Asthma


Analysis I Analysis II

 

  Analysis I

Asthma is a common illness characterized by repeated attacks of paroxysmal dyspnea with wheezing. Generally speaking, it involves a variety of disorders resulting from disturbance of qi activities, and can be divided into two types: deficiency and excess.

Etiology and Pathogenesis

The causative factors are varied from the exogenous pathogenic factors to weakened body resistance. Asthma due to exogenous pathogenic factors is of excess type, and that due to weakened body resistance is of deficiency type. a )

Excess type:

Wind - cold type: It denotes asthma due to invasion of wind cold, which impairs the smooth flow of the lung qi, injures the skin and hair, and makes the pores closed. Since the lung and the superficial defensive system are weakened, the lung qi fails to disperse and descend, leading to cough.

Phlegm - heat type: It refers to asthma due to failure of the spleen in transformation and transportation, resulting in production of phlegm from the accumulated dampness. Long - standing retention of phlegm turns into heat, or excessive fire of the lung evaporates the fluids to phlegm. When the phlegm fire stays in the lung, the lung qi is stagnated and the normal activity of the lung is impaired. Failure of the lung qi in descending function results in asthma.

Deficiency type:

Lung deficiency: A prolonged and protracted cough can weaken and injure the lung qi. Overstrain and internal injury can also bring about deficiency of the lung qi. In either case, shortness of breath and dyspnea may occur.

Kidney deficiency: Overwork and sexual indulgence can injure the kidney. A severe or chronic disease weakens the body resistance and damages the essential qi. Long - standing asthma also affects the kidney. In any of the above cases, failure of the kidney in receiving qi may give rise to asthma.

Excess type

Wind - cold type:

Main manifestations: Cough with thin sputum, rapid breathing, accompanied by chills, fever, headache, and anhidrosis at the early stage, absence of thirst, white tongue coating, superficial and tense pulse.

Analysis: The lung is in charge of respiration and is associated with the skin and hair, which are first attacked by wind cold in the invasive procedure. If wind cold resides in the lung, stagnation of qi and failure of the lung qi in dispersing result in cough with thin sputum and rapid breathing. If wind cold still resides in the superficial part of the body to make the pores close, there appear chills, fever, headache and anhidrosis. Since the wind cold has not transformed into heat yet, thirst is absent. White tongue coating, superficial and tense pulse are the signs of wind cold staying in the lung and the defensive system.

Treatment

Method: Points of the taiyin LU and yangming ST are selected as the principal points. Reducing method is applied in combination with moxibustion to eliminate wind cold and soothe asthma.

Prescription: [BL13 – BL12 – DU14 – LU7 – LI4].

Explanation: BL13 and BL12 are the points of taiyang BL and located in the vicinity of the lung. They are able to clear the lung and eliminate wind. DU14, LU7 and LI4 are in function to eliminate wind and cold, clear the lung and soothe asthma.

Phlegm - heat type:

Main manifestations: Rapid and short breathing, strong and coarse voice, cough with thick yellow sputum, sensation of chest stuffiness, fever, restlessness, dryness of the mouth, thick yellow or sticky coating, rolling and rapid pulse.

Analysis: Phlegm heat turned from dampness or long - standing phlegm fire gathered in the lung blocks the air passage, causing impairment of the lung qi, and thus presenting rapid and short breathing, strong and coarse voice, and cough with thick yellow sputum. When the phlegm stays in the lung, sensation of chest stuffiness appears. Fever, restlessness and dryness of the mouth are due to the presence of the fire heat. Thick yellow or sticky coating, rolling and rapid pulse are the signs of the phlegm heat.

Treatment

Method: Points of taiyin LU and yangming ST are selected as the principal points with reducing method applied to resolve phlegm, reduce heat and soothe asthma.

Prescription: [BL13 – Dingchuan (Extra) – RN22 – LU5 – ST40].

Explanation: LU5, the he-sea point of taiyin LU is able to reduce phlegm heat and soothe asthma. ST40, a point of yangming ST is able to strengthen the spleen function and resolve phlegm. BL13 is applied to clear the lung and regulate the flow of qi. RN22 is in function to descend qi and resolve phlegm. Dingchuan (Extra) is an empirical point to pacify breathing.

Deficiency type

Lung deficiency:

Main manifestations: Short and rapid breathing, feeble voice, weak and low sound of coughing, sweating on exertion, pale tongue, pulse of deficiency type

Analysis: The lung dominates qi. When there is deficiency of the lung qi the function of the lung is impaired. There appear short and rapid breathing, feeble voice, weak and low sound of coughing. When the lung qi is weak, and the superficial defensive system is not strong, even mild exertion will induce sweating. Pale tongue and pulse of deficiency type are the signs of deficiency of the lung qi.

Treatment

Method: Points of the taiyin LU and yangming ST are selected as the principal points with reinforcing method applied to strengthen the lung qi. Moxibustion is also advisable.

Prescription: [BL13 – LU9 – ST36 – SP3].

Explanation: LU9, the yuan-primary point of taiyin LU, is able to reinforce the lung qi. BL13 used in acupuncture and moxibustion, can strengthen the lung qi. ST36 is the he-sea point of Yangming ST. SP3 is the yuan-primary point of taiyin SP. The lung pertains to metal and the spleen to earth, which is able to promote metal. Reinforce the mother in case of deficiency. ST36 and SP3 are selected here to strengthen the lung through invigorating the spleen and stomach.

Kidney deficiency:

Main manifestations: Dyspnea on exertion after longstanding asthma, severe wheezing, indrawing of the soft tissues of the neck, short breath, lassitude and weakness, sweating, cold limbs, pale tongue, deep and thready pulse.

Analysis: Long - standing asthma affects the kidney which is the source of qi. The kidney in lowered functioning fails to receive qi, and therefore dyspnea on exertion, severe wheezing and short breath appear. When there is deficiency of the kidney qi in a chronic case, emaciation and lassitude happen. Exhausted kidney yang may lead to weakening of the superficial defensive yang, and hence sweating. If the yang qi fails to warm up the body surface, cold limbs appear. Pale tongue, deep and thready pulse are the signs of weakened kidney yang.

Treatment

Method: Points of  Shaoyin KI and Ren  are selected as the principal points with reinforcing method applied to strengthen the kidney function in receiving qi. Moxibustion is also advisable.

Prescription: [KI3 – BL23 – BL13 – RN17 – RN6].

Supplementary points:

  • Persistent asthma: [DU12 – B 43]
  • Deficiency of the spleen: [RN12 – B 20].

Explanation: KI3, the yuan-primary point of shaoyin KI, is able in combination with BL23 to strengthen the primary qi of the kidney. RN17, the qi point of the Eight Influential Points, and BL13, the metameric LU shu point, are needled to reinforce qi and pacify breathing. RN6, an important point to reinforce qi, is able to regulate qi in the lower jiao, reinforce shaoyin KI, strengthen the primary qi, invigorate yang and control essence. Puncture on these points strengthens the kidney in receiving qi and pacify breathing. Moxibustion on DU12 and BL43 may relieve chronic asthma, while moxibustion on RN12 and BL20 may strengthen the function of the spleen and reinforce qi.

 

  Analysis II
  • Acute onset – during attack (cold, hot, or deficiency)
  • Remission stage (cold, hot, and deficiency)

 

Acute onset – during attack of Cold

P/T – warm up meridians, disperse Cold, eliminate Phlegm, relieve Asthma

Acupuncture Rx

  • hand Taiyin, Ren, sedate, LU 7, 5, BL 13 (expel patho., relieve asthma), Ren 17, ding chuan
  • wheezing – Ren 22
  • runny nose – LI 20, ST 3
  • Phlegm – ST 40
  • Fever – LI 4, LI 11

Acute onset – during attack of Heat

P/T – descend and disperse Lung Qi, clear Lung Heat, transform Phlegm, stop Asthma

Acupuncture Rx

  • LI4, LI11, DU14 (clear heat), LU1, LU6 (relieve asthma), RN17, ding chuan (descend LU Qi), ST40 (phlegm)
  • heat – bleed LI1, LI11
  • wheezing – RN22
  • Phlegm – RN12
  • Liver Fire attack Lung – LR3, LR14

Acute onset – during attack from deficiency

P/T – nourish Qi, relieve Asthma

Acupuncture Rx

  • hand Taiyin, back-shu, ding chuan, LU 9, BL 13, 43

Remission stage – cold, hot, and deficiency

Lung, Spleen, and Kidney Qi deficiency

P/T – tonify Qi

Acupuncture Rx

  • Lung Qi : LU 9, BL 13, 20, 43,
  • Spleen Qi: LU 9, BL 13, 43, ST 36, 40, SP 3
  • Kidney Qi: LU 9, BL 13, 43, 23, 24, KI 3

 

Alternative treatment methods

  • auricular – LU, shenmen, bronchi, adrenal, sympathetic
  • Moxa – back-shu during remission stage
  • herbal application – Bai Jie Zi 21g, Yan Hu Suo 21g, Xi Xin 15g, Gan Sui 12g
    Place on ding chuan, BL 13, Ren 20, ST 16 (may cause blister)
  • electro – LU 5

 

Remarks

This condition includes bronchial asthma, asthmatic bronchitis, obstructive pulmonary emphysema and dyspnea present in some other diseases. However, for symptomatic dyspnea, a combined treatment should be taken into account.