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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.
| Allergic conditions |
Hay Fever
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
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| Eczema |
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.
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| Urticaria |
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.
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| Psoriasis |
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.
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.)
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| Atopic dermatitis |
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.
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