Chinese herbal medicine for the treatment of allergic diseases
- Xiu-Min Li, MD
Xiu-Min Li, MD
- Professor of Pediatrics and Immunobiology
- Mount Sinai School of Medicine
Traditional Chinese medicine (TCM) includes herbal therapy, acupuncture, massage, and dietary therapy. These practices originated in China and have been used in East Asia for centuries as a part of mainstream medical care. TCM is beginning to play a role in Western healthcare as a complementary and alternative medicine (CAM).
This topic will discuss Chinese herbal therapy for asthma, atopic dermatitis (AD), and food allergy. These therapies are considered experimental from the standpoint of conventional medicine. Overviews of herbal medicine and use of CAM in pediatrics are presented separately. Acupuncture for the treatment of asthma and allergic rhinitis is also discussed separately. (See "Overview of herbal medicine and dietary supplements" and "Overview of complementary and alternative medicine in pediatrics" and "Pharmacotherapy of allergic rhinitis", section on 'Adjunctive and other therapies' and "Complementary, alternative, and integrative therapies for asthma", section on 'Acupuncture'.)
The prevalence of allergic disorders such as asthma, atopic dermatitis (AD), and food allergy has increased dramatically in industrialized countries over the past several decades. Atopic diseases are a serious public health problem, particularly in children. Conventional therapies, such as glucocorticoids, are widely used in controlling asthma and AD. However, these therapies are not completely effective in all patients, and there are concerns about side effects, especially in children. In addition, there is no curative treatment for food allergy, just rescue treatment of reactions. These and other issues have led patients and their families to seek complementary and alternative medicine (CAM) treatments.
Traditional Chinese medicine (TCM) has a long history of use in China and other Asian countries, such as Japan and Korea. TCM has several features that differ significantly from Western medicine:
●TCM practice does not focus only on the disease or a single organ. Rather, it also focuses on establishing and maintaining the balance of yin-yang (two opposite, but complementary forces), the homeostasis of organ systems in the body, and interactions with the environment . The concepts and terminology of TCM cannot be easily translated to Western medicine.
- www.nccam.nih.gov/health/backgrounds/wholemed.htm (Accessed on February 11, 2010).
- Radix glycyrrhizae. In: WHO monographs on selected medicinal plants, Vol. 1, World Health Organization, Geneva 1999. p.183.
- The State Pharmacopoeia Commission of The People's Republic of, China. Pharmacopoeia of the People's Republic of China, 6th ed, People's Medical Publishing House, Beijing 2005.
- Bensky D, Barolet R. Chinese herbal medicine: Formulas and strategies, Eastland Press, Seattle 1990.
- Li XM, Brown L. Efficacy and mechanisms of action of traditional Chinese medicines for treating asthma and allergy. J Allergy Clin Immunol 2009; 123:297.
- Kelly-Pieper K, Patil SP, Busse P, et al. Safety and tolerability of an antiasthma herbal Formula (ASHMI) in adult subjects with asthma: a randomized, double-blinded, placebo-controlled, dose-escalation phase I study. J Altern Complement Med 2009; 15:735.
- Zhang T, Srivastava K, Wen MC, et al. Pharmacology and immunological actions of a herbal medicine ASHMI on allergic asthma. Phytother Res 2010; 24:1047.
- Bielory L, Lupoli K. Herbal interventions in asthma and allergy. J Asthma 1999; 36:1.
- Li XM. Traditional Chinese herbal remedies for asthma and food allergy. J Allergy Clin Immunol 2007; 120:25.
- Hsu CH, Lu CM, Chang TT. Efficacy and safety of modified Mai-Men-Dong-Tang for treatment of allergic asthma. Pediatr Allergy Immunol 2005; 16:76.
- Chan CK, Kuo ML, Shen JJ, et al. Ding Chuan Tang, a Chinese herb decoction, could improve airway hyper-responsiveness in stabilized asthmatic children: a randomized, double-blind clinical trial. Pediatr Allergy Immunol 2006; 17:316.
- Chang TT, Huang CC, Hsu CH. Clinical evaluation of the Chinese herbal medicine formula STA-1 in the treatment of allergic asthma. Phytother Res 2006; 20:342.
- Wen MC, Wei CH, Hu ZQ, et al. Efficacy and tolerability of anti-asthma herbal medicine intervention in adult patients with moderate-severe allergic asthma. J Allergy Clin Immunol 2005; 116:517.
- Li XM. Complementary and alternative medicine in pediatric allergic disorders. Curr Opin Allergy Clin Immunol 2009; 9:161.
- Srivastava K, Zhang T, Yang N, et al. Anti-Asthma Simplified Herbal Medicine Intervention-induced long-lasting tolerance to allergen exposure in an asthma model is interferon-γ, but not transforming growth factor-β dependent. Clin Exp Allergy 2010; 40:1678.
- Sorkness CA, LaForce C, Storms W, et al. Effects of the inhaled corticosteroids fluticasone propionate, triamcinolone acetonide, and flunisolide and oral prednisone on the hypothalamic-pituitary-adrenal axis in adult patients with asthma. Clin Ther 1999; 21:353.
- Zora JA, Zimmerman D, Carey TL, et al. Hypothalamic-pituitary-adrenal axis suppression after short-term, high-dose glucocorticoid therapy in children with asthma. J Allergy Clin Immunol 1986; 77:9.
- Peirce A. The American pharmaceutical association practical guide to natural medicines, William Morrow and Company, New York 1999.
- Busse PJ, Wen MC, Huang CK, et al. Therapeutic effects of the Chinese herbal formula, MSSM-003d, on persistent airway hyperreactivity and airway remodeling. J Allergy Clin Immunol 2004; 113:S220 (Abstract).
- Busse PJ, Schofield B, Birmingham N, et al. The traditional Chinese herbal formula ASHMI inhibits allergic lung inflammation in antigen-sensitized and antigen-challenged aged mice. Ann Allergy Asthma Immunol 2010; 104:236.
- Jayaprakasam B, Doddaga S, Wang R, et al. Licorice flavonoids inhibit eotaxin-1 secretion by human fetal lung fibroblasts in vitro. J Agric Food Chem 2009; 57:820.
- Slotkin W, Lopez-Exposito I, Jones M, et al. Investigation of the individual herbs in ASHMI (Anti-Asthma Herbal Medicine Intervention) that is most responsible for reducing IgE secretion. J Allergy Clin Immunol 2009; 123:S192 (Abstract).
- Xue CC, Hügel HM, Li CG, Story DF. Efficacy, chemistry and pharmacology of chinese herbal medicine for allergic rhinitis. Curr Med Chem 2004; 11:1403.
- Wang S, Tang Q, Qian W, Fan Y. Meta-analysis of clinical trials on traditional Chinese herbal medicine for treatment of persistent allergic rhinitis. Allergy 2012; 67:583.
- Hu G, Walls RS, Bass D, et al. The Chinese herbal formulation biminne in management of perennial allergic rhinitis: a randomized, double-blind, placebo-controlled, 12-week clinical trial. Ann Allergy Asthma Immunol 2002; 88:478.
- Li XM, Zhang TF, Huang CK, et al. Food Allergy Herbal Formula-1 (FAHF-1) blocks peanut-induced anaphylaxis in a murine model. J Allergy Clin Immunol 2001; 108:639.
- Srivastava KD, Kattan JD, Zou ZM, et al. The Chinese herbal medicine formula FAHF-2 completely blocks anaphylactic reactions in a murine model of peanut allergy. J Allergy Clin Immunol 2005; 115:171.
- Qu C, Srivastava K, Ko J, et al. Induction of tolerance after establishment of peanut allergy by the food allergy herbal formula-2 is associated with up-regulation of interferon-gamma. Clin Exp Allergy 2007; 37:846.
- Srivastava KD, Qu C, Zhang T, et al. Food Allergy Herbal Formula-2 silences peanut-induced anaphylaxis for a prolonged posttreatment period via IFN-gamma-producing CD8+ T cells. J Allergy Clin Immunol 2009; 123:443.
- Simpson AB, Glutting J, Yousef E. Food allergy and asthma morbidity in children. Pediatr Pulmonol 2007; 42:489.
- Srivastava K, Sampson HA, Li XM. The traditional Chinese medicine formula FAHF-2 provides complete protection from anaphylaxis in a murine model of multiple food allergy. J Allergy Clin Immunol 2009; 123:S151 (Abstract).
- Song Y, Qu C, Srivastava K, et al. Food allergy herbal formula 2 protection against peanut anaphylactic reaction is via inhibition of mast cells and basophils. J Allergy Clin Immunol 2010; 126:1208.
- Wang J, Patil SP, Yang N, et al. Safety, tolerability, and immunologic effects of a food allergy herbal formula in food allergic individuals: a randomized, double-blinded, placebo-controlled, dose escalation, phase 1 study. Ann Allergy Asthma Immunol 2010; 105:75.
- Patil SP, Wang J, Song Y, et al. Clinical safety of Food Allergy Herbal Formula-2 (FAHF-2) and inhibitory effect on basophils from patients with food allergy: Extended phase I study. J Allergy Clin Immunol 2011; 128:1259.
- Gu S, Yang AW, Xue CC, et al. Chinese herbal medicine for atopic eczema. Cochrane Database Syst Rev 2013; :CD008642.
- Zhang W, Leonard T, Bath-Hextall F, et al. Chinese herbal medicine for atopic eczema. Cochrane Database Syst Rev 2005; :CD002291.
- Hon KL, Leung TF, Ng PC, et al. Efficacy and tolerability of a Chinese herbal medicine concoction for treatment of atopic dermatitis: a randomized, double-blind, placebo-controlled study. Br J Dermatol 2007; 157:357.
- Leung TF, Wong KY, Wong CK, et al. In vitro and clinical immunomodulatory effects of a novel Pentaherbs concoction for atopic dermatitis. Br J Dermatol 2008; 158:1216.
- Chan BC, Hon KL, Leung PC, et al. Traditional Chinese medicine for atopic eczema: PentaHerbs formula suppresses inflammatory mediators release from mast cells. J Ethnopharmacol 2008; 120:85.
- Cheng H-M, Chiang L-C, Jan Y-M, et al. The efficacy and safety of a Chinese herbal product (Xiao-Feng-San) for the treatment of refractory atopic dermatitis: a randomized, double-blind, placebo-controlled trial. Int Arch Allergy Immunol 2011; 155:141.
- Wisniewski J, Oh M, Nowak-Wegrzyn A, et al. Efficacy and safety of traditional Chinese medicine for treatment of atopic dermatitis (AD). J Allergy Clin Immunol 2009; 123:S37 (Abstract).
- Salameh F, Perla D, Solomon M, et al. The effectiveness of combined Chinese herbal medicine and acupuncture in the treatment of atopic dermatitis. J Altern Complement Med 2008; 14:1043.
- THERAPY FOR ASTHMA
- Antiasthma herbal medicine intervention (ASHMI) formula
- - Indications for use
- - Clinical response
- - Immunologic response
- - Enhanced adrenal function
- - Possible mechanisms of action
- - Side effects and interactions
- Modified Mai Men Dong Tang (mMMDT) formula
- STA-1 formula
- Ding Chuan Tang (DCT) formula
- THERAPY FOR ALLERGIC RHINITIS AND CONJUNCTIVITIS
- THERAPY FOR FOOD ALLERGY
- Food allergy herbal formula-2 (FAHF-2)
- - Indications for use
- - Response
- - Mechanisms of action
- - Side effects and interactions
- THERAPY FOR ATOPIC DERMATITIS