An
oral combination of three Chinese herbs could be as effective as
conventional medicines at alleviating asthma symptoms but without
such severe side effects, report Chinese and American researchers.
The researchers,
from the Weifang Asthma Hospital and Weifang School of Medicine
in China, and Mount Sinai School of Medicine in New York, sought
to investigate alternatives to corticosteroids, the “cornerstone”
of Western asthma treatment.
Since corticosteroids
can cause side effects, such as greater susceptibility to infections
due to immune suppression and reduced growth velocity, they said
that there is a need for additional effective treatments with fewer
side effects.
In China, traditional
medicine is part of mainstream practice, either used alone or in
conjunction with Western medications. However, little clinical research
has been carried out into traditional Chinese medicine for asthma,
say the researchers.
For the double-blind
placebo-controlled study published in the September issue of the
Journal of Allergy and Clinical Immunology (vol. 116, issue 3),
they investigated the effects of a combination of three Chinese
herbal extracts: Ling-Zhi (Ganoderma lucidum), Ku-Shen (Radix Sophora
flavescentis) and Gan-Cao (Radix Glycyrrhiza uralensis). The combination
was dubbed ASHMI - antiasthma herbal medicine intervention.
The formulation
notably excluded Ma Huang, used in many herbal asthma remedies throughout
the world, since it is a source of ephedrine. Ephedine has been
associated with adverse effects on the cardiovascular and central
nervous systems. In the United States, dietary supplements containing
more than 10mg of ephedrine alkaloids are outlawed, but the ban
does not extend to Ma Huang.
ASHMI was in fact
developed as a simplified version of a 14-herb formula known as
MSSM-002, which the same team previously found to effectively reduce
the symptoms of asthma in a mouse model. Prepared by Weifang Pharmaceutical
Manufacturing Factory, ASHMI was formulated on the basis of the
actions of the individual herbs in MSSM-002, and according to traditional
Chinese medicine formulation concepts.
The new trial involved
91 subjects with moderate to severe persistent asthma. They were
admitted to hospital for the four-week duration.
Forty-six patients
were randomly assigned to receive 12 ASHMI capsules per day, each
one containing 0.3g of dried aqueous extract. The total daily dosage
of extracts was equivalent to 20g of raw Ling-Zhi, 9g of Ku-Shen,
and 3g of Gan-Cao. Patients in this group also received placebo
tablets similar in appearance to prednisone, an oral administration
of the hormone cortisone.
The 46 patients
in the placebo group received 20mg of prednisone per day, plus placebo
capsules resembling ASHMI.
The researchers
measured participants' lung function, side effects and serum cortisol,
cytokine and igE levels before and after treatment. The effects
of prednisone and ASHMI on lung function were “slightly but
significantly greater” with prednisone. However unlike prednisone,
ASHMI was seen to have no adverse effects on adrenal function, and
had a beneficial effect on TH1 and TH2 cytokine levels.
In addition, fewer
patients receiving ASHMI experienced gastric discomfort compared
to those receiving prednisone, and the prednisone patients showed
significant weight gain after four weeks of treatment.
“Taken together,
the findings of this study show that ASHMI is effective and well-tolerated
in nonsteroid-dependent patients with moderate-severe persistent
asthma,” wrote the researchers.
They said that the
mechanisms underlying its “remarkable” effects are largely
unknown but that they are likely to be the result of synergistic
or additive effects of the complex nature of its constituents.
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