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Home > Newsletters > February 2008 > TCM Treatment of Bronchial Asthma In Clinical Practice

TCM Treatment of Bronchial Asthma
In Clinical Practice

By William Morse, D.C., F.I.A.C.A.

Common Asthmatic Presentation

Patients commonly present with dyspnea, which is paroxysmal, restricting both inhalation and exhalation and is accompanied by wheezing and sometimes cough. This is due to severe bronchiospasm resulting as the body attempts to expel excessive mucous from within the bronchial passages. Personal history may include chronic allergic rhinitis or an acute lung illness, such as bronchitis. Family history most often includes asthma, COPD and/or other lung diseases.

From a TCM standpoint, asthma, called Chuan Xiao, is seen therapeutically in a similar manner to other respiratory ailments. That is, as a result of pernicious external pathogenic processes invading the lungs and effecting the Lung, Kidney and Spleen. Contributing factors include diet, chronic respiratory infections, improper care after illness, climactic change, emotional turbulence, and overstrain or “stress,” all of which leads to the retention of endogenous phlegm. Phlegm and Qi then ascend inappropriately to the throat resulting in the symptoms we call asthma. Chronic or recurrent asthma may result in simultaneous asthenia (deficiency of healthy Qi) of the Lung, Spleen and Kidney and could progress further to involve the Heart, resulting in critical conditions.

Diagnostically, asthma can be seen to involve one of the five causative syndromes: Retention of Cold-Fluid in the lung; Retention of Phlegm-Heat in the lung; Asthenia of Spleen and Lung Qi; Asthenia of Lung and Kidney Yin; and Asthenia of Heart and Kidney Yang. These syndromes tend to represent a progression from mild to critical and may be found in transition or in multiple forms.

Syndrome Differentiation

Retention of Cold-Fluid in the Lung

This can occur after a cold, viral respiratory infection, seasonal change, or excessive cold exposure. Signs and symptoms include dyspnea which “roars,” expectoration of thin, white sputum, and a light-colored tongue with white, slippery fur. The pulse is floating and slippery in the early phases. The patient may also present with fever, headache with diaphoresis (sweating), and an aversion to cold.

Retention of Phlegm-Heat in the Lung

Typical presentation includes dyspnea with limited chest excursion, yellow and sticky sputum, and slightly frothy expectoration. This will be accompanied by fever, thirst, red tongue with yellow and greasy fur as well as rapid and slippery pulse.

Asthenia of Spleen and Lung Qi

Common presentation includes cough, shortness of breath (lack of oxygen), aggravation on exertion, low voice and breath sounds, thin sputum, aversion to wind, spontaneous sweating, lassitude, poor appetite, loose stools, light-colored tongue with thin, white fur and a soft and thin pulse.

Asthenia of Lung and Kidney Yin

This person often presents with dyspnea and shortness of breath, cough with scant expectoration, dizziness and tinnitus, aching and weakness of the loins and knees, tidal fever, night sweats, red tongue with scant fur and a thin, rapid pulse.

Asthenia of Heart and Kidney Yang

This patient is short of breath, has more trouble with inhalation, is averse to cold, has cold extremities, is edematous with scant urine, may be restless and experience palpitations and profuse cold sweating, is of low spirit, may have cyanotic lips, purplish tongue with ecchymoses, thin and white tongue fur, and either a deep and thin pulse or one which is slightly weak, slow and irregular in rhythm or interval.

Acupuncture Treatment

Body Points

Primary needle therapy: BL 13 (Feishu), M-BW-1 (Dingchuan), CV 22 (Tiantu), LU 1 (Zongfu), LU 6 (Kongzui), and CV 17 (Tanzhong).

For Retention of Cold-Fluid in the Lung add: BL 12 (Fengmen) and LU 9 (Tiayuan).

For Retention of Phlegm-Heat in the Lung add: GV 14 (Dazhui) and ST 40 (Fenglong).

For Asthenia of Spleen and Lung Qi add: BL 20 (Pishu), BL 43 (Gaohuang), ST 36 (Zusanli), and CV 6 (Qihai).

For Asthenia of Lung and Kidney Yin add: BL 23 (Shenshu), CV 4 (Guanyuan), KI 3 (Taixi), and SP 6 (Sanyinjiao).

For Asthenia of Heart and Kidney Yang add: BL 15 (Xinshu), BL 23 (Shenshu), CV 4 (Guanyuan), CV 6 (Qihai), and PC 6 (Neiguan).

For Acute attacks add: GV 25 (Suliao) and GV 26 (Shuigou).

For edema, fever and sweats add: HT 6 (Yinxi) and KI 7 (Fuliu).

For slow, weak and intermittent pulse add: CV 4 (Guanyuan) and CV 6 (Qihai) with moxa.

Auriculotherapy

In acute cases, needle the following points: Antitragic Apex (Stop Wheezing), Adrenal Gland, Trachea, Lung, Subcortex and Sympathetic. With electrical or laser therapy add the Lung, Spleen and Kidney areas of the posterior pinna.

Cupping Therapy

Treat the Jiaji (7th Cervical to 6th Thoracic vertebral regions) via warm cupping. This area responds well during chronic episodes, but should not be used if fever is present. Needling of Ashi points along the Jiaji is very effective as well.

General Treatment Comments

Note that the first two syndromes represent excess conditions and the remaining three deficient conditions. Use reducing and reinforcing techniques as appropriate. Cold and Asthenia syndromes respond well to needling with moxa and/or electrical stimulation along with needling. As the condition becomes more chronic, needling with moxibustion, especially at Zongfu and Tanzhong can be very effective. Treat the ear in acute cases with needles and rely on laser or electrical stimulation later on. As the patient responds and his or her “program” becomes stabilized and non-critical, patient home use of low level laser therapy or electrical stimulation units can be very beneficial.

Diet, exercise and herbal therapy are important and essential adjuncts to the successful long term treatment of asthma. The elimination of fried, high fatty foods, refined sugars and alcohols are imperative. A good anti-allergy diet is also a must. Chinese Herbal Medicine should support whichever syndrome is active.

The complication of a lung infection should always be considered and adjunctive medical therapy considered.

References

Daosheng L, Min S, Acupuncture-Moxibustion, People’s Medical Publishing House, 2000, pp 326-329.

Gongwang L, Acupoints & Meridians, HuaXia Publishing House, 1997.

Morse W, Personal Experience Points, 1980 - 1998, Unpublished.

O’Connor J, Bensky D, Acupuncture A Comprehensive Text, Eastland Press, 1991.

Xinnong C, Chinese Acupuncture and Moxibustion, Foreign Languages Press, 2006.

Yangfu Z, Diagnostics of Traditional Chinese Medicine, Publishing House of Shanghai University of Traditional Chinese Medicine, 2002.

Yangfu Z, Chinese Acupuncture and Moxibustion, Publishing House of Shanghai University of Traditional Chinese Medicine, 2002, pp 240-249.
This Month's Articles

February 2008
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