EVALUATION OF EFFICACY OF TRADITIONAL CHINESE MEDICINES IN THE TREATMENT OF CHILDHOOD BRONCHIAL-ASTHMA - CLINICAL-TRIAL, IMMUNOLOGICAL TESTS AND ANIMAL STUDY

Traditional Chinese medicines (TCM) have been used to treat bronchial asthma for several centuries and a certain degree of clinical benefit has been observed; however, scientific substantiation is lacking, A mu lticenter, double-blind and placebo-controlled study was therefore con ducted to evaluate the clinical efficacy in terms of symptom score, me dication score, morning and evening PEFRs, and changes of immunoregula tory function, such as distribution of lymphocyte subsets and in vivo and in vitro production of lymphokines (IFN-gamma and IL-4) and inflam matory mediators (histamine, PGE2 and LTC4), Furthermore, the protecti ve effect of TCM on the late asthmatic reaction (LAR) was evaluated by using asthmatic guinea pigs, Three hundred and three asthmatic childr en were classified by Chinese doctors, according to a standardized que stionnaire designed on the basis of basic logic of Chinese medicine, i nto three groups of specific constitution (group A, B and C). Group A consisted of 32 herb A-treated patients and 34 placebo-treated; group B, 74 herb B-treated and 64 placebo-treated; and group C, 55 herb C-tr eated and 44 placebo-treated. The study period was six months. The res ults were: 1) Both treatment group and placebo group showed an improve ment in all clinical parameters, thus demonstrating a placebo effect, However, the improvement was usually greater in the former than the la tter, although only the difference in PEFR was significant; 2) Herb A could increase total T cell and decrease B cell; 3) Herb A and B enhan ced production of PGE2 but not LTC4, IFN-gamma and IL-4; 4) There was a general tendency for in vivo and in vitro production of histamine to decrease at the end of study in both treatment group and placebo grou p; however, the decrease was significantly greater in the former than the latter; 5) In asthmatic guinea pigs, 10-day's pretreatment with Ch inese herbs could reverse the decrease of sGaw, suppress eosinophilia in bronchoalveolar lavage fluid (BALF), prevent the eosinophil infiltr ation of airways, increase PGE2 production and decrease LTC4 productio n in serum and BALF Thus, traditional Chinese medicines did show a cer tain degree of clinical efficacy. The decreased production of histamin e and LTC4, increased production of PGE2 that were found in both asthm atic children and asthmatic guinea pigs, and prevention of occurrence of LAR by suppressing eosinophil infiltration of airways and preservin g ah-way conductance that were observed in asthmatic guinea pigs after allergen challenge might be used to account partly for the effectiven ess.