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