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Communications to the Editor |

Herbalism for the Treatment of Asthma FREE TO VIEW

Satoshi Yoshida, MD, FCCP; Edzard Ernst, MD, PhD
Author and Funding Information

Brigham & Women’s Hospital Harvard Medical School Boston, MA Correspondence to: Satoshi Yoshida, MD, FCCP, Pulmonary & Critical Care Medicine, Brigham & Women’s Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; e-mail: syoshida@nisiq.net University of Exeter Exeter, UK Correspondence to: Edzard Ernst, MD, PhD, Department of Complementary Medicine, Postgraduate Medical School, University of Exeter, 25 Victoria Park Rd, Exeter UK EX2 4NT



Chest. 1999;116(2):582. doi:10.1378/chest.116.2.582
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To the Editor:

I read with great interest the editorial of Ernst (January 1999)1regarding complementary/alternative medicine (CAM) for asthma. The author proposed that we advise our patients responsibly about the risks and benefits of CAM because there are still too few investigations into the effectiveness of these therapies for asthma. However, the traditional herbal therapy for the treatment of asthma has already been established in Japan.2 The Japanese Ministry of Health and Welfare authorized 161 complexes of traditional herbs for medical use. Of course, governmental health insurance covers the cost of treatments with these herbal complexes. These herbal medicines, which we call Kanpo, originated in ancient China. They were modified and refined in Japan and were integrated into traditional Japanese medicine.

Herbal therapy for the treatment of asthma has been established a long time ago in Japan. Although traditional Japanese herbal therapy is very systemic, its theory is completely different from that of Western medicine. Doctors who want to use herbal medicine should learn how to evaluate patients’ conditions and to choose the best herbal medicine to improve patients’ illness, in addition to learning the theory of Oriental medicine. According to their expertise, doctors have to determine whether patients are responders or nonresponders before beginning herbal therapy. The fundamental rules that are used for choosing appropriate herbal medicines are based on the patients’ constitutions, predispositions, stamina, and strength of response against illness. Six kinds of herbal complexes are included as recommended therapies in the Japanese National Guidelines for the Management of Asthma.2 For the acute phase of asthma, Mao is used along with several similar herbal complexes, including ephedrine, because patients’ bronchodilation and sedation rapidly improve. On the other hand, the long-term administration of Saiko is performed to stabilize symptoms, since Saiko and its relatives have anti-inflammatory and immunoregulatory effects. In addition, Japanese doctors often prescribe herbal medicines to enhance nutrition and improve stamina. As mentioned above, herbal therapy is an effective strategy for the management of asthma in Japan. I wonder why such an established strategy has not been known to the world and is unavailable outside of Japan.

In the United States, patients have easier access to more kinds of CAM than do patients in Japan.3 At present, with the notable exceptions of certain herbs, some acupuncture therapies, and some homeopathic treatments, there is inadequate proof that most CAMs are more effective than the placebo. Moreover, such remedies are not always cost-effective, safe, or easy to incorporate into a patient’s daily life.4 Each CAM should be reviewed and addressed with the most rigorous research design possible in order to get new strategies for the management of asthma.

References

Ernst, E, De Smet, PA, Shaw, D, et al (1998) Traditional remedies and the “test of time.”Eur J Clin Pharmacol54,99-100. [PubMed] [CrossRef]
 
Ernst, E. Complementary medicine, an objective appraisal. 1996; Butterworth. Oxford, UK:.
 
Ernst, E, De Smet, PA Risks associated with complementary therapies. Dukes, MNG eds.Meyler’s side effects of drugs 13th ed.1996 Elsevier. Amsterdam, The Netherlands:
 

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References

Ernst, E, De Smet, PA, Shaw, D, et al (1998) Traditional remedies and the “test of time.”Eur J Clin Pharmacol54,99-100. [PubMed] [CrossRef]
 
Ernst, E. Complementary medicine, an objective appraisal. 1996; Butterworth. Oxford, UK:.
 
Ernst, E, De Smet, PA Risks associated with complementary therapies. Dukes, MNG eds.Meyler’s side effects of drugs 13th ed.1996 Elsevier. Amsterdam, The Netherlands:
 
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