Research: Allergies

Allergy is a phenomenon associated with many medical conditions, including hay fever, eczema, urticaria, asthma and anaphylaxis. Treatment involves the identification of the cause of the problem and choosing from the many treatment techniques the best combination for the individual patient. Food allergies and intolerances can cause many symptoms and their identification and avoidance can have a significant impact on health. Nutrition is also important, particularly as the healing process is very demanding of micronutrients such as zinc and other minerals and vitamins. Various techniques of desensitisation can also be very helpful in managing symptoms or achieving cure. Homeopathy, in its various forms can have a part to play as well as phytotherapy (herbal medicine). For example, recent trials, published in the British Medical Journal, of the herbal remedy butterbur have shown significant benefit in hay fever.

• Hay Fever
• Allergic Asthma
• Eczema
• Urticaria
• Psoriasis
• Atopic Dermatitis
• Acne
• Anaphylaxis

Hay Fever (Acupuncture)

Hey fever is an allergy to grass pollens and is one variety of allergic rhinitis. The typical symptoms of itchy nose, sneezing and sore, runny eyes are well known. The same symptoms can also occur at times of the year when the pollen count is low and other airborne particles are present in large numbers – such as moulds, tree dander etc. A combination of Western and Chinese medicine for allergic rhinitis Although a number of methods for treating allergic rhinitis have been tried, many patients have not been satisfied with their treatment. The authors of this study evaluated the effect of a cooperative system of Oriental and Western medicine to develop a new diagnosis protocol for treating allergic rhinitis. The authors measured improvement rate and acoustic rhinometry after the allergeninduction test and performed a filter paper test as a nonspecific hypersensitivity test with 60 patients who are allergic to dust mites. They divided the patients into two groups, one of which was treated with Western medicine only and the other, which received a combination of Western and Oriental herbal medicines. According to one of their measurements, the authors observed more symptomatic improvements among the patients who received a combination of Western and Oriental medicines. In the filter paper test there was no significant difference between the two groups. Jeong, Su-Hyeon, et al. The effect of a cooperative system of Oriental and Western medicine in the treatment of allergic rhinitis. Korean Journal of Oriental Medicine 24(4):64-70. Acupuncture may help itchy eyes in hay fever sufferers (eye allergies) Ocular allergy is a common complaint of allergy sufferers, many of whom may choose to use complementary and alternative medicine in the treatment of these symptoms. In this review, the researchers assess major complementary and alternative medicine modalities including herbal therapies, acupuncture, homeopathy, alternative immunotherapy and behavior modification for evidence of their effectiveness in the treatment of ocular allergy symptoms. They found that certain herbs including Euphrasia officinalis, Petasites hybridus and Argemone mexicana have been evaluated in control studies in the treatment of ocular allergy. Honey is no more effective than placebo in the treatment of ocular allergy. Acupuncture used regularly has demonstrated some positive trends in ocular allergy sufferers. Homeopathy has shown conflicting results in the treatment of ocular allergy, while alternative forms of immunotherapy have been shown to develop immunologic tolerogenic effects in the control of the condition. Several forms of complementary and alternative medicine have been studied for their effectiveness in treatment of ocular allergy symptoms. The researchers conclude that further research is needed to assess mechanisms of action and to establish practice guidelines for using these modalities. Bielory L. and Heimall J. Review of complementary and alternative medicine in treatment of ocular allergies. Current opinion in Allergy and Clinical Immunology 3(5):395-9 Acupuncture for the treatment of childhood persistent allergic rhinitis A double-blind, randomized, placebo-controlled study was performed in order to compare acupuncture with sham acupuncture for the treatment of persistent allergic rhinitis in children. 72 children from outpatient clinics were placed in randomized groups to receive either regular acupuncture or sham acupuncture. For eight weeks, 35 patients were randomized to receive regular acupuncture and 37 patients were randomized to receive sham acupuncture. Acupuncture was performed twice per week for both groups. The outcome measures included daily rhinitis scores, symptom-free days, visual analog scale scores for immediate effects of acupuncture, daily relief medication scores, blood eosinophil counts, serum IgE levels, nasal eosinophil counts, patients' and parents' preferences for treatment modalities, and adverse effects. Both the assessing pediatricians and the patients were blinded. There were significantly lower daily rhinitis scores and more symptom-free days for the group receiving regular acupuncture, during both the treatment and the follow-up periods. The visual analog scale scores for immediate improvement after acupuncture were also significantly better for the regular acupuncture group. There was no significant difference in the following outcome measures between the regular and sham acupuncture groups: daily relief medication scores, blood eosinophil counts, serum IgE levels, and nasal eosinophil counts, except for the IgE levels before and 2 months after acupuncture in the sham acupuncture group. No severe adverse effects were encountered. Numbness, headache, and dizziness were found in both the regular and sham acupuncture groups, with no difference in incidence, and the effects were self-limiting. In conclusion, this study demonstrated that regular acupuncture was more effective than sham acupuncture in decreasing the symptom scores for persistent allergic rhinitis and increasing the symptom-free days. Also, there were no serious adverse effects in this study. A larger study is essential to confirm the safety of acupuncture for children. Ng DK, et al. Department of Paediatrics, Kwong Wah Hospital, 25 Waterloo Rd, Kowloon, SAR, Hong Kong. dkkng@ha.org.hk

Hay Fever (Herbs)

Chinese Herbs Effective for Allergic Rhinitis An Australian study has demonstrated the benefits of a Chinese herbal preparation (Biminne) in the treatment of allergic rhinitis (AR) Hay fever. In a randomised, double-blind, placebo-controlled clinical trial, 58 patients received 5 capsules of either Biminne or placebo, twice a day for 12 weeks. Outcomes were assessed by changes in symptom diaries, quality of life scores, patients' evaluations of improvement on visual analog scores, physicians' overall evaluation, and total serum immunoglobulin E levels. A statistically significant improvement was found in the symptoms of AR, whereas others exhibited a positive trend that did not reach statistical significance. Total serum immunoglobulin E was reduced after the herbal treatment. A follow-up one year after completion of the trial suggested that benefit of the treatment persisted. (Annals Allergy Asthma Immunol 2002 May;88(5):478-87). Chinese Medicine and Hayfever In a randomised blinded trial, 52 patients suffering from seasonal allergic rhinitis (hay fever) were assigned to an active treatment group or a control group. The active group received a semi-standardised acupuncture treatment, once a week, and an appropriate Chinese herbal formula, taken as a decoction three times daily for six weeks. The control group received acupuncture applied to non-points and a “non-specific herbal formula”. 85% of patients in the active group experienced improvement in the Global Assessment of Change scale compared to 40% of the control group. (Allergy. 2004 Sep;59(9):953-60).

Allergic Asthma (Herbs)

Chinese Herbs and the Treatment of Allergic Asthma An oral combination of Chinese herbs could be as effective as conventional medicines at alleviating asthma symptoms but without such severe side effects, report American and Chinese researchers. The researchers, from the world famous Mount Sinai School of Medicine in New York along with Weifang Asthma Hospital and Weifang School of Medicine in China, 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, and has been used for centuries for treating a wide range of disease, however relatively 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 Chinese herbal extracts (dubbed ASHMI - antiasthma herbal medicine intervention). The 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 ASHMI as well as 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 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.

Eczema (Acupuncture)

Eczema is an inflammatory process in the skin causing redness, itching, dryness and, in severe cases, discharge, cracking and bleeding. Some patients are born with an allergic tendency, inherited from their parents – a condition known as “atopy”. Others have specific allergies or intolerances to foods or chemicals and yet others may become sensitised to commonly used chemicals to which they are repeatedly exposed. This leads to contact dermatitis and can be caused by chemicals such as nickel in jewellery, chromium in cement or detergent in washing powder. Identification and avoidance is helpful but often impractical. Various techniques can be used to try and settle the problem.

Eczema (Herbs)

Chinese herbs for eczema A Chinese herbal formula had been found to reduce the production of inflammatory proteins linked with causing eczema. A Hong Kong team assessed the effects of the ‘Pentaherbs formulation’ (PHF, containing honeysuckle flower (jin yin hua), peppermint (bo he), peony root bark (mu dan pi), atractylodes rhizome (cang zu), and phellodendron bark (huang bai)) on immune cell cultures and patients with atopic eczema. In the in vitro study, the researchers isolated peripheral blood mononuclear cells from randomly chosen transfusion blood samples. Cell cultures were then exposed to PHF and the effects on cell growth and production of inflammatory mediators were analysed. PHF reduced production of four inflammatory mediators: brain-derived neurotrophic factor (BDNF), interferon (IFN)-gamma, tumour necrosis factor (TNF)-alpha and thymus and activation-regulated chemokine (TARC), following stimulation of the cells with microbial toxins. In the second part of the experiment, 28 Chinese patients (5-21 years old) with moderate to severe eczema were treated with PHF for three months. Most continued to take steroid medication. Blood samples were taken at the beginning and end of this period. Although there was no change in the amount of steroids used by the patients, they found that levels BDNF and TARC reduced over the three months. (In vitro and clinical immunomodulatory effects of a novel Pentaherbs concoction for atopic dermatitis. Br J Dermatol. 2008 Mar 13 [Epub ahead of print].) Treatment of severe atopic eczema with Chinese herbal medicine A report in the British Journal of Dermatology (1) reveals that Traditional Chinese Herbal Medicine has been shown to be extremely effective in the treatment of severe cases of atopic eczema. A controlled study carried out at the Department of Dermatology, Great Ormond Street Hospital for Sick Children, U.K. proves what has been know for a long time by practitioners of Chinese medicine: Chinese herbal medicine has a major role to play in treating moderate and severe cases of atopic eczema (the most common form of eczema to afflict children and adults). The researchers acknowledged that severe and widespread atopic eczema often fails to respond adequately to conventional treatments and, after observing substantial benefit in patients receiving daily decoctions of traditional Chinese medicinal plants, they decided to undertake a placebo-controlled double-blind trial. A specific prescription of Chinese herbs was specially formulated for widespread non-exudative atopic eczema. Forty seven children were randomly selected to receive the Chinese herbal formula or a placebo (medicine that has no effect on the disease) for 8 weeks, with an intervening 4-week wash-out period. Thirty-seven children completed the treatment. The response to the treatment was significantly greater than the response to placebo, and was judged by the researchers to be clinically valuable. There was no evidence of haematological, renal or hepatic toxicity in any of the children who participated in the study and the researchers predicted that there would be considerable therapeutic potential for traditional Chinese medicinal plants, not only in the treatment of eczema, but also for other skin diseases. The same researchers were so impressed with the results of the 8 week study that they went on to do a longer term investigation, analysing the results of 37 children who were suffering from severe atopic eczema. This study conducted over a one year period found that 49% of the children experienced at least 90% reduction in the severity of their eczema. These studies demonstrated that Chinese medicine is a valid therapeutic option available in the treatment of childhood and adult eczema. But until earlier this year, researchers were still unsure how or why the treatment worked. Scientists at the Department of Immunology, UCL Medical School, London discovered that selected Chinese herbs have a significant effect on the production of white blood cells and thereby affect the immune system, reducing allergic responses and alleviating inflammation. 1.British Journal of Dermatology (1992) 126 179-184 2.The Lancet Vol 340: July, 1992. A new study demonstrates the effectiveness and safety of herbs in eczema It is reported in an article published in the August, 2007 issue of the British Journal of Dermatology, that doctors at the Chinese University of Hong Kong conducted a double blind placebo controlled trial to established whether Chinese medicine has a beneficial effect in treating atopic eczema. Between February 2004 and July 2005, 85 children suffering with moderate to severe forms of this common childhood eczema where recruited for the trial. 42 children were given a mixture of five traditional Chinese herbs, which have long been used to treat eczema. According to Chinese medicine these herbs, when combined in exact proportions have the effect of “clearing heat, draining dampness and resolving fire toxin” (a metaphorical but precise description for reducing inflammation, alleviating itching and controlling allergic response). The herbs where administered twice daily for 12 weeks. To ascertain their effectiveness, the remaining 43 children were given placebos (ingredients that have no medicinal effect, but are used as a control to establish if the active herbs do indeed make a difference) for the same duration of time. Despite the shortcomings of the trial (according to Chinese medicine typically a specific and varied group of herbs are prescribed individually to suit the characteristics of each patient, rather than one fixed formula that is used for all cases), by the end of the study, the conditions of the children who were given the herbs "significantly improved" and their use of corticosteroid creams and ointments was also "significantly reduced by one third". "Adverse events, tolerability, haematological and biochemical parameters were monitored during the study, and no serious adverse effects were observed between the groups".

Urticaria (Acupuncture)

Urticaria is a skin rash which is triggered by an allergen, often food, chemical or drug. It manifests as, often widespread, itching “wheals”, like a nettle rash, which are red and white, raised in the centre and can occur without warning. Some trigger factors are known, such as the chemical salicylate which is found in aspirin and many foods, but often the cause is unknown and therefore hard to manage. Asthma - this is an inflammatory condition of the lungs, often triggered by allergy or intolerance. Symptoms can range from mild, such as an irritating cough, up to severe wheezing with a productive cough and shortness of breath requiring hospitalisation. It is treated in conventional medicine using the “step-wise” approach and involves the use of “reliever” inhalers, “preventer” inhalers and various chemical blockers which are designed to block chemicals such as histamine and cytokines which are produced as part of the allergic reaction. “Preventer” inhalers tend to be steroid-based, although Sodium Cromoglycate can be used in mild cases. Oral steroids are also used in severe asthma. They can certainly be life-saving in acute situations but tend to cause side-effects if used over a long period of time.

Urticaria (Herbs)

Coming soon...

Psoriasis (Acupuncture)

Acupuncture treatment for psoriasis: a retrospective case report Abstract: We treated 61 cases of psoriasis with acupuncture, including 25 patients with complications of joint involvement and two cases with scleroderma additionally. All of the patients had failed to respond to their prior conventional western medical management. 25 patients were males and 36 were females. Their ages ranged from 22 to 84 years, with an average of about 52 years. There was no significant difference of the average ages between the sexes. Most of them (about 61%) had quite extensive involvement of the body. The average of duration of their illness was over 16 years, ranging from two to 65 years. br /> They received an average of about nine sessions of acupuncture treatment, ranging from one to 15. Almost one third (19) of them had eleven to thirteen sessions. With the acupuncture treatment, about one-half (30) of the 61 patients had complete or almost complete clearance of the skin lesions. About a quarter (14 patients) of them had a clearance of about two thirds of the skin lesions. Eight of them had a clearance of one third of the skin lesions. Nine patients had minimal or no improvement. Our experience indicates that acupuncture is an effective therapeutic modality for psoriasis, particularly when the western medical management is unsuccessful. We speculated about the possible involvement of the cutaneous reticuloendothelial system in the clearance of the skin lesions. By Liao SJ; Liao TA.  Chinese Reports on the Treatment of Various Dermatological Conditions Acupuncture and Electro-Therapeutics Research, 1992 Jul-Sep, 17(3):195-208. (UI: 93034519) AT: UCLA siomed wl AC999T (PE title: Acupuncture & electro-therapeutics research).

Psoriasis (Herbs)

Psoriasis and Chinese herbal medicine A clinical trial at the famous Beijing Guan Anmen hospital, Department of Dermatology by professor Zhu Renkang enrolled 108 patients with widespread plaque psoriasis to investigate the efficacy of Chinese herbal medicine in treating this stubborn disease. The patient group were assigned to one of two groups - either “Hot blood type”, or “Dry blood type” of psoriasis (in accordance to principles of Chinese medicine where the morphology of the lesions and other symptoms and signs, including the appearance of the tongue, is taken into account). The administration of Chinese herbs continued for up to 24 weeks (average was 18 weeks). The following results were recorded: “Hot blood” group (54 patients) 72.2% had total clearing of skin; 11.1% had significant improvement (over 80% improvement); 11.1% had some improvement (between 30-80% improvement); 3% had no change. “Dry blood” group (54 patients) 59.2% had total clearing of skin; 16.7% had significant improvement (over 80% improvement); 18.5% had some improvement (between 30-80% improvement); 6% had no change. The patients from both groups who had total clearing were followed up for 12-32 months and assessed for the condition of their skin. 63.6% remained stable, 5% had mild relapse, whilst 25% had total relapse. (Reported in the Zhongyi Zazhi (The Journal of Traditional Chinese medicine) 1981. 4. P22-24 Author Zhuren Kang).

Atopic Dermatitis (Acupuncture)

Efficacy and tolerability of a Chinese herbal medicine concoction for treatment of atopic dermatitis: a randomized, double-blind, placebo-controlled study Background: There has been considerable interest in traditional Chinese herbal medicine (TCHM) as a treatment for atopic dermatitis (AD). A twice-daily concoction of an ancestral formula containing five herbs has been found to be beneficial in an open study. Objectives: To assess the efficacy and tolerability of the concoction in children with AD. Methods Following a 2-week run-in period, children with long-standing moderate-to-severe AD were randomized to receive a 12-week treatment with twice-daily dosing of three capsules of either TCHM or placebo. The SCORing of Atopic Dermatitis (SCORAD) score, Children’s Dermatology Life Quality Index (CDLQI), allergic rhinitis score, and requirement for topical corticosteroid and oral antihistamine were assessed before and at weeks 4, 8, 12 and 16 after treatment. Adverse events, tolerability, haematological and biochemical parameters were monitored during the study. Results: Eighty-five children with AD were recruited. Over 12 weeks, the mean SCORAD score fell from 58·3 to 49·7 in the TCHM group (n = 42; P = 0·003) and from 56·9 to 46·9 in the placebo group (n = 43; P = 0·001). However, there was no significant difference in the scores at the corresponding time points between the two groups. The CDLQI in TCHM-treated patients was significantly improved compared with patients receiving placebo at the end of the 3-month treatment and 4 weeks after stopping therapy (P = 0·008 and 0·059, respectively). The total amount of topical corticosteroid used was also significantly reduced by one-third in the TCHM group (P = 0·024). No serious adverse effects were observed between the groups. Conclusions: The TCHM concoction is efficacious in improving quality of life and reducing topical corticosteroid use in children with moderate-to-severe AD. The formulation was palatable and well tolerated. Dr Kam-Lun Ellis Hon. E-mail: ehon@cuhk.edu.hk; ehon@hotmail.com The study was registered with the Clinical Trial Registration, Centre for Clinical Trial, Chinese University of Hong Kong [trial number CUHK_CCT00084; http://137.189.150.15/registry/publictriallist.php (accessed 9 March 2007)]. Chinese medicine may offer relief for skin disorders Acupuncture is an old therapeutic method that includes both needle and nonneedle acupuncture. Nonneedle acupuncture includes moxibustion, cupping, and acupressure. In the field of dermatology, acupuncture has been reported to be beneficial for the treatment of acne, postherpetic neuralgia, psoriasis, atopic dermatitis, and urticaria. In acupuncture treatment of dermal diseases, both the filiform needle and the cutaneous needle are powerful tools. In the treatment of refractory dermal diseases, cutaneous needle acupuncture is usually followed by cupping to intensify the therapeutic effect. In cases where needle acupuncture is not possible, acupuncture-like transcutaneous electrical nerve stimulation (TENS) is a good alternative. In addition, reflex therapy based on foot reflex areas may also be an alternative. A lack of controlled studies is the main drawback for the methods mentioned above. However, the experiences from experts in this field may offer us new ideas to resolve refractory disorders in dermatology. Chen, C.J. and Yu, H.S. Acupuncture, electrostimulation, and reflex therapy in dermatology. Dermatologic therapy 16(2):87-92.

Acne (Herbs)

Chinese herbal medicine in the treatment of 58 cases of acne 58 patients with acne (15 men, and 43 women with age ranging between 16 - 38, average age being 27) were all given a standard water decoction based on the Chinese herbal formula Qing fei yi rou tang, but adjusted according to the morphology of the lesions and the constitution of the patient. Results: After a variable time of treatment ranging from 2-6 months the following results were recorded. 46 cases were classified as clinically cured (all papules, pustules, nodules and cysts cleared, with no reoccurrence). 10 cases were classified as improved (reduction in all lesions, but mild reoccurrence on stopping the herbs) 2 cases no change. (Xinzhongyi. New Journal of Chinese medicine 2001.4 – 33-4 Author: Zhouxin zhong)

Anaphylaxis (Herbs)

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