Disease and Condition Overview
Bronchial asthma is characterized by coughing, wheezing, difficulty breathing and unable to lie down as primary symptoms. In Chinese medicine, it is caused by phlegm and fluid residing in the lung. External wind cold, wind heat can cause the irregulation of the lung which leads the fluid to accumulate into phlegm. Or it may be caused by poor diet, in which the regulatory functions of the spleen is disrupted and the dampness gathers to form phlegm. Changes in weather, stress, exhaustion, allergic reactions can all trigger excess secretion of fluid and phlegm, intertwined with qi to obstruct passage ways, resulting in asthma. The initial location of asthma is at the lung, most are excess syndromes: if recurring constantly, it may cause deficiency in spleen, lung, kidney and heart.
Bronchial asthma can occur in all age groups throughout the year, especially in colder months and during the change of seasons.

Pair-point Treatment Combinations

(1) Fengmen (BL12), Feishu (BL13) (Fig 69)
Fengmen (BL12), Feishu (BL13) are both points on the foot-taiyang channel. This pair point combination, one clears, one tonifies, work in synergy to dispel wind, harmonize and regulate lung, treating external and internal symptoms, expels the pathogenic elements. Appropriate for all types of chronic bronchitis.

Needling techniques:
1. During an asthma attack, needle Fengmen (BL12) perpendicular insertion 1 cun, Feishu (BL13) perpendicular insertion 1 cun.
2. When it is in remission, mostly use moxibustion (warm needle or moxa stick, wheat grain moxa).

(2) Fengmen (BL12), Shenzhu (DU12) (Fig 77)
Fengmen (BL12): on the back, below the spinous process of the second thoracic vertebra (T2), 1.5 cun lateral to the posterior midline.
Shenzhu (DU12): on the back, on the posterior midline, in a depression below the spinous process of the third thoracic vertebra.
Fengmen (BL12), a point on the foot-taiyang channel, it dispels wind and clears lung. Shenzhu (DU12) is a point on the Du channel. It clears heat and resolves phlegm. This pair point combination dispels wind, clears heat, stop cough and wheezing. Appropriate for wind heat type or phlegm heat type of asthma.

Needling techniques:
1. Fengmen (BL12) perpendicular insertion 1 cun.
2. Shenzhu (DU12) perpendicular insertion 1 cun.
3. Use twirling reducing method.

(3) Kongzui (LU6), Hegu (LI4) (Fig 74)  
Kongzui (LU6) is the xi-cleft point of hand-taiyin channel. It clears lung heat. Hegu (LI4) is the yuan-source point of hand-yangming channel. It clears large intestine heat. This pair point combination, one exterior, one interior, working in conjunction, clear release the exterior and interior, dispel wind, clears heat, promote lung and stops wheezing.  Appropriate for coughs, asthma with heat syndrome.

Needling techniques:
1. Kongzui (LU6) perpendicular insertion 1.5 cun.
2. Hegu (LI4) perpendicular insertion 1 cun.
3. Needling -- use even manipulation method or reducing method.

(4) Tiantu (RN22), Chize (LU5) (Fig 78)
Tiantu (RN22): on the neck, on the anterior midline, at the center of the suprasternal fossa.
Chize (LU5): on the transverse cubital crease, on the radial side of the tendon of biceps brachii.
Tiantu (RN22) is a point on the Ren channel, connecting interiorly to all relating to lung. Chize (LU5) is the he-sea point of the hand-taiyin channel. This pair point combination, one promote and one descends the lung qi. Appropriate for asthma and cough caused by irregular functioning of lung qi.

Needling techniques:
1. Tiantu (RN22) point needle interiorly along the posterior border of the sternum, needling sensation needs to be felt at the chest.
2. Chize (LU5) perpendicular insertion 1 cun, use reducing method or use three-edged needle to prick the collaterals for bloodletting.

(5) Feishu (BL13), Zhongfu (LU 1) (Fig 79)
Feishu (BL13): on the back, below the spinous process of the third thoracic vertebra (T3), 1.5 cun lateral to the posterior midline.
Zhongfu (LU1): on the lateral aspect of the chest, 1 cun directly below Yunmen (LU2), in the first intercostal space, 6 cun lateral to the anterior midline.
Feishu (BL13) is the back-shu point of the lung channel. Zhongfu (LU1) is the front-mu point of the lung. This pair point combination, one front-mu point, and one back-shu point, one anterior, one posterior, working in checks and balances to harmonize, regular lung and stop asthma. Appropriate for all types of bronchial asthma.

Needling techniques:
1. Feishu (BL13) perpendicular insertion 1 cun
2. Zhongfu (LU1) perpendicular insertion 1 cun.
3.Those with cold syndrome should use moxa in conjunction.
4. Those with heat syndrome should only needle, no moxibustion.
5. During an acute attack, cupping may be applied as well.

(6) Xuanji (RN21), Qihai (RN6) (Fig 75)
Xuanji (RN21), Qihai (RN6) are both points on the Ren channel. Xuanji (RN21) is located at the upper jiao, Qihai (RN6) is located at the lower jiao. This pair point combination, one superior and one inferior, one tonifies while one reduces, keeps each point in check, work in synergy to promote lung, harmonize and regulate qi, open air passage ways and relieve asthma. Appropriate for bronchial asthma with qi deficiency.

Needling techniques:
1. Xuanji (RN21) towards inferior direction, oblique insertion 0.5 cun.
2. Qihai (RN6) moxa using moxa stick for 10-20 minutes.

(7) Zhongwan (RN12), Fenglong (ST40) (Fig 76)
Zhongwan (RN12) is located at the middle jiao, is the front-mu point of the stomach. Fenglong (ST40) is the luo-connecting point of the foot-yangming channel, connecting to foot-taiyin channel. This pair point combination strengthens spleen harmonizes stomach by resolving phlegm and dampness. Appropriate for bronchial asthma patients with heavy dampness and phlegm.

Needling techniques:
1. Zhongwan (RN12) point needle 1 cun, warm needle or moxa using moxa stick for 20 minutes.
2. As for acute asthma attack, needle Fenglong (ST40) using dao-qi or the “guiding qi” method, twirling the needle for about 15 minutes.

(8) Guanyuan (RN4), Shenshu (BL23) (Fig 30)
Guanyuan (RN4) is the location for congenital yin and yang. Shenshu (BL23) is where the qi and blood of kidney infuse. This pair point combination, one anterior, one posterior, tonifies kidney, fortifies yuan or congenital qi, opens air passage ways and relieves asthma. Appropriate for congenital endowment deficiency, prolonged wheezing, or loss or damage of original, yuan qi, failure of kidney in receiving air.

Needling techniques:
1. Guanyuan (RN4) perpendicular insertion 1 cun.
2. Shenshu (BL23) perpendicular insertion 1 cun.
3. Mostly use the tonify method, as for kidney yang deficiency, emphasize the use of moxibustion.

(9) Feishu (BL13), Kongzui (LU6) (Fig 80)
Feishu (BL13): on the back, below the spinous process of the third thoracic vertebra (T3), 1.5 cun lateral to the posterior midline.
Kongzui (LU6): on the medial border of the radius, along the line connecting Chize (LU5) and Taiyuan (LU9), 7 cun proximal to the distal wrist crease.
Feishu (BL13) is the back-shu point of the lung channel. Kongzui (LU6) is the xi-clefl point of the lung channel. This pair point combination promotes and nourishes lung, stops cough and asthma. Appropriate for acute attack of bronchial asthma.

Needling techniques:
1. Feishu (BL13) perpendicular insertion 1 cun, apply cupping after needling.
2. Kongzui (LU6) perpendicular insertion 1 cun, needling use reducing method.

(10) Dazhui (DU14), Neiguan (PC6) (Fig 81)
Dazhui (DU14): on the posterior midline, in the depression below the seventh cervical vertebra.
Neiguan (PC6): on the palmer side of the forearm, on the line connecting Daling (PC7) and Quze (PC3), 2 cun superior to the wrist crease, between the tendons of m. palmaris longus and m. flexor carpi radialis.
Dazhui (DU14) is a point on the Du channel that connects six hand and foot yang channels. Neiguan (PC6) is the Luo-connecting point of the hand-jueyin channel. This pair point combination promotes yang, releases the exterior, disperses and regulates Sanjiao (upper, middle and lower jiao), soothes the chest, harmonizes and regulates qi. Appropriate for bronchia asthma with excess phlegm.

Needling techniques:
1. Dazhui (DU14) perpendicular insertion 1 cun, use even method, apply cupping after needling.
2. Neiguan (PC6) perpendicular insertion 1 cun, use dao-qi or the “guiding qi” method.

Commentaries
Treatment for acute stage should focus on stopping cough and wheezing.
Kongzui (LU6), Hegu (LI4): Tiantu (RN22), Chize (LU5); Zhongwan (RN12), Fenglong (ST36); Dazhui (DU14), Neiguan (PC6). These pair-points would often be used.
If heavy wheezing not accompanied by dampness and phlegm, but has heat syndrome, select Kongzui (LU6), Hegu (LI4).
No apparent cold/heat syndrome, select Tiantu (RN22), Chize (LU5).
Excess of dampness and phlegm, select Zhongwan (RN12), Fenglong (ST40).
Excess runny phlegm, select Dazhui (DU14), Neiguan (PC6).
During remission, it is important to treat the root cause:
Lung qi deficiency, select Fengmen (BL12), Feishu (BL13) or Feishu (BL13), Zhongfu (LU1).
Over all qi deficiency, select Xuanji (RN21), Qihai (RN6).
To strengthen kidney yuan, select Guanyuan (RN4), Shenshu (BL23).
Generally, needling method is used in the acute attacks, Manipulation time should be 10-15 minutes. In remission stage, often use moxibustion.