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| Asthma • J Asthma. 2004 Apr;41(2):131-9. |
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April 1, 2004 |
| Author / Title |
Complementary and alternative medicines (CAM) in the management of asthma: an examination of the evidence. / Markham AW, Wilkinson JM. |
| Abstract |
Although individuals are using Complementary and Alternative Medical (CAM) therapies to help manage their asthma, there is no clear direction in the current guidelines for the use of CAM in asthma. This literature review undertakes to determine the current science regarding the use of CAM in asthma management. Electronic literature searched all EBM Reviews, Medline, OVID full text, and PubMed and National Complementary and Alternative Medication databases for Randomised Controlled Trials (RCT) published in English between 1997 and 2002 with keywords "asthma" and "complementary medicine" or "complementary therapy" or "alternative medicine" or "alternative therapy." Abstracts (N=197) were reviewed for inclusion in the review and duplicates discarded (N=65). Abstracts of non-RCT studies, review articles, and surveys were also discarded (N=66). Abstracts discussing environmental control measures and pharmaceutical alternatives to steroid therapy were discarded (N=9). The 15 final studies were grouped within three categories: mind-body and relaxation, manual therapies, and diet and reviewed for statistical and clinical significance, suggesting some CAM therapies have shown minimally significant improvements in asthma quality of life (breathing exercises) or pulmonary function (relaxation) and immune function (relaxation and acupuncture) in select asthma populations. Although CAM therapy is being used in the management of asthma, these 15 studies show a tendency to little or no significant difference between placebo or sham therapy. This may be due, in part, to the enhanced placebo effect of sham therapies used as control and the small size of most studies. Although the changes in the immune function seen in two studies are provocative, these changes did not translate to changes in lung function. More research is needed to assist in determining the efficacy of CAM therapies in asthma management. |
| Conclusion |
Although the changes in the immune function seen in two studies are provocative, these changes did not translate to changes in lung function. More research is needed to assist in determining the efficacy of CAM therapies in asthma management. |
| Local |
William Osler Health Centre, Brampton, Ontario, Canada. |
| Web |
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15115165&query_hl=5 |
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| Asthma • Drugs Today (Barc). 2001 Oct;37(10):651-664. |
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October 1, 2001 |
| Author / Title |
Unconventional therapies in asthma. / Szelenyi I, Brune K. |
| Abstract |
Complementary/alternative medicine (CAM) is more popular than ever before. Patients with allergic diseases often seek so-called alternative treatment as supplementation but seldom as a real alternative to classical medicine. Innumerable physicians and even more patients feel confident that CAM is effective and safe without seriously questioning this notion. The lack of clear opinion or guidelines can be explained on the one hand by the present trend that tradition should be questioned in general and on the other hand by the argument that they have "stood the test of time". Healthcare providers need to be aware of the CAM therapies their patients are using, as well as their potential side effects. Despite the demand for CAM, there is a paucity of well-founded evidence about its effectiveness. There are few good studies and those that exist are often inconclusive. CAM should be approached in the same way as some of orthodox medicine is evaluated now and how most, if not all, will be assessed in the future. Remedies, if shown to be effective and safe, should be part of the interventions made available to patients. Ineffective or unsafe therapies should be abandoned. Unproven interventions should be evaluated in high-quality clinical trials. CAM is often promoted and perceived to be entirely risk-free. However, it is not true: herbal remedies may induce liver damage, acupuncture may cause trauma of vital tissue, homeopathy may aggravate symptoms, etc. We all agree that rigorous research must be performed on this special area of asthma therapy in order to evaluate the real value and significance of CAM in the interest of our patients. (c) 2001 Prous Science. All rights reserved. |
| Conclusion |
CAM is often promoted and perceived to be entirely risk-free. However, it is not true: herbal remedies may induce liver damage, acupuncture may cause trauma of vital tissue, homeopathy may aggravate symptoms, etc. We all agree that rigorous research must be performed on this special area of asthma therapy in order to evaluate the real value and significance of CAM in the interest of our patients. |
| Local |
Department Pulmonary Pharmacology, Corporate Research & Development, ASTA Medica AG, Radebeul, Germany. |
| Web |
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12738963&query_hl=1 |
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