Effects of Hochuekkito combined with pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

Hamada,Hironobu; Sekikawa,Kiyokazu; Murakami,Isao; Aimoto,Kouichi; Kagawa,Kazuyoshi; Sumigawa,Tatsuya; Okusaki,Ken; Dodo,Takefumi; Awaya,Yoshikazu; Watanabe,Masatoshi; Kondo,Keiichi; Ogawa,Takashi; Yamamoto,Hikaru; Hattori,Noboru

doi:10.3892/etm.2018.6837

Effects of Hochuekkito combined with pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

Authors:
- Hironobu Hamada
- Kiyokazu Sekikawa
- Isao Murakami
- Kouichi Aimoto
- Kazuyoshi Kagawa
- Tatsuya Sumigawa
- Ken Okusaki
- Takefumi Dodo
- Yoshikazu Awaya
- Masatoshi Watanabe
- Keiichi Kondo
- Takashi Ogawa
- Hikaru Yamamoto
- Noboru Hattori
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Affiliations: Department of Physical Analysis and Therapeutic Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima 734‑8551, Japan, Department of Respiratory Medicine, Higashi‑Hiroshima Medical Center, Higashi-Hiroshima, Hiroshima 739‑0041, Japan, Department of Respiratory Medicine, Hiroshima City Medical Association‑Administered Hiroshima City Aki Hospital, Hiroshima, Hiroshima 736‑0088, Japan, Department of Internal Medicine, Mihara Medical Associations Hospital, Mihara, Hiroshima 723‑0051, Japan, Department of Respiratory Medicine, Miyoshi Central Hospital, Miyoshi, Hiroshima 728‑8502, Japan, Department of Respiratory Medicine, Tadanoumi Hospital, Takehara, Hiroshima 729‑2316, Japan, Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima 734‑8551, Japan
Published online on: October 9, 2018 https://doi.org/10.3892/etm.2018.6837
Pages: 5236-5242
Copyright: © Hamada et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Chronic obstructive pulmonary disease (COPD) has significant systemic effects, such as weight loss, which affects exercise capacity, health‑related quality of life (HRQOL) and survival. The traditional herbal medicine, Hochuekkito (TJ‑41), improves the nutritional status and decreases systemic inflammation in patients with COPD. However, to date, the additive effect of TJ‑41 on pulmonary rehabilitation (PR) in patients with COPD has not been researched comprehensively. The purpose of the present study was to investigate the efficacy and safety of adding TJ‑41 to PR for patients with COPD. Thirty‑three malnourished patients with COPD were randomly assigned to receive low‑intensity exercise with (TJ‑41 group) or without (control group) TJ‑41 treatment for 12 weeks. The primary outcome was the change in the 6‑min walk distance (6MWD). Secondary outcomes included changes in the body composition, peripheral muscle strength, modified Medical Research Council dyspnea score, visual analog scale (VAS) score for dyspnea, VAS score for fatigue and COPD assessment test (CAT) score. After the 12‑week treatment, body weight and percent ideal body weight were significantly increased in the TJ‑41 group (P<0.05), but not in the control group. After the 12‑week treatment, the modified Medical Research Council dyspnea score, VAS score for dyspnea, VAS score for fatigue and total CAT score decreased significantly in the TJ‑41 group (all P<0.05), but not in the control group. There were no significant differences in the 6MWD and peripheral muscle strength between baseline and after 12 weeks of treatment in either group. No adverse effects were noted with the use of TJ‑41. It was concluded that the addition of TJ‑41 to PR may benefit malnourished patients with COPD with respect to dyspnea and HRQOL.

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1	Schols A: Nutritional modulation as part of the integrated management of chronic obstructive pulmonary disease. Proc Nutr Soc. 62:783–791. 2003. View Article : Google Scholar : PubMed/NCBI
2	Cao C, Wang R, Wang J, Bunjhoo H, Xu Y and Xiong W: Body mass index and mortality in chronic obstructive pulmonary disease: A meta-analysis. PLoS One. 7:e438922012. View Article : Google Scholar : PubMed/NCBI
3	Wagner PD: Possible mechanisms underlying the development of cachexia in COPD. Eur Respir J. 31:492–501. 2008. View Article : Google Scholar : PubMed/NCBI
4	McCarthy B, Casey D, Devane D, Murphy K, Murphy E and Lacasse Y: Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. CD003793:2015.
5	Ferreira IM, Brooks D, White J and Goldstein R: Nutritional supplementation for stable chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 12:CD0009982012.PubMed/NCBI
6	Sugawara K, Takahashi H, Kasai C, Kiyokawa N, Watanabe T, Fujii S, Kashiwagura T, Honma M, Satake M and Shioya T: Effects of nutritional supplementation combined with low-intensity exercise in malnourished patients with COPD. Respir Med. 104:1883–1889. 2010. View Article : Google Scholar : PubMed/NCBI
7	Sugawara K, Takahashi H, Kashiwagura T, Yamada K, Yanagida S, Homma M, Dairiki K, Sasaki H, Kawagoshi A, Satake M and Shioya T: Effect of anti-inflammatory supplementation with whey peptide and exercise therapy in patients with COPD. Respir Med. 106:1526–1534. 2012. View Article : Google Scholar : PubMed/NCBI
8	Miki K, Maekura R, Nagaya N, Nakazato M, Kimura H, Murakami S, Ohnishi S, Hiraga T, Miki M, Kitada S, et al: Ghrelin treatment of cachectic patients with chronic obstructive pulmonary disease: A multicenter, randomized, double-blind, placebo-controlled trial. PLoS One. 7:e357082012. View Article : Google Scholar : PubMed/NCBI
9	Creutzberg EC, Schols AM, Weling-Scheepers CA, Buurman WA and Wouters EF: Characterization of nonresponse to high caloric oral nutritional therapy in depleted patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 161:745–752. 2000. View Article : Google Scholar : PubMed/NCBI
10	Kuroiwa A, Liou S, Yan H, Eshita A, Naitoh S and Nagayama A: Effect of a traditional Japanese herbal medicine, hochu-ekki-to (Bu-Zhong-Yi-Qi Tang), on immunity in elderly persons. Int Immunopharmacol. 4:317–324. 2004. View Article : Google Scholar : PubMed/NCBI
11	Satoh N, Sakai S, Kogure T, Tahara E, Origasa H, Shimada Y, Kohoda K, Okubo T and Terasawa K: A randomized double blind placebo-controlled clinical trial of Hochuekkito, a traditional herbal medicine, in the treatment of elderly patients with weakness N of one and responder restricted design. Phytomedicine. 12:549–554. 2005. View Article : Google Scholar : PubMed/NCBI
12	Mori K, Kido T, Daikuhara H, Sakakibara I, Sakata T, Shimizu K, Amagaya S, Sasaki H and Komatsu Y: Effect of Hochu-ekki-to (TJ-41), a Japanese herbal medicine, on the survival of mice infected with influenza virus. Antiviral Res. 44:103–111. 1999. View Article : Google Scholar : PubMed/NCBI
13	Tajima S, Bando M, Yamasawa H, Ohno S, Moriyama H, Takada T, Suzuki E, Gejyo F and Sugiyama Y: Preventive effect of Hochu-ekki-to on lipopolysaccharide-induced acute lung injury in BALB/c mice. Lung. 184:318–323. 2006. View Article : Google Scholar : PubMed/NCBI
14	Tajima S, Bando M, Yamasawa H, Ohno S, Moriyama H, Terada M, Takada T, Suzuki E, Gejyo F and Sugiyama Y: Preventive effect of hochu-ekki-to, a Japanese herbal medicine, on bleomycin-induced lung injury in mice. Respirology. 12:814–822. 2007. View Article : Google Scholar : PubMed/NCBI
15	Tatsumi K, Shinozuka N, Nakayama K, Sekiya N, Kuriyama T and Fukuchi Y: Hochuekkito improves systemic inflammation and nutritional status in elderly patients with chronic obstructive pulmonary disease. J Am Geriatr Soc. 57:169–170. 2009. View Article : Google Scholar : PubMed/NCBI
16	Global initiative for chronic obstructive lung disease: Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2018 Report. http://www.goldcopd.orgJuly 12–2018
17	ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories, . ATS statement: Guidelines for the six-minute walk test. Am J Respir Crit Care Med. 166:111–117. 2002. View Article : Google Scholar : PubMed/NCBI
18	Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, McCormack MC, Carlin BW, Sciurba FC, Pitta F, et al: An official European Respiratory Society/American Thoracic Society technical standard: Field walking tests in chronic respiratory disease. Eur Respir J. 44:1428–1446. 2014. View Article : Google Scholar : PubMed/NCBI
19	Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, et al: Standardisation of spirometry. Eur Respir J. 26:319–338. 2005. View Article : Google Scholar : PubMed/NCBI
20	Celli BR and MacNee W; ATS/ERS Task Force, . Standards for the diagnosis and treatment of patients with COPD: A summary of the ATS/ERS position paper. Eur Respir J. 23:932–946. 2004. View Article : Google Scholar : PubMed/NCBI
21	Jones PW, Harding G, Berry P, Wiklund I, Chen WH and Kline Leidy N: Development and first validation of the COPD Assessment Test. Eur Respir J. 34:648–654. 2009. View Article : Google Scholar : PubMed/NCBI
22	Glaxo Smith Kline group of companies. COPD Asessment Test 2016. http://www.catestonline.orgJuly 12–2018
23	Vogelmeier C, Hederer B, Glaab T, Schmidt H, Rutten-van Mölken MP, Beeh KM, Rabe KF and Fabbri LM; POET-COPD investigators, . Tiotropium versus salmeterol for the prevention of exacerbations of COPD. N Engl J Med. 364:1093–1103. 2011. View Article : Google Scholar : PubMed/NCBI
24	Chen Y, Shergis JL, Wu L, Yu X, Zeng Q, Xu Y, Guo X, Zhang AL, Xue CC and Lin L: A systematic review and meta-analysis of the herbal formula Buzhong Yiqi Tang for stable chronic obstructive pulmonary disease. Complement Ther Med. 29:94–108. 2016. View Article : Google Scholar : PubMed/NCBI
25	Jeong JS, Ryu BH, Kim JS, Park JW, Choi WC and Yoon SW: Bojungikki-tang for cancer-related fatigue: A pilot randomized clinical trial. Integr Cancer Ther. 9:331–338. 2010. View Article : Google Scholar : PubMed/NCBI
26	Enomoto Y, Hagiwara E, Komatsu S, Nishihira R, Baba T, Kitamura H, Sekine A, Nakazawa A and Ogura T: Pilot quasi-randomized controlled study of herbal medicine Hochuekkito as an adjunct to conventional treatment for progressed pulmonary Mycobacterium avium complex disease. PLoS One. 9:e1044112014. View Article : Google Scholar : PubMed/NCBI
27	Katsura H, Yamada K and Kida K: Both generic and disease specific health-related quality of life are deteriorated in patients with underweight COPD. Respir Med. 99:624–630. 2005. View Article : Google Scholar : PubMed/NCBI
28	Kunik ME, Roundy K, Veazey C, Souchek J, Richardson P, Wray NP and Stanley MA: Surprisingly high prevalence of anxiety and depression in chronic breathing disorders. Chest. 127:1205–1211. 2005. View Article : Google Scholar : PubMed/NCBI
29	Hanania NA, Müllerova H, Locantore NW, Vestbo J, Watkins ML, Wouters EF, Rennard SI and Sharafkhaneh A; Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study investigators, . Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study investigators. Determinants of depression in the ECLIPSE chronic obstructive pulmonary disease cohort. Am J Respir Crit Care Med. 183:604–611. 2011. View Article : Google Scholar : PubMed/NCBI
30	Tohda M and Mingmalairak S: Evidence of antidepressive effects of a Wakan-yaku, Hochuekkito, in depression model mice with learned-helplessness behavior. Evid Based Complement Alternat Med. 2013:3190732013. View Article : Google Scholar : PubMed/NCBI
31	Baarends EM, Schols AM, Mostert R and Wouters EF: Peak exercise response in relation to tissue depletion in patients with chronic obstructive pulmonary disease. Eur Respir J. 10:2807–2813. 1997. View Article : Google Scholar : PubMed/NCBI
32	Sabino PG, Silva BM and Brunetto AF: Nutritional status is related to fat-free mass, exercise capacity and inspiratory strength in severe chronic obstructive pulmonary disease patients. Clinics (Sao Paulo). 65:599–605. 2010. View Article : Google Scholar : PubMed/NCBI
33	Franssen FM, Broekhuizen R, Janssen PP, Wouters EF and Schols AM: Limb muscle dysfunction in COPD: Effects of muscle wasting and exercise training. Med Sci Sports Exerc. 37:2–9. 2005. View Article : Google Scholar : PubMed/NCBI
34	Teopompi E, Tzani P, Aiello M, Ramponi S, Andrani F, Marangio E, Clini E and Chetta A: Fat-free mass depletion is associated with poor exercise capacity irrespective of dynamic hyperinflation in COPD patients. Respir Care. 59:718–725. 2014. View Article : Google Scholar : PubMed/NCBI