Systematic review links specific TCM constitutions to worse COPD outcomes in 2,168 patients
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Key Takeaway
Note that yang-deficiency and qi-deficiency TCM constitutions associate with higher smoking index and worse lung function in COPD.
This systematic review and network meta-analysis evaluated Traditional Chinese Medicine (TCM) constitutions among 2,168 COPD patients. The study aimed to identify patterns in smoking index, lung function, exacerbation frequency, and quality of life scores based on constitutional types.
The analysis identified that the top two TCM constitutions with higher smoking index were yang-deficiency and qi-deficiency. Additionally, the top two constitutions associated with low FEV1/FVC ratios were also yang-deficiency and qi-deficiency. The top three constitutions linked to low FEV1%Pred included yang-deficiency, blood-stasis, and qi-deficiency.
Regarding disease progression and symptoms, the top three constitutions with higher numbers of acute exacerbations per year and higher CAT scores were yang-deficiency, blood-stasis, and qi-deficiency. The authors state that adverse events, serious adverse events, and discontinuations were not reported in the source data.
The authors suggest these results can assist clinicians in prevention, evaluation, treatment, and rehabilitation decision-making. However, because the primary outcome was not reported and safety data were absent, the clinical certainty regarding these associations remains limited.
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View Original Abstract ↓
To investigate the characteristics of Chronic Obstructive Pulmonary Disease (COPD) patients with different Traditional Chinese Medicine (TCM) constitutions by analyzing the differences of indexes (smoking index, ratio of forced expiratory volume in 1 sec and forced vital capacity (FEV1/FVC),forced expiratory volume in 1 sec % predicted (FEV1%Pred), number of acute exacerbations per year (AE/y) and COPD assessment test (CAT)) in COPD patients with different TCM constitutions.
Literatures were retrieved from PubMed, Embase (Ovid platform), Cochrane Library, CNKI, VIP, Wanfang Database, and Sinomed, eligible literature was screened. Quality assessment was performed using the Agency for Healthcare Research and Quality (AHRQ) checklist and the Newcastle-Ottawa Scale (NOS). Network meta-analysis was conducted using Stata and Addis software for data analysis. The study was registered with PROSPERO, https://www.crd.york.ac.uk/PROSPERO/view/CRD42023433078.
A total of 11 studies, which contain 13 references, with 2,168 participants were included. Network Meta-analysis revealed that in COPD patients, the top two TCM constitutions with higher smoking index were yang-deficiency and qi-deficiency; the top two TCM constitutions with low FEV1/FVC were yang-deficiency and qi-deficiency; the top three TCM constitutions with low FEV1%Pred were yang-deficiency, blood-stasis and qi-deficiency; the top three TCM constitutions with higher acute exacerbate numbers per year and CAT scores were yang-deficiency, blood-stasis and qi-deficiency.
The indexes of COPD patients with different TCM constitutions are varying. The indexes of yang-deficiency and qi-deficiency are always among the worst group, and other indexes differed from each other. The result can help clinicians in prevention, evaluation, treatment and rehabilitation decision-making.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42023433078, identifier (CRD42023433078).
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