Treating acute exacerbations of COPD with Chinese herbal medicine to aid antibiotic use reduction (Excalibur): a randomised double-blind, placebo-controlled feasibility trial

作者：Merlin Willcox, Xiao-Yang Hu, Tom Oliver, Kerensa Thorne, Cherish Boxall, George He, Catherine Simpson, Becci Brotherwood, Alice O’Neil, Robert Waugh, Emma Tilt, Jeanne Trill, Neville Goward, Nick Francis, Michael Thomas, Paul Little, Tom Wilkinson, Jianping Liu, Gareth Griffiths, Michael Moore · 发表于：Frontiers in Pharmacology · 年份：2023 · DOI：10.3389/fphar.2023.1221905 · 被引用次数：4 · 研究领域：Chronic Obstructive Pulmonary Disease (COPD) Research、Respiratory and Cough-Related Research、Pediatric health and respiratory diseases

Background: Although many acute exacerbations of COPD (AECOPD) are triggered by non-bacterial causes, they are often treated with antibiotics. Preliminary research suggests that the Chinese herbal medicine “Shufeng Jiedu” (SFJD), may improve recovery and therefore reduce antibiotic use in patients with AECOPD. Aims: To assess the feasibility of conducting a randomised placebo-controlled clinical trial of SFJD for AECOPD in UK primary care. Methods: GPs opportunistically recruited patients experiencing an AECOPD. Participants were randomised 1:1 to usual care plus SFJD or placebo for 14 days. Participants, GPs and research nurses were blinded to treatment allocation. GPs could prescribe immediate, delayed or no antibiotics, with delayed prescribing encouraged where appropriate. Participants were asked to complete a participant diary, including EXACT-PRO and CAT™ questionnaires for up to 4 weeks. Outcomes included recruitment rate and other measures of study feasibility described using only descriptive statistics and with no formal comparisons between groups. We also conducted qualitative interviews with recruited and non-recruited COPD patients and clinicians, analysed using framework analysis. Results: Over 6 months, 19 participants (6 SFJD, 13 placebo) were recruited. Sixteen (84%) participants returned diaries or provided a diary by recall. Overall, 1.3 participants were recruited per 1,000 patients on the COPD register per month open. Median duration of treatment was 9.8 d...