Galen's Watch

Fibromyalgia Studies: Treatment Strategies & Learning from Others

More fibromyalgia studies to come in the future that I have covered in the journal watch but today a few resources I found. It is always educational to see how other people structure their treatment plans.

There are 2 articles in the the latest Townsend Letter.

Effective Treatment of Chronic Fatigue Syndrome and Fibromyalgia: A Comprehensive Medicine Approach
by Jacob Teitelbaum, MD

• An interesting article using the SHINE "Sleep, Hormonal support, Infections, Nutritional support, and Exercise as able" protocol. In addition to natural suggestions he also lists pharmaceuticals that can help.

Chronic Fatigue-Fibromyalgia: The Adrenal–Thyroid Connection
by Michael Gerber, MD, HMD

• This article also has some gems but what I like is the personal way it is told with examples and cases.

If herbs are your practice focus then the article by Chanchal Cabrera is for you.
Chronic Fatigue Syndrome a Holistic Herbal Treatment Approach 
© Chanchal Cabrera MSc, MNIMH, AHG


Full of herbal suggestions, and case studies with  individualized herbal formulas. Chanchal also wrote a book on Fibromyalgia. Fibromyalgia: A Journey Toward Healing

I also did a post on the fibromyalgia study A program consisting of a phytonutrient-rich medical food and an elimination diet ameliorated fibromyalgia symptoms and promoted toxic-element detoxification in a pilot trial.

• This study used UltraClear MACRO and RENEW  (Metagenics) in female patients with fibromyalgia

Other fibromyalgia studies:

J Altern Complement Med. 2009 Apr;15(4):399-405.
A new nonpharmacological method in fibromyalgia: the use of wool.

2002 Jun;22(2):56-9. Epub 2002 Mar 29.

The effects of balneotherapy on fibromyalgia patients.

J Altern Complement Med. 2010 Apr;16(4):397-409.
Traditional Chinese medicine for treatment of fibromyalgia: a systematic review of randomized controlled trials.

J Altern Complement Med. 2009 Mar;15(3):247-57.
Intravenous micronutrient therapy (Myers' Cocktail) for fibromyalgia: a placebo-controlled pilot study.

Arch Phys Med Rehabil. 2010 Oct;91(10):1551-7.
The effects of 12 weeks of resistance exercise training on disease severity and autonomic modulation at rest and after acute leg resistance exercise in women with fibromyalgia.

Pain. 2010 Nov;151(2):530-9.
A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia.

J Altern Complement Med. 2010 Nov;16(11):1191-200.
Efficacy of Biodanza for treating women with fibromyalgia.

N Engl J Med. 2010 Aug 19;363(8):743-54.
A randomized trial of Tai chi for fibromyalgia.

Heat Therapy for Fibromyalgia Pain

In doing some continuing professional education I came across a study showing that patients with fibromyalgia found a benefit from wearing wool underwear. I wondered if any other studies supported warmth in patents with fibromyalgia for pain relief and found a few. As well, there was a case study of two patients using warmth for pain relief with success. Continuing my research into FM pain and warmth I found this article using a certain species of dog as heat therapy in FM.  Surely, as well as, offering unusual heat these dogs offer the comfort of companionship. Of course some patients do not feel better with heat and seem to respond better to cold and there are studies showing that people with FM do not deal well with temperature extremes or adjust quickly to temperature changes.


A new nonpharmacological method in fibromyalgia: the use of wool.

• 50 patients with fibromyalgia
• wore woollen underwear covering them from shoulders to thighs, used woollen bedding for 6 weeks
• The woollen group had a significant reduction in pain levels, tender point count and Fibromyalgia Impact Questionnaire scores

Effects of thermal therapy combining sauna therapy and underwater exercise in patients with fibromyalgia.

• 44 females with fibromyalgia
• underwent sauna therapy 3 days a week and underwater exercise 2 days a week for 12 weeks
• all patients reported significant reductions in pain and symptoms (31-77%)
• patients remained relatively stable during 6 month follow-up (28-68%)

Pain relief in women with fibromyalgia: a cross-over study of superficial warmth stimulation and transcutaneous electrical nerve stimulation.

• 32 women with fibromyalgia
• either used superficial warmth or transcutaeous electrical nerve stimulation
• Both treatments were effective in reducing pain
• warmth reduced pain from 77.5 to 62.5 pts and nerve stimulation from 80 to 62.5 pts
• there was a slightly higher preference for warmth therapy

Habituation and sensitization to heat and cold pain in women with fibromyalgia and healthy controls.

• 33 women with fibromyalgia (FM) matched to 44 healthy controls
• to examine the differences in habituation to cold pain in women with FM
• FM group showed sensitization and had decreased cold pain thresholds across trials (they felt cold pain at higher temperatures) the control group habituated to the cold stimuli
• both groups habituated to heat pain

Case Study:

J Psychosom Res. 2005 Apr;58(4):383-7.
The effects of repeated thermal therapy for two patients with chronic fatigue syndrome.
Masuda A, Kihara T, Fukudome T, Shinsato T, Minagoe S, Tei C.
Source


OBJECTIVE:This paper describes the successful treatment of two patients with chronic fatigue syndrome (CFS) using repeated thermal therapy.
METHODS: Two patients with CFS underwent treatment with prednisolone (PSL), with no satisfactory effect. They were subjected to thermal therapy that consisted of a far-infrared ray dry sauna at 60 degrees C and postsauna warming. The therapy was performed once a day, for a total of 35 sessions. After discharge, these subjects continued the therapy once or twice a week on an outpatient basis for 1 year.
RESULTS:Symptoms such as fatigue, pain, sleep disturbance, and low-grade fever were dramatically improved after 15 to 25 sessions of thermal therapy. Although PSL administration was discontinued, the subjects showed no relapse or exacerbation of symptoms during the first year after discharge. The patients became socially rehabilitated 6 months after discharge.
CONCLUSIONS:These results suggest that repeated thermal therapy might be a promising method for the treatment of CFS.

PMID: 15992574

Homeopathic Drops Reduce Ear Pain in Otitis Media Similar to Topical Benzocaine

A study that will be in the next Galen's Watch report.

Homeopathic ear drops may have a role in reducing antibiotics in otitis media using a watch and wait approach to care while using the homeopathic eardrops to manage pain and discomfort. The researchers noted that:

 The use of a delayed antibiotic prescription for certain patients with otitis media is a strategy recommended in the AAP guildeline. However, despite the recommendation, it has been estimated that the delayed prescription management plan is only utilized in approximately 15% of cases of pediatric otitis media

The researchers also noted that:

This (the results) suggests that homeopathic ear drops may be most effective in the early period after a diagnosis of AOM (acute otitis media) and could possibly reduce the use of delayed antibiotics.

 

Homeopathic Ear Drops for Otitis Media in Children

One hundred and nineteen children (6 months -11years) diagnosed with otitis media in an in-office visit were randomly assigned to standard care alone or standard care plus homeopathic ear drugs* The homeopathic drops were administered at 3-4 drops up to 3 times a day for a maximum of 5 days. The children receiving ear drops symptom scores tended to be lower than the stand care alone group, Those differences were significant at second and third assessments (24 and 36 hours). The ear drop group also had faster symptom improvement. By day 3 there was little difference between the groups although the ear drops group used less medication. Thirty children received delayed antibiotic prescriptions. Although the sample size was too small to find a statistical difference only 7.1% of the ear drop group filled their prescriptions compared to 36.5% of the standard therapy group. The researchers state that the efficacy of the ear drops  is comparable to the demonstrated effectiveness of topical benzocaine drops in alleviating ear pain in children with acute otitis media.

*Hylands Earache Drops, Pulsatilla, Chamomilla, Sulphur, Calcarea carbonica, Belladonna, ad Lycopodium, all in the 30c potency.

Homeopathy. 2011 Jul;100(3):109-15.
Homeopathic ear drops as an adjunct to standard therapy in children with acute otitis media.
21784326

 

Is Milk Thistle the Best Herb For Chronic Hepatitis C? Doesn't Look Like It.

Last week there it was reported that Milk Thistle No Help in Chronic HCV from an abstract presented at the AASLD conference. This of course peeked my interest and I had to go and read what I could on the report. I love these side-line investigations. So I am going to break down the report into point form and then look at a few other studies using milk thistle. Is milk thistle the best herb choice? And what about the dosage? After looking at the studies I think both are in question.


Fried MW, et al "A randomized, placebo-controlled trial of oral silymarin (milk thistle) for chronic hepatitis C: final results of the SYNCH multicenter study" AASLD 2011; Abstract 228.

• The study involved 154 patents with a history of failed interferon-therapy and Hepatitis C Visus (HCV) and a serum ALT >/= 65 IU
• 2 doses of silymarin were used 420 or 700 mg/day for 6 months
• Symptom scores and QoL were unchanged at study end
• There was little effect on ALT
• 4% of patients in each group met the endpoint decline of ALT to=/> 45 IU or at least a 50% decline from baseline
• Conc: had no detectable effect on hepatitis C virus (HCV) disease activity in comparison with placebo in patients with previously treated chronic disease,

To help put this report in context about milk thistle and hepatitis Let’s take a look at the properties of milk thistle (silymarin) and liver disease, past studies involving hepatitis C, milk thistle and anti oxidants.

Milk Thistle (silybum marianum)

• Has been traditional used for the treatment of liver disorders and as a hepatoprotective
• In experimental models is has shown hepatoprotective and anti carcinogenic activity
• Has been shown  to lower liver enzymes in alcohol-related disorders and non-alcoholic fatty liver disease
• Contains flavanolignan mixture (silymarin: mostly silybin, silychristin and silydianin)

Simon Mills MNIMH says "it can be concluded that milk thistle should not be solely relied on for the treatment of hepatitis C, but may have some role as an hepatoprotective agent"

Milk thistle may not be the been the best herb choice in this study for HCV.  As as seen in the studies below In combination with other agents it may have faired better. As well the dosage of silybum in this report may have been low or perhaps as they outline  not effective given orally.

There are a few studies  and case studies showing that antioxidant therapy in Hepatitis C  has fairly good results:

Med Klin (Munich). 1999 Oct 15;94 Suppl 3:84-9.
A conservative triple antioxidant approach to the treatment of hepatitis C. Combination of alpha lipoic acid (thioctic acid), silymarin, and selenium: three case histories.
Berkson BM.

World J Gastroenterol. 2007 Oct 28;13(40):5317-23.
Antioxidant therapy for chronic hepatitis C after failure of interferon: results of phase II randomized, double-blind placebo controlled clinical trial.
Gabbay E, Zigmond E, Pappo O, Hemed N, Rowe M, Zabrecky G, Cohen R, Ilan Y.

J Med Virol. 2008 Nov;80(11):1900-6.
Treatment with silybin-vitamin E-phospholipid complex in patients with hepatitis C infection.
Falasca K, Ucciferri C, Mancino P, Vitacolonna E, De Tullio D, Pizzigallo E, Conti P, Vecchiet J.


There was a study in the spring of 2011 on the Effects of silybum marianum on patients with chronic hepatitis C.

• In this study 55 patients with HCV received 620 mg/day of silymarin for 24 weeks.
• Liver fibrosis markers (YKL 40 and HA) results before treatment, patients were divided into three stages: Fibrosis group: YKL 40 > 150 ng/ml and HA > 60 ng/ml or YKL 40 > 150 ng/ml or HA > 100 ng/ml; Non-fibrosis group: YKL 40 < 100 ng/ml and HA < 20 ng/ml
• They found there was improved serum HCV-RNA, ALT and AST, hepatic fibrosis and quality of life. There was a statistical improvement only in the Fibrosis group.

Finally there was a study on the oral availability of milk thistle and the dosages required.  This last study found to achieve steady-state concentrations of silybin A and B that silymarin must be dosed tid and at dosages above 2.1g day. And at 2.1g a day silybin A and B concentrations "were still 1 to 2 orders of magnitude below those concentrations associated with antiviral effects in vitro"

• 32 patients with chronic non cirrhotic HCV  who previously failed interferon therapy were divided into 4 groups and given 140, 280, 560, or 700 mg silymarin were administered every 8 hours for 7 days.
• They concluded that Oral doses of silymarin up to 2.1 g per day were safe and well tolerated. The nonlinear pharmacokinetics of silybin A and silybin B suggests low bioavailability associated with customary doses of silymarin may be overcome with doses above 700 mg.
• These data suggest that multiple daily oral doses must be administered at least 3 times per day if steady-state concentrations and antiviral effects are to be achieved.
• At the highest dose of 700 mg, which may represent a reasonable pill burden limit for patients, the steady-state peak plasma concentrations of silybin A and silybin B achieved were still 1 to 2 orders of magnitude below those concentrations associated with antiviral effects in vitro, and trough concentrations were approximately 25-fold lower than peak concentrations

Silymarin Ascending Multiple Oral Dosing Phase I Study in Noncirrhotic Patients With Chronic Hepatitis C 

Alternative therapies for Children: Nutritional Status in Autism, Yoga for IBS, Allergenic Foods and Acupuncture

The latest edition of Galen's Watch just went out. Here is a sample of the studies in the Pediatrics section on alternative therapies for children. There are a few interesting studies. 

Nutritional and Metabolic Status of Children with Autism

Yoga for Children with IBS or Functional Abdominal Pain

Introduction of Allergenic Foods in Infants Does Not Affect Wheezing or Eczema

Acupuncture Reduces Visceral Adipose Tissue in Obese Children

And from Previous Issues:

Probiotic Supplement VSL#3 Improves IBS Symptoms in Children (GW#9, 2010)

Lactobacillus rhamnosus for Children with IBS (GW#2, 2011)

 

The study abstracts:

Nutritional and Metabolic Status of Children with Autism

Fifty-five children (5-16 years) with Autism Spectrum Disorder were compared to control children for nutritional and metabolic biomarker differences. None of the subjects had taken vitamin/mineral supplements for 2 months prior to samples being taken. For most vitamins, children with autism had levels that lay within the neurotypical childrens’ reference range. More than 25% of the Austism group was lower in total carotenes and higher in vitamin C, free choline, total choline and Formiminoglutamic acid (FIGLU). There was also a lower level in whole blood lithium and a higher red blood cell iron (above the 90th percentile for 42%) in the autism group. SAM and reduced plasma glutathione were significantly lower in the autism group and uridine was significantly higher. Oxidized glutathione (the ratio of oxidized to reduced glutathione)  and plasma nitrotyrosine were significantly higher in the autism group.  Several of the biomarker groups were significantly associated with variations in the severity of autism. 

Free open access article

Nutr Metab (Lond). 2011 Jun 8;8(1):34.

Nutritional and metabolic status of children with autism vs. neurotypical children, and the association with autism severity.

Yoga for Children with IBS or Functional Abdominal Pain 

Twenty children with irritable bowel syndrome (IBS) or functional abdominal pain (FAP) were enrolled to receive 10 yoga classes. Each yoga class was 1.5 hours in length with a children's yoga teacher. The children began with an education about their condition and a high-fibre diet but with insufficient effect. The baseline period was one month which functioned as a control phase, followed by a 12 week treatment period and a 3 month follow-up. Pain frequency was significantly decreased by end of therapy compared to baseline in the 8-11 and 11-18 year olds. Pain intensity was significantly decreased  in the 8-11 group at 12 weeks. After 3 months, there was still a significant reduction in pain frequency in the 8-11 group  and a borderline significant decrease in pain frequency for the total group. Parents reported better quality of life after yoga treatment. 

Complement Ther Med. 2011 Jun;19(3):109-14. Epub 2011 May 26.

A pilot study of yoga treatment in children with functional abdominal pain and irritable bowel syndrome.

From Previous Issues  studies on alternative therapies for children

Probiotic Supplement VSL#3 Improves IBS Symptoms in Children (GW#9, 2010)

Fifty-nine children aged 4-18 years were randomly assigned to receive either VSL#3* or placebo for 6 weeks. After a 2-week wash-out period, the patients were switched to the opposite group for an additional 6 weeks. Both placebo and VSL#3  groups had improvement in some of the parameters. VSL#3 was significantly superior to placebo in the primary endpoint of subjective symptom relief. VSL#3 also improved abdominal pain/discomfort, abdominal bloating and family assessment of life disruption. No adverse effects were recorded.

* VSL#3® is the medical food probiotic with the highest available concentration of beneficial live bacteria. Each packet of VSL#3® contains 450 billion live lactic acid bacteria, which collectively act as a Living Shield™ in the gastrointestinal (GI) tract.

J Pediatr Gastroenterol Nutr. 2010 Jul;51(1):24-30.

VSL#3 improves symptoms in children with irritable bowel syndrome: a multicenter, randomized, placebo-controlled, double-blind, crossover study.

Lactobacillus rhamnosus for Children with IBS (GW#2, 2011)

One hundred and forty-one children with irritable bowel syndrome (IBS)  or functional abdominal pain were randomized to  Lactobacillus rhamnosus GG (LGG) or placebo for 8 weeks with 8 weeks of follow-up. There was a significant reduction in frequency and severity of abdominal pain in the LGG group compared to placebo. Treatment success was achieved in 48 children in the LGG group and 37 children in the placebo group, and this success was maintained at end of follow-up. Intestinal permeability tests were done and at study entry, 59% of children had abnormal results. There was a significant decrease in the number of patients with abnormal results in the LGG group , and these results were mainly seen in children with IBS.

Pediatrics. 2010 Dec;126(6):e1445-52. Epub 2010 Nov 15.

A randomized controlled trial of Lactobacillus GG in children with functional abdominal pain.

Introduction of Allergenic Foods in Infants Does Not Affect Wheezing or Eczema

A total of 6905 preschool children were included in this study. Using the International Study of Asthma and Allergies in Childhood core questionnaire, information was gathered on the outcome of eczema and wheezing and the age of food introduction at 6 and 12 months. At the age of 2, wheezing was reported in 31% of children and in 14% of children at 3 and 4 years. Eczema at 2, 3 and 4 years was 38%, 20% and 18%. The introduction of cow's milk, hens’ eggs, peanuts, tree nuts, soy and gluten before the age of 6 months was not associated with eczema or wheezing at any age after including potential co-founders:  birth weight, gender, daycare attendance, older siblings, and family history of atopy. The results did not change with the addition of child's cow milk allergy or parental history of atopy. A study weakness could be the potential for recall bias for food introduction timing.

Arch Pediatr Adolesc Med. 2011 Jun 6. [Epub ahead of print]

The introduction of allergenic foods and the development of reported wheezing and eczema in childhood: the generation R study.

Acupuncture Reduces Visceral Adipose Tissue in Obese Children

Ten healthy obese children with a BMI of 29.03 ± 4.81 were assigned to 1 month of acupuncture sessions. The acupuncture sessions lasted 15 minutes twice a week. The children were diagnosed with either excessive 'heat' in the stomach and intestine (7 cases) or 'dampness' due to spleen and primary qi deficiency (3 cases). The excessive heat pattern was treated at acupoints: Tianshu (ST25), Liangqiu (ST34), Zusanli (ST36), Gongsun (SP4), Quchi (LI11), Hegun (LI4), Zhigou (SJ6), Shangjuxu (ST37), and Neiting (ST44). The dampness pattern was treated at acupoints: Tianshu (ST25), Liangqiu (ST34), Zusanli (ST36), Gongsun (SP4), Zhongwan (RN12), Yinlingquan (SP9), Fenglong (ST40), Qihai (RN6), and Shuifen (RN9).   There was a decrease in visceral adipose tissue (VAT) but not subcutaneous adipose tissue (SAT). After 1 month of treatment, subjects’ BMI was reduced by 3.5%, VAT volume by 16.04%, abdominal total adipose tissue by 10.45%,  and abdominal visceral to subcutaneous fat ratio by 10.59%. The reduction in VAT may be explained by VAT's increased sensitivity to lipolytic stimulation thanSAT. There were no significant changes in body weight but there was a reduction is VAT content. 

J Altern Complement Med. 2011 May;17(5):413-20.

Effects of acupuncture therapy on abdominal fat and hepatic fat content in obese children: a magnetic resonance imaging and proton magnetic resonance spectroscopy study.

 

Sabra

Natural Flu Remedies: Stock Your Medicine Cabinet Now-Probiotics, Vit D, Maxingshigan-yinqiaosan, Elderberry

 Natural flu remedies, you want to stock them in your dispensary, recommend them to patients in your handouts or over the phone on a call-in. Good prevention is in lifestyle but everyone gets busy and even the healthiest can get the flu so having some natural flu remedies on hand is a great idea. Be prepared before it strikes so when the chills and fever come on you can hunker down and grab your stock of natural flu remedies and hopefully be back on your feet, a few days earlier.

The first two studies were reported on earlier Galen's Watch editions and are all about proven prevention. They really are natural flu remedies but you need to plan ahead. Of course many would say that Vitamin D and probiotics are just part of a healthy living program. 

The third study is scheduled for up coming Galen's Watch and compares the Chinese Formula Maxingshigan-yinqiaosan to Oseltamivir for H1N1.

The fourth study is on elderberry from 2004.

Probiotics Reduce Number of Missed School Days in Children
This double-blind, placebo-controlled study randomly assigned 326 children (3-5 years of age) to receive placebo, Lactobacillus acidophilus NCFM, or L acidophilus NCFM in combination with Bifidobacterium animalis subsp lactis Bi-07 twice a day for 6 months. With single and combination probiotics, but not placebo, reduced fever incidence, coughing incidence and rhinorrhea incidence were observed. Overall, fever, coughing, and rhinorrhea duration was decreased significantly, relative to placebo, by 32% (single strain) and 48% (combination). Antibiotic use and absentee days were also reduced. Results were better for the combination probiotics group than the single strain probiotics group. The researchers concluded that daily dietary probiotic supplementation for 6 months was a safe, effective way to reduce fever, rhinorrhea, and cough incidence,  duration and antibiotic prescription incidence, as well as the number of missed school days attributable to illness, for children 3 to 5 years of age. In a 2008 study, it was found that that a regular, long-term intake of various synbiotics may improve health by reducing the incidence and severity of respiratory diseases during the cold season. That 3-stage prospective, randomized, double blind, placebo-controlled study was carried out over a 3-year period with several synbiotic preparations containing 3-5 strains of Lactobacillus plantarum, Lactobacillus rhamnosus, and Bifidobacterium lactis, lactoferrin and prebiotics such as either FOS (short-chain fructooligosaccharides) or GOS (galactooligosaccharides).

Free full text
Pediatrics. 2009 Aug;124(2):e172-9. Epub 2009 Jul 27.
Probiotic effects on cold and influenza-like symptom incidence and duration in children.
 
J Clin Gastroenterol. 2008 Sep;42 Suppl 3 Pt 2:S224-33.
A new chance of preventing winter diseases by the administration of synbiotic formulations.
 
Vitamin D Supplementation in School-aged Children Reduces Incidence of Influenza A
 
The study randomized 334 school-aged children to either receive vitamin D(3) supplements (1200 IU/day) or placebo for December through March. Influenza A occurred in 10.8% of children in the D3 group and 18.6% of the placebo group. The reduction in influenza A was more predominant in children who had not been taking other vitamin D supplements and who started nursery school after age 3. In children with a previous diagnosis of asthma, two children in the D3 group had asthma attacks compared to 12 in the placebo group.
 
Ann Intern Med. 2011 Aug 16;155(4):217-25.
Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren.

Oseltamivir compared with the Chinese traditional therapy maxingshigan-yinqiaosan in the treatment of H1N1 influenza: a randomized trial.

BACKGROUND: Observational studies from Asia suggest that maxingshigan-yinqiaosan may be effective in the treatment of acute H1N1 influenza.
OBJECTIVE:To compare the efficacy and safety of oseltamivir and maxingshigan-yinqiaosan in treating uncomplicated H1N1 influenza.
DESIGN:Prospective, nonblinded, randomized, controlled trial. (ClinicalTrials.gov registration number: NCT00935194)
SETTING:Eleven hospitals from 4 provinces in China.
PATIENTS:410 young adults aged 15 to 59 years with laboratory-confirmed H1N1 influenza.
INTERVENTION:Oseltamivir, 75 mg twice daily; maxingshigan-yinqiaosan decoction (composed of 12 Chinese herbal medicines, including honey-fried Herba Ephedrae), 200 mL 4 times daily; oseltamivir plus maxingshigan-yinqiaosan; or no intervention (control). Interventions and control were given for 5 days.
MEASUREMENTS:Primary outcome was time to fever resolution. Secondary outcomes included symptom scores and viral shedding determined by using real-time reverse transcriptase polymerase chain reaction.
RESULTS:Significant reductions in the estimated median time to fever resolution compared with the control group (26.0 hours [95% CI, 24.0 to 33.0 hours]) were seen with oseltamivir (34% [95% CI, 20% to 46%]; P < 0.001), maxingshigan-yinqiaosan (37% [CI, 23% to 49%]; P < 0.001), and oseltamivir plus maxingshigan-yinqiaosan (47% [CI, 35% to 56%]; P < 0.001). Time to fever resolution was reduced by 19% (CI, 0.3% to 34%; P = 0.05) with oseltamivir plus maxingshigan-yinqiaosan compared with oseltamivir. The interventions and control did not differ in terms of decrease in symptom scores (P = 0.38). Two patients who received maxingshigan-yinqiaosan reported nausea and vomiting.
LIMITATIONS:Participants were young and had mild H1N1 influenza virus infection. Missing viral data precluded definitive conclusions about viral shedding.
CONCLUSION:Oseltamivir and maxingshigan-yinqiaosan, alone and in combination, reduced time to fever resolution in patients with H1N1 influenza virus infection. These data suggest that maxingshigan-yinqiaosan may be used as an alternative treatment of H1N1 influenza virus infection.

Ann Intern Med. 2011 Aug 16;155(4):217-25.
Oseltamivir compared with the Chinese traditional therapy maxingshigan-yinqiaosan in the treatment of H1N1 influenza: a randomized trial.

Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections.

Elderberry has been used in folk medicine for centuries to treat influenza, colds and sinusitis, and has been reported to have antiviral activity against influenza and herpes simplex. We investigated the efficacy and safety of oral elderberry syrup for treating influenza A and B infections. Sixty patients (aged 18-54 years) suffering from influenza-like symptoms for 48 h or less were enrolled in this randomized, double-blind, placebo-controlled study during the influenza season of 1999-2000 in Norway. Patients received 15 ml of elderberry or placebo syrup four times a day for 5 days, and recorded their symptoms using a visual analogue scale. Symptoms were relieved on average 4 days earlier and use of rescue medication was significantly less in those receiving elderberry extract compared with placebo. Elderberry extract seems to offer an efficient, safe and cost-effective treatment for influenza. These findings need to be confirmed in a larger study.

J Int Med Res. 2004 Mar-Apr;32(2):132-40.
Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections.

                                                                                                                    Sabra

Recent Acupuncture Studies - Depression, TMD, Low back pain, Plantar Faciitis

 

The Immediate Effect of Acupuncture on Obstructive Sleep Apnoea
 
Forty patients with moderate obstructive sleep apnoea were randomly assigned to either a manual acupuncture treatment group, an electroacupuncture 10 Hz treatment group, an electroacupuncture 20 Hz treatment group or a control group. The treatment was done just before sleep at 8 pm. The manual acupuncture points used were as follows: LU6, LU7, LI4, LI20, GV20, CV23, ST36, ST40, SP6, KI6. An extra point is located between the hyoid bone and the menton symphysis (Shanglianquan). For electroacupuncture the electrodes were placed in the points of the neck (deep enough to reach the genioglossus muscle - CV23 and Shanglianquan)  and also along the body in LI4 and ST36 bilaterally. The Apnoea-Hypopnoea Index results for the manual acupuncture group and the electroacupuncture 10 Hz group were significantly different from the control and electroacupuncture 20 Hz groups. Manual acupuncture and electroacupuncture 10 Hz exerted better immediate effects than electroacupuncture 20 Hz and no treatment in reducing the Apnoea-Hypopnoea Index as well as the number of nocturnal respiratory events.
 
Acupunct Med. 2010 Sep;28(3):115-9. Epub 2010 Jun 15.
Immediate effect of acupuncture on the sleep pattern of patients with obstructive sleep apnoea.
 
 
Electro-acupuncture Improves Specific Functions in Children with Autism Spectrum Disorder
 
Fifty-five children with autism spectrum disorder (ASD) were randomly assigned to either electro-acupuncture (EA) or sham electro-acupuncture (SEA). There were a total of 12 sessions of EA or SEA over 4 weeks. Eight acupoints were used: Sishencong (EX-HN1), Yintang (EX-NH3), Neiguan (PC6), Shenmen (HT7), TaiChong (LR3), Ear naodian (AT3), Ear shenmen (TF4), and Sanyinjiao (SP6). The EA group had significant improvements in the language comprehension domain of the Functional Independence Measure for Children (WeeFIM), self-care caregiver assistant domain of the Pediatric Evaluation of Disability Inventory (PEDI), and Clinical Global Impression-Improvement (CGI-I) scale. The parental report showed significantly better social initiation, receptive language, motor skills, coordination and attention span.
 
Full free text article
Altern Med Rev. 2010 Jul;15(2):136-46.
Randomized controlled trial of electro-acupuncture for autism spectrum disorder.
 
 
Acupuncture Improves Depression and Myalgia Scores in Patients with Chronic Hepatitis B and C
 
This prospective, uncontrolled, observational study enrolled 28 patients with chronic hepatitis B and C divided them into 3 groups. Group A (n=13) had high Beck's Depression Inventory (BDI) and myalgia scores. Group B  (n=11) had low BDI scores and high myalgia scores and Group C (n=4) had high BDI and low myalgia scores. The following needling points were bilaterally sued: Yintang (0.3 cun), LU9 (0.2 cun), CV 17 (0.2-0.3 cun), SP6 (0.5-1 cun), LI4 (1 cun), ST36 (1-1.5 cun), KI3 (0.5 cun) and LR3 (0.5 cun). Patients received 2 weekly 20-minute sessions for 6 weeks. The mean age of the patients was 35,89% had chronic hepatitis B and 1 patient had both hepatitis B and C. Three patients were receiving interferon. The median BDI and myalgia scores decreased significantly in Groups A and B after treatment. Group C had a non-significant change in the BDI score and the myalgia score was similar before and after treatment. Exclusion criteria were pregnancy, psychiatric disorders, and history of antidepressant use during the preceding 3 months, coagulation disorders and drug addiction.
 
Acupunct Med. 2010 Sep;28(3):136-9. Epub 2010 Jun 7.
Acupuncture for depression and myalgia in patients with hepatitis: an observational study.
 
 
Acupuncture Helpful for Depression
 
Eighty patients with major depressive disorder (MDD) were randomized into 2 groups. Group 1 received verum acupuncture, 10 mg/day of fluoxetine and placebo. Group 2 received sham acupuncture, 20-30 mg/day of fluoxetine for 6 weeks. Acupuncture in Group 1 was applied 5 times a week at 6 different locations: GV20 (Baihui), EX-HN1 (Sishencong), EX-HN3 (Yintang), GV26 (Shuigou), P6 (Neiguan), H7 (Shenmen), Liv3 (Taichong) and L14 (Hegu). Needling was done until there was needling sensation and retained for 30 minutes and manipulated once again during treatment. Group 2 was needled in non-specific locations 1-3 cm from the acupuncture points not recognized as true acupoints of meridians. Patients were allowed to use Zolpidem 10 mg prn for insomnia. No statistical difference was seen between groups at the end of the study even though Group 1 received a lower dose of fluoxetine. Group 1 also showed better improvement in symptoms of anxiety and antidepressant side effects. Group 1 also showed a statistically reduced use of zolpidem in the third period of the study.
 
J Altern Complement Med. 2009 Aug;15(8):837-44.
Combination of acupuncture and fluoxetine for depression: a randomized, double-blind, sham-controlled trial.
 
 
Acupuncture Treatment for Plantar Faciitis
 
In this randomized trial, patients were assigned to either a treatment group or a control group. The treatment group recefacuived needling at acupoint PC 7 and the control group received needling at acupoint Hegu (LI 7). Morning pain (22.6 ± 4.0 versus 12.0 ± 3.0, mean ± SEM), overall pain and pressure pain threshold was significantly different, in favour of the treatment group.
 
Evid Based Complement Alternat Med. 2009 Nov 23. [Epub ahead of print]
Acupuncture treatment for plantar fasciitis: a randomized controlled trial with six months follow-up.
 
 
Acupuncture and its Effect on Type I Hypersensitivity Itch
 
Thirty patients with atopic eczema received acupuncture before (direct effect) and after (preventative effect) exposure to an allergen stimulus (house dust mite or grass pollen skin prick). Patients either received verum acupuncture at points Quchi and Xuehai dominant side, or placebo acupuncture on the dominant side, or no acupuncture.  Direct and preventative effect itch intensity was significantly lower in the verum acupuncture group compared to the placebo and no acupuncture groups. Mean wheal and flare size were significantly lower in the verum acupuncture group compared to the placebo and no acupuncture groups. In both treatment approaches, itch questionnaire results were significantly lower in the verum acupuncture group.
 
Allergy. 2010 Jul;65(7):903-10. Epub 2009 Dec 11.
Influence of acupuncture on type I hypersensitivity itch and the wheal and flare response in adults with atopic eczema: a blinded, randomized, placebo-controlled, crossover trial
 
 
Acupuncture Effective Treatment in Temporomandibular Disorders (TMD)
 
Seventeen patients (37-50 years of age) with Temporomandibular joint (TMJ) pain, including signs and symptoms of TMD with a primarily muscular origin and  pain for at least 6 months received acupuncture treatment for 10 weeks. The acupuncture needling bilateral points were IG4, E6, E7, B2, VB14, VB20, ID18, ID19, F3, E36, VB34, E44, R3, and HN3, with 10 sessions conducted on a weekly basis, for 20 minutes each session.  After acupuncture treatment electromyography (EMG) was decreased at rest, as well as, clenching for all muscles. The molar maximal bite force increased after treatment. The EMG decrease did not reach an ideal of zero and EMG activity persisted and was higher in temporalis rather than masseter muscles. There was a better distribution of EMG activity after treatment. Individuals in this study also reported decreased pain and this may have contributed to the increased bite strength. However, the trial was of small size and lacked a sham placebo component.
 
J Altern Complement Med. 2009 Dec;15(12):1307-10.
Acupuncture and temporomandibular disorders: a 3-month follow-up EMG study.
 
 
Combined Abdominal Acupuncture with Conventional Acupuncture Improves Knee Osteoarthritis
 
One hundred and five patients with knee osteoarthritis were divided randomly into 3 groups. Group A received abdominal acupuncture at Zhongwan (CV 12), Guanyuan (CV 4), Wailing (ST 26), Daheng (SP 15), Lower Rheumatism point and Qipang with needles retained for 30 minutes. Group B received conventional acupuncture at Neixiyan (EX-LE4) and Dubi (ST 35) of the affected limb, Yanglingquan (GB 34), Liangqiu (ST 34), Xuehai (SP 10) and Xiyangguan (GB 33). Group C received both abdominal and conventional acupuncture. Treatment was given once daily, 6 days a week, for 4 weeks. Group C had the most "remarkably relieved" patients with 13 of the 35, followed by Group A with 8 of 25 and Group B with 7 of 35. Group C also had a higher number of "relieved" patients with 16 of the 35.  Abdominal acupuncture has a synergized function when combined with conventional acupuncture.
 
J Tradit Chin Med. 2009 Dec;29(4):249-52.
Clinical research on abdominal acupuncture plus conventional acupuncture for knee osteoarthritis.
 
 
Acupuncture Superior to Western Medicine and Chinese Medicine for Relieving Hyperemesis Gravidarum
 
Ninety individuals were randomly divided in an acupuncture group, a Western medicine group and a Chinese medicine group for 7 days of treatment. All subjects received a water and electrolyte supplement.  The acupuncture group recieved acupuncture at Dazhu (BL 11), Shangjuxu (ST 37), Neiguan (PC 6), and Gongsun (SP 4). The Western medicine group received Luminal 30 mg tid and the Chinese medicine group received a herbal decoction according to TCM syndrome differentiation.  The therapeutic effect, ketone bodies, carbon dioxide combining power (CO2-CP) and electrolyte imbalanceswere observed in all the groups. The acupuncture group had an efficacy rate of 96.7%, the Western group a rate of 46.7% and the Chinese medicine group a rate of 60%.
 
Zhongguo Zhen Jiu. 2009 Dec;29(12):973-6.
Observation on therapeutic effect of acupuncture on hyperemesis gravidarum
[Article in Chinese]
 
 
Acupuncture Plus Baclofen Works Better than Baclofen Alone for Lower Back Pain
 
Eighty-four men (50-60 years) with non-specific back low back pain (LBP) were randomly assigned to 4 groups for 5 weeks. Group 1 received baclofen 30 mg/day, Group 2 received acupuncture, Group 3 received both treatments, and Group 4 was a control group. For the acupuncture protocol each patient in Group 2 and 3 received needles bilaterally at points Shenshu (BL23), Dachangshu (BL25), Panguanshu (BL28), Ciliao (BL32), Kunlun (BL60), Huantiao (GB30) and Yanglingquan (GB34). Each acupuncture session consisted of 10-12 needles which were used bilaterally and needles were left in place for 20-25 minutes. Bacolfen alone was effective in reducing pain, but pain relief was not found to be significantly different from baseline at 3, 4, 5 and 10 weeks follow-up. Acupuncture alone significantly decreased pain at weeks 2, 3, 4 and 5 compared to baseline.  Relief was stable in the acupuncture group at week 10. The baclofen and acupuncture groups had significant pain reduction and the pain scores were lower than the baclofen or acupuncture monotherapy groups. 
 
Free full text article
Chin Med. 2010 Apr 24;5:15.
Reduction of chronic non-specific low back pain: a randomised controlled clinical trial on acupuncture and baclofen.

Tea Tree Oil for Slow Healing Wounds- Case Study

I thought this case study was interesting not only for diabetic wound care but other slow healing or infected wounds as well. My husband, who is active, in sports has had a couple of foot blisters become abscesses and one post-surgical wound infection. The post surgical wound infection was serious and treated with anti-biotics but the wound care was similar to this case below in that it consisted of irrigation and packing with anti-microbial products. The other 2 smaller abscesses I treated with foot poultices that opened the abscesses and allowed them to drain and essential oils to aid healing.  I was successful with both of these smaller infections. This case study highlights how essential oils can be employed for non-healing open wounds.

Altern Ther Health Med. 2011 Mar-Apr;17(2):46-7.
Chronic wound treatment with topical tea tree oil.

 

• 85 year old man
• smoker, non-diabetic, moderately active
• following surgery for a ruptured aneurysm (May 2006) he reported foot pain and a non-healing sore on his left foot (Nov 2007) and admitted to hospital (Dec 2007) for a below knee amputation
• Feb 2008- Two nickel sized areas 2 cm deep were observed on the stump  with no signs of infection - standard wound care was ordered
• Mar 2008- Another surgery was scheduled to further amputate 2-3 inches of the leg
• Patient wished to avoid surgery because of past narcotic reaction
• A alternative wound treatment was suggested by the primary health advocate of 7-10% tea tree oil and the surgeon agreed
• A solution of 10% organic tea tree oil and 90% organic pumpkin seed oil was used. The wound was irrigated and then packed with gauze strips soaked in the tea tree mixture once daily
• May 2008 the surgeon noted a significant decrease in the depth and size of wounds although they were still present
• Aug 2008 the tea tree treatment was discontinued and the surgeon stated that no surgery was necessary. The wounds sites had some redness at this point
• The wounds completely healed ( no date given)

Observations

• Patience! The care of these wounds was over 5 months.
• Tea tree oil is known to be antibacterial so perhaps the tea tree oil prevented infection from settling in and  allowed greater time for the wound to heal on its own. Julia Lawless in The Encyclopedia of Essential Oils lists Tea tree EO as anti-bacterial but also as a cicatrisant (helps formation of scar tissue.) and a vulnerary (prevents tissue degeneration and arrests bleeding in wounds.) In Jane Buckle's Clinical Aromatherapy there are human studies supporting tea tree oil as anti-bacterial (click page image to the left to read). She also lists them for elderly wound care (click page images to the right to read)
•  

• Pumpkin seed oil's main nutrients are: essential fatty acid - Omega 6, Omega 9, Vitamin A & E, antioxidants, phytosterols and carotenoids. It is unknown how this would affect the wound healing but essential fatty acids and the other components can be absorbed through the skin and in this case the outer horny layer of the dermis was missing so they were probably better absorbed.
• As this is a case of one it cannot be established that the treatment helped in the healing or if it did help was it the tea tree oil or the pumpkin seed oil or both.

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Fibromyalgia: Symptom Improvement with Diet and a Medical Food Supplement

This small pilot study looked at using an elimination diet in conjunction with a Phytonutrient-rich Medical Food in women with fibromyalgia and what effect it had on their symptoms. Medical food in this case is a rice protein based powder with added nutrients made my Metagenics called UltraClear. There are similar products made by other companies such as Thorne Research's MediClear and Douglas Labs Ultra Protein Plus Pea Protein.

There was an small improvement for the women in this study. The study itself was very small (8) and the only treatment was diet and the additional medical food. There was the addition of botanicals to program B as part of the UltraClear RENEW medical food. Additional interventions would be too difficult to measure within a study but what would be the outcome if they were utilized as well? Additional studies for fibromyalgia are listed at the bottom of the post.

Altern Ther Health Med. 2011 Mar-Apr;17(2):36-44.

A program consisting of a phytonutrient-rich medical food and an elimination diet ameliorated fibromyalgia symptoms and promoted toxic-element detoxification in a pilot trial.www.ncbi.nlm.nih.gov/pubmed/21717823
            - The study was funded by a subsidiary of Metagenics and used two of their products UltraClear MACRO and UltraClear RENEW.


DETAILS

• 8 female subjects with fibromyalgia with 3 or more months of widespread pain and at least 11/18 tender points and 4 or more current dental amalgams.
• Age 48-74 years
• BMI 20.4-44.8

DESIGN

• All subjects started with 1 week of seafood avoidance.

Program A 4 weeks of the standard Americam Diet exclusing seafood following food pyramid guidlines plus a Rice protein supplement twice a day- UltraClear MACRO with Calcium (60 mg), iron (2 mg), phosphorus (350 mg), magnesium (200 mg), manganese (1 mg), sodium (30 mg), potassium (730 mg)

Program B (immediately following program A with no washout period): 4 weeks of a hypoallergenic/elimination diet eliminating refined and added simple sugars, artificial colorings, flavorings, and sweeteners; caffeinated beverages; gluten-containing grains; eggs and dairy products; and allergenic foods or foods high in arachidonic acid  and seafood.
plus UltraClear RENEW twice daily with Beta-carotene (4000 IU), vitamin A (1000 IU), vitamin C (300 mg), calcium (150 mg), vitamin D (35 IU), vitamin E (42 IU), thiamin (2 mg), riboflavin (2 mg), niacin (7 mg), vitamin B6 (3.4 mg), folate (80 μg), vitamin B12 http://www.metadocs.com/products/detail.asp?pid=219
(3.6 μg), biotin (135 mg), pantothenic acid (36 mg), sodium (220 mg), potassium (520 mg), iron (1 mg), phosphorus (230 mg), iodine (53 μg), magnesium (160 mg), zinc (10 mg), copper (1 mg), manganese (1 mg), chromium (50 μg), sulfate (20 mg), Spent hops (1 g), pomegranate rind extract (50 mg), prune skin extract (125 mg), watercress whole plant extract (67 mg), and decaffeinated green tea extract (15 mg) * http://www.metadocs.com/products/detail.asp?pid=653

*The botanical mixture was chosen because those herbs are thought to upregulate the expression of mRNAs for  glutathione S-transferase, NADPH quinone reductase, and heme oxygenase-1, and spent hops upregulates expression of mRNA for metallothionein in vitro

RESULTS

• Both groups showed a trend towards lower mean total Fibromyalgia Impact Questionnaire (FIQ ), total Medical Symptoms Questionnaire(MSQ ), total FibroQuest Symptoms Survey (FibroQuest), FIQ stiffness score and FibroQuest headaches score. Only the MSQ total score was statistically lower in Group A than baseline.
• Fibromyalgia Impact Questionnaire (FIQ ) ranges from 0 to 80; Medical Symptoms Questionnaire (MSQ ) ranges from 0 to 284; FibroQuest Symptom Survey (FibroQuest) total score ranges from 0 to 120; FIQ pain score ranges from 0 to 10; FIQ stiffness score ranges from 0 to 10; FibroQuest headaches score ranges from 0 to 10. Higher scores indicate more severe symptoms.
• In comparison to baseline Program A had better pain tolerance in 4 tender spots and Program B in 8 tender spots. Program B had better pain toleracne at 5 tender points  in comparison to Program A and worse pain tolerance at the second rib on the right side. Grip strength was not changed throughout the study.
• Compared to baseline the mean creatinine-adjusted urinary mercury excretion was significantly increased in program A and B. The data suggested that is was higher in Program B. The difference between programs was not significant for creatinine-adjusted urinary mercury, cadmium, lead and arsenic.
• The programs were well tolerated and there were 20 mild adverse events and 1 moderate one. Symptomology was consistent with detoxification. Symptoms included constipation, diarrhea, gastrointestinal hypermotility, lethargy, hypersensitivity, upper respiratory tract infection, urinary tract infection, muscle spasms, myalgia, headache, nocturia, pruritis, and rash.

ADDITIONAL STUDIES

J Altern Complement Med. 2009 Apr;15(4):399-405.
A new nonpharmacological method in fibromyalgia: the use of wool.

2002 Jun;22(2):56-9. Epub 2002 Mar 29.

The effects of balneotherapy on fibromyalgia patients.

J Altern Complement Med. 2010 Apr;16(4):397-409.
Traditional Chinese medicine for treatment of fibromyalgia: a systematic review of randomized controlled trials.

J Altern Complement Med. 2009 Mar;15(3):247-57.
Intravenous micronutrient therapy (Myers' Cocktail) for fibromyalgia: a placebo-controlled pilot study.

Arch Phys Med Rehabil. 2010 Oct;91(10):1551-7.
The effects of 12 weeks of resistance exercise training on disease severity and autonomic modulation at rest and after acute leg resistance exercise in women with fibromyalgia.

Pain. 2010 Nov;151(2):530-9.
A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia.

J Altern Complement Med. 2010 Nov;16(11):1191-200.
Efficacy of Biodanza for treating women with fibromyalgia.

N Engl J Med. 2010 Aug 19;363(8):743-54.
A randomized trial of Tai chi for fibromyalgia.

Childhood Asthma and Probiotics: Are There any Studies?

A twitter follower suggested I look at studies using probiotics for childhood asthma. Good suggestion and so here it is! It is not an in depth analysis of each study but I have point-form summarized the studies and given overall bullet points for the studies as a whole.

I found 6 studies involving childhood asthma and probiotics, they also often include allergic rhinitis and allergic sensitization. Five of the studies are with probiotics administered to children and one is with probiotics given to expecting mothers.

A few overall thoughts on the studies

• One childhood study uses a fermented milk beverage. Milk could be an allergen in individuals with respiratory disease so I don’t think it was the best choice. This study shows that, " results suggest that even over the short time period of eight weeks, an egg- and milk-free diet can reduce atopic symptoms and improve lung function in asthmatic children."       J R Soc Promot Health. 2004 Mar;124(2):74-80. The effects of exclusion of dietary egg and milk in the management of asthmatic children: a pilot study.
  
• Most of the studies use one strain of probiotic. It is possible that better clinical results would come from a broad spectrum of probiotics. One study did use a combinations of probiotics but it was given to expecting women. The other study using a combination of probiotics was given for the first 6 months of life but the study was based on the follow-up at 5 years.
• Two studies had a short duration of 8 weeks
• None of the studies used a whole treatment approach to childhood asthma of diet, supplementation, or other complementary modalities used together. One study did use laser acupuncture in combination with probiotics.
  

Conclusion:

• Only one study showed a positive effect of probiotics on childhood asthma
• There was some effect on atopic dermatitis, allergic sensitization and allergic rhinitis in most of the studies

The studies in brief with links to full abstracts.

Randomized placebo-controlled trial of lactobacillus on asthmatic children with allergic rhinitis.

Pediatr Pulmonol. 2010 Nov;45(11):1111-20.

• Lactobacillus gasseri A5 for 8 weeks
• asthma and allergic rhinitis
• RCT
• 105 children 6-12 with asthma or allergic rhinitis
• probiotics significantly increased pulmonary function and peak expiratory flow rates (PEFR), clinical symptoms scores for asthma and allergic rhinitis decreased
• there was a significant  reduction in  TNF-α, IFN-γ, IL-12, and IL-13 production by the  peripheral blood mononuclear cells  following the probiotic treatment

Efficacy of probiotic Lactobacillus GG on allergic sensitization and asthma in infants at risk.

Clin Exp Allergy. 2010 Sep;40(9):1398-405. Epub 2010 Jun 28.

• Lactobacillus rhamnosus (LGG, 10(10) colony forming units) 6 months
• allergic sensitization and asthma.
• RCT
• 131 children,  6-24 months with 2 wheezing episodes and first-degree family history of atopic disease
• At follow-up there was no significant decrease in atopic dermatitis or childhood asthma related events
• There were fewer sensitizations towards aero-allergens after 6 months and after the following 6 month follow-up

A randomized prospective double blind controlled trial on effects of long-term consumption of fermented milk containing Lactobacillus casei in pre-school children with allergic asthma and/or rhinitis.

Pediatr Res. 2007 Aug;62(2):215-20.

• fermented milk containing a specific Lactobacillus casei 12 months
• RCT
• 187 children 2-5 years with  allergic childhood asthma and/or rhinitis
• No statistical difference between intervention and control group occurred in asthmatic children.
• In rhinitis, the annual number of rhinitis episodes was lower in the intervention group, and the mean duration of an episode of diarrhea was lower in the intervention group. Described as a mild effect

Laser acupuncture and probiotics in school age children with asthma: a randomized, placebo-controlled pilot study of therapy guided by principles of Traditional Chinese Medicine.
 

Pediatr Allergy Immunol. 2007 Mar;18(2):160-6.

• Enterococcus faecalis 8 weeks with laser acupuncture
• RCT
• 17 children 6-12 years with intermittent or mild persistent childhood asthma
• TCM group had fewer days of acute febrile infections when compared with the control group

Airway inflammation in probiotic-treated children at 5 years.

Pediatr Allergy Immunol. 2011 Mar;22(2):249-51.

• probiotic combination, plus pre-biotics (no dosage)
• RCT
• 1018 children during 6 months from birth
• Allergic disease and IgE-sensitization was not different between groups

Probiotics in pregnant women to prevent allergic disease: a randomized, double-blind trial.

Br J Dermatol. 2010 Sep;163(3):616-23.

• 415 moms
• probiotic milk or placebo from 36 weeks of gestation to 3 months postnatally during breastfeeding.
•  Lactobacillus rhamnosus GG, L. acidophilus La-5 and Bifidobacterium animalis subsp. lactis Bb-12.
• There were no significant effects on childhood asthma or atopic sensitization but reduced the cumulative incidence of atopic dermatitis

View at www.galenswatch.com