Condition Treated / Pain Conditions

 

Asthma

Asthma

Asthma, or "Xiao Chuan" in Chinese, is a disease characterized by repeated attacks of paroxysmal
shortness of breath, wheezing in the throat, despite having the mouth open and shoulders raised.
Actually, "Xiao" (wheezing) and "Chuan" (panting) are different symptoms, but they both
manifest as coarse breathing. "Xiao" (Wheezing)is characterized by wheezing in the throat, while "Chuan" (panting) is difficulty in breathing even breathing with the mouth open and the shoulders raised. Their causes and pathogenesis of the disease are similar, and they often appear clinically simultaneously, so they are discussed together as "Xiao Chuan" (asthma). Asthma attacks occur year­ round, especially during cold seasons or drastic climate changes. In western medicine, it refers to diseases such as bronchial asthma, chronic asthmatic bronchitis, pneumonia, emphysema and cardiac asthma.

Causes and Pathogenesis of the Disease

The basic cause of the disease is the internal retention of phlegm-fluid. It can be partiality
blamed on the consumption of salty and greasy food, or sea foods such as shrimps and crabs. It may cause dysfunction of the spleen in transformation and transportation, resulting in retention of
dampness and phlegm which may block the air passages. In children, the asthma attacks are usually induced by seasonal contraction of external evils. In adults, the attacks are induced by prolonged coughing, emotional disturbance and over-exertion, which can provoke the hidden phlegm-fluid in the lung. During the stage of paroxysm, the disease manifests as an excessive pattern since there is a blockage of qi and an accumulation of phlegm. In the stage of intermission, the disease manifests as a deficiency pattern since the repeat recurrent attacks impair the functions of the lung and kidney.

Identification of Patterns

(1) Excess patterns
Chief symptoms An asthma attack presents with harsh, deep and prolonged breathing, with a
preference for exhaling, and a forceful pulse during a brief episode or in a full-blown stage of
paroxysm.
The pattern of wind-cold invasion may manifest as coughing and panting, expectoration of watery
sputum, aversion to cold, absence of sweating, headache, absence of thirst, a thin white tongue
coating and a floating, tight pulse.

The pattern of phlegm­ heat obstructing the lung may manifest as coughing, difficulty in expectorating sputum, oppression in the chest, pain in the chest and hypochondriac regions, or accompanied by fever, thirst, poor appetite, constipation, a red tongue with a yellow greasy coating and a slippery, rapid pulse.

(2) Deficiency patterns
Chief symptoms Asthma with a low sound, dyspnea, weak constitution, a forceless and feeble pulse, long course of other diseases, recurrent paroxysm, or in the stage of intermission.
The pattern of deficiency of lung-qi may manifest as dyspnea with shortness of breath aggravated by exertion, sputum wheezing in the throat, lassitude, debility, watery sputum, sweating by exertion, a light-colored tongue with a thin white coating and a thready, rapid pulse. In the pattern of deficiency of kidney-qi, it may be manifested as short and abrupt breathing, increased exhalation and decreased inhalation, discontinuous breathing, asthma aggravated by exertion, cold limbs after perspiration, a pale tongue with a thin white coating and a deep, thready pulse.

Treatment

(1) Primary treatment

Excess patterns
Principal points Lieque (LU 7), Chize (LU 5), Danzhong (CV 17), Feishu (BL 13), and Dingchuan (EX-B1)
Supplementary points In the pattern of wind-cold, add Fengmen (BL 12); in the pattern of wind-heat, add Dazhui (GV 14) and Quchi (LI 11); in the pattern of phlegm­ heat, add Fenglong (ST 40); and in the pattern of severe dyspnea, add Tiantu (CV 22).

Explanation Lieque (LU 7) of hand-taiyin channel is selected to disperse lung­ qi and dispel the evil qi out of the body. Chize (LU 5), the He-Sea Point of hand-taiyin channel, is used to descend the adverse-rising of lung-qi for dissipating phlegm and subsiding asthma. Danzhong (CV 17), the Influential Point of qi, is used to release the distressed chest and regulate qi dynamics. Feishu (BL 13), the Back-Shu Point of the lung, is selected to allow the lung to dissipate phlegm. Dingchuan (EX-Bl) is an empiric and effective point for asthma.

Deficiency patterns
Principal points Feishu (BL 13), Gaohuang (BL 43), Shenshu (BL 23), Dingchuan (EX-B1), Taiyuan (LU 9), Taixi (KI 3) and Zusanli (ST 36).
Supplementary points In the pattern of deficiency of lung-qi, add Chize (LU 5) and Qihai (CV 6). In the pattern of deficiency ofkidney-qi, add Yingu (KI 10) and Guanyuan (CV 4)..

Explanation Acupuncture with moxibustion on Feishu (BL 13) and Gaohuang (BL 43) can torrify lung-qi and moisten lung-yin. Shenshu (BL 23) can enhance the reception of kidney-qi. Joint use of Taiyuan (LU 9) and Taixi (KI 3), the respective Yuan-Source Points of lung channel and kidney channel, can supplement the original qi of the lung and kidney. Zusanli (ST 36) can regulate the spleen and stomach to supply the source of vital activity so as to transport the refined substances from foodstuff up to the lung and make lung-qi sufficient. Dingchuan (EX-Bl) is an empiric and effective point for asthma.

(2) Alternate methods of treatment

External point-application Select Feishu (BL 13), Gaohuang (BL 43) and Dingchuan (EX-B1). Grind baijie zi (Semen Sinapis Albae) 30g, gan sui (Radix Kansui) 15g, and xi xin (Herba Asari) 15g into a powder, and mix the herbal powder with ginger juice into a paste, shaping it into small cakes the size of a lima bean. Then, put a little Dinggui Powder on the herbal cakes, apply the cakes on the above points and affix coated fabric on them. Remove them in 3 hours when the applied regions become flushed and slightly painful. In case of blistering, sterilize and prick the blisters, and then apply gentian violet on the affected areas. It is also advisable to apply ban mao (Cantharis) plaster using the same procedure as above on the blistering points. Point catgut implantation Select Dingchuan (EX-B1) and Feishu (BL 13). After disinfection and local infiltration anesthesia of the points, embed catgut (0#) in the muscle layer under the points using a triangle suture needle. Repeat the treatment every 10 to 15 days.

(3) Commonly used patent Chinese herbal products

I. Yu Ping Feng Ke Li Ji Actions: Supplements qi and consolidates the exterior. Indications:
Wheezing in remission stage due to lung-deficiency.
2. Jin Shui Baa Jiao Nang Actions: Tonifies the lung and kidney, and supplements essential qi.
Indications: Wheezing in remission stage due to deficiency of both the lung and kidney.
3. Hai Zhu Chuan Xi Ding Pian Actions: Resolves phlegm, stops coughs and stops wheezing.
Indications: Wheezing due to phlegm retention.

4. Zhu Li Da Tan Wan Actions: Resolves phlegm, clears heat and regulates qi. Indications:
Dyspnea due to phlegm-heat.
5. Bai Ling Jiao Nang Actions: Tonifies the lung and supplement essential qi.
Indications: Dyspnea due to deficiency of both the lung and kidney.
6. Qi Wei Du Qi Wan Actions: Tonifies the kidney-qi. Indications: Dyspnea, panting,
chest oppression and more exhalation than inhalation due to kidney failing to absorb qi.

Life style recommendations

1. Keep warm according to weather changes and avoid being attacked by external pathogenic factors;
2. Eat bland food, stay away from raw and cold food, sweet and fatty food, spicy food and sea food
and stop smoking;
3. Keep fresh air in the room and avoid contacting dust, smelly gas or pollen;
4. Avoid sexual indulgence and keep a peaceful mind;
5. Do appropriate physical exercise and take medicine of supplementing qi at usual times.

Remarks

Acupuncture. can remarkably reduce the frequency of attacks during the stage of intermission.
Treatment during the Three Periods of Dog Days in the summer has better preventive effects. For
cases with severe asthma, medications are recommended.

Asthma may be seen in many diseases. After relieving the asthmatic paroxysm, the
primary diseases should be treated accordingly. Cardiac asthma is often seen in left heart
insufficiency due to pneumonedema, and should be properly diagnosed. In this case, acupuncture may be used as an adjunctive therapy.

Patients should keep warm during the time of seasonal change, and do suitable outdoor exercises.
For cases with an allergic constitution, it is advisable to stay away from allergens, quit smoking
and drinking alcohol, and stop consuming greasy, pungent and allergy-inducing foods.


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