Chinese Medicine: Advances in Treatment of Allergic AsthmaAdina Stanescu, R.TCMP June 1, 2010
Allergic asthma is one of the unfortunate health consequences of industrial development and the pollution it brings. Three hundred million people have it, worldwide. Incidence of allergic asthma in North America has increased 75% in the last two decades, and continues to escalate. The U.K. has one of the highest rates of allergic asthma, with roughly 20% of six- to seven-year-olds burdened by this condition. And it is indeed children who are the most affected by allergic asthma, a disease that was previously the domain of the old and feeble.
As with its sister conditions of hayfever, nut allergies, and eczema, allergic asthma is a condition of hyper-immunity and inflammation. To understand what happens, we need to look at the normal immune response to an invader, for example a common cold virus. As the virus is inhaled and attaches to the mucosal lining of our breathing tubes – the bronchi – the immune system sends defenders to fight it off. The defending immune cells produce antibodies in response to the virus, and these replicate in high numbers. The airways swell and a great amount of mucus is produced to surround, envelop, and dispose of the viral invaders. The bronchi are now inflamed and slathered in thick mucus, leading to the cough, discomfort, and possible bronchitis of an upper respiratory tract infection.
In allergic asthma, the same sequence of events occurs, except it does not only occur in response to an infection or other real threat, but also in response to ordinarily benign substances such as pollen, animal dander, mould, or dust mites. The body secretes antibodies known as IgE, which mark the invading pollens or dander as a threat, and will continue to react to them forever more, setting in motion a chronic and needless inflammation, constriction, and mucus, which leads to the wheeze, cough, and breathlessness of asthma. But what if it’s not forever? Is it possible that this inappropriate allergic response, once turned on, can be turned off?
In fact, even without treatment, some children with asthma will outgrow it in adulthood, which shows allergies are not set in stone, or at least that allergies may not always continue to lead to an asthma attack. This fact alone allows for some optimism that the immune response can be nudged in the right direction with correct treatment. Additionally, the experience of Traditional Chinese Medicine (TCM), both ancient and modern, suggests that it might be possible to aid this process with herbal treatment.
NEW RESEARCH SHOWS REMARKABLE SUCCESS USING CHINESE HERBS FOR ALLERGIC ASTHMA
In the last few years, one researcher has done more than any other to bring Chinese medicine’s gifts to the fore in the West, for the treatment of allergic asthma and other allergic conditions, with stunning results. Dr. Xiu Min Li, from the Mount Sinai School of Medicine in New York, has unleashed a series of studies and reviews on the topic – the most dramatic of which showed that Chinese herbs can completely block the anaphylactic reaction in peanut allergic mice.(1)
After several weeks of treatment with the herbal combination, the mice were given peanuts and simply did not react. Their airways did not swell or constrict: the immune response was normal and uneventful. The formula includes coptis root, phellodendron, ginseng, ginger, cinnamon, and reishi mushroom – an unusual combination of cooling and tonifying ingredients that together produced a nearly magical effect.
The results have wonderful implications for asthmatics, as well – many of whom are highly allergic to nuts. The multiple levels of allergy – on the skin, in the gut, in the lungs and nose – continually reinforce each other, and interrupting this vicious circle anywhere is extremely valuable. It also shows that normalization of the immune response is possible, and opens the door to other inquiries, such as the question of whether treating an allergic mother during pregnancy might decrease the likelihood of passing on the allergic tendency, which currently shows a strong family link.
Another formula, named AHSMI, and also developed by Dr. Li, was tested specifically on asthmatics in a randomized placebo controlled study. It was unusually simple for a Chinese formula, containing only three ingredients: sophora flavescentis root, reishi mushroom, and licorice root. After several weeks of treatment, results were nearly identical to the effect of corticosteroid inhalers. And in a surprise twist, it was shown that the herbs were beneficial to adrenal function, as well.
In contrast, one of the problems of corticosteroid therapy is that it can knock out the adrenal glands and greatly decrease their production of the essential hormone cortisol, which negatively effects immunity and energy metabolism. In contrast, the herbs had a beneficial, balancing effect on the adrenal glands, while concurrently calming the immune hyperactivity. It is as if the herbs acted like smart bombs, taking out only the nefarious, excessive aspects of the immune reaction and leaving the good alone.
The authors of the study concluded that: “Anti-asthma herbal medicine intervention appears to be a safe and effective alternative medicine for treating asthma. In contrast with prednisone, AHSMI had no adverse effect on adrenal function…” The study was published in the Journal of Allergy and Clinical Immunology in 2005. (2)
The single ingredient Sophora flavescentis was also tested by itself, this time on 14 patients with severe and refractory asthma, who were concurrently administered the standard medical therapies: bronchodilators (relievers), and inhaled corticosteroids (preventers). (3) They took the sophora root extract for three years, during which time they saw their need for the Western medications decrease steadily, with measurable improvement accruing over time, such that:
• After four weeks of treatment, patients had an average of 45% reduction in their need for bronchodilators, but this became a 92% reduction at three months, a 95% reduction at one year, and finally a 97% reduction at three years.
• The inhaled corticosteroids were decreased 45% at four weeks, and then 84%, 92%, and finally 100% at three years for all patients.
CUSTOMIZED TREATMENT FOR REAL WORLD ASTHMA CASES
While these studies show tantalizing possibilities, they do apply a modified approach in order to satisfy various requirements of accepted scientific models. This approach includes reducing the number of ingredients and giving everyone in the studies the same herb(s). It is useful to remember that in a proper TCM clinic, the treatment would be individualized and often consist of a larger formula that addresses multiple symptoms and presentations.
For example, for some asthmatics, cough, not wheeze, is actually the primary symptom. In such a case, the formula would primarily use anti-cough medicines such as coltsfoot, fritillary, and aster. And once symptoms go into remission, the formula is changed completely, switching to herbs that strengthen the lungs and kidney, rather than anti-inflammatory, bronchodilating herbs. This ensures the problem will not relapse. One of the most common formulas used for this final phase of treatment is Liu Wei Di Huang Wan, a simple but potent tonic combination that has been found to improve lung function and reduce airway hyper-reactivity.
Interestingly, one study tested this combination prepared in two different ways: one was a simple powder made of the six ingredients, ground-up.(4) The other was a water extract, similar to the granulated “instant coffee” versions of Chinese herbs so popular these days. Two groups of asthmatics were treated, one with each respective version. Only the ground-up powder had a beneficial effect, showing a “statistically significant reduction of symptom scores, systemic steroid dose, and total IgE and specific IgE levels.” It also improved pulmonary lung function. Traditionally, this formula, which was first published in the ancient TCM text Key to Therapeutics of Children’s Diseases in the 1100s, was prepared as a pill, using exactly the ground-up powder that seemed to work in the asthma study. In other words, the method of preparation might be another significant variable in the already bewildering world of studying herbal medicines.
In conclusion, if you have asthma, Chinese herbal medicine is a strong option for controlling or even reversing the condition. However, any changes to Western medicines must be gradual and supervised by a medical doctor. With herbal treatment, patients usually notice a decreased need for their bronchodilators, which they regulate themselves. If this improvement holds over time, they can confidently approach their physician to discuss changes in their preventer inhalers, as well. Over time, it may well be possible to be off all medication.
(1) The Chinese herbal medicine formula FAHF-2 completely blocks anaphylactic reactions in a murine model of peanut allergy. Journal of Allergy Clin Immunology. 2005 Jan.;115(1):171-8. Srivastava et al.
(2) Efficacy and tolerability of anti-asthma herbal medicine intervention in adult patients with moderate-severe allergic asthma. Journal of Allergy Clinical Immunology. 2005;116(3):517–24. Wen et al.
(3) New approach in asthma treatment using excitatory modulator. Phytotherapy Research Journal, 2007 – Hoang et al.
(4) Clinical evaluation of the Chinese herbal medicine formula STA-1 in the treatment of allergic asthma. Phytotherapy Research Journal. 2006 May; 20(5):342-7 Chang et al.