Panax ginseng for Chronic Obstructive Pulmonary Disease (COPD)
Creators: name: Shergis, Johannah
Publisher: name: RMIT University
Year: 2024

description: Chronic obstructive pulmonary disease (COPD) is characterised by shortness of breath, cough and excess sputum production. The most common conditions included in COPD are chronic bronchitis (inflammation in the airway) and emphysema (destruction of lung tissue) resulting in irreversible airflow restriction. COPD is a major cause of morbidity and mortality and predicted to be the third leading cause of death by 2030.<br><br>The causes of COPD are the long-term exposure to toxic substances and gases such as cigarette smoke, which induce an amplified inflammatory response in the lung, particularly in the small airway. Due to the irreversible nature of the condition, available treatments only provide symptomatic relief and management of exacerbations. These treatments are limited in their effectiveness and are associated with a range of adverse events.<br><br>Patients with COPD have increasingly used complementary and alternative medicines (CAM). In Australia, 17.3% or nearly one in five COPD sufferers have used some form of CAM therapy. Panax ginseng is one herb, which shows promise for a number of health conditions including COPD. However, existing Panax ginseng studies have produced inconsistent evidence on efficacy due to a range of methodological issues.<br><br>The research presented in the thesis achieved the objectives, which include: 1) search and analysis of the classical literature on Chinese herbal medicine for symptoms associated with COPD; 2) review extant systematic reviews of Panax ginseng; 3) systematically review the English and Chinese literature of Panax ginseng in randomised controlled trials (RCTs) ; 4) review the potential mechanisms of Panax ginseng on reducing inflammation and oxidative stress; and 5) design and implement an RCT that addresses the methodological short falls identified in the literature and evaluate the efficacy and safety of Panax ginseng for patients with moderate COPD.<br><br>A stepwise approach was developed to identify candidate herbal medicines for COPD through systematic reviews on classical and modern literature, and then prioritise the key herb for further investigation with respect to its efficacy, potential mechanisms of action and evaluation of its efficacy and safety through an RCT. Although there is extensive literature, methodological flaws often limit the acceptance and applicability of results. This highlights the importance of improving standards and reporting in future research. The clinical trial presented here will provide critical clinical data and build on previous RCTs and systematic reviews. Given the increasing prevalence and burden associated with COPD, particularly in the elderly, this research is timely to explore alternatives that may help patients to improve their quality of life and lung function.<br><br>This thesis applies a systematic “whole evidence” approach in investigating a herb for the management of a major health condition. There is no cure in modern medicine for COPD, and thus an investigation such as this is of significant value. This thesis revealed promising benefits of Panax ginseng for the treatment of COPD. Our multi-centre RCT will provide a conclusive answer to this well-characterised Ginseng product for the management of moderate level COPD patients.