An assesssment of non-conventional measures of lung function and the effect of a herbal extract on mild-moderate childhood asthma
Creators: name: MAXWELL, Sheena
Publisher: name: RMIT University
Year: 2024

description: Background: Respiratory conditions are prevalent and cause an enormous burden on society. In recent decades, there has been a global increase in asthma in children and adults, yet the diagnosis of asthma must be made on clinical grounds as the diagnostic use of pharmacological reversibility of airway obstruction remains controversial. It is possible however that tools exist from different medical paradigms that may assist in the clinical diagnosis of asthma. Tools such as Traditional Chinese Medicine (TCM) enquiry, Breath Holding Time (BHT) or Electro-Dermal Screening Test (EDST) may provide useful clinical information, yet their use has not been widely explored or validated.

Integrative medicine may be considered to represent a new frontier in medicine where each therapy and diagnostic method is seen to have its own advantages and limitations and where an integration of both diagnostic and therapeutic techniques from conventional and complementary medicine is seen to produce the best results. However, while there is a high community use of complementary therapies for conditions such as asthma, there is also a need to maintain accepted standards of medical and scientific principles and foster high quality research into complementary therapies.

Objectives: The current study sought to determine:
• If there is a correlation between conventional measures of lung function such as Forced Expiratory Volume in one second (FEV1) and less conventional measures such as airways expired NO level (eNO), electrodermal measures, TCM enquiry and BHT.
• If any of the lung function measures are able to distinguish between asthmatic and healthy subjects.
• If the use of a rye grass extract is better than placebo in improving requirements for bronchodilator medication, peak flow, forced expiratory volume in one second or quality of life in mild to moderate childhood asthma.

Rational for carrying out two separate studies as one study; The author was interested on both the integration of diagnostic techniques as well as the effect of the herbal extract on asthma so it was decided to use the opportunity and put both in one study.

Method: A range of conventional and non-conventional measures were conducted in healthy and asthmatic children including demographic details, quality of life data, spirometry measures, airway nitric oxide levels, electro-dermal measures, TCM history enquiries, breath holding time, and skin prick tests. The data were analysed to determine any significant correlations between these measures. A double blind randomized controlled pilot clinical trial was also performed to assess the effect of using rye grass extract in asthmatic children aged 8 to 16 years.

Results: There were significant correlations between forced expiratory volume in one second and active quality of life, TCM spleen score and fraction of exhaled nitric oxide measurements. There were also statistically significant differences between asthmatic and healthy subjects in TCM history, breath holding time and exhaled nitric oxide. The use of rye grass extract did not produce any significant improvement over placebo in any of the asthma outcome measures.

Conclusions: The use of inexpensive measures such as BHT and TCM enquiry may provide useful clinical information when assessing respiratory conditions such as asthma. However, further research is required in larger populations to confirm their use. The use of the rye grass extract at the dose given in this study did not provide any clinical benefit for the asthmatic children in this study.