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      The effect of acupoint application of traditional Chinese medicine for the treatment of chronic obstructive pulmonary disease : A protocol for systematic review and meta-analysis

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          Abstract

          Background:

          Chronic obstructive pulmonary disease (COPD) is a public threat, leading to progressive physical activity and poor quality of life. Although modern medicine has excellent achievement of COPD, the recurrence rate of stable COPD and the mortality of acute exacerbation COPD remain high. As one of the external therapy of traditional Chinese medicine, acupoint application has been treated COPD in China for a long time. Nevertheless, study evaluating the effect of acupoint application for COPD could not satisfy needs for clinic.

          Method:

          Randomized controlled trials meeting the inclusion criteria will be collected by the 2 reviewers. We choose the following electronic databases of Web of Science, Pub Med, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wan Fang, Chinese Scientific Journals Database, and Chinese Biomedical Database as our retrieval tool. The retrieval time was from inception to March 2020. The key to evaluation criteria is total clinical efficacy rate and lung function will be measured. Secondary outcomes include assessment scales and adverse reactions. The studies extracted will be assessed. The merging analysis will be carried out by Review Manager Software.

          Result:

          A scientific evidence of efficacy and safety of acupoint application for COPD will be found.

          Conclusion:

          The evaluation of the efficacy and safety of acupoint application for COPD will be presented.

          INPLASY registration number:

          INPLASY202090023.

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          Most cited references29

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          Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019

          Precision medicine is a patient-specific approach that integrates all relevant clinical, genetic and biological information in order to optimise the therapeutic benefit relative to the possibility of side-effects for each individual. Recent clinical trials have shown that higher blood eosinophil counts are associated with a greater efficacy of inhaled corticosteroids (ICSs) in chronic obstructive pulmonary disease (COPD) patients. Blood eosinophil counts are a biomarker with potential to be used in clinical practice, to help target ICS treatment with more precision in COPD patients with a history of exacerbations despite appropriate bronchodilator treatment. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 pharmacological treatment algorithms, based on the ABCD assessment, can be applied relatively easily to treatment-naive individuals at initial presentation. However, their use is more problematic during follow-up in patients who are already on maintenance treatment. There is a need for a different system to guide COPD pharmacological management during follow-up. Recent large randomised controlled trials have provided important new information concerning the therapeutic effects of ICSs and long-acting bronchodilators on exacerbations. The new evidence regarding blood eosinophils and inhaled treatments, and the need to distinguish between initial and follow-up pharmacological management, led to changes in the GOLD pharmacological treatment recommendations. This article explains the evidence and rationale for the GOLD 2019 pharmacological treatment recommendations.
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            Effect of pharmacotherapy on rate of decline of lung function in chronic obstructive pulmonary disease: results from the TORCH study.

            Chronic obstructive pulmonary disease (COPD) is characterized by an accelerated decline in lung function. No drug has been shown conclusively to reduce this decline. In a post hoc analysis of the Toward a Revolution in COPD Health (TORCH) study, we investigated the effects of combined salmeterol 50 microg plus fluticasone propionate 500 microg, either component alone or placebo, on the rate of post-bronchodilator FEV(1) decline in patients with moderate or severe COPD. A randomized, double-blind, placebo-controlled study was conducted from September 2000 to November 2005 in 42 countries. Of 6,112 patients from the efficacy population, 5,343 were included in this analysis. Spirometry was measured every 24 weeks for 3 years. There were 26,539 on-treatment observations. The adjusted rate of decline in FEV(1) was 55 ml/year for placebo, 42 ml/year for salmeterol, 42 ml/year for fluticasone propionate, and 39 ml/year for salmeterol plus fluticasone propionate. Salmeterol plus fluticasone propionate reduced the rate of FEV(1) decline by 16 ml/year compared with placebo (95% confidence interval [CI], 7-25; P < 0.001). The difference was smaller for fluticasone propionate and salmeterol compared with placebo (13 ml/year; 95% CI, 5-22; P = 0.003). Rates of decline were similar among the active treatment arms. FEV(1) declined faster in current smokers and patients with a lower body mass index, and varied between world regions. Patients who exacerbated more frequently had a faster FEV(1) decline. Pharmacotherapy with salmeterol plus fluticasone propionate, or the components, reduces the rate of decline of FEV(1) in patients with moderate-to-severe COPD, thus slowing disease progression. Clinical trial (GSK Study Code SCO30003) registered with www.clinicaltrials.gov (NCT00268216).
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              Pathobiological mechanisms underlying metabolic syndrome (MetS) in chronic obstructive pulmonary disease (COPD): clinical significance and therapeutic strategies

              Chronic obstructive pulmonary disease (COPD) is a major incurable global health burden and is currently the 4th largest cause of death in the world. Importantly, much of the disease burden and health care utilisation in COPD is associated with the management of its comorbidities (e.g. skeletal muscle wasting, ischemic heart disease, cognitive dysfunction) and infective viral and bacterial acute exacerbations (AECOPD). Current pharmacological treatments for COPD are relatively ineffective and the development of effective therapies has been severely hampered by the lack of understanding of the mechanisms and mediators underlying COPD. Since comorbidities have a tremendous impact on the prognosis and severity of COPD, the 2015 American Thoracic Society/European Respiratory Society (ATS/ERS) Research Statement on COPD urgently called for studies to elucidate the pathobiological mechanisms linking COPD to its comorbidities. It is now emerging that up to 50% of COPD patients have metabolic syndrome (MetS) as a comorbidity. It is currently not clear whether metabolic syndrome is an independent co-existing condition or a direct consequence of the progressive lung pathology in COPD patients. As MetS has important clinical implications on COPD outcomes, identification of disease mechanisms linking COPD to MetS is the key to effective therapy. In this comprehensive review, we discuss the potential mechanisms linking MetS to COPD and hence plausible therapeutic strategies to treat this debilitating comorbidity of COPD.
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Lippincott Williams & Wilkins (Hagerstown, MD )
                0025-7974
                1536-5964
                23 October 2020
                23 October 2020
                : 99
                : 43
                : e22730
                Affiliations
                [a ]No.3 Affiliated Hospital of Chengdu University of TCM (West District), Chengdu Pidu District Hospital of TCM
                [b ]School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu
                [c ]Chengdu Shuangliu Hospital of Traditional Chinese Medicine, Sichuan, China.
                Author notes
                []Correspondence: Yu Li, No.169, Section 1, Zhongxin Avenue, Pidu District, Chengdu, Sichuan, China (e-mail: Liyu@ 123456cdutcm.edu.cn ); Quansheng Feng, No. 1166, Liutai Avenue, Wenjiang District, Chengdu 611137, Sichuan, China (e-mail: fengqs118@ 123456163.com ).
                Article
                MD-D-20-08852 22730
                10.1097/MD.0000000000022730
                7581166
                33120771
                b11b567a-b38e-4a9b-8ab0-2d1cdbe64be1
                Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                : 11 September 2020
                : 15 September 2020
                Funding
                Funded by: Quansheng Feng
                Award ID: the Science and Technology Bureau of Chengdu (No. 2016-XT00-00033-GX)
                Award Recipient : Yefang Liu
                Funded by: Yu Li
                Award ID: Sichuan Administration of Traditional Chinese Medicine (2016C067)
                Award Recipient : Yefang Liu
                Funded by: Yefang Liu
                Award ID: the Foundation of Chengdu University of Traditional Chinese Medicine (YYZX1720)
                Award Recipient : Yefang Liu
                Categories
                3700
                Research Article
                Study Protocol Systematic Review
                Custom metadata
                TRUE

                acupoint application,chronic obstructive pulmonary disease,protocol,systematic review

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