Integrative concepts in asthma and allergy treatment in children: TCM

Abstract

Traditional Chinese medicine (TCM) has considered the lung to be connected to the large intestine for 2000 years. According to the principles of TCM and the theory of the Five Elements any treatment aimed at the lung, as a Yin-organ, also implicates treatment and regulation of the large intestine, as the linked Yang-organ. This interaction between lung and large intestine was recently re-detected by epidemiological studies carried out to generate hypothesis of plausible mechanisms for the increasing prevalence of asthma and atopic diseases in developed countries. The “Hygiene Hypothesis” postulates that improvements in public health, hygiene practices and smaller family sizes result in a reduced exposure to TH 1-trophic microbial stimuli from both commensals and pathogens. Observations of altered intestinal microflora in allergic children and clinical studies elucidated the role of non-pathogenic microbes of the gut and the GALT as a major factor essential for the maturation of the immune system to a nonatopic mode. A randomised, placebo-controlled pilot study of laser acupuncture and probiotics in school age children with asthma showed a beneficial clinical effect on bronchial hyperreactivity. Acupuncture treatment of patients with allergic asthma resulted in a significant decrease in Th2 cytokines IL-4, IL-6 and IL-10 serum levels. Acupuncture in allergic rhinitis leads to clinically relevant and persistent benefits. Tentatively, it appears that acupuncture and Chinese herbal medicine can be effective in allergic rhinitis and asthma, but for confirmatory evidence larger, multi-centre trials are necessary. Recently, use of paracetamol and antibiotics for common cold diseases in the first year of life and the later childhood were shown to be associated with the risk of inducing asthma, rhino-conjunctivitis and eczema. A low risk for asthma-related morbidity was also shown for ibuprofen use in febrile children. How can TCM counteract these mechanisms? Shang han lun, the oldest surviving Chinese medical text devoted to externally contracted (common) cold diseases, presents a systematized knowledge concerning the origin and development of such diseases and their treatment by highly sophisticated use of herbs combined in formulae that are skillfully modulated to deal with a vast variety of disease manifestations. Examples will be presented. Strict guidelines on diet and lifestyle are essential in TCM and will be explained.