A pilot study of Banxia Houpu Tang, a traditional Chinese medicine, for reducing pneumonia risk in older adults with dementia

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.