CAM and respiratory disease

Use of Complementary and Alternative Medicine in Pediatric Respiratory Diseases

In this study, our purpose was to determine prevalence of complementary and alternative medicine (CAM) in pediatric respiratory diseases and methods of CAM use accordingly. Each of the CAM treatment has a special risk/benefit combination and it is absolutely crucial for health care professionals to question those methods.

Chinese patent medicine for chronic obstructive pulmonary disease based on principles of tonifying Qi, promoting blood circulation by removing blood stasis, and resolving phlegm: a systematic review of randomized controlled trials

OBJECTIVE

To assess the efficacy and safety of Chinese patent medicine (CPM) with the principle of tonifying Qi, promoting blood circulation by removing blood stasis, and resolving phlegm (TQ-PBC-RP) in the management of stable chronic obstructive pulmonary disease (COPD).

METHODS

A systematic review of randomized controlled trials (RCTs) identified from electronic databases and print was conducted. RCTs testing CPMs with TQ-PBC-RP against any type of controlled intervention in patients with stable COPD and assessing clinically relevant outcomes were included. Methodological quality was evaluated with the risk of bias tool according to systematic review handbook 5.0.2. Quality of evidence was estimated by the rating approach developed by the Grading of Recommendations, Assessment, Development, and Evaluation Working Group.

RESULTS

Thirteen eligible RCTs with 12 oral CPMs were tested. Significant differences between groups in favor of CPMs were not reported in all trials. Most trials included were deemed to be of low methodological quality with poor evidence quality. Because of large data heterogeneity, statistical pooling was not performed for all outcomes.

CONCLUSION

The effectiveness of CPM in the treatment of stable COPD is not supported by evidence. Currently, evidence from RCTs is scarce and methodologically weak. Considering the popularity of CPMs among patients undergoing COPD, rigorously designed trials are warranted.

Adjunctive treatment with oral AKL1, a botanical nutraceutical, in chronic obstructive pulmonary disease

Purpose

The objective of this pilot trial was to evaluate the safety and efficacy of AKL1, a patented botanical formulation containing extracts of Picrorhiza kurroa, Ginkgo biloba, and Zingiber officinale, as add-on therapy for patients with chronic obstructive pulmonary disease (COPD) and chronic cough.

Patients and methods

This randomized, double-blind, placebo-controlled trial enrolled male and female patients >18 years old with COPD and Leicester Cough Questionnaire (LCQ) score of <18. The 10-week study period comprised a 2-week single-blind placebo run-in period followed by add-on treatment with AKL1 or placebo twice daily for 8 weeks. The primary study endpoint was the change from week 0 to week 8 in cough-related health status, as assessed by the LCQ.

Results

Of 33 patients enrolled, 20 were randomized to AKL1 and 13 to placebo. Patients included 19 (58%) men and 14 (42%) women of mean (standard deviation [SD]) age of 67 (9.4) years; 15 (45%) patients were smokers and 16 (49%) were ex-smokers. The mean (SD) change from baseline in LCQ score at 8 weeks was 2.3 (4.9) in the AKL1 group and 0.6 (3.7) in the placebo group, with mean difference in change of 1.8 (95% confidence interval: −1.5 to 5.1; P=0.28). The St George’s Respiratory Questionnaire score improved substantially in the AKL1 treatment group by a mean (SD) of −7.7 (11.7) versus worsening in the placebo group (+1.5 [9.3]), with mean difference in change of −9.2 (95% confidence interval: −19.0 to 0.6; P=0.064). There were no significant differences between treatment groups in change from baseline to week 8 in other patient-reported measures, lung function, or the 6-minute walk distance.

Conclusion

Further study is needed with a larger patient population and over a longer duration to better assess the effects of add-on therapy with AKL1 in COPD.

Traditional plant-based therapies for respiratory diseases found in North Jeolla Province, Korea

OBJECTIVES

This study aims to record and conserve orally transmitted traditional plant-based therapies for respiratory diseases in North Jeolla Province, Korea.

METHODS

Data were collected with semistructured questionnaires through the participatory rural appraisal method.

RESULTS

This study reveals that overall, 14 respiratory diseases have been treated with a total of 43 species of medicinal plants belonging to 40 genera in 26 families. This study also reports 149 different modes of plant-based therapeutic application of medicinal material. The informant consensus factor for the common cold is 0.84, the highest among 14 different respiratory ailments, followed by whooping cough, asthma, nosebleed, bronchitis, cough, and so on. Medicinal plants used to treat seven respiratory ailments had a 100% fidelity level.

CONCLUSIONS

This study can help to preserve the traditional knowledge and local health traditions of North Jeolla Province amid rapid industrialization and urbanization. The findings of this study warrant follow-up clinical research to determine the most effective traditional remedies toward development of herbal medicinal products for integration into the Korean health care system.

Alternative and complementary treatment for food allergy

Despite increased consumer interest in complementary and alternative medicine (CAM) for the treatment of food allergy, there remains a relative paucity of knowledge regarding the clinical efficacy, mechanisms of action, and safety of most CAM treatments available to consumers. This article focuses on recent advances in CAM for food allergy, including acupuncture, herbal medicine, probiotics, and alternative approaches to allergen immunotherapy. The mechanism of action of several novel approaches to treatment of food allergy is reviewed, but FAHF-2 is the only investigational herbal formulation currently validated for use in human clinical trials.