The relationship between traditional Chinese medicine constitution and indexes in chronic obstructive pulmonary disease patients: a systematic review and network meta-analysis

Objective To investigate the characteristics of Chronic Obstructive Pulmonary Disease (COPD) patients with different Traditional Chinese Medicine (TCM) constitutions by analyzing the differences of indexes (smoking index, ratio of forced expiratory volume in 1 sec and forced vital capacity (FEV1/FVC),forced expiratory volume in 1 sec % predicted (FEV1%Pred), number of acute exacerbations per year (AE/y) and COPD assessment test (CAT)) in COPD patients with different TCM constitutions. Methods Literatures were retrieved from PubMed, Embase (Ovid platform), Cochrane Library, CNKI, VIP, Wanfang Database, and Sinomed, eligible literature was screened. Quality assessment was performed using the Agency for Healthcare Research and Quality (AHRQ) checklist and the Newcastle-Ottawa Scale (NOS). Network meta-analysis was conducted using Stata and Addis software for data analysis. The study was registered with PROSPERO, https://www.crd.york.ac.uk/PROSPERO/view/CRD42023433078 . Results A total of 11 studies, which contain 13 references, with 2,168 participants were included. Network Meta-analysis revealed that in COPD patients, the top two TCM constitutions with higher smoking index were yang-deficiency and qi-deficiency; the top two TCM constitutions with low FEV1/FVC were yang-deficiency and qi-deficiency; the top three TCM constitutions with low FEV1%Pred were yang-deficiency, blood-stasis and qi-deficiency; the top three TCM constitutions with higher acute exacerbate numbers per year and CAT scores were yang-deficiency, blood-stasis and qi-deficiency. Conclusion The indexes of COPD patients with different TCM constitutions are varying. The indexes of yang-deficiency and qi-deficiency are always among the worst group, and other indexes differed from each other. The result can help clinicians in prevention, evaluation, treatment and rehabilitation decision-making. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42023433078 , identifier (CRD42023433078).