Preliminary report of use of picrorrhiza kurroa root in bronchial asthmaBina K Shah, SR Kamat, UK Sheth
Departments of Chest Medicine, Clinical Pharmacology Unit, and Dept. of Pharmacology, Seth G. S. Medical College &K.E.M. Hospital, Bombay-400 012., India
Correspondence Address: Source of Support: None, Conflict of Interest: None PMID: 614425
Source of Support: None, Conflict of Interest: None
A preliminary study of Picrorrhiza Kurroa root in Bronchial asthma in 10 patients is reported. There was evidence of short term benefit in some 6 subjects. In 4 there were significant side effects.
Roots of Picrorrhiza Kurroa-an in digeneous plant-have been reported to be useful in the treatment of bronchial asthma.  There is also some experimental evidence that the drug given as a whole root powder orally has action Similar to sodium chromoglycate of dexamethasone in allergen induced bron chospasm. , These studies indicated that the drug is likely to have a beneficial effect in the control of bronchospastic exacerbations.
This is a report of our pilot experience in treating 10 cases of acute exacerbations with bronchial asthma.
From cases admitted in hospital with acute status asthmaticus with a history of at least 2 weekly attacks, no evidence o: respiratory infection and no requirement of steroid treatment were taken for study 48 hours after control of the acute state. Patients with presence of high (over 1000) eosinophil count, chronic productive cough or complications like cardiac failure, pregnancy and children below 10 years were considered unsuitable. The trial was done by open method with first 5 patients getting 160 mg of powdered root of picrorrhiza kurroa twice daily and next 5 patients 300 mg twice daily each for 14 days. All were kept in the hospital as per our standard methods.  Lung Function in form of FVC, FEV 1 , and PEF were measured twice a week for 2 weeks and later weekly for the next 4 weeks.
Clinical background: Of the 10 patients, 7 were females and 3 males. Mean age was 32.8 years and mean duration of history was 10.7 (3-16) years. Routine chemistry, blood counts and liver function were estimated in each patient before and after the drug trial. One patient showed a fall of haemoglobin from 14.4 to 11.5 gm% (probably with coexisting history of peptic ulcer) and another from 16.3 to 12.9 gm %. Only in one case there was an increase in E.S.R. from 18 to 65 mm. There were no other changes in other laboratory parameters attributable to this drug.
On lower dose (320 mg) one patient had headache, abdominal pain, vomiting, increased dyspnoea and giddiness; while on higher dose (600 mg) three patients had similar symptoms [Table 1]. Only in one it was mild. Thus side-effects seemed significant despite hospitalisation.
We have followed our subjects for 4 to 15 weeks (mean 8.1). On low dose two patients showed improvement and one was worse, and 2 remained unchanged while on high dose, 4 patients showed improvement and one was worse. When followed on low dose, 3 required steroid and 2 maintained clinical improvement. On high dose two relapsed but could be controlled with bronchodilators, two required steroids and only one maintained improvement.
Lung Function Changes. [Table 2]
In all patients there was significant improvement in FEV I after isoprenaline aerosol (15.4 to 55.0%). On low dose, at the end of 2 weeks 3 showed lower function while in 2 there was slight and large improvement.
On high dose, one showed transitory improvement with later relapse; one showed slight improvement which was large with steroids, one showed improvement which decreased a little later; one showed transitory decrease and later improvement and one worsened. Thus there was some improvement in 4 cases which was sustained in only one case.
Our experience with Picrorrhiza suggests that in some subjects there is evidence of subjective and objective improvement. These results are not as good as those reported by Rajaram  in 45 patients. But he has mainly studied Clinical parameters and his cases may be less severe than our cases. Also perhaps we have tested the drug in more acute stage of bronchospasm.
However we consider these results as indicative of showing some benefit in a proportion of patients. This experience needs to be confirmed in a longer trial with a high dose, in a double blind fashion.
We wish to thank Dr. D. Rajaram fox discussions, Shri A. V. Mody, M.Sc., Managing Director, Unichem Ltd., for the drug supply and Dr. C. K. Deshpande, Dean for allowing this trial.
[Table 1], [Table 2]