Prescriptions from Traditional Chinese Medicine compared with salbutamol and montelukast for the treatment of pediatric asthma: a randomized controlled trial.

OBJECTIVE: To compare the effects of a series of Traditional Chinese Medicine (TCM) empirical prescriptions with salbutamol and montelukast (SM) in children with asthma. METHODS: A total of 182 children with asthma were randomized into the TCM group (n = 97) or SM group (n = 85). Patients in the TCM group were treated with a series of TCM prescriptions, whereas those in the SM group received salbutamol and montelukast; both groups received their respective treatment for 12 weeks. Asthma control, changes in scores of TCM symptom patterns, and asthma symptom control (SC) scores after treatment were compared between the two groups. RESULTS: A higher percentage of patients in the TCM group had asthma control compared with those in the SM group (91.67% and 76.83%, respectively, P = 0.006). Scores for abnormal feces (P < 0.001), hyperhidrosis (P < 0.001), and tongue appearance (P = 0.001) in the TCM group were significantly better than those in the SM group. However, the total scores of TCM symptom patterns and SC scores did not differ significantly between the two groups (P > 0.05). CONCLUSION: Compared with salbutamol and montelukast, the TCM prescriptions tested were better for symptom control in children with asthma.

Effect of Traditional Chinese Medicine on Inflammatory Mediators in Pediatric Asthma.

Objective. To observe the effects of empirical prescriptions of traditional Chinese medicine (TCM) on inflammatory mediators in pediatric asthma and to explore the underlying molecular mechanism in the treatment of asthma. Methods. A total of 182 children with asthma were randomly placed into either the TCM group (n = 97) or the salbutamol and montelukast (SM) group (n = 85). Patients in the TCM group were treated with a series of empirical prescriptions of TCM, while those in the SM group received salbutamol and montelukast. Both groups received their respective treatment for 12 weeks. There were 35 patients in TCM group and 34 patients in SM group providing venous blood. Real-time PCR was used to determine the mRNA expression levels of interleukin- (IL-) 10, IL-17, matrix metalloproteinase-9 (MMP-9), and transforming growth factor ß1 (TGF-ß1) in peripheral blood mononuclear cells before and after treatment. Enzyme-linked immunosorbent assay was used to measure the levels of IL-10, IL-17, MMP-9, and TGF-ß1 in peripheral blood before and after treatment. Results. The mRNA expression of TGF-ß1 in the SM group was downregulated (P = 0.00) after treatment. No significant differences were found between the TCM group and the SM group after treatment (P > 0.05). In the TCM group, the levels of IL-10, IL-17, and MMP-9 significantly decreased after treatment (P = 0.01, 0.04, and 0.03, resp.). In the SM group, IL-17, MMP-9, and TGF-ß1 levels significantly decreased after treatment (P = 0.00, 0.03, and 0.00, resp.). There was no significant difference between the two groups regarding the levels of IL-10, IL-17, TGF-ß1, and MMP-9 (P > 0.05). The difference of the level of IL-17 was negatively correlated with the change of C-ACT score in TCM group and SM group. Conclusion. TCM has a regulatory effect on the balance of some inflammatory mediators in pediatric asthma.

A quantification model of Traditional Chinese Medicine syndromes in children with idiopathic precocious puberty and early puberty.

OBJECTIVE: To establish a quantification model of Traditional Chinese Medicine (TCM) syndromes by sampling patients undergoing idiopathic precocious puberty (IPP) and early puberty. METHODS: A questionnaire for classifying and quantifying TCM syndromes was designed and administered. All the results were analyzed; the relationship between 3 types of syndrome and 47 symptoms were summated. Meanwhile, the frequency distribution of each symptom or sign was aggregated. Fuzzy mathematics was used to develop a quantification model ofTCM syndromes. RESULTS: We found that precocious puberty had 3 types of syndrome, including hyperactivity of fire due to Yin deficiency (Syndrome I), depressed liver Qi transforming into fire (Syndrome II), and end retention of damp heat (Syndrome III). In the IPP group, Syndrome I was the most common principal syndrome (100%). Forty-six patients (43.81%) were diagnosed with Syndrome I accompanied by Syndrome II and 11 (10.48%) were diagnosed with Syndrome I accompanied by Syndrome III. In the early puberty group, Syndrome I was also the main syndrome (98.39%). The degrees of most symptoms were mild to moderate. Reddened tongue was the most common tongue manifestation (62.86% prevalence) in the IPP group. The most common pulse manifestations were slippery pulse, thread pulse, and taut pulse. The Asymptotic Normalization Coefficient (ANC) method was used to quantify the TCM syndromes in 167 cases. Diagnostic accuracy rate reached 91%, comparable to expert diagnosis. CONCLUSION: We find that there are 3 types of syndrome in the IPP group and in the early puberty group. Syndrome I (hyperactivity of fire due to Yin deficiency) is the main syndrome in the two groups. ANC may be an appropriate for quantification model of TCM syndromes.

Regulatory effects of stage-treatment with established Chinese herbal formulas on inflammatory mediators in pediatric asthma.

OBJECTIVE: To explore the regulatory effects of established Chinese herbal formulas on inflammatory mediators released during asthma attacks, and to elucidate the molecular mechanism of Traditional Chinese Medicine in the treatment of asthma. METHODS: Seventy-five asthmatic children were randomly divided into a Chinese medication group (45 cases) and a Western medication control group (30 cases). Patients in the Chinese medication group were treated with a series of established Chinese herbal formulas, whereas the Western medication control group received a leukotriene receptor antagonist and a bronchial relaxant. Real-time PCR was used to determine the mRNA expression levels of interleukin (IL)-4, cysteinyl leukotriene receptor 1 (CysLTR1), and interferon (IFN)-gamma in peripheral blood mononuclear cells before and after treatment. Enzyme-linked immunosorbent assay was used to measure the peripheral blood levels of IL-4, leukotriene (LTE)-4, and INF-gamma before and after treatment. RESULTS: After treatment, the mRNA expression levels of IL-4 and CysLTR1 were down-regulated (P< 0.01) and the mRNA expression levels of IFN-gamma were up-regulated (P < 0.05) in the Chinese medication and Western medication groups; no significant difference was found between the two groups. In the Chinese medication group, IL-4 blood level was decreased and it was significantly different from that in the Western medication group (P < 0.05); there was also a significant increase in IFN-gamma blood levels after treatment with Chinese medication (P < 0.05). There were no significant differences in LTE-4 blood levels between the two groups before and after treatment (P > 0.05). CONCLUSION: Chinese medication has a regulatory effect on leukotriene receptor gene expression and the imbalance of Th1/Th2 immune cells during asthma attacks in pediatric patients.

[Effects of Cordyceps extract on cytokines and transcription factors in peripheral blood mononuclear cells of asthmatic children during remission stage].

OBJECTIVE: To explore the effects of Cordyceps extract in regulating the imbalance of Th1/Th2 ratio and inhibiting the inflammatory reaction, and to find the theoretical basis of Cordyceps extract for treating asthma in remission stage. METHODS: A total of 20 peripheral venous blood samples (3 mL) were collected from 20 asthmatic children during remission stage, and peripheral blood mononuclear cells (PBMCs) were separated by Ficoll method. PBMCs were separated into three groups (blank group, low-dose group and high-dose group). The PBMCs were incubated in vitro for 48 hours in the absence (blank group) or presence (low-dose group and high-dose group) of Cordyceps extract at different concentrations (10, 20 microg/mL). The expressions of interferon-gamma (IFN-gamma), interleukin-4 (IL-4), IL-10, T-box expressed in T cells (T-bet), GATA-binding protein-3 (GATA-3) and forkhead/winged-helix transcription factor-3 (Foxp3) mRNAs in PBMCs were measured by real-time fluorescent quantitative polymerase chain reaction, and the contents of IFN-gamma, IL-4 and IL-10 in supernatants were measured by enzyme-linked immunosorbent assay. RESULTS: The expressions of IFN-gamma mRNA showed no significant differences among the three groups. The expressions of the IL-4 mRNA in the high-dose group and the low-dose group were lower than that in the blank group (P=0.014, P=0.011). The expression of IL-10 mRNA in the high-dose group was higher than that in the blank group (P=0.034). And the differences of the IFN-gamma mRNA/IL-4 mRNA ratio presented no statistic significance among the three groups. The level of IL-4 content in the high-dose group was lower than that in the blank group (P=0.018), but the level of IL-10 content, and ratio of IFN-gamma/IL-4 in the high-dose group were higher than those in the blank group (P=0.011, P=0.045). The differences of the IFN-gamma presented no statistic significance among the three groups. The T-bet/GATA-3 ratio and Foxp3 mRNA expression in the high-dose group were higher than those in the blank group (P=0.001, P=0.015). There was significant difference in expression of GATA-3 mRNA between the high-dose group and the blank group (P=0.028), and between the low-dose group and the blank group (P=0.019). The expression differences of T-bet mRNA were insignificant between any two groups. CONCLUSION: Cordyceps extract can inhibit the proliferation and differentiation of Th2 cells and reduce the expression of related cytokines by down-regulating the expression of GATA-3 mRNA and up-regulating the expression of Foxp3 mRNA in PBMCs. Meanwhile, it can alleviate the chronic allergic inflammation by increasing the content of IL-10.