Tuesday, 26 November 2013

Asthma (Respiratory Disease) Treatments In traditional Chinese medicine perspective

Respiratory Disease is defined as medical conditions which affect the breathing organ and tissues including Inflammatory lung disease, Obstructive lung diseases, Restrictive lung diseases, Respiratory tract infections, trachea, bronchi, bronchioles, alveoli, the nerves and  muscles breathing , etc,.
I. Asthma 
Asthma is a chronic inflammatory disease affecting the air way of the lung with recurring symptoms, such as wheezing, chest tightness, shortness of breath, and coughing. The disease affects people of all ages, and mostly starts during childhood. In the study of 463,801 children aged 13-14 years in 155 collaborating centres in 56 countries. Children self-reported, through one-page questionnaires, symptoms of these three atopic disorders. In 99 centres in 42 countries, a video asthma questionnaire was also used for 304,796 children, found that for asthma symptoms, the highest 12-month prevalences were from centres in the UK, Australia, New Zealand, and Republic of Ireland, followed by most centres in North, Central, and South America; the lowest prevalences were from centres in several Eastern European countries, Indonesia, Greece, China, Taiwan, Uzbekistan, India, and Ethiopia(1). In the United States, approximately, asthma affects 25 million people, 7 million of them are children.
F. Treatments
F.3. In traditional Chinese medicine perspective
F.3.1. Differentiation
Traditional Chinese medicine defined asthma is a condtion as a result of invasion of
1.  Wind and cold pathogens with symptoms of shortness of breath and chest distress exacerbated by attack of cold, chills, fever, running nose, pink tongue with white and slippery coating, and floating and slow pulse.
2. Wind and hot pathogens with symptoms of chest distress, yellow and sticky sputum difficult to spit out, thirst, red tongue with yellow and greasy coating, and rolling and rapid pulse.
3. Lung deficiency with symptoms of shortness of breath, low and weak coughing, dry mouth, red tongue, and thready and weak pulse.
F.3.2. Chinese herbal formulas
In the review of 5 clinical studies of antiasthma TCM herbal remedies published between 2005 and 2007 and the summarization of possible mechanisms underlying their effects on the basis of data in the original articles, published abstracts, and available databases, possible mechanisms include anti-inflammation, inhibition of airway smooth muscle contraction, and immunomodulation, found that Evidence from clinical studies supports beneficial effects of TCM herbal therapy on asthma. A number of mechanisms may be responsible for efficacy of these agents. Strong preclinical study data suggest potential efficacy of FAHF-2 for food allergy(85).
1. Invigorating Kidney herbs
In the study of 35 cases of asthmatics in the convalescent stage  given the Chinese herbal decoction of chiefly invigorating Kidney (Viscum coloratum 15g, Psoralea corylifolia 15g, Eucommia ulmoides 15g, Lycium chinense 9g, Tussilago farfara 15g, Artemisia capillaris 9g, and Pogostemon cablin 9g as daily dosage) for treatment of 10 weeks and measuring MEFV curves to observe their changes before and after treatment, showed that different parameters of MEFV was improved in some extent which suggested that the airway obstruction of asthmatics in the convalescent stage was reversible(86).
2. Radix Glycyrrhizaem, Radix Sophorae Flavescentis, Ganoderma
In the study to investigate the efficacy and tolerability of an anti-asthma herbal medicine intervention (ASHMI, which contains 3 herbs (Radix Glycyrrhizaem, Radix Sophorae Flavescentis, Ganoderma) in Moderate-to-severe persistent asthma, showed that treatment was administered daily over 4 weeks. This study found that following treatment, lung function (FEV1 and peak expiratory flow values) was significantly improved in both ASHMI (64.9± 6 3.6 to 84.2± 6 5.0; P < 0.001) and prednisone (65.2± 6 3.7 to 88.4 ± 6 8.0; P < 0 .001) groups. No significant side effects were observed in either group. All hematological, electrocardiographic and liver and kidney function test results were normal in both groups(87).
3. Modified Mai Men Dong Tang (mMMDT)
In the study to evaluate to evaluate the efficacy and safety of a Chinese herbal formula modified Mai-Men-Dong-Tang (mMMDT) for treatment of persistent, mild-to-moderate asthma, researchers at the China Medical University Hospital found that the Chinese herbal formula mMMDT provided improvements in lung function and relieved asthma symptoms in our sample of patients. Given its efficacy and safety, we consider mMMDT a credible treatment regimen for persistent, mild-to-moderate asthma(88).
4. Ding Chuan Tang (DCT)
In the randomized, double blind, placebo-controlled clinical trial to assess the effect of Ding Chuan Tang (DCT) in airway hyper-responsiveness (AHR) on asthmatic children, indicated that The AHR, symptom and medication scores in children with persistent asthma were significantly improved with DCT treat for 12 wk. The results suggested more stable airways achieved with such an add-on complementary therapy(89).
5. Sophora flavescens Ait 
In the study of the impact of a herbal extract with excitatory modulator activity in the management of asthma was studied. An open and selective 3-year follow-up of 14 chronic refractory asthmatics aged between 22 and 7, showed that the quality of life, clinical symptoms and respiratory function improved during all periods of measurement. The use of inhaled corticosteroid and beta-agonists were reduced or eliminated. There were no significant adverse reactions reported. Therefore the extract of S. flavescens as an excitatory modulator appears to be a safe and may be an effective alternative treatment for refractory chronic asthma(90).
F.3.3. Acupuncture
The study observed efficacy differences of acupuncture at “Zusanli” (ST 36) in rats with asthma and asthma with spleen-deficency, so as to investigate the therapeutic mechanism, conducted by College of Acupuncture-Moxibustion and Massage, Liaoning University of TCM, showed that acupuncture at “Zusanli” (ST 36) can regulate the disorders of Fas mRNA and Bcl-2 mRNA expression in the state of both asthma and asthma with spleen-deficency, promote EOS apoptosis so as to inhibit the development of inflammatory reaction of asthma(91).
F3.4. Simple acupoint catgut embedding
showed that the improvement of the simple acupoint catgut embedding at “Feishu” (BL 13), “Danzhong” (CV 17)and “Shenshu” (BL 23) on the airway inflammation in asthmatic rats is better than that of catgut embedding at “Feishu” (BL 13) and “Danzhong” (CV 17) or at “Shenshu” (BL 23) only(92).
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(1) http://www.ncbi.nlm.nih.gov/pubmed/9643741
(85) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2748395/
(86) http://www.ncbi.nlm.nih.gov/pubmed/2611953
(87) http://www.ncbi.nlm.nih.gov/pubmed/16159618
(88) http://www.ncbi.nlm.nih.gov/pubmed/15693916
(89) http://www.ncbi.nlm.nih.gov/pubmed/16846448
(90) http://www.ncbi.nlm.nih.gov/pubmed/17295384
(91) http://www.ncbi.nlm.nih.gov/pubmed/23072095
(92) http://www.ncbi.nlm.nih.gov/pubmed/22997795

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