Chinese herbal paste may help prevent exacerbations of COPD

The study results are being presented at the ATS 2011 International Conference in Denver.

"We had performed observational studies of XCP which had shown the paste decreased the frequency of COPD exacerbations, but this study is the first randomized controlled trial showing the effectiveness and safety of XCP in the prevention of COPD exacerbation," said study author Yongjun Bian, MD, clinical researcher in the respiratory department of Gunag'anmen Hospital in Beijing. "These data confirmed the beneficial effect of XCP on the prevention of winter COPD exacerbations."

Xiao Chuan paste has been used in China for centuries to aid in breathing disorders, including COPD and asthma. To treat winter exacerbations of COPD and other breathing problems, the paste is applied in the summer on specific acupuncture points on the back.

"The herbs contained in XCP and natural remedies may have some immune regulation properties, which in turn may aid in their ability to prevent COPD exacerbations," Dr. Bian said.

The researchers enrolled 142 patients and randomized them to receive either XCP or a placebo paste. Both pastes were applied on the same back points four times during the eight-week period of July and August.

For the study, exacerbations were defined as either a worsening of respiratory symptoms resulting in the patient taking oral steroids or antibiotics, or a hospital admission for an acute respiratory complaint. Patients were monitored for exacerbations from November through February. Adverse events were evaluated using the Chinese Herb Skin Stimulation Classification.

"Treatment with XCP significantly reduced the frequency of winter exacerbation compared with patients treated with placebo," Dr. Bian said. "XCP patients experienced statistically significant reductions in steroid use and episodes of shortness of breath, and XCP patients also reported an improved quality of life compared to those treated with placebo."

The incidence of adverse events was two percent in treatment group, and all patients who experienced an adverse event recovered without intervention after stopping the medication. There were no adverse events in placebo group.

"Although this treatment has been used in China for thousands of years, no scientific studies had been performed on this conventional Chinese natural therapy," Dr. Bian said. "This study results helped us standardize the treatment protocol and avoid adverse events in future clinical practice."

The primary ingredients of XCP are Ephedra vulgaris, Asarum heterothropoides and Acorus gramineus Soland, all plants which are native to China.

Dr. Bian said future research should include longer follow-up times to evaluate the long-term efficacy of the paste in treating COPD exacerbations, and also should explore the mechanisms at play in reducing exacerbations.