Evaluation of Wet Cupping Therapy (Hijama) as an Adjuvant Therapy in the Management of Bronchial Asthma

The aim of this study is to evaluate the effectiveness of cupping therapy as an adjuvant therapy in the management of patient with bronchial asthma. To achieve this target, a total of 50 patients suffering from moderate persistent bronchial asthma were included in this study. They were selected from chest clinics in Giza Chest Hospital and Ain Shams University Hospital.

Patients were selected according to positive history of asthma, and other clinical examinations. They were divided into two randomly equal matched groups, 25 patients each, according to the time of attendance to the outpatient clinic.

Group I: 25 patients each subjected to complimentary cupping therapy besides the conventional medication set by Global Initiative For Asthma 2006.

Group II: 25 patients each received conventional medication only set by Global Initiative For Asthma 2006. The conventional treatment is recommended by GINA 2006.

All our patients were subjected to clinical evaluation (daytime symptoms, nocturnal symptoms, need for rescue medications , limitation of activity and exacerbations) and respiratory function tests before and after 3 months of treatment. In addition to serum ECP were measured using IMMULITE/ IMMULITE 2000 Analyzers and complete blood picture with emphasis on esinophilic count at base line before and after 3 months of treatment, as well as just before and after the 1st and 3^rdcupping sessions.

In the present study, we found that there was clinical improvement of highly significant statistical value in both groups, however, group (I) showed better response regarding all clinical parameters. Regarding the improvement in the pulmonary function tests before and after treatment in both groups there was statistically significant difference in the improvement in group (I) compared to group (II) especially as regard FEV1, FEV1 \ FVC% and FEF25 – 75 %. Regarding relative esinophilic count in peripheral blood film before and after 3 months’ treatment, there was statistical significant reduction in group (I) and non significant statistical reduction in group (II) , but as a salient feature , there was significant statistical reduction in esinophilic count in group (I) after as compared to before the 1st session (30 minutes average). Regarding serum ECP levels of venous sample before and after 3 months’ treatment there was significant statistical reduction in serum ECP levels in the group (I), and non significant statistical reduction in group (II). Regarding complete blood picture CBC results (hemoglobin % , RBCs count , WBCs and platelets) of venous samples drawn from all patients before and after cupping in group (I) showed non significant differences in them. On the other hand there was significant statistical difference between cupping and venous samples regarding the platelet count where the platelet count of the cupping blood was less than the platelet count of the venous sample. Therefore cupping is considered as a filter to keep the beneficial elements to the body and get red of the harmful elements . In the present study in comparison between the two groups after the period of 3 months treatment it was found that group (I) had a significant statistical difference than group (II) as regard daytime symptoms, nocturnal symptoms, need for reliever, exacerbations, ECP, Peripheral Esinophilic count, FVC % and FEF25%-75%.On the other hand a high significant statistical difference as regard FEV1/FVC% and FEV1 % was found.