Bronchial Asthma
Bronchial asthma
is and episodic allergic pulmonary disease. The attack is mostly induced by the
inhalation of or contact with allergens, such as pollens, dusts, insects (such
as mite), germs, etc. During the attack, patients have severe dyspnea which is
due to spasm of bronchial smooth muscles, swelling of the bronchial mucosa, and
hypersecretion of the mucus, leading to bronchial obstruction. When the attack
can not be relieved for a long time, it is called "status asthmaticus."
The disease is often seen in children and teenagers. In TCM, it is attributable
to the categories of "xiao" (bronchial wheezing) and "chuan"
(dyspnea).
Main Points of Diagnosis
1. Notice whether there is an
allergic history of the patient and his family. For patients with histories of
allergic rhinitis and urticaria, the disease is easy to be diagnoses.
2. The
onset is abrupt, frequently occurring at night. Usually the patients suddenly
have a sense of suffocation and of constriction in the chest, and orthopnea. The
attack lasts from several minutes to several hours. On auscultation, typical wheezes
can be heard over the lung fields. Moist rales may be present if pulmonary infection
coexists. Termination of the episode is frequently accompanied by a cough with
profuse mucoid sputum.
3. The status asthmaticus: In some cases the acute
attack may persist for a long time (over 24 hours), or the episode can not be
relieved by various drugs. The patients have severe dyspnea, accompanied with
profuse sweating, pallor, cyanosis, tachycardia and coldness of limbs. Respiratory
failure may occur in critical cases, and death may ensue if timely treatment is
not given.
4. Laboratory examinations: The eosinophilic leukocyte count may
increase markedly during the attack, up to 5-15 percent or more in differential
count. Sputum examination may reveal more eosinopilic leukocytes and rhomboid
crystals in the sputum. Serum concentration of IgE may be increased. Skin test
for specific antigens is helpful to find the allergic agent, but the provocative
allergic test may have potential danger of inducing asthmatic attack. Therefore,
it should be performed with caution.
Differentiation and Treatment of Common
Syndromes
1. Asthma of Cold Type
Main Symptoms and Signs: A feeling of
fullness and distress in the chest, dyspnea with wheezing sound in the throat,
cough with thin sputum, frequent attacks in cold seasons or caused by cold, whitish,
moist and glossy fur of the tongue, taut and tight pulse.
Therapeutic Principle:
Ventilating the lung and expelling pathogenic cold, eliminating phlegm to relieve
asthma.
Recipe: Belamcanda and Ephedra Decoction with additional ingredients.
belamcanda rhizome
ephedra
asarum herb
pinellia tuber
schisandra
fruit
aster root
coltsfoot flower
fresh ginger
Chinese date
bitter
apricot kernel
perilla fruit,
All the above drugs are to be decocted in
water for oral administration.
Besides, 10 grams of cinnamon twig is added
for the case with chill, 10 grams of epimedium seed and 10 grams of earthworm
for the case with sever asthma, which also responds well to the treatment of Minor
Decoction of Green Dragon.
2. Asthma of Heat Type
Main Symptoms and Signs:
Dyspnea with wheezing, irritable oppressed sensation in the chest even gasping
for breath, yellowish mucoid sputum, thirst, frequent occurrence in hot seasons
or onset closely associated with heat, reddened tongue with yellow greasy fur,
slippery and rapid pulse.
Therapeutic Principle: Removing heat-phlegm and
facilitating the flow of the lung-qi to relieve asthma.
Recipe: Modified Prescriptions
of Decoction of Ephedra, Apricot Kernel, Gypsum and Licorice combined with Decoction
of Three Kinds of Seeds for the Aged.
ephedra
bitter apricot kernel
gypsum
perilla
fruit
licorice root
perilla fruit
epimedium seed
earthworm
mulberry
bark
trichosanthes seed
Sichuan fritillary bulb
All the above herbs are
to be decocted in water for oral administration.
In case of profuse perspiration,
ephedra is removed from the above recipe, on the other hand, 30 grams of honeysuckle
flower is added if fever is present; 18 grams of powder of clam shell, 15 grams
of glehnia root are employed for patients who cough with thick yellowish sputum;
6 grams of eagle wood and 10 grams of magnolia bark for patients with dyspnea
and adverse flow of qi.
3. Asthma of Deficiency Type
Main Symptoms and
Signs: Chronic and recurrent attacks for a long time, constant minor and persistent
asthma at ordinary times. The sound of cough being low and weak, palpitation and
shortness of breath, spontaneous perspiration and aversion to wind, general debility,
pale tongue with little fur, deep thready and weak pulse.
Therapeutic Principle:
Tonifying the lung and spleen, improving inspiration to relieve asthma.
Recipe:
Powder of Ginseng and Gecko with additional ingredients.
ginseng
gecko
gecko,
(ground and taken after being infused in the finished decoction)
walnut kernel
ophiopogon
root
schisandra berry
astragalus root
cordyceps
lily bulb
poria
red
tangerine peel
prepared licorice root
All the above herbs except gecko are
to be decocted in water for oral administration.
By
Dr. Ming's TCM Medical
Center,
Hua Xi Xiao Yuan, Hutian Developing Area,
Huaihua city, Hunan province
China