Key points for TCM diagnosis
1. Chronic simple rhinitis
(1) Nasal obstruction is intermittent or alternative. Generally, nasal obstruction abates or disappears after physical labour at daytime or in the environment with fresh and moist air; nasal obstruction aggravates in the case of prolonged sitting at night and fatigue as well as in the environment with cold turbid air or after drinking; in the case of a latericumbent position, severe nasal obstruction occurs in the lower side of the nasal cavity and mild nasal obstruction appears in the upper side of the nasal cavity. Nasal discharge is often muciform and semitransparent. Rhinophonia of nasal obstruction may exist when the patient speaks.
(2) Local examination: Nasal mucosa is swollen, especially in the inferior nasal concha. Secretion of the nasal cavity lies in nasal floor, inferior nasal meatus or common nasal meatus. Palpation with a probe shows the concha is soft and elastic. The indentation will appear when the nasal concha is pressed by the probe and the indentation will vanish when the probe is withdrawn. Marked contraction of mucosa will occur when the mucosa contacts 1% ephedrine.
2. Chronic hypertrophic rhinitis
(1) Nasal obstruction is severer and mostly persistent. Often, hyposmia occurs. Obstruction rhinophonia will be severer when the patient speaks. Nasal discharge is mostly thick and mucous or mucopurulent which is not easily blown out. General symptoms may include tinnitus, headache, dizziness, hypomnesis, and insomnia, etc
(2) Local examination. The surface of the nasal mucosa is unsmooth, nodular or moruloid, with dark red or violet red. The inferior nasal concha may be hypertrophic. Nasal discharge often lies in nasal floor and inferior nasal meatus. Palpation of the nasal concha with a probe shows hardness and fullness. Indentation will not appear when the mucosa is pressed by a probe, or indentation appear without immediate vanishment. The contraction of mucosa is not sensitive to 1% ephedrine.
Four syndromes of chronic rhinitis categorized in TCM diagnosis
Stagnated heat of lung meridian
Asthenic cold of the lung qi
Excessive dampness due to asthenia of spleen
Blood stasis due to qi stagnation