title: Comparison of conventional medicine, TCM treatment, and combination of both conventional medicine and TCM treatment for patients with chronic obstructive pulmonary disease: study protocol of a randomized comparative effectiveness research trial.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) affects millions worldwide. Although many therapies exist and are being developed to relieve symptoms and reduce mortality, few data are available to understand which of the therapeutic alternatives is the most cost-effective for COPD patients in everyday clinical practice, especially for traditional Chinese medicine (TCM). Comparative effectiveness research can help patients, clinicians, and decision-makers make best informed treatment decisions where such evidence was previously lacking. This study aims to compare the effectiveness and economic evaluation of three treatments: (1) conventional Western medicine; (2) TCM treatments, which have been evaluated and have certain effect; and (3) a combination of both conventional Western medicine and TCM treatments, and then determine which treatment is the most suitable for COPD patients.
  
  
  METHODS
  A multicenter, pragmatic, randomized, controlled trial is adopted. A total of 360 patients will be recruited and randomly assigned to one of the three treatments group, with 120 in each group. Patients in the conventional Western medicine group will be given Salbutamol, Formoterol, Salmeterol/fluticasone, respectively, according to the guidelines. For the TCM group, patients will be given Bufei granule, Bu-Fei Jian-Pi granule, Bu-Fei Yi-Shen granule, and Yi-Qi Zi-Shen granule based on their corresponding TCM syndrome patterns, respectively. For the combination of conventional medicine and TCM treatments group, patients will be given a combination of conventional Western medicine and TCM granules. Treatments in each group are recognized as a whole comprehensive intervention. After the 26-week treatment, another 26 weeks will be followed up. The outcome measures including the frequency and duration of acute exacerbations, lung function, dyspnea, exercise capacity, quality of life, and economic evaluation will be assessed.
  
  
  CONCLUSIONS
  It is hypothesized that each of the three treatments will have beneficial effects in reducing the frequency and duration of acute exacerbations, improving exercise capacity and psychosocial function of COPD patients. In addition, the combination of conventional medicine and TCM treatments may be most suitable for COPD patients with better effectiveness and economic evaluation.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01836016.
authors.affiliation: The Geriatric Department, Henan University of Traditional Chinese Medicine, Longzihu University Town, Zhengdong New District, Zhengzhou, People's Republic of China. li_js8@163.com.
authors.forename: Jian-Sheng
authors.initials: JS
authors.lastname: Li
authors.forename: Yang
authors.initials: Y
authors.lastname: Xie
authors.forename: Su-Yun
authors.initials: SY
authors.lastname: Li
authors.forename: Xue-Qing
authors.initials: XQ
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000420:Albuterol / Q000031:analogs & derivatives / Q000627:therapeutic use; D000730:Androstadienes / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000191:economics / Q000627:therapeutic use*; D002681:China; D057186:Comparative Effectiveness Research; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D004338:Drug Combinations; D016527:Drug Costs; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000191:economics / Q000627:therapeutic use*; D004983:Ethanolamines / Q000627:therapeutic use; D005260:Female; D000068297:Fluticasone-Salmeterol Drug Combination; D000068759:Formoterol Fumarate; D006801:Humans; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008516:Medicine, Chinese Traditional / Q000191:economics; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000191:economics / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D012107:Research Design; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000730:Androstadienes; D001993:Bronchodilator Agents; D004338:Drug Combinations; D004365:Drugs, Chinese Herbal; D004983:Ethanolamines; D000068297:Fluticasone-Salmeterol Drug Combination; D000420:Albuterol; D000068759:Formoterol Fumarate