Wang Zhiwan

Effect of sequential treatment with syndrome differentiation on acute exacerbation of chronic obstructive pulmonary disease and "AECOPD Risk-Window": study protocol for a randomized placebo-controlled trial

BackgroundFrequent chronic obstructive pulmonary disease (COPD) exacerbation is a major cause of hospital admission and mortality. It has been reported that Traditional Chinese Medicine (TCM) may relieve COPD symptoms and reduce the incidence of COPD exacerbations, thus improving life quality of COPD patients. The acute exacerbation of COPD risk-window (AECOPD-RW) is the period after an exacerbation and before the patient returns to baseline. In the AECOPD-RW, patients are usually at increased risk of a second exacerbation, which may lead to hospital admission and high mortality. It may be beneficial for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients to receive interventions during AECOPD-RW. During exacerbations the treatment principle is to eliminate exogenous pathogens, whereas the AECOPD-RW treatment principle focuses on enhancing body resistance.Methods/DesignA prospective, multi-center, single-blinded, double-dummy and randomized controlled clinical trial is being conducted to test the therapeutic effects of a sequential two stage treatment, which includes eliminating pathogen and strengthening vital qi with syndrome differentiation. A total of 364 patients will be enrolled in this study with 182 in each treatment group (TCM and control). Patients received medication (or control) according to their assigned group. TCM for AECOPD were administered twice daily to patients with AECOPD over 7 to 21 days, followed by TCM for AECOPD-RW over 28 days. All patients were followed for six months. The clinical symptoms, the modified medical research council dyspnea (MMRC) scale and exacerbations were used as the primary outcome measures. Pulmonary function, quality of life and mortality rate were used as secondary outcome measures.DiscussionIt is hypothesized that sequentially eliminating pathogens and strengthening vital qi treatments with syndrome differentiation will have beneficial effects on reducing the frequency and duration of acute exacerbation, relieving symptoms and improving quality of life for COPD patients.Trial registrationThis study is registered at ClinicalTrials.gov, ChiCTR-TRC-11001460.

Research on diagnosis of TCM syndromes of chronic obstructive pulmonary disease in a stable state based on neuro-fuzzy theory

To make a summary of methods to establish diagnostic models of the syndromes in traditional Chinese medicine (TCM) by studying the results of data mining of chronic obstructive pulmonary disease (COPD)in a stable state. First, we carried out data management. In accordance with the selection criteria, we collected more than one thousand copies of clinical data from the patients with COPD in a stable state by way of clinical epidemiology. Secondly, we worked out the plan for modeling: building up fuzzy neural net models on the basis of dynamic Kohonen network and testing their reliability with the Fisher-iris data. Finally, with the help of the models, we studied the clinical data and obtained the diagnostic criteria for common syndromes of COPD in a stable state according to TCM basic theories. The model can be applied to the studies of diagnostic criteria for syndromes of COPD in a stable state by data check-up.

Research on diagnostic models of pneumonia syndromes in TCM based on fuzzy-neural net

To explore methods of establishing standard models of pneumonia syndromes in TCM (traditional Chinese medicine) by studying the results of data mining of pneumonia. First, in accordance with the selection criterion, 1058 pieces of clinical data from the patients with pneumonia were collected by clinical epidemiological methods. Secondly, fuzzy neural net models were built up on the basis of dynamic kohonen network and their reliability was tested with the Fisher-iris data. Then, with the help of the models the clinical data was studied and the diagnostic criterion for commonly-seen syndromes of pneumonia was obtained according to TCM basic theories. Simultaneously, the reliability was tested by data check-up. The coincident diagnostic rate reached 86% in comparison of the diagnostic criterion and original diagnostic data. The model, for its rational characteristics, can be applied to the study of diagnostic criterion for pneumonia syndromes.