Bronchial asthma is a chronic disease of respiratory tract. Inflammation plays an important role in its aetiology. Asthma is one of the most widespread diseases in the world. About 100 – 150 million people suffers from asthma. In Europe about 4,5% of adults and more than 10 % of children have this disease. 

Modern medicine offers treatments based on agonists of β-adrenergic receptors, leading to the dilatation of muscles in the bronchi and anti-inflammatory drugs, mostly steroids. In this situation many patients look for other therapies, including acupuncture.

In 2009 scientists working fro Cochrane Collaboration Group published their report summarizing data from twelve randomised clinical trials focused on the effectiveness of acupuncture in the treatment of asthma. Due to heterogeneity of those trials the Authors didn’t drew firm conclusions. However they point to some important facts:

two of those trials (from 1984 and 2000) report significant reduction in usage of drugs in the acupuncture group

some trials show als improvement in subjective parameters 

different forms of control were used in different trials. Puncturing skin in other areas than acupuncture points results in some level of therapeutic effects snd shouldn’t be used as control

the Authors discussed also differences between interventions forced by scientific research and real acupuncture performed by educated acupuncturists according to laws of Chinese Medicine. Due to those methodological difficulties the Authors  propose not to focus on “standardized” model of therapy, but rather on finding ways to describe complex influence of acupuncture on functioning of body in patients suffering form asthma.

From 2009 other groups of scholars have been presenting the results of their experiments and reviews of literature.  In 2001 Korean Authors presented their review and metaanalysis of effectiveness of pharmacopuncture in the treatment of asthma. Pharmacopuncture is a method of applying small dosages of herbal formulations into the acupuncture points. The quality of included trials was not high, but this time the Authors showed statistically significant difference between pharmacopuncture and standard treatment. Two of included trials show additionally beneficial influence of acupuncture on Peak Expiratory Flow – proving the reduction of the obstruction in the airways.

In 2013 an article was published, showing the results of Danish trial researching the effectiveness of acupuncture in the treatment of asthma in a group of pre-school children. During the trial children treated with acupuncture felt improvement measured by subjective scales, and were using drugs less frequently. This beneficial effect didn’t last long after the termination of treatment.

It is believed, that the usage of coherent laser light instead of needles is better tolerated by children, so lasers are often used in this group of patients. In 2012  the review of data from trials on photopuncture was published. Due to small amount of well designed trials the Authors didn’t perform the metaanalysis. They decided to analyse only some of thirteen trials giving inconsistent results. The Authors concluded that  more rigorous trials are needed.

Following those conclusions, the next trial was performed in Europe, researching the influence of laser acupuncture on state and objective measurements in children with bronchial asthma. In a group of 50 children 10 sessions of laser stimulation of acupuncture points were performed. It resulted in great reduction of symptoms (from 36 children suffering daytime and nocturnal symptoms to 2 patients reporting nocturnal symptoms), and improvement in objective measurements of spirometry:

Forced Expiratory Volume in the first second 81,8 – 98,5

Forced Vital Capacity 85,4 – 104,3

Peak Expiratory Flow 71,8 – 84,3

Asthma Controll Questionaire 13,9 – 23,3

The daily steroids dosage was reduced from 200-450 μg to 0-200 μg. The patients also stopped using B2 receptor agonists.  

The part of article explaining the molecular basis for anti-inflammatory action of acupuncture in bronchial tree is available only in Polish. Expected date of English translation: 04 June 2014

Meanwhile have a look at the original article describing this topic:

http://www.hindawi.com/journals/ecam/2012/850512/

STRENGTH OF EVIDENCE
Power of arguments
BIBLIOGRAFIA

1 McCarney RW, Brinkhaus B, Lasserson TJ, Linde K. “Acupuncture for chronic asthma”. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD000008. DOI: 10.1002/14651858.CD000008.pub2.

2 Shen FY, Lee MS, Jung SK. “Effectiveness of pharmacopuncture for asthma: a systematic review and meta-analysis.” Evid Based Complement Alternat Med. 2011; 2011: 678176

3 Karlson G, Bennicke P. “Acupuncture in asthmatic children: a prospective, randomized, controlled clinical trial of efficacy.” Altern Ther Health Med. 2013 Jul-Aug;19(4):13-9.

4 Zhang J, Li X, Xu J, Ernst E. “Laser acupuncture for the treatment of asthma in children: a systematic review of randomized controlled trials.” J Asthma. 2012 Sep;49(7):773-7

5 Elseify MY, Mohammed NH, Alsharkawy AA, Elseoudy ME. “Laser acupuncture in treatment of childhood bronchial asthma.” J Complement Integr Med. 2013 Jul 9;10.

6 Reinhold T, Brinkhaus B, Willich SN, Witt C “Acupuncture in Patients Suffering from Allergic Asthma: Is It Worth Additional Costs?” J Altern Complement Med. 2013 Nov 20

7 Yang YQ, Chen HP, Wang Y, Yin LM, Xu YD, Ran J. “Considerations for use of acupuncture as supplemental therapy for patients with allergic asthma.” Clin Rev Allergy Immunol. 2013 Jun;44(3):254-61

8 Sangmi Lee, Sungchul Kim “The Effects of Sa-Am Acupuncture Treatment on Respiratory Physiology Parameters in Amyotrophic Lateral Sclerosis Patients: A Pilot Study” Evidence-Based Complementary and Alternative Medicine, vol. 2013, Article ID 506317, 7 pages, 2013. doi:10.1155/2013/50631

9 Jiang JH, Yang EJ, Baek MG, Kim SH, Lee SM, Choi SM. “Anti-Inflammatory Effects of Electroacupuncture in the Respiratory System of a Symptomatic Amyotrophic Lateral Sclerosis Animal Model” Neurodegener Dis. 2011;8(6):504-14. doi: 10.1159/000327911. Epub 2011 Aug 18

10 Geng WY, Liu ZB, Song NN, Geng WY, Zhang GH, Jin WZ, Li L, Cao YX, Zhu DN, Shen LL “Effects of electroacupuncture at Zusanli (ST36) on inflammatory cytokines in a rat model of smoke-induced chronic obstructive pulmonary disease.” J Integr Med. 2013 May;11(3):213-9.

11 Deng GE, Rausch SM, Jones LW, Gulati A, Kumar NB, Greenlee H, Pietanza MC, Cassileth BR. “Complementary therapies and integrative medicine in lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines”. Chest. 2013 May;143(5 Suppl):e420S-36S.

12 Kasymjanova G, Grossman M, Tran T, Jagoe RT, Cohen V, Pepe C, Small D, Agulnik J. “The potential role for acupuncture in treating symptoms in patients with lung cancer: an observational longitudinal study.” Curr Oncol. 2013 Jun;20(3):152-7

13 Passalacqua G, Bousquet PJ, Carlsen KH, Kemp J, Lockey RF, Niggemann B, Pawankar R, Price D, Bousquet J. “ARIA update: I–Systematic review of complementary and alternative medicine for rhinitis and asthma.” J Allergy Clin Immunol. 2006 May;117(5):1054-62.

14 Xiao L, Li B, Du YH, Xiong J, Gao X “Systematic evaluation of the randomized controlled trials about acupuncture and moxibustion treatment of allergic rhinitis”. Zhongguo Zhen Jiu. 2009 Jun;29(6):512-6. – artykuł w języku chińskim

15 Choi S-M, Park J-E, Li S-S, Jung H, Zi M, Kim T-H, Jung S, Kim A, Shin M, Sul J-U, Hong Z, Jiping Z, Lee S, Liyun H, Kang K, Baoyan L. “A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis.” Allergy 2013; 68: 365–374.

16 B. Brinkhaus, C. M. Witt, S. Jena, B. Liecker, K. Wegscheider, and S.N.Willich, “Acupuncture in patients with allergic rhinitis: a pragmatic randomized trial,” Annals of Allergy, Asthma and Immunology, vol. 101, no. 5, pp. 535–543, 2008.

17 Brinkhaus B, Ortiz M, Witt CM, Roll S, Linde K, Pfab F, Niggemann B, Hummelsberger J, Treszl A, Ring J, Zuberbier T, Wegscheider K, Willich SN. “Acupuncture in patients with seasonal allergic rhinitis: a randomized trial.” Ann Intern Med. 2013 Feb 19;158(4):225-34.

18 Shiue HS, Lee YS, Tsai CN, Hsueh YM, Sheu JR, Chang HH “DNA microarray analysis of the effect on inflammation in patients treated with acupuncture for allergic rhinitis.” J Altern Complement Med. 2008 Jul;14(6):689-98.

19 Shiue HS, Lee YS, Tsai CN, Hsueh YM, Sheu JR, Chang HH. “Gene expression profile of patients with phadiatop-positive and -negative allergic rhinitis treated with acupuncture” J Altern Complement Med. 2010 Jan;16(1):59-68

20 John L. McDonald, Allan W. Cripps, Peter K. Smith, Caroline A. Smith, Charlie C. Xue, and Brenda Golianu, “The Anti-Inflammatory Effects of Acupuncture and Their Relevance to Allergic Rhinitis: A Narrative Review and Proposed Model,” Evidence-Based Complementary and Alternative Medicine, vol. 2013, Article ID 591796, 12 pages, 2013. doi:10.1155/2013/591796

21 Jung D, Lee S, Hong S. “Effects of acupuncture and moxibustion in a mouse model of allergic rhinitis.” Otolaryngol Head Neck Surg. 2012 Jan;146(1):19-25

22 Reinhold T, Roll S, Willich SN, Ortiz M, Witt CM, Brinkhaus B. “Cost-effectiveness for acupuncture in seasonal allergic rhinitis: economic results of the ACUSAR trial.” Ann Allergy Asthma Immunol. 2013 Jul;111(1):56-63

23 Zhang CS, Yang AW, Zhang AL, Fu WB, Thien FU, Lewith G, Xue CC. “Ear-acupressure for allergic rhinitis: a systematic review” Clin Otolaryngol. 2010 Feb;35(1):6-12

O AUTORZE