Efficacy of shenling baizhu san for the treatment of stable copd: A systematic review and meta-analysis

Objective: To assess the efficacy and safety of Shenling Baizhu San (SLBZS) for the treatment of stable chronic obstructive pulmonary disease (COPD) through systematic review. Methods: Biomedical databases, including PubMed, EMbase, The Cochrane Central Register of Controlled Trials (CENTRAL), CBM-disk, CNKI, VMIS and WFMO were searched from their inceptions until 31th October 2015. Randomized controlled trials of oral SLBZS involving the outcome measures of symptom improvement, quality of life assessment, forced expiratory volume in one second (FEV1), arterial blood gas analysis and/or frequency of dyspnea or diaphragmatic fatigue. Twelve studies were identified and extracted by two reviewers. The Cochrane Risk of Bias tool was conducted for the assessment of Methodological quality. Data were analyzed using the RevMan 5.3.0 software. Results: Twelve studies involving 814 participants were included and all of them were carried out in china. The results of meta-analysis indicated patients receiving SLBZS plus conventional therapy showed a significantly relieving in clinical manifestation than those receiving conventional therapy alone (RR:5.00, 95% CI: 2.98 to 8.39), SLBZS plus conventional therapy also had greater improvement in the quality of life no matter using CAT (RR:-4.52, 95% CI: -5.72 to -3.32) or SGRQ (RR:-13.33, 95% CI: -15.97 to -10.68) for assessment. SLBZS may have a potential benefit in increasing dyspnea remission rate and decreasing the incidence of respiratory failure (RR:0.95, 95% CI: 0.62 to 1.47), as well as improving ventilation in patients (RR:-1.41, 95% CI:-2.49 to -0.33). It seems all trails had showed beneficial tendency. Nevertheless, the interpretation of research results still need to be cautious, because none of the trails described the method of allocation concealment, blind and follow-up. Conclusions: SLBZS seems to be an acceptable, additional treatment measures for stable stage COPD patients. The further evaluation of SLBZS in efficacy and safety needs more high quality randomized controlled clinical trial evidence.