Chinese herbal therapy dates back 3500 years. The first known Chinese herb book listed 365 medicinal plants and their uses, including Ma Huang (Ephedra sinica), the desert shrub that introduced the drug ephedrine to modern medicine. Ma Huang, known for its ability to dilate the bronchi, was traditionally used in Chinese formulas to treat asthma until it was banned in the United States in 2005 due to its unregulated and off-label use as a diet supplement.

The ban on Ma Huang prompted researchers to investigate alternative herbal formulas for asthma that did not include Ma Huang. Dr. Xiu-Min Li, MD, spent many years researching a 14 ingredient classical formula called ASHMI. Dr. Li found that just 3 ingredients from this formula that had remarkable efficacy in treating asthmatic symptoms.

Dr. Li reviewed an anti asthma simplified herbal medicine intervention (ASHMI, 3 herbs) derived from a classic 14-herb formula. A clinical trial collaborative study investigated the efficacy and tolerability of ASHMI with a randomized, double-blind, placebo-controlled model. This study was conducted through a grant from the NCCAM.

The 3 herbs in ASHMI (equivalent pharmaceutical names) are Reishi (Ganoderma lucidum), Ku Shen (Radix Sophorae Flavescentis), and Licorice (Radix Glycyrrhizae). Ninety-one patients, 18-60 years of age, with persistent moderate-to-severe asthma were randomly assigned into 2 groups. The ASHMI group received 4 capsules of ASHMI 3 times per day and prednisone placebo. The prednisone group received ASHMI placebo and 20 mg of prednisone each day. All groups were treated for 4 weeks. Measurements of results were based on spirometry, symptom scores, and side effects. Serum cytokine, cortisol, and immunoglobulin IgG levels were obtained before and after treatment.

The results showed significant improvement in lung function for both groups, as shown by both increased forced expiratory volume in 1 second (FEV) and peak expiratory flow. Both groups had improved clinical symptom scores and reduced use of bronchodilators. Both groups, to a similar degree, had reduced serum IgG levels. Both groups had significantly reduced cytokine levels, lower in the prednisone group than in the ASHMI group (P < .05). The prednisone group had reduced cortisol levels, and the ASHMI group had increased levels of cortisol. Cortisol is an anti inflammatory hormone.

Dr. Li reported that there were no severe side effects on the major organs tested in the ASHMI group. In addition, the ASHMI group had no significant effects on body weight and no negative effects on adrenal function. Dr. Li concluded that ASHMI may be an effective, safe, and well-tolerated botanical drug for asthma.

The availability of valid scientific data and research on this classic Chinese herbal formula has garnered enough attention for practitioners of other disciplines to begin using these herbs as a supplement to treat asthma. Herbal research can lead to findings that foster the streamlining of ancient formulas into simplified but equally effective treatments, as well as promoting their use among practitioners other than acupuncturists. Allergy Research now manufactures the 3 ingredient asthma formula as a supplement called PhytoCort.