Tonifying kidney therapy for stable chronic obstructive pulmonary disease: a systematic review

OBJECTIVE: To evaluate the efficacy and safety of tonifying kidney therapy(Bushen, TK) for stable chronic obstructive pulmonary disease(COPD).METHODS: Randomized controlled trials(RCTs) of TK use for treatment of stable COPD were searched in four databases including Pub Med, the Cochrane Library, Chinese Biomedical Literature Database,and China National Knowledge Infrastructure Database from inception to December 2017. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies. Rev Man 5.3 software was used for the Meta-analysis.RESULTS: Eight RCTs involving 809 patients with stable COPD were included. Compared with the conventional Western Medicine(CWM) group, the TK group(TK combined with CWM) showed significant improvements in the effectiveness rates(RR =1.37, 95% CI 1.22 to 1.53, P < 0.000 01) and 6-min walk distance in meters(MD 11.92, 95% CI 3.52 to20.32, P = 0.005), this study also showed that the TK group can decrease The Traditional Chinese Medicine Syndrome Score(MD-8.01, 95% CI-12.89 to-3.13, P = 0.001). The lung function [forced expiratory volume in one second%(FEV1%), FEV1/forced vital capacity] showed no difference between the TK and control groups.CONCLUSION: For patients with stable COPD, TK can improve the clinical effectiveness and exercise capacity but fail to improve the patient's symptoms. Because of the low methodological quality of the included trials, additional high-quality and large-scale RCTs are required.