A Pilot Study of Banxia Houpu Tang, a Traditional Chinese Medicine, for Reducing Pneumonia Risk in Older Adults with Dementia

Authors

  • Koh Iwasaki MD, PhD,

    1. From the *Center for Asian Traditional Medicine, Graduate School of Medicine and §Department of Health Administration and Policy, Department of Geriatrics and Gerontology, School of Medicine, Tohoku University, Sendai, JapanDepartment of Cardiology and Pneumology, School of Medicine, Dokkyo University, Tochigi, JapanUtsunomiya-Higashi Hospital, Tochigi, Japan#Yamagata-Kosei Hospital, Yamagata, Japan.
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  • Shiro Kato MD, PhD,

    1. From the *Center for Asian Traditional Medicine, Graduate School of Medicine and §Department of Health Administration and Policy, Department of Geriatrics and Gerontology, School of Medicine, Tohoku University, Sendai, JapanDepartment of Cardiology and Pneumology, School of Medicine, Dokkyo University, Tochigi, JapanUtsunomiya-Higashi Hospital, Tochigi, Japan#Yamagata-Kosei Hospital, Yamagata, Japan.
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  • Yasutake Monma MS,

    1. From the *Center for Asian Traditional Medicine, Graduate School of Medicine and §Department of Health Administration and Policy, Department of Geriatrics and Gerontology, School of Medicine, Tohoku University, Sendai, JapanDepartment of Cardiology and Pneumology, School of Medicine, Dokkyo University, Tochigi, JapanUtsunomiya-Higashi Hospital, Tochigi, Japan#Yamagata-Kosei Hospital, Yamagata, Japan.
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  • Kaijun Niu MD, PhD,

    1. From the *Center for Asian Traditional Medicine, Graduate School of Medicine and §Department of Health Administration and Policy, Department of Geriatrics and Gerontology, School of Medicine, Tohoku University, Sendai, JapanDepartment of Cardiology and Pneumology, School of Medicine, Dokkyo University, Tochigi, JapanUtsunomiya-Higashi Hospital, Tochigi, Japan#Yamagata-Kosei Hospital, Yamagata, Japan.
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  • Takashi Ohrui MD, PhD,

    1. From the *Center for Asian Traditional Medicine, Graduate School of Medicine and §Department of Health Administration and Policy, Department of Geriatrics and Gerontology, School of Medicine, Tohoku University, Sendai, JapanDepartment of Cardiology and Pneumology, School of Medicine, Dokkyo University, Tochigi, JapanUtsunomiya-Higashi Hospital, Tochigi, Japan#Yamagata-Kosei Hospital, Yamagata, Japan.
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  • Reina Okitsu MD,

    1. From the *Center for Asian Traditional Medicine, Graduate School of Medicine and §Department of Health Administration and Policy, Department of Geriatrics and Gerontology, School of Medicine, Tohoku University, Sendai, JapanDepartment of Cardiology and Pneumology, School of Medicine, Dokkyo University, Tochigi, JapanUtsunomiya-Higashi Hospital, Tochigi, Japan#Yamagata-Kosei Hospital, Yamagata, Japan.
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  • Satoshi Higuchi BS,

    1. From the *Center for Asian Traditional Medicine, Graduate School of Medicine and §Department of Health Administration and Policy, Department of Geriatrics and Gerontology, School of Medicine, Tohoku University, Sendai, JapanDepartment of Cardiology and Pneumology, School of Medicine, Dokkyo University, Tochigi, JapanUtsunomiya-Higashi Hospital, Tochigi, Japan#Yamagata-Kosei Hospital, Yamagata, Japan.
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  • Shiro Ozaki MD,

    1. From the *Center for Asian Traditional Medicine, Graduate School of Medicine and §Department of Health Administration and Policy, Department of Geriatrics and Gerontology, School of Medicine, Tohoku University, Sendai, JapanDepartment of Cardiology and Pneumology, School of Medicine, Dokkyo University, Tochigi, JapanUtsunomiya-Higashi Hospital, Tochigi, Japan#Yamagata-Kosei Hospital, Yamagata, Japan.
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  • Noboru Kaneko MD,

    1. From the *Center for Asian Traditional Medicine, Graduate School of Medicine and §Department of Health Administration and Policy, Department of Geriatrics and Gerontology, School of Medicine, Tohoku University, Sendai, JapanDepartment of Cardiology and Pneumology, School of Medicine, Dokkyo University, Tochigi, JapanUtsunomiya-Higashi Hospital, Tochigi, Japan#Yamagata-Kosei Hospital, Yamagata, Japan.
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  • Takashi Seki MD, PhD,

    1. From the *Center for Asian Traditional Medicine, Graduate School of Medicine and §Department of Health Administration and Policy, Department of Geriatrics and Gerontology, School of Medicine, Tohoku University, Sendai, JapanDepartment of Cardiology and Pneumology, School of Medicine, Dokkyo University, Tochigi, JapanUtsunomiya-Higashi Hospital, Tochigi, Japan#Yamagata-Kosei Hospital, Yamagata, Japan.
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  • Katsutoshi Nakayama MD, PhD,

    1. From the *Center for Asian Traditional Medicine, Graduate School of Medicine and §Department of Health Administration and Policy, Department of Geriatrics and Gerontology, School of Medicine, Tohoku University, Sendai, JapanDepartment of Cardiology and Pneumology, School of Medicine, Dokkyo University, Tochigi, JapanUtsunomiya-Higashi Hospital, Tochigi, Japan#Yamagata-Kosei Hospital, Yamagata, Japan.
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  • Katsutoshi Furukawa MD, PhD,

    1. From the *Center for Asian Traditional Medicine, Graduate School of Medicine and §Department of Health Administration and Policy, Department of Geriatrics and Gerontology, School of Medicine, Tohoku University, Sendai, JapanDepartment of Cardiology and Pneumology, School of Medicine, Dokkyo University, Tochigi, JapanUtsunomiya-Higashi Hospital, Tochigi, Japan#Yamagata-Kosei Hospital, Yamagata, Japan.
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  • Masahiko Fujii MD, PhD,

    1. From the *Center for Asian Traditional Medicine, Graduate School of Medicine and §Department of Health Administration and Policy, Department of Geriatrics and Gerontology, School of Medicine, Tohoku University, Sendai, JapanDepartment of Cardiology and Pneumology, School of Medicine, Dokkyo University, Tochigi, JapanUtsunomiya-Higashi Hospital, Tochigi, Japan#Yamagata-Kosei Hospital, Yamagata, Japan.
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  • Hiroyuki Arai MD, PhD

    1. From the *Center for Asian Traditional Medicine, Graduate School of Medicine and §Department of Health Administration and Policy, Department of Geriatrics and Gerontology, School of Medicine, Tohoku University, Sendai, JapanDepartment of Cardiology and Pneumology, School of Medicine, Dokkyo University, Tochigi, JapanUtsunomiya-Higashi Hospital, Tochigi, Japan#Yamagata-Kosei Hospital, Yamagata, Japan.
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Address correspondence to Koh Iwasaki, MD, PhD, Center for Asian Traditional Medicine, Graduate School of Medicine, Tohoku University, 1-1 Seiryo-machi, Aoba Ward, Sendai, Miyagi, 980-8574 Japan. E-mail: QFG03604@nifty.com

Abstract

OBJECTIVES: To evaluate whether the traditional Chinese herbal medicine Banxia Houpu Tang (BHT, formula magnolia et pinelliae) prevents aspiration pneumonia and pneumonia-related mortality in elderly people.

DESIGN: A prospective, observer-blinded, randomized, controlled trial.

SETTING: Two long-term care hospitals for handicapped elderly patients in Japan from March 2005 to February 2006.

PARTICIPANTS: One hundred four elderly patients (31 men and 73 women; mean age±standard deviation 83.5±7.8) with dementia and cerebrovascular disease, Alzheimer's disease, or Parkinson's disease.

INTERVENTION: Ninety-five participants (mean age 84.0, M:F=28:67) were randomly assigned to the BHT treatment group (n=47) or the control group (n=48) and took BHT or placebo for 12 months.

MEASUREMENTS: The occurrence of pneumonia, mortality due to pneumonia, and the daily amount of self-feeding.

RESULTS: Complete data were available for analysis on 92 of the 95 subjects randomized. Four patients in the BHT group developed pneumonia, and one of them died as a result. Fourteen patients in the control group developed pneumonia, and six of them died as a result. There was a significant difference between the two groups in pneumonia onset (P=.008), and a tendency toward significance in pneumonia-related mortality (P=.05). The relative risk of pneumonia in the BHT group compared with the control group was 0.51 (95% confidence interval (CI)=0.27–0.84, P=.008) and that of death from pneumonia was 0.41 (95% CI=0.10–1.03, P=.06) according to the Cox proportional hazards model. No adverse events were observed from treatment with BHT. The BHT group was able to maintain self-feeding better than the control group (P=.006).

CONCLUSION: Treatment with BHT reduced the risk of pneumonia and pneumonia-related mortality in elderly patients with dementia.

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