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Chinese Herbal Medicine for Cough Variant Asthma (CVA)
Introduction to Cough Variant Asthma (CVA)
Cough Variant Asthma (CVA) is a unique form of asthma where the primary symptom is a chronic cough, rather than the typical wheezing and shortness of breath associated with asthma. This condition can significantly impact the quality of life and is often treated with anti-inflammatory medications. However, these treatments may not always provide long-term relief, leading to a search for alternative therapies .
Efficacy of Chinese Herbal Medicine (CHM) in Treating CVA
Comparative Effectiveness of CHM and Conventional Treatments
Several studies have explored the effectiveness of Chinese herbal medicine (CHM) in treating CVA. A meta-analysis of 10 randomized controlled trials (RCTs) involving 896 patients found that Suhuang Zhike Capsule (SZC), a commonly used CHM, significantly increased the efficacy rate of CVA treatment compared to conventional Western medicine (RR 1.25, 95% CI, 1.16–1.35). Another study indicated that CHM, when compared with Montelukast, showed a higher efficacy rate (OR = 4.13; 95% CI: 3.29–5.20) and fewer adverse effects (OR = 0.26; 95% CI: 0.16-0.43).
Long-term Benefits and Safety of CHM
A randomized placebo-controlled double-blind trial aimed to evaluate the long-term efficacy and safety of CHM combined with anti-inflammatory medications for CVA. The study highlighted that CHM could potentially reduce the rate of symptom relapse and improve lung function over a 6-month follow-up period. Additionally, a systematic review and meta-analysis of 20 RCTs on childhood CVA suggested that CHM auxiliary therapy (CHMAT) not only improved the total effective rate but also reduced the recurrence rate of symptoms.
Mechanisms of Action of CHM in CVA
Network Pharmacology and Molecular Docking Studies
Research using network pharmacology and molecular docking has provided insights into the mechanisms by which CHM exerts its effects on CVA. For instance, the HuangQiXiXin decoction (HQXXD) was found to interact with 132 candidate target genes related to CVA, suggesting that it may modulate key biological pathways involved in inflammation and immune response. Similarly, the yin nourishing and heat clearing prescription was shown to act on targets such as AKT1, IL-6, and VEGFA, which are involved in reducing airway inflammation and hyperresponsiveness.
Specific Herbal Formulations and Their Effects
The San'ao decoction with scorpio and bombyx batryticatus (SSB) has demonstrated significant anti-tussive and anti-asthmatic effects in a CVA mice model. This formulation was found to reduce cough counts, decrease airway hyperresponsiveness, and alleviate airway inflammation by modulating cytokines and neuropeptides, as well as regulating TRPA1, TRPV1, and TRPV5 channels in lung and brain tissues.
Conclusion
Chinese herbal medicine offers a promising alternative or complementary treatment for cough variant asthma, with several studies indicating its efficacy and safety. CHM formulations such as Suhuang Zhike Capsule, HuangQiXiXin decoction, and San'ao decoction have shown potential in reducing cough frequency, improving lung function, and minimizing adverse effects compared to conventional treatments. Further large-scale, high-quality randomized controlled trials are needed to confirm these findings and fully establish the role of CHM in managing CVA.
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