Disease of Respiratory System


Acupuncture for bronchitis
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Introduction
Acute and chronic bronchitis refers to inflammation of trachea and bronchia due to various factors. The main clinical symptoms are cough, expectoration and asthma. Acute and chronic bronchitis pertains to the conceptions of cough, cough and dyspnea as well as phlegm and fluid-retention in TCM. The cause of this disease is either exogenous or endogenous. Exogenous cause refers to attack by wind, cold, heat and dryness that lead to non-conveyance of pulmonary qi, failure of body fluids to distribute and obstruction of the trachea by sputum. Endogenous cause refers to dysfunction of the lung, spleen and kidney. Lung asthenia results in failure of pulmonary qi to convey and descend; dysfunction of the spleen leads to accumulation of dampness into phlegm which attacks the lung; kidney asthenia brings about dysfunction of qi and upward adverse flow of qi; or invasion of liver fire into the lung leads to consumption of body fluid by lung heat. Acute bronchitis is usually of sthenia syndrome, while chronic bronchitis is usually of asthenia syndrome or syndrome with asthenia in root and sthenia in branch.

Syndrome Differentiation
1. Wind-cold Encumbering Lung
Cough with white sputum, nasal obstruction and running nose, aversion to cold and fever, headache and general aching, light-colored tongue with thin and white fur, floating and tense pulse.

2. Wind-heat Attacking Lung
Cough with yellow sputum, difficulty in expectoration due to thick sputum, dry mouth and sore throat, fever and headache, tongue with red tip and margins, thin and yellow tongue fur, floating and rapid pulse.

3. Dry-heat Impairing Lung
Dry cough without sputum, or scanty and sticky sputum, or even blood in sputum, unsmooth expectoration, dry nose and throat, headache and fever, red tongue with scanty fluid, thin and yellow tongue fur, thin and rapid pulse.

4. Retention of Phlegm and Dampness in Lung
Cough with profuse sputum, white and sticky sputum easy to expectorate, heavy cough, fullness and oppression in chest or dyspnea and shortness of breath, anorexia and abdominal distension, light-colored tongue with white and greasy tongue fur, soft and slippery pulse.

5. Liver Fire Scorching Lung
Paroxysmal cough involving the rib-side, scanty and sticky sputum difficult to expectorate, or even blood in sputum, dry and itching throat, red eyes and bitter taste in the mouth, constipation and brown urine, tongue with red tip and margins, thin and yellow tongue fur, taut and rapid pulse.

6. Asthenia of Lung and Kidney Yin
Dry cough without sputum or with scanty sputum, sticky or bloody sputum, dry mouth and throat, feverish sensation in the palms, soles and chest, night sweating and tidal fever, emaciation, red tongue with scanty fur, thin and rapid pulse.

7. Asthenia of Spleen and Kidney Yang
Cough and dyspnea, aggravation on exertion, thin sputum, bright white complexion, cold body and limbs, dropsy of face and limbs, dysuria, light-colored tongue, thin, white and slightly greasy tongue fur, deep and thin pulse.

Treatment
1. Body Acupuncture
Prescription: Feishu (BL 13), Lieque (LU 7), Tiantu (CV 22) and Taiyuan (LU 9).
Modification: For wind-cold encumbering the lung, Fengchi (GB 20) and Hegu (LI 4) are added; for wind-heat attacking lung, Dazhui (GV 14) and Quchi (LI 11) are added; for dry-heat impairing lung; Chize (LU 5) and Waiguan (TE 15) are added; for retention of phlegm and dampness in the lung, Zusanli (ST 36) and Fenglong (ST40) are added; for liver fire scorching lung, Xingjian (LR 2) and Yuji (LU 10) are added; for asthenia of lung and kidney yin, Shenshu (BL 23 ), Gaohuang (BL 43) and Taixi (KI 3) are added; for asthenia of spleen and kidney yang, Pishu (BL 20), Shenshu (BL 23), Guanyuan (CV 4) and Zusanli (ST 36) are added; for blood in sputum, Kongzui (LU 6) is added; for night sweating, Yinxi (HT 6) is added; for dropsy of face and limbs and dysuria, Yinlingquan (SP 9) and Sanyinjiao (SP 6) are added.
Performance: Needling techniques are selected according to the nature of the syndromes. For the treatment of wind-cold encumbering the lung, retention of phlegm and dampness in the lung and asthenia of spleen and kidney yang, Back-Shu acupoint can be needled with the addition of moxibustion or cupping, Guanyuan (CV 4) and Zusanli (ST 36) can be moxibusted. For acute bronchitis, the treatment is given once or twice a day; for chronic bronchitis, the treatment is given once every 1 - 2 days.

2. Ear Acupuncture
Prescription: Lung (CO14), Spleen (CO13), Kidney (CO10), Trachea (CO16), Ear Shenmen (TF4), Adrenal Gland (TG2p) and Antitragic Apex (AT1,2,4i).
Performance: Each time 2 - 3 acupoints are selected and needled with filiform needles. For acute bronchitis, the needling is done with strong stimulation; while for chronic bronchitis, the needling is done with moderate stimulation. The needles are manipulated once every 5-10 minutes. Or ear-pressure with Wangbuliuxingzi (Semen Vaccariae) is used.

3. Acupoints Application
Prescription: Feishu (BL 13), Gaohuang (BL 43), Dazhui (GV 14), Dazhu (BL 11), Shenzhu (BL 23), Dingchuan (EX-B 1), Tiantu (CV 22), Zhongfu (LU 1) and Tanzhong (CV 17).
Performance: This treatment is applicable to chronic bronchitis. Baijiezi (Semen Sinapis Albae), Gansui (Radix Euphordiae Kansui), Xixin (Herba Asari), Yanhusuo (Rhizoma Corydalis), Rougui (Cortex Cinnamomi) and Dannanxing (Arisaema cum Bil) are prepared into paste which is applied to 3 - 4 acupoints each time. The application is changed once every 3 days and 10 days make up one course of treatment.
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