ARIA update: I - Systematic review of complementary and alternative medicine for rhinitis and asthma

University of Aberdeen, Aberdeen, Scotland, United Kingdom
Journal of Allergy and Clinical Immunology (Impact Factor: 11.25). 06/2006; 117(5):1054-62. DOI: 10.1016/j.jaci.2005.12.1308
Source: PubMed

ABSTRACT Complementary-alternative medicines are extensively used in the treatment of allergic rhinitis and asthma, but evidence-based recommendations are lacking. To provide evidence-based recommendations, the literature was searched by using MedLine and the Cochrane Library to March 2005 (Key words: Asthma [OR] Rhinitis, [AND] Complementary [OR] Alternative Medicine, [OR] Herbal, [OR] Acupuncture, [OR] Homeopathy, [OR] Alternative Treatment). Randomized trials, preferably double-blind and published in English, were selected. The articles were evaluated by a panel of experts. Quality of reporting was assessed by using the scale validated by Jadad. The methodology of clinical trials with complementary-alternative medicine was frequently inadequate. Meta-analyses provided no clear evidence for the efficacy of acupuncture in rhinitis and asthma. Some positive results were described with homeopathy in good-quality trials in rhinitis, but a number of negative studies were also found. Therefore it is not possible to provide evidence-based recommendations for homeopathy in the treatment of allergic rhinitis, and further trials are needed. A limited number of studies of herbal remedies showed some efficacy in rhinitis and asthma, but the studies were too few to make recommendations. There are also unresolved safety concerns. Therapeutic efficacy of complementary-alternative treatments for rhinitis and asthma is not supported by currently available evidence.

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    ABSTRACT: Traditional Chinese Medicine (TCM) was reimbursed by the statutory health insurance in Switzerland ("Obligatorische Krankenpflegeversicherung" (OKP)) between 2000 and 2005. A project was set up specifically to evaluate TCM, as well as other 4 systems and methods of complementary medical care from a scientifically sound perspective. The decision to stop granting these 5 systems of complementary medical care OKP reimbursement at the end of the evaluation period after 2005 was not based on scientific facts but was at least in parts politically motivated. After the referendum decision in favour of anchoring "the duty to consider complementary medical care approaches" in the constitution, a new application for automatic reimbursement is being submitted based on new data. TCM is to be applied exclusively by specially trained and certified doctors ("certificate of special ability in acupuncture and TCM") if warranted by the indication, the resulting costs are to be reimbursed by the OKP. Any indication covering the whole spectrum of medicine may warrant TCM treatment if treatment by conventional medical practice is not absolutely necessary. This explicitly excludes diseases which have been proven to respond most efficiently to conventional treatment or where conventional medical treatment is needed to prevent damage for the patient. For many diseases, Western medicine is not able to either supply any treatment which is able to deal with the causes of the disease, or to supply any treatment which leads to a satisfactory measure of healing or improvement in the patient's suffering. The symptomatic pharmacological treatment used by western medicine in this context is often not well tolerated by the patient or leads to side effects with complications. Many acute or chronically relapsing infections do not necessarily require an antibiotic treatment. Considering the global threat of resistance, this is even to be avoided wherever possible. Due to the different paradigm employed, TCM is often able to offer successful treatment from its perspective for many diseases.
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    ABSTRACT: Objectives. Allergic rhinitis is a common disease with increasing prevalence and high impact on economic burden and comorbidities. As treatment with pharmacological drugs is not always satisfactory due to side effects and incomplete efficacy, alternative treatment strategies are needed. Ectoine is an osmolyte with membrane stabilizing and inflammation reducing capacities. Nasal spray and eye drops containing ectoine are promising new treatment regimens for allergic rhinitis sufferers. Design and Methods. The current two noninterventional trials evaluated the efficacy and safety of ectoine containing nasal spray and eye drops for treating allergic rhinitis in comparison with either azelastine or cromoglycic acid containing products. Nasal and ocular symptom developments as well as judgment of tolerability and efficacy were assessed both by investigators and patients over a time period of one to two weeks. Results. Both trials confirmed that ectoine containing products reduced nasal and ocular symptoms in allergic rhinitis patients. Results clearly demonstrated good safety profiles of the ectoine products comparable to those of azelastine and even better to those of cromoglycate products. Conclusion. Ectoine containing nasal spray and eye drops are interesting new treatment strategies for sufferers of allergic rhinitis, combining both good efficacy and absence of side effects.
    Journal of Allergy 01/2014; 2014:176597. DOI:10.1155/2014/176597
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    ABSTRACT: Rhinitis is a common medical condition and can seriously impact patients' quality of life. The objective of this study was to investigate the association between disease-specific quality of life and use of complementary and alternative medicine (CAM) modalities among Taiwanese rhinitis patients. A cross-sectional survey was undertaken at the outpatient department of otolaryngology in a medical center in Taiwan. Sociodemographic information, disease-specific quality of life (Chinese version of the 31-item Rhinosinusitis Outcome Measure, CRSOM-31), and previous use of CAM modalities for treatment of rhinitis of the patients were ascertained. Factor analysis was performed to reduce the number of CAM modalities. The resulting factors were analyzed for their association with CRSOM-31 score using linear regression analyses. Results from the multiple linear regression analyses indicated that Factor 1 (traditional Chinese medicine), Factor 2 (mind-body modalities), Factor 3 (manipulative-based modalities), female sex, and smoking were significantly associated with a worse disease-specific quality of life. In conclusion, various CAM modalities, female sex, and smoking were independent predictors of a worse disease-specific quality of life in Taiwanese patients with rhinitis.
    Evidence-based Complementary and Alternative Medicine 01/2014; 2014:958524. DOI:10.1155/2014/958524 · 2.18 Impact Factor

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