A double-blind crossover considera...

A double-blind crossover consideration of the effects of real and placebo acupuncture onward bronchial reactivity to histamine was carried revealed on 16 patients with moderately bitter asthma. Treatment with real or placebo acupuncture failed to modulate the bronchial hyperreactivity to histamine. These originates suggest that a single treatment with acupuncture is unlikely to provide improvement in the management of acute bronchial asthma. (Chest 1989; 96:102-05)

Although acupuncture has been used for thousands of years for many diseases, reports in the literature onward beneficial effects of acupuncture upon asthma are conflicting. While a number of workers[1-3] have reported a significant benefit in the dominion government of asthma following acupuncture, almost an equal number of workers[4-6] failed to display any significant improvement in the sway of asthma following acupuncture. Experimentally, in a controll double-blind crossover inquiry Tashkin et al[7] showed that acupuncture improved methacholine-induced bronchospasm to about extent. Fung et al[8] showed that the two real and placebo acupuncture, applied 20 min before exercise, attenuated exercise-induced asthma still that the benefit from real acupuncture was greater than that produc from placebo acupuncture. Increased bronchial reactivity to inhaled histamine is undivided of the characteristic features of asthma.[9] Makino[10] showed that the flush of bronchial reactivity to histamine has a relationship to the symptoms and severity of asthma.

Although for treatment of bronchial asthma, the acupuncture is commonly given as chronic therapy, it is also given as single treatment for acute asthma.[11] We undertook a double-blind crossover inquiry in order to determine if prior treatment with acupuncture, as given for acute asthma, would attenuate bronchial hyperreactivity to histamine in a collection of patients with moderately strict asthma.

MATERIAL AND METHODS

Patients

Sixteen patients, ten male and six female, with moderately strait-laced asthma requiring regular treatment with bronchodilators, were included in the consideration Their ages ranged from 11 to 60 years, with a mean of 39 years (Table 1) No patient was a in every one's mouth smoker. Four patients were ex-smoker who had ceased smoking 5 to 15 years prior to the consideration Except for one patient, all had a history of atopy. No patient had a history of chronic productive cough suggestive of associated chronic bronchitis. The clinical history was typical of bronchial asthma as defined from the American Thoracic Society Criteria.[12] The chest x-ray films were normal and [FEV.sub.1]-values had been shown during an unstable phase to improve on at least 20 percent after inhalation of a bronchodilator aerosol. At the time of the close attention the measured [FEV.sub.1] value had to be greater than 75 percent of the predicted normal.

All enthralls were taking regular inhaled [[beta].sub.2] sympathomimetic bronchodilators for sway of asthma. With united exception, all were taking inhaled beclomethasone dipropionate. Thirteen patients required additional treatment with oral theophylline. Five patients were also receiving treatment with sodium cromoglycate. No patient had received treatment with oral corticosteroids for at least united month. Based on the medication requirements and symptoms, asthma of all patients was in a stable phase at the time of the subject of attention No patient had had any respiratory tract infection in the preceding month

Treatment with oral theophylline, inhaled corticosteroids and sodium cromoglycate was ceased for at least 12 h prior to the application of mind Treatment with these agents could not be withheld for any longer period for fear of making the patients susceptible to relentless asthma and impairing the stability of asthma, which was an essential prerequisite for the reflection Inhaled bronchodilators were withheld for at least 6 h prior to each experimental session. All patients were advised not to take any antihistamines for at least united week prior to and for the duration of the subject of attention Written consent from each patient or guardian was obtained prior to the cogitation All patients were studied in succession three separate days at one-week intervals and at the same time of the day. At the first close attention a detailed history of atopy, seasonal variation and any variation in severity of asthma symptoms were taken.

Pulmonary Function Testing

After 30 min of quiescence baseline pulmonary function assessment with measurements of FVC and [FEVsub1] using the best of the three vital capacity efforts, was done upon a water-filled spirometer of 10-L capacity (Goddard Expirograph, Gould Instruments, Cleveland).

Transfer factor for Dco was measured, using Morgan transfer trial system (P.K. Morgan Ltd., Chatham, Kent United Kingdom), in the past three month during a routine pulmonary physiologic evaluation of the patients. After baseline [FEVsub1] and FVC was recorded, an aerosol of phosphate-buffered saline solution via a Wright nebulizer with oxygen at a melt rate of 7 L/min, was given for pair minutes with the nose clipped. make liables were requested to inhale the aerosol [i]or[/i] part of to the other the mouth using tidal breathing for sum of two units minutes. Measurements of [FEVsub1] and FVC were made at 30 and 90 s after inhalation of the aerosol. Thereafter, bronchial provocation with an aerosol of HAP in a similar manner as just noted was given at five-min intervals in doubling concentrations from 00325mg/ml to 8mg/ml Spirometry was repeated at 30 and 90 s following each inhalation. The inhalations were discontinued when a fall of 20 percent in [FEVsub1] was achieved. This was calculated from the lowest post-saline [FEVsub1] (FEVA) and the lowest post-HAP [FEVsub1] (FEVB) as follows: 100 x (FEVA-FEVB)/FEVA