Tianjiu therapy for patients with chronic asthma : an evaluation of efficacy and exploration of the optimal treatment duration

Abstract

Although Tianjiu Therapy in Sanfu Days (三伏天灸) is extensively being used for the treatment of asthma in Mainland China, there is a lack of convincing evidence to support its efficacy to expand its clinical application into asthma treatment. This study incorporated two related studies, the first was a randomized, double-blind, placebo-controlled trial with an aim to evaluate the efficacy of Tianjiu Therapy in Sanfu Days for patients suffering from chronic asthma. The second was a self-control clinical efficacy observation study aiming to compare the efficacy of 2 courses Tianjiu Therapy with 1 course such treatment in order to find the optimal duration of Tianjiu Therapy. In the first study, 323 patients with chronic asthma were randomly assigned to Tianjiu Therapy group (n=165), and placebo group (n=158). There was no significant difference in primary and secondary outcome as compared with placebo group at the end of 3rd treatment and four times follow ups. But sub-analysis of secondary outcome in four times follow ups showed that Tianjiu Therapy significantly reduced the proportion of participants who didn’t need medical treatment during asthma attack increased from 6% to 15% at 1st follow up and 0% to 7% at 3rd follow up (P<0.05). In addition, Tianjiu Therapy was significantly superior to placebo in reducing the percentage of participants who were susceptibly waken up by asthma symptoms from 27% to 14%, and the percentage of participants who had the symptom of running nose and sneezing before onset from 18% to 8% at 2nd follow up ( P<0.05). Improvements also occurred with treatment group, it reduced the proportion of participants who were spontaneous sweating at 3rd follow up (P<0.05). In the second study, totally 102 patients received two courses of Tianjiu Therapy (3 sessions Tianjiu Therapy in a year constituted one course of treatment). After treatment, the number of symptoms which were associated with Chinese Medicine added by 1.38 points (95% CI, 0.25 to 2.51), 2.93±0.41 in the 1 course group and 4.31±0.41 in the 2 courses group (P<0.05). The number of days with asthma-related symptoms increased by 3.05 points (95% CI, 0.37 to 5.73), 1.98±0.96 in 1 course group and 5.03±0.96 in 2 courses group (P<0.05). But both 1 course and 2 courses Tianjiu Therapy as compared with baseline (didn’t receive Tianjiu Therapy at this time point) have a significant improvement in the most outcome measurements. From study 1, it was found that Tianjiu Therapy significantly decreased the need for pharmaceuticals to control asthma and improved the quality of participants’ life after one course Tianjiu Therapy. Study 2 indicated that although 2 courses Tianjiu Therapy was not as effective as 1 course Tianjiu Therapy in the treatment of asthma, both 1 course and 2 courses Tianjiu Therapy provided a significant improvement as compared with baseline. It was still unknown the optimal duration of Tianjiu Therapy, so it was worth to conduct the third course or more Sanfutianjiu Thearpy in future.