters and Quality of Life in Subjects With COPD. Respir Care. 2017;62(9):1203–11.CrossRefPubMed
26.
go back to reference Mccray JLA. “Ome sweet” omics—a genealogical treasury of words. Scientist. 2001;15(7):8. Mccray JLA. “Ome sweet” omics—a genealogical treasury of words. Scientist. 2001;15(7):8.
27.
go back to reference Leitao Filho FS, Alotaibi NM, Ngan D, et al. Sputum microbiome is associated with 1-year mortality after chronic obstructive pulmonary disease hospitalizations. Am J Resp Crit Care. 2019;199(10):1205–13.CrossRef Leitao Filho FS, Alotaibi NM, Ngan D, et al. Sputum microbiome is associated with 1-year mortality after chronic obstructive pulmonary disease hospitalizations. Am J Resp Crit Care. 2019;199(10):1205–13.CrossRef
28.
go back to reference Dickson RP, Schultz MJ, van der Poll T, et al. Lung microbiota predict clinical outcomes in critically Ill patients. Am J Resp Crit Care. 2020;201(5):555–63.CrossRef Dickson RP, Schultz MJ, van der Poll T, et al. Lung microbiota predict clinical outcomes in critically Ill patients. Am J Resp Crit Care. 2020;201(5):555–63.CrossRef
29.
go back to reference Sun Z, Zhu QL, Shen Y, Yan T, Zhou X. Dynamic changes of gut and lung microorganisms during chronic obstructive pulmonary disease exacerbations. Kaohsiung J Med Sci. 2020;36:107–13.CrossRefPubMed Sun Z, Zhu QL, Shen Y, Yan T, Zhou X. Dynamic changes of gut and lung microorganisms during chronic obstructive pulmonary disease exacerbations. Kaohsiung J Med Sci. 2020;36:107–13.CrossRefPubMed
30.
go back to reference Siva R, Birring SS, Berry M, Rowbottom A, Pavord ID. Peptic ulceration, Helicobacter pylori seropositivity and chronic obstructive pulmonary disease. Respirology. 2013;18:728–31.CrossRefPubMed Siva R, Birring SS, Berry M, Rowbottom A, Pavord ID. Peptic ulceration, Helicobacter pylori seropositivity and chronic obstructive pulmonary disease. Respirology. 2013;18:728–31.CrossRefPubMed
31.
go back to reference Yang L, Dunlap DG, Qin S, et al. Alterations in oral microbiota in HIV are related to decreased pulmonary function. Am J Respir Crit Care Med. 2020;201:445–57.CrossRefPubMedPubMedCentral Yang L, Dunlap DG, Qin S, et al. Alterations in oral microbiota in HIV are related to decreased pulmonary function. Am J Respir Crit Care Med. 2020;201:445–57.CrossRefPubMedPubMedCentral
32.
33.
go back to reference Wang Z, Bafadhel M, Haldar K, et al. Lung microbiome dynamics in COPD exacerbations. Eur Respir J. 2016;47(4):1082–92.CrossRefPubMed Wang Z, Bafadhel M, Haldar K, et al. Lung microbiome dynamics in COPD exacerbations. Eur Respir J. 2016;47(4):1082–92.CrossRefPubMed
34.
go back to reference Mayhew D, Devos N, Lambert C, et al. Longitudinal profiling of the lung microbiome in the AERIS study demonstrates repeatability of bacterial and eosinophilic COPD exacerbations. Thorax. 2018;73(5):422–30.CrossRefPubMed Mayhew D, Devos N, Lambert C, et al. Longitudinal profiling of the lung microbiome in the AERIS study demonstrates repeatability of bacterial and eosinophilic COPD exacerbations. Thorax. 2018;73(5):422–30.CrossRefPubMed
35.
go back to reference Soler N, Torres A, Ewig S, et al. Bronchial microbial patterns in severe exacerbations of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation. Am J Respir Crit Care Med. 1998;157(5 Pt 1):1498–505.CrossRefPubMed Soler N, Torres A, Ewig S, et al. Bronchial microbial patterns in severe exacerbations of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation. Am J Respir Crit Care Med. 1998;157(5 Pt 1):1498–505.CrossRefPubMed
36.
go back to reference Sze MA, Dimitriu PA, Hayashi S, et al. The lung tissue microbiome in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012;185(10):1073–80.CrossRefPubMedPubMedCentral Sze MA, Dimitriu PA, Hayashi S, et al. The lung tissue microbiome in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012;185(10):1073–80.CrossRefPubMedPubMedCentral
37.
go back to reference Huang YJ, Kim E, Cox MJ, et al. A persistent and diverse airway microbiota present during chronic obstructive pulmonary disease exacerbations. OMICS. 2010;14(1):9–59.CrossRefPubMedPubMedCentral Huang YJ, Kim E, Cox MJ, et al. A persistent and diverse airway microbiota present during chronic obstructive pulmonary disease exacerbations. OMICS. 2010;14(1):9–59.CrossRefPubMedPubMedCentral
39.
go back to reference Lai HC, Lin TL, Chen TW, et al. Gut microbiota modulates COPD pathogenesis: role of anti-inflammatory Parabacteroides goldsteinii lipopolysaccharide. Gut. 2022;71(2):309–21.CrossRefPubMed Lai HC, Lin TL, Chen TW, et al. Gut microbiota modulates COPD pathogenesis: role of anti-inflammatory Parabacteroides goldsteinii lipopolysaccharide. Gut. 2022;71(2):309–21.CrossRefPubMed
40.
go back to reference Pascoe S, Locantore N, Dransfield MT, Barnes NC, Pavord ID. Blood eosinophil counts, exacerbations, and response to the addition of inhaled fluticasone furoate to vilanterol in patients with chronic obstructive pulmonary disease: a secondary analysis of data from two parallel randomised controlled trials. Lancet Respir Med. 2015;3(6):435–42.CrossRefPubMed Pascoe S, Locantore N, Dransfield MT, Barnes NC, Pavord ID. Blood eosinophil counts, exacerbations, and response to the addition of inhaled fluticasone furoate to vilanterol in patients with chronic obstructive pulmonary disease: a secondary analysis of data from two parallel randomised controlled trials. Lancet Respir Med. 2015;3(6):435–42.CrossRefPubMed
41.
go back to reference Siddiqui SH, Guasconi A, Vestbo J, et al. Blood Eosinophils: A Biomarker of Response to Extrafine Beclomethasone/Formoterol in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2015;192(4):523–5.CrossRefPubMedPubMedCentral Siddiqui SH, Guasconi A, Vestbo J, et al. Blood Eosinophils: A Biomarker of Response to Extrafine Beclomethasone/Formoterol in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2015;192(4):523–5.CrossRefPubMedPubMedCentral
Metadata
Title
Effect of YuPingFeng granules on clinical symptoms of stable COPD: study protocol for a multicenter, double-blind, and randomized controlled trial
Authors
Ruifeng Chen
Yangqing Zhan
Zhengshi Lin
Xiao Wu
Jinchao Zhou
Zifeng Yang
Jinping Zheng
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2024
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-023-04271-7

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