Acupoint Herbal Patching with or without Conventional Treatment for Stable Chronic Obstructive Pulmonary Disease: A Systematic Review of Randomized Controlled Trials

Abstract

Background: Acupoint herbal patching (AHP) alone or as an adjuvant therapy with conventional treatment (CT) has been widely used for prevention and treatment of chronic obstructive pulmonary disease (COPD). However, current clinical evidence from a systematic review of RCTs is lacking. Objective: To evaluate the effectiveness and safety of AHP with or without CT for people with COPD at stable stage. Methods: We searched randomized controlled trials comparing AHP (with or without CT) with no intervention, placebo, or CT from six databases. Two authors selected studies, extracted data and evaluated risk of bias of included trials. RevMan 5.2 software was used to analysis data. Results: Twenty one RCTs (2327 participants) were included. AHP of non sanfu applied on no fixed dates with CT significantly decreased the mean frequency of acute exacerbation of COPD (times per year) (MD: -1.24; 95% CI: -2.02 to -0.46; 2 trials), and improved lung function parameters and quality of life. The AHP with CT showed no better effect in 6-minute walking distance (6MWD) that CT alone. AHP applied at sanfu (specific dates based on lunar calendar) with CT had significant effect for 6MWD (MD: 11.20; 95% CI: 0.83 to 21.56; I2 = 0%; 3 trials). One trial reported skin irritation from AHP. Another trial reported two patients had eye discomfort, which was inferred as the adverse effects of seretide. Conclusion: AHP used as an adjunct to CT, appears to be more effective than CT alone in patients with stable COPD. However, further large, rigorously designed trials are warranted to confirm these potential effects.