Effects of Ninjin'yoeito on Patients with Chronic Obstructive Pulmonary Disease and Comorbid Frailty and Sarcopenia: A Preliminary Open-Label Randomized Controlled Trial

Int J Chron Obstruct Pulmon Dis. 2024 May 7:19:995-1010. doi: 10.2147/COPD.S441767. eCollection 2024.

Abstract

Purpose: To present the preliminarily findings regarding the effects of a herbal medicine, Ninjin'yoeito, on comorbid frailty and sarcopenia in patients with chronic obstructive pulmonary disease (COPD).

Patients and methods: Patients with COPD (GOLD II or higher) and fatigue were randomly assigned to Group A (n = 28; no medication for 12 weeks, followed by 12-week administration) or B (n= 25; 24-week continuous administration). Visual analog scale (VAS) symptoms of fatigue, the COPD assessment test (CAT), and the modified Medical Research Council (mMRC) Dyspnea Scale were examined. Physical indices such asknee extension leg strength and walking speed, skeletal muscle mass index (SMI), and respiratory function test were also measured.

Results: VAS fatigue scales in Group B significantly improved after 4, 8, and 12 weeks compared to those in Group A (each p<0.001, respectively). Right and left knee extension leg strength in Group B significantly improved after 12 weeks compared to that in Group A (p=0.042 and p=0.037, respectively). The 1-s walking speed for continued to increase significantly over 24 weeks in Group B (p=0.016, p<0.001, p<0.001, p=0.004, p<0.001, and p<0.001 after 4, 8, 12, 16, 20, and 24 weeks, respectively); it also significantly increased after the administration of Ninjin'yoeito in Group A. In Group B, the SMI significantly increased at 12 weeks in patients with sarcopenia (p=0.025). The CAT scores in Group B significantly improved after 12 weeks compared to those in Group A (p=0.006). The mMRC scores in Group B also significantly improved after 8 and 12 weeks compared to those in Group A (p= 0.045 and p <0.001, respectively). The changes in %FEV1.0 in Group B were significantly improved at 12 and 24 weeks (p=0.039 and p=0.036, respectively).

Conclusion: Overall, Ninjin'yoeito significantly improved patients' quality of life, physical activity, muscle mass, and possibly lung function, suggesting that Ninjin'yoeito may improve frailty and sarcopenia in patients with COPD.

Keywords: Ninjin’yoeito; clinical study; frailty; sarcopenia; therapeutic effect.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Comorbidity
  • Drugs, Chinese Herbal* / adverse effects
  • Drugs, Chinese Herbal* / therapeutic use
  • Exercise Tolerance* / drug effects
  • Fatigue / diagnosis
  • Fatigue / drug therapy
  • Fatigue / physiopathology
  • Female
  • Frail Elderly
  • Frailty* / diagnosis
  • Frailty* / epidemiology
  • Frailty* / physiopathology
  • Functional Status
  • Humans
  • Lung* / drug effects
  • Lung* / physiopathology
  • Male
  • Middle Aged
  • Muscle Strength* / drug effects
  • Pulmonary Disease, Chronic Obstructive* / complications
  • Pulmonary Disease, Chronic Obstructive* / diagnosis
  • Pulmonary Disease, Chronic Obstructive* / drug therapy
  • Pulmonary Disease, Chronic Obstructive* / physiopathology
  • Recovery of Function
  • Sarcopenia* / diagnosis
  • Sarcopenia* / drug therapy
  • Sarcopenia* / epidemiology
  • Sarcopenia* / physiopathology
  • Time Factors
  • Treatment Outcome
  • Walking Speed

Substances

  • Drugs, Chinese Herbal
  • ninjin'yoeito