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I first started seeing
a patient for exercise-induced asthma in December 2003.
At first, she was having trouble catching her breath while
doing bikram yoga, which as you may know is performed in
very, very hot rooms. More recently, she sometimes felt
short of breath even when not exercising.
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After our first acupuncture treatment, she noticed an improvement
in her breathing. After several treatments, the problem was gone.
She was baffled by how exactly acupuncture changed her physiology,
so I promised her I'd look into the research and given her a scientific
explanation. I'd already given her the Chinese medicine explanation,
but, in my experience, people feel more satisfied with research-based
answers - patients tell me that those answers make more sense
to them.
Bear in mind that the 1996 National Institutes of Health Consensus
Statement on Acupuncture, which was quite conservative, found
the effective treatment of asthma by acupuncture to be one of
the few for which evidence was strong. So we shouldn't be surprised
to find good research on it, nor do we need to reinvent the wheel
and examine the quality and methodology of every study. Plus,
since researchers have already determined that acupuncture improves
asthma, my review of the literature was directed not at effectiveness,
but the mechanisms by which acupuncture does it.
What's the Cause of Asthma?
The first thing I wanted to clarify was what biological mechanisms
are involved in asthma - that is, what processes go on inside
the body that lead to the experience of shortness of breath and
wheezing? Once I found this information, I could correlate it
with the effects of acupuncture for asthma.
The research reviews (1) said abnormal immune system activity
is responsible for the:
- bronchial airway inflammation,
- increased mucus production, and
- airway hyper-responsiveness…
…that lead to wheezing, coughing, and shortness of breath
(asthma). This abnormal immune activity is cause by and related
to factors such as genetics, viruses, fungi, heavy metals, nutrition,
and pollution. I'll relate the research below to the 3 causes
listed above.
What Does Acupuncture do to the Processes of asthma?
- A 2001 placebo-controlled study of acupuncture for 192 people
with bronchial asthma found that acupuncture improves bronchial
permeability.
- Another placebo-controlled study (2) investigated the immunologic
effects of acupuncture on patients with allergic asthma, and
found a 79% improvement in the well being of the acupuncture
group (compared to 47% in the control group), certain beneficial
immune factors increased, other immune factors that cause the
problems of asthma decreased, and eosinophils (immune factors
that indicate allergic reactions) decreased. In other words,
acupuncture countered the allergic asthma process. This relates
to causes #1 and #3 above.
- An older 1989 study (3) discussed changes from acupuncture
observed in 30 bronchial asthma patients including bronchiodilation,
decrease in intrapulmonary resistance, shifts in the regulation
of breathing and the activity of the muscles that control breathing.
This relates to causes #1 and #3 above.
- Another study (4) of 32 patients with both asthma and rheumatoid
arthritis monitored the effects of acupuncture on the immunoglobulins,
and found that it changed them. This relates to cause #1 above.
- In 1995, acupuncture on 94 patients with bronchial asthma
(5) caused nervous system, immune system, and metabolism changes
that resulted in a reduction of the sensitivity and reactivity
of the bronchioles. In other words, it made the smaller airways
of the lung less likely to react to the factors that lead to
asthma. This relates to causes #1 and #3 above.
- Also in 1995, a study (6) of acupuncture on patients with
allergic asthma demonstrated a reduction in IgA levels. IgA
is an immunoglobulin involved in allergic reactions. Thus, this
may be another explanation of how acupuncture reduces allergic
responses. This relates to cause #1 above.
As you can see, this research, which is likely not an exhaustive
review of all the acupuncture and asthma studies, clearly shows
how acupuncture regulates 2 of the 3 biological mechanisms of
asthma.
References
- Miller AL. The etiologies, pathophysiology, and alternative/complementary
treatment of asthma. Altern Med Rev. 2001 Feb;6(1):20-47.
- Joos S, Schott C, Zou H, Daniel V, Martin E. Immunomodulatory
effects of acupuncture in the treatment of allergic asthma:
a randomized controlled study. J Altern Complement Med. 2000
Dec;6(6):519-25.
- Strukov AV. [Effect of acupuncture on respiratory mechanisms
in patients with bronchial asthma] Ter Arkh. 1989;61(3):46-50.
- Guan Z, Zhang J. Effects of acupuncture on immunoglobulins
in patients with asthma and rheumatoid arthritis. J Tradit Chin
Med. 1995 Jun;15(2):102-5.
- Aleksandrova RA, Nemtsov VI, Lan' PL, Sinitsina TM, Verkhovskaia
VA, Goncharova VA, Bondarenko VL, Kozlov VG, Zagustina NA. [An
analysis of the acupuncture treatment results in bronchial asthma
patients] Vopr Kurortol Fizioter Lech Fiz Kult. 1995 May-Jun;(3):10-2.
- Yang Y, Chen H, Zhao C, Wang R. [Studies on regulatory effects
of acupuncture on mucosal secretory IgA in patients with allergic
asthma] Zhen Ci Yan Jiu. 1995;20(2):68-70.
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