Objective:To systematically evaluate the clinical efficacy and safety of Hanchuan Zupa granule(HCZPG)in the treatment of bronchial asthma.Methods:The Cochrane Library,Pubmed,EMBASE,CNKI,CBM,VIP and Wanfang were search...Objective:To systematically evaluate the clinical efficacy and safety of Hanchuan Zupa granule(HCZPG)in the treatment of bronchial asthma.Methods:The Cochrane Library,Pubmed,EMBASE,CNKI,CBM,VIP and Wanfang were searched up to June 2021.Randomized controlled trials,which assessed the effects of HCZPG in the treatment of bronchial asthma,were included in this review,and the references included in the selected studies were also tracked.The methodological quality of eligible studies were assessed by the Cochrane Collaboration’s tool.Data of the included studies were extracted independently by two authors and meta-analysis was conducted using RevMan5.3.Results:A total of 97 relevant literatures were retrieved,and 13 studies were finally included,involving 1189 patients.The aggregated meta-analysis results indicated that HCZPG improved total clinical efficacy[RR=1.18,95%CI(1.13,1.24),P<0.00001],FEV1(L)[WMD=0.48,95%CI(0.22,0.74),P=0.0003],FVC(L)[WMD=1.23,95%CI(0.5,1.96),P=0.001],FEV1/FVC(%)[WMD=7.37,95%CI(5.91,8.84),P<0.00001],PEF[SMD=1.19,95%CI(0.82,1.56),P<0.00001],IL-4[WMD=-12.13,95%CI(-16.36,-7.90),P<0.00001],IL-6[WMD=-29.55,95%CI(-40.71,-18.39),P<0.00001],TNF-α[SMD=-2.73,95%CI(-3.57,-1.88),P<0.00001],PaO2[WMD=8.97,95%CI(6.09,11.85),P<0.00001],but the risk of adverse events were not statistically significant between the two groups[RR=0.68,95%CI(0.39,1.18),P=0.17].Conclusion:HCZPG shows good clinical curative effects in treating bronchial asthma without increasing the incidence of adverse events.展开更多
Background So far, in China, there has been no effective or easy procedure to define the control of asthma. This study assesses the validity of Asthma Control Test in Chinese patients. Methods Three questionnaires （A...Background So far, in China, there has been no effective or easy procedure to define the control of asthma. This study assesses the validity of Asthma Control Test in Chinese patients. Methods Three questionnaires （Asthma Control Test, Asthma Control Questionnaire and the 30 second asthma test） were administered to 305 asthma patients from 10 teaching hospitals across China. Spirometry was also used. Asthma specialists rated the control of asthma according to patients＇ symptoms, medications and forced expiratory volume in first second. The patients were divided into noncontrolled group and controlled group according to the specialists＇ rating. Reliability, empirical validity and screening accuracy were conducted for Asthma Control Test scores. Screening accuracy was compared among 3 questionnaires. The patients＇ self rating and the specialists＇ rating were also compared. Results The internal consistency reliability of the 5-item Asthma Control Test was 0.854. The correlation coefficient between Asthma Control Test and the specialists＇ rating was 0.729, which was higher than other instruments. Asthma Control Test scores discriminated between groups of patients differing in the percent predicted forced expiratory volume in first second （F=-26.06, P〈0.0001）, the specialists＇ rating of asthma control （F=-88.24, P〈0.0001） and the Asthma Control Questionnaire scores （F=-250.57, P〈0.0001）. Asthma Control Test showed no significant difference with Asthma Control Questionnaire in the percent correctly classified, while the percent correctly classified by Asthma Control Test was much higher than 30 second asthma test. The patients＇ self rating was the same as assessment of the specialists （t=0.65, P=-0.516）. Conclusion The Asthma Control Test is an effective and practicable method for assessing asthma control in China.展开更多
Background Many studies have shown the superior efficacy of budesonide （BUD）/formoterol （FORM） maintenance and reliever therapy, but still lack evidence of its efficacy in Chinese asthma patients in a relative lar...Background Many studies have shown the superior efficacy of budesonide （BUD）/formoterol （FORM） maintenance and reliever therapy, but still lack evidence of its efficacy in Chinese asthma patients in a relative large patient-group. We finished this research to compare BUD/FORM maintenance and reliever therapy and high-dose salmeterol （SALM）/fluticasone （FP） maintenance plus an as-needed short-acting IB2-agonist in Chinese patients with persistent uncontrolled asthma. This was a post hoc analysis based on a 6-month, multicenter, randomized, double-blind study （NCT00242775）. Methods A total of 222 eligible asthma patients from nine centers in China were randomized to either BUD/FORM＋as- needed BUD/FORM （160/4.5 pg/inhalation） （640/18 pg/d; n=111 ）, or SALM/FP＋as-needed terbutaline （0.4 mg/inhalation） （100/1000 pg/d; n=111）. The primary endpoint was time to first severe exacerbation while secondary endpoints included various measures of pulmonary function, symptom control and quality-of-life. Results Time to first severe exacerbation over six months was lower with the BUD/FORM than with the SALM/FP treatment （risk ratio=0.52, 95% CI 0.22-1.22）, but the difference did not achieve statistical significance （P=-0.13）. The cumulative number of severe exacerbations in the BUD/FORM group was lower than in the SALM/FP group （7.2% vs. 13.5%; risk ratio=0.45, P=0.028）. BUD/FORM produced significantly better improvements in reliever use, cumulative mild exacerbations, symptom-free days （%）, and morning/evening peak expiratory flow （PEF） than SALM/FP （P 〈0.05 in all cases）. The two groups achieved similar improvements in their time to first mild exacerbation, forced expiratory volume in one second （FEV1）, asthma control questionnaire and asthma symptom scores, and percentage of nights with awakening（s）. Both treatments were well tolerated. Conclusions In Chinese patients with persistent asthma, BUD/FORM decreased severe and mild exacerbations, decreased reliever use, increased symptom-free days, and improved morning/evening PEF compared with SALM/FP. There were no significant differences in time to first severe exacerbation or other assessments regarding daily asthma control between BUD/FORM and SALM/FP. BUD/FORM was more effective in this Chinese sub-group than in the total cohort involved in the oriclinal study. （Clinical Trial Registry Number： NCT00242775）展开更多
Background Nicotine,a major component of tobacco,is the main cause of smoking addiction.It was found that asthmatic patients who smoke were insensitive to glucocorticoid treatment.In this paper,we investigated whether...Background Nicotine,a major component of tobacco,is the main cause of smoking addiction.It was found that asthmatic patients who smoke were insensitive to glucocorticoid treatment.In this paper,we investigated whether nicotine could inhibit histone deacetylase 6 activity （HDAC6） and chaperone-dependent activation of the glucocorticoid receptor （GR） in A549 cells.Furthermore,the expression level of heat shock protein 90 （HSP90） was determined.Methods Quantitative real-time polymerase chain reaction was used to detect the levels of RNA transcription,and Western blotting was applied to analyze the levels of protein expression of HDAC6,GR,and HSP90 in A549 cells.Moreover,the effects of dexamethasone and trichostatin A were observed in A549 cells.Results A549 cell proliferation was inhibited in the presence of nicotine,and the level of RNA and protein expression of HDAC6 and GR were down-regulated.Conclusions Nicotine could inhibit HDAC6 activity and chaperone-dependent activation of GR.This might be the main reason why asthmatic patients who smoke show insensitivity to the glucocorticoid treatment.展开更多
基金National Natural Science Foundation of China(NO.82170027)。
文摘Objective:To systematically evaluate the clinical efficacy and safety of Hanchuan Zupa granule(HCZPG)in the treatment of bronchial asthma.Methods:The Cochrane Library,Pubmed,EMBASE,CNKI,CBM,VIP and Wanfang were searched up to June 2021.Randomized controlled trials,which assessed the effects of HCZPG in the treatment of bronchial asthma,were included in this review,and the references included in the selected studies were also tracked.The methodological quality of eligible studies were assessed by the Cochrane Collaboration’s tool.Data of the included studies were extracted independently by two authors and meta-analysis was conducted using RevMan5.3.Results:A total of 97 relevant literatures were retrieved,and 13 studies were finally included,involving 1189 patients.The aggregated meta-analysis results indicated that HCZPG improved total clinical efficacy[RR=1.18,95%CI(1.13,1.24),P<0.00001],FEV1(L)[WMD=0.48,95%CI(0.22,0.74),P=0.0003],FVC(L)[WMD=1.23,95%CI(0.5,1.96),P=0.001],FEV1/FVC(%)[WMD=7.37,95%CI(5.91,8.84),P<0.00001],PEF[SMD=1.19,95%CI(0.82,1.56),P<0.00001],IL-4[WMD=-12.13,95%CI(-16.36,-7.90),P<0.00001],IL-6[WMD=-29.55,95%CI(-40.71,-18.39),P<0.00001],TNF-α[SMD=-2.73,95%CI(-3.57,-1.88),P<0.00001],PaO2[WMD=8.97,95%CI(6.09,11.85),P<0.00001],but the risk of adverse events were not statistically significant between the two groups[RR=0.68,95%CI(0.39,1.18),P=0.17].Conclusion:HCZPG shows good clinical curative effects in treating bronchial asthma without increasing the incidence of adverse events.
文摘Background So far, in China, there has been no effective or easy procedure to define the control of asthma. This study assesses the validity of Asthma Control Test in Chinese patients. Methods Three questionnaires （Asthma Control Test, Asthma Control Questionnaire and the 30 second asthma test） were administered to 305 asthma patients from 10 teaching hospitals across China. Spirometry was also used. Asthma specialists rated the control of asthma according to patients＇ symptoms, medications and forced expiratory volume in first second. The patients were divided into noncontrolled group and controlled group according to the specialists＇ rating. Reliability, empirical validity and screening accuracy were conducted for Asthma Control Test scores. Screening accuracy was compared among 3 questionnaires. The patients＇ self rating and the specialists＇ rating were also compared. Results The internal consistency reliability of the 5-item Asthma Control Test was 0.854. The correlation coefficient between Asthma Control Test and the specialists＇ rating was 0.729, which was higher than other instruments. Asthma Control Test scores discriminated between groups of patients differing in the percent predicted forced expiratory volume in first second （F=-26.06, P〈0.0001）, the specialists＇ rating of asthma control （F=-88.24, P〈0.0001） and the Asthma Control Questionnaire scores （F=-250.57, P〈0.0001）. Asthma Control Test showed no significant difference with Asthma Control Questionnaire in the percent correctly classified, while the percent correctly classified by Asthma Control Test was much higher than 30 second asthma test. The patients＇ self rating was the same as assessment of the specialists （t=0.65, P=-0.516）. Conclusion The Asthma Control Test is an effective and practicable method for assessing asthma control in China.
文摘Background Many studies have shown the superior efficacy of budesonide （BUD）/formoterol （FORM） maintenance and reliever therapy, but still lack evidence of its efficacy in Chinese asthma patients in a relative large patient-group. We finished this research to compare BUD/FORM maintenance and reliever therapy and high-dose salmeterol （SALM）/fluticasone （FP） maintenance plus an as-needed short-acting IB2-agonist in Chinese patients with persistent uncontrolled asthma. This was a post hoc analysis based on a 6-month, multicenter, randomized, double-blind study （NCT00242775）. Methods A total of 222 eligible asthma patients from nine centers in China were randomized to either BUD/FORM＋as- needed BUD/FORM （160/4.5 pg/inhalation） （640/18 pg/d; n=111 ）, or SALM/FP＋as-needed terbutaline （0.4 mg/inhalation） （100/1000 pg/d; n=111）. The primary endpoint was time to first severe exacerbation while secondary endpoints included various measures of pulmonary function, symptom control and quality-of-life. Results Time to first severe exacerbation over six months was lower with the BUD/FORM than with the SALM/FP treatment （risk ratio=0.52, 95% CI 0.22-1.22）, but the difference did not achieve statistical significance （P=-0.13）. The cumulative number of severe exacerbations in the BUD/FORM group was lower than in the SALM/FP group （7.2% vs. 13.5%; risk ratio=0.45, P=0.028）. BUD/FORM produced significantly better improvements in reliever use, cumulative mild exacerbations, symptom-free days （%）, and morning/evening peak expiratory flow （PEF） than SALM/FP （P 〈0.05 in all cases）. The two groups achieved similar improvements in their time to first mild exacerbation, forced expiratory volume in one second （FEV1）, asthma control questionnaire and asthma symptom scores, and percentage of nights with awakening（s）. Both treatments were well tolerated. Conclusions In Chinese patients with persistent asthma, BUD/FORM decreased severe and mild exacerbations, decreased reliever use, increased symptom-free days, and improved morning/evening PEF compared with SALM/FP. There were no significant differences in time to first severe exacerbation or other assessments regarding daily asthma control between BUD/FORM and SALM/FP. BUD/FORM was more effective in this Chinese sub-group than in the total cohort involved in the oriclinal study. （Clinical Trial Registry Number： NCT00242775）
文摘Background Nicotine,a major component of tobacco,is the main cause of smoking addiction.It was found that asthmatic patients who smoke were insensitive to glucocorticoid treatment.In this paper,we investigated whether nicotine could inhibit histone deacetylase 6 activity （HDAC6） and chaperone-dependent activation of the glucocorticoid receptor （GR） in A549 cells.Furthermore,the expression level of heat shock protein 90 （HSP90） was determined.Methods Quantitative real-time polymerase chain reaction was used to detect the levels of RNA transcription,and Western blotting was applied to analyze the levels of protein expression of HDAC6,GR,and HSP90 in A549 cells.Moreover,the effects of dexamethasone and trichostatin A were observed in A549 cells.Results A549 cell proliferation was inhibited in the presence of nicotine,and the level of RNA and protein expression of HDAC6 and GR were down-regulated.Conclusions Nicotine could inhibit HDAC6 activity and chaperone-dependent activation of GR.This might be the main reason why asthmatic patients who smoke show insensitivity to the glucocorticoid treatment.
