Definition
Western
Allergies are the hypersensitive immunological reactions that are triggered upon oral / inhalational / direct exposure to substances such as certain food, drugs or airborne particles which are generally harmless to the normal human body [1]. Such reactions could be attributed to the immature development of the mucosal barriers and the immune system in genetically predisposed individuals [1]. There is also increasing evidence in supporting the hypothesis that non-genetically disposed individuals living in sterile environment and hence lacking early childhood exposure to foreign particles are also at higher riskof developing allergies in later part of their lives [2-4]. Outcomes of the allergies are thus influenced by the unique physiological characteristics of the victim’s immune responses as well as the resistance against the triggering allergens [5].
Traditional Chinese Medicine (TCM)
Allergies usually occur in individuals who have weaker defense system (inherently or due to negative lifestyle influences) against the invasion of the exogenous pathogenic factors and are thus less able to counteract their effects. This results in the disorders in the body’s various systems namely those of respiratory, skin and digestive systems, which are presented as a range of symptoms in different types of allergies.
Symptoms Displayed / Classification in TCM Context
Disorders of the Respiratory Tract
Individuals who are likely to develop this category of disorders usually have a history of being prone to falling sick, or have slow recoveries from even the light illnesses such as common colds. Individuals will repeatedly feel tired and perspire easily. Their respiratory systems could be inherently weak or developed poorly as a result of inadequate nutrition or recurring chronic illnesses. The respiratory tract symptoms are commonly attributed to inhalant allergies such as pollen and dust, though they may sometimes result from food hypersensitivities as well [6]. Common symptoms displayed during allergic reactions include recurring runny nose, constant sneezing, nasal congestion, itchy nose / throat, shortness of breath, wheezing, tightness in chest, and other cutaneous and / or gastrointestinal symptoms.
Disorders of the Skin
Usually accounted by practising unhealthy dietary habits such as high consumptions of alcohol, meat and dairy products, deep-fried or spicy foods. In addition, people who lead stressful lifestyle of long working hours are also more likely to develop such skin disorders. This category of symptoms is commonly associated with food allergies, and the conditions are usually complicated by infections, irritants, heat and humidity [7]. Such factors interfere with the normally smooth flow of blood in the body, leading to inefficient supply of nutrients to nourish the skin as well as help in the removal of toxins or waste metabolic products, hence resulting in skin disorders. Common symptoms include red patches / papules / macula or swellings on skin, intense itching, swollen and watery eyes and other respiratory and/or gastrointestinal symptoms.
Disorders of the Gastrointestinal Tract
People who have poor eating habits, such as binge-eating, consuming cold foods such as ice-cream, ice-cold carbonated drinks or uncooked vegetables tend to be more susceptible to developing such gastrointestinal disorders, as these weaken the digestive functions. Frequently a result of food hypersensitivities e.g. peanuts, eggs, milk, seafood, this set of symptoms occurs each time the gastrointestinal tract is exposed to the particular allergens. Instead of recognising the digested foods as useful nutrients, the body mistakes them as harmful substances and hence launches a fight-back response against them, so as to destroy or expel them from the body. Common symptoms include nausea, vomiting, gastric pain, abdominal pain, fatigue, diarrhoea, and other respiratory or cutaneous symptoms.
Cause & Risk Factors
People with family history of allergies; weak digestive system, especially those who frequently consume cold foods, alcohol, spicy and oily foods, or have irregular diet pattern, lead stressful lifestyle i.e. work long hours and have inadequate rest or those who catch colds or fall sick easily.
Treatments
Herbal prescriptions: Herbs commonly used include:
1. Xin Yi - 辛夷
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English/ Common name
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Biond Magnolia flower
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Latin species
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Magnolia biondii Pamp.
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Park of plant used
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Flower
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Action/s
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Helps to constrict blood vessels in the nasal mucosa and promotes reabsorption of mucous secretions [20]. It also has antihistamine-like and antimicrobial effects [8].
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Precaution/s
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Place herb in a cloth bag when boiling. People who sweat during sleep, experience hot flushes, or are frequently thirsty should avoid.
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2. Huang Qi - 黄芪
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English/ Common name
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Chinese Astragalus root
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Latin species
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Astragalus membranaceus (Fisch.) Bge.
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Park of plant used
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Roots
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Action/s
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Proven effective in promoting the body’s metabolism and boosting one’s immunity. In addition, it has anti-bacterial [10] and inhibitory effects on some influenza viruses [20]. This herb is well-known for its ability to regulate immunity, and hence is often used in immunotherapy [11-12]. It also has some anti-fatigue and anti-ageing effects [9,20].
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Precaution/s
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No significant side-effects.
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3. Bai Xian Pi - 白鲜皮
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English/ Common name
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Dittany Bark
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Latin species
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Dictamnus dasycarpus Turcz.
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Park of plant used
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Root bark
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Action/s
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Found to have antifungal [13] and bactericidal effects [14]. Also help to constrict blood vessels [20] to reduce inflammations.
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Precaution/s
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People who have soft or watery stools, feel cold easily or often feel tired and sleepy should take with caution.
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4. Fang Feng - 防风
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English/ Common name
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Divaricate Saposhniovia root
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Latin species
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Saposhnikovia divaricata (Turcz.) Schischk.
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Park of plant used
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Roots
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Action/s
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Found to have antimicrobial, pain-relieving, anti-convulsant [20] and also anti-inflammatory effects [15].
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Precaution/s
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Not suitable for people with low blood pressure, anaemia, epilepsy, have the tendency to feel giddy or experience numbness in hands and feet.
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5. Sheng Jiang - 生姜
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English/ Common name
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Ginger
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Latin species
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Zingiber officinale Ros.
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Park of plant used
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Rhizome
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Action/s
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Helps to protect the mucosa of the gastric wall and has nausea-relieving effects[20], as well as found to have some anti-bacterial [16] and anti-inflammatory effects [17,18].
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Precaution/s
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Not suitable for people with hard dry stools, foul breath, swollen gums, yellow phlegm and those who are feverish or extremely thirsty.
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6. Sha Ren - 砂仁
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English/ Common name
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Cardamom Seeds
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Latin species
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Amomum villosum Lour.
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Park of plant used
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Fruits
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Action/s
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Helps to promote secretion of digestive juices and induce peristaltic movements of the gastrointestinal tract [20]. Also slows the activities of colonic bacterial enzymes and reduces exposure of the intestinal mucosa to harmful substances like bacteria and toxins [19].
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Precaution/s
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Not recommended to boil for more than 10 minutes. Not suitable for people with dry, scaly skin or dry eyes, or those who often experience muscle spasms or numbness in limbs.
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Tests & Diagnosis
1. Blood tests to check for eosinophilic responses
2. Refer to medical and family history to help for further diagnosis
3. Allergen challenge test and / or skin prick test to identify possible allergic factors [1,5,7].
Lifestyle & Home Remedies
Abstain from allergens. Avoid consuming alcohol, oily, spicy foods or seafood. Rest adequately and reduce stress. Have a good work-life balance and exercise regularly.
Do not wash skin rashes with scalding hot water or with soap. Refrain from scratching the rashes.
Xin Yi + Huang Qi + Chinese Licorice
a) Soak all ingredients in a flask of hot water for at least 20 minutes.
b) Best serve warm.
Bai Xian Pi + Fang Feng
a) Place ingredients in a cooking pot and add enough water to cover
b) Bring to boil for 10 minutes. Simmer for 20 minutes.
c) Allow it to cool for 20 minutes.
d) Soak a towel in the solution and wash the areas of skin rashes (avoid the area around the eyes).
Ginger + Sha Ren + White grain rice
a) Place ginger in a cooking pot and add enough water to cover
b) Bring to boil for 10 minutes. Simmer for further 10 minutes.
c) Add Sha Ren and simmer for 10 minutes
d) Filter the herbs and keep the broth
e) In another pot, cook plain rice porridge until it is soft
f) Mix porridge with broth from (e). Serve warm.
References
1. HA Sampson Update on food allergy. Journal of Allergy and Clinical Immunology May 2004 113(5): pp805-819
2. Grammatikos AP The genetic and environmental basis of atopic diseases. Ann Med. 2008; 40(7):pp482-495
3. Bufford JD, Gern JE The hygiene hypothesis revisited. Immunol Allergy Clin North Am May 2005 25(2): pp247–262, v–vi.
5. SH Sicherer, HA Sampson Food allergy. Journal of Allergy and Clinical Immunology Feb 2010 125(2): pp S116-125
6. JM James Respiratory tract and food hypersensitivity. Immunology and Allergy Clinics of North America Aug 1999 19(3): pp519-532
7. HA Sampson The evaluation and management of food allergy in atopic dermatitis. Clinics in Dermatology 2003 21(3): pp183-192
8. MA Kelm, MG Nair A brief summary of biologically active compounds from Magnolia spp.. Studies in Natural Products Chemistry 2000 24(5): pp845-873
9. KI Block, MN Mead Immune System Effects of Echinacea, Ginseng, and Astragalus: A Review. Integr Cancer Ther 2003 (2): pp247
10. Liu JP, Yang M, Du XM Herbal medicines for viral myocarditis. Cochrane Database of Systematic Reviews 2004 (3): ppCD003711
11. Yin X, Zhang Y, Wu H, Zhu X, Zheng X, Jiang S, Zhuo H, Shen J, Li L, Qiu J Protective effects of Astragalus saponin I on early stage of diabetic nephropathy in rats. Journal of Pharmacological Sciences 2004 (95): pp256-266
12. M Kusum, V Klinbuavaem, M Bunjob, S Sangkitporn Preliminary efficacy and safety of oral suspension SH, combination of five Chinese medicinal herbs, in people living with HIV/AIDS; the phase I/II study. Journal of the Medical Association of Thailand 2004(87): pp1065-1070
13. Zhao WM, J-L Wolfender, K Hostettmann, Xu RS, Qin GW Antifungal alkalokds and limonoid derivatives from Dictamnus dasycarpus.. Phytochemistry Jan 1998 47(1): pp7-11
14. Lei JC, Yu JQ, Yu HD, Liao ZX Composition, cytotoxicity and antimicrobial activity of essential oil from Dictamnus dasycarpus.. Food Chemistry Apr 2008, 107(3): pp1205-1209
15. Wang CC, Chen LG, Yang LL Inducible nitric oxide synthase inhibitor of the Chinese herb I Saposhnikovia divaricata (Turcz.) Schischk. Cancer Letters 1999 145(1-2): pp151-157
16. Yin MC, Cheng WS Inhibition of Aspergillus niger and Aspergillus flavus by some herbs and spices. J Food Protect. 1998 (61): pp123-125
17. RC Lantz, GJ Chen, M Sarihan, AM Solyom, SD Jolad, BN Timu The effect of extracts from ginger rhizome on inflammatory mediator production. Phytomedicine Feb 2007 14(2-3): pp123-128
18. JA Ojewole Analgesic, anti-inflammatory and hypoglycaemic effects of ethanol extract Zingiber officinale (Roscoe) rhizomes (Zingiberaceae) in mice and rats. Phytother Res 2006 (20): pp764-772
19. Huang YL, Yen GC, Sheu F, Lin JY, Chau CF Dose effects of the food spice cardamom on aspects of hamster gut physiology. Molecular Nutrition and Food Research 2007 51(5): pp602-608
Gao XM. Zhong Yao Xue. 2002.