Introduction
Bronchial asthma is a kind of paroxysmal allergic disease of the bronchia. The clinical manifestations are paroxysmal and exhaling dyspnea accompanied by wheezing. The patients usually have allergy and family history. This disease is similar to asthma and asthmatic cough in TCM. It is usually caused by dysfunction of the lung, spleen and kidney due to exogenous pathogenic factors, improper diet and improper caring after illness, leading to retention of endogenous phlegm in the lung.
The latent phlegm is easy to be provoked by climatic changes, diet, emotional changes and overstrain, leading to ascendance of the phlegm with qi that obstructs the trachea and causes asthma. Recurrent asthma will result in simultaneous asthenia of the lung, spleen and kidney, or even involve the heart and bring about critical conditions.
Syndrome Differentiation
1. Retention of Cold Fluid in the Lung
Occurrence after cold attack, dyspnea, or sputum roaring in the throat, expectoration of thin and white sputum, usually accompanied by aversion to cold, fever, headache without sweating, light-colored tongue with white and slippery fur as well as floating and tense pulse in the early period.
2. Retention of Phlegm-Heat in the Lung
Dspnea and chest oppression, sputum roaring in the throat, yellow and sticky sputum, unsmooth expectoration, or accompanied by fever, thirst, red tongue, yellow and greasy tongue fur as well as slippery and rapid pulse.
3. Asthenia of Spleen and Lung Qi
Cough, asthma and shortness of breath, aggravation on exertion, low voice in cough, thin sputum, aversion to wind and spontaneous sweating, lassitude, poor appetite and loose stool, light-colored tongue with thin and white fur, soft and thin pulse.
4. Asthenia of Lung and Kidney Yin
Shortness of breath and dyspnea, cough with scanty sputum, dizziness and tinnitus, aching and weakness of loins and knees, tidal fever and night sweating, red tongue with scanty fur and thin and rapid pulse.
5. Asthenia of Heart and Kidney Yang
Asthma and shortness of breath, more exhalation and less inhalation, aversion to cold and cold limbs, scanty urine and edema, even dyspnea and restlessness, palpitation and low spirit, profuse cold sweating, cyanotic lips and nails, purplish tongue with ecchymoses, thin and white tongue fur, deep and thin pulse or slightly weak and slow regular intermittent pulse or slow pulse with irregular intervals.
Treatment
1. Body Acupuncture
Prescription:
Feishu (BL 13), Dingchuan (EX – B1), Tiantu (CV 22), Zhongfu (LU 1), Tanzhong (CV 17) and Kongzui (LU 6).
Modification:
For retention of cold fluid in the lung, Fengmen (BL 12) and Taiyuan (LU 9) are added; for stagnation of phlegm-heat in the lung, Dazhui (GV 14) and Fenglong (ST 40) are added; for asthenia of spleen and lung qi, Pishu (BL 20), Gaohuang (BL 43), Qihai (CV 6) and Zusanli (ST 36) are added; for asthenia of lung and kidney yin, Shenshu (BL 23), Guanyuan (CV 4), Taixi (KI 3) and Sanyinjiao (SP 6) are added; for asthenia of heart and kidney yang, Xinshu (BL 15), Shenshu (BL 23), Qihai (CV 6), Guanyuan (CV 4) and Neiguan (PC 6) are added; for tidal fever and night sweating, Yinxi (HT 6) and Fuliu (KI 7) are added; for coma, Shuigou (GV 26) and Suliao (GV 25) are added.
Performance:
In the stage of attack, usually filiform needles are used with reducing techniques. For the treatment of syndrome with a mixture of asthenia and sthenia, mild reinforcing and reducing technique can be used. The needling is done twice or more a day. Electrical acupuncture can also be used at the same time. Each time 2 - 3 couples of acupoints are selected and dense or sparse wave can be chosen, 400 - 500 times one minute. The stimulation is monitored to the tolerance of the patient.
The electricity is attached to the needles for 30 - 40 minutes. In the remission stage, reinforcing technique is used. The needling is done once every 1- 2 days. For the treatment of cold syndrome, qi asthenia syndrome and yang asthenia syndrome, acupuncture and moxibustion can be used together; for weak and slow regular intermittent pulse and slow pulse with irregular intervals, Qihai (CV 6) and Guanyuan (CV 4 ) are moxibusted heavily for restoring yang and stopping prostration.
2. Ear Acupuncture
Prescription:
Antitragic Apex (AT1,2,4i), Adrenal Gland (TG2p), Trachea (CO16), Lung (CO14), Subcortex (AT4) and Sympathetic (AH6a).
Performance:
In the stage of attack, the filiform needles are used with strong stimulation. The needles are retained for 30 minutes and manipulated once every 5 – 10 minutes. The needling is done once or twice a day. In the remission stage, needling is done with mild stimulation and twice a week.
3. Moxibustion in Summer
Prescription:
Dazhui (GV 14), Fengmen (BL 12), Feishu (BL 13), Gaohuangshu (BL 43), Pishu (BL 20), Shenshu (BL 23), Tanzhong (CV 17) and Qihai (CV 6).
Performance:
The moxibustion is done in the three periods of dog days. Each time 3 - 4 acupoints are selected and moxibusted once every other day. Three times make up one course of treatment. The moxibustion in this way should continue for over three years. Such a treatment is effective in preventing bronchitis.