bubble_chart Concept

Traditional Chinese Medicine believes that this disease falls under the categories of "wheezing disease," "wheezing syndrome," "fluid retention pattern," etc. It is mostly caused by latent phlegm in the lungs, compounded by external contraction of the six excesses, internal damage from diet, emotions, or overstrain, leading to pathogenic factors accumulating in the lungs and causing lung qi to ascend counterflow. The main mechanisms of the disease are:

1. Combined internal and external pathogens: latent turbid phlegm, compounded by external contraction, combined internal and external pathogens, obstructing the airway, leading to lung dysfunction in descending, resulting in panting and breathlessness.
2. Lung-spleen qi deficiency: dysfunction of the spleen in transportation, internal generation of phlegm-dampness, lung qi failing in dispersion, phlegm-turbidity congesting the lungs, leading to panting and breathlessness.
3. Lung-kidney yang deficiency: kidney yang deficiency leads to decline of the life gate fire, unable to nourish the heart, thus affecting heart yang; lung deficiency fails to regulate, leading to imbalance in qi and blood circulation, resulting in panting and collapse.

bubble_chart Modern Research

Bronchial asthma is an allergic disease characterized by an excessive increase in the reactivity of the trachea and bronchi to antigenic or non-antigenic stimuli. Its clinical features include dyspnea with wheezing during attacks, lasting from several minutes to several hours or longer, which can resolve spontaneously or after treatment. Long-term recurrent attacks often lead to chronic bronchitis and lung qi swelling. Based on clinical manifestations, it is generally divided into the acute stage of attack and the chronic stage of remission.

Modern medicine believes that the main disease cause and mechanism of disease are, on one hand, the quality and quantity of specific IgE or mast cells controlled by immune genes, and on the other hand, the reactivity of airway receptors controlled by the central or autonomic nervous system, leading to a significant increase in the sensitivity of the bronchial membrane.

[Diagnosis]

1. Medical history: There is a clear history of exposure to allergens (such as mongolian snakegourd root) or upper respiratory tract infections, and it is related to seasons (more common in spring and autumn).
2. Symptoms and signs: There are obvious "three depressions" signs and expiratory dyspnea with wheezing. Percussion of the lungs shows generalized hyperresonance, and auscultation reveals widespread dry and wet rales in both lungs.
3. Laboratory tests: During the stage of attack, eosinophils in the blood may increase, white blood cells increase with infection, and the level of specific antibody IgE in the blood increases. Charcot-Leyden crystals can be seen in the sputum.

bubble_chart Pattern Analysis

1. Lung Cold︰Shortness of breath with wheezing sounds in the throat, a feeling of fullness and tightness in the chest as if blocked, severe coughing, scanty and difficult-to-expectorate sputum, a dull and bluish complexion, absence of thirst or a preference for hot drinks, tendency to flare up in cold weather or upon exposure to cold, aversion to cold with chills. The tongue appears pale red with a white and greasy coating, and the pulse is wiry and tight or floating and tight. The treatment principle is to warm the lungs and dissipate cold, resolve phlegm, and relieve asthma. Modified Belamcanda and Ephedra Decoction is used: Belamcanda Rhizome 12g, honey-fried Ephedra 10g, Asarum 6g, processed Pinellia 12g, Aster 10g, Coltsfoot Flower 12g, Schisandra Fruit 6g, Cinnamon Twig 10g, Bitter Apricot Seed 10g, fresh Ginger Rhizome 2–3 slices, raw Liquorice Root 6g. For severe phlegm congestion and wheezing, add Pepperweed Seed 15g, cultivated Purple Perilla Fruit 12g, White Mustard Seed 10g. If it is a case of exterior cold with internal fluid retention, with clear, thin, and frothy phlegm, add Asarum 10g, Dried Ginger 12g. For upper excess and lower deficiency, add Aquilaria 10g, Inula Flower 10g (wrap-boiled).
2. Lung Heat︰Coarse and rapid breathing, with wheezing sounds in the throat like a roar, chest tightness and shortness of breath, paroxysmal coughing, yellow and sticky phlegm that is difficult to expectorate, dysphoria and restlessness, sweating and flushed face, bitter taste in the mouth, dry mouth with a preference for cold drinks, severe constipation. The tongue is red with a yellow-white greasy coating, and the pulse is slippery and rapid. Treatment involves clearing heat, ventilating the lungs, and resolving phlegm to relieve asthma. Modified Panting-Arresting Decoction is used: Ginkgo Seed 10g, roasted Ephedra 6g, Bitter Apricot Seed 10g, Skullcap Root 10g, White Mulberry Root-Bark 10g, Pro Formula Pinellia 10g, Cultivated Purple Perilla Fruit 10g, Coltsfoot Flower 10g, raw Liquorice Root 5g. If the phlegm is thick and difficult to expectorate, add whole Trichosanthis Fruit 12g and Bile Arisaema 10g. For severe chest tightness, add Submature Bitter Orange 12g and Magnolia Bark 12g. For severe lung heat, add raw Gypsum 20–30g (to be decocted first) and Heartleaf Houttuynia Herb 20g. For severe constipation, use raw Rhubarb Rhizoma 15g (soaked in water and taken separately).
3. Yang Exhaustion︰Severe dyspnea with gasping, flaring nostrils, and inability to lie flat, sitting upright with shoulders raised. Wheezing sounds in the throat, palpitations, dysphoria, chest tightness as if suffocating, cyanosis of the face and lips, profuse sweating like beads, cold limbs. The pulse is floating, large, and rootless, or intermittent, or even faint and on the verge of disappearing. The treatment aims to restore yang to save from collapse and relieve asthma to stabilize the condition. Modified Shenfu Longmu Decoction combined with Black Tin Pill is used. Ingredients: Ginseng 15-20g (stewed separately), prepared common monkshood daughter root 20-30g (decocted first), raw Fossil Bone 30g (decocted first), raw oyster shell 30g (decocted first), Asiatic Cornelian Cherry Fruit 30g, Tokay Gecko powder 5g (taken orally), Black Tin Pill 5-9g (taken with salt water).
4. Lung Qi Deficiency︰Spontaneous sweating, aversion to wind, frequent common colds, often triggered by weather changes, sneezing before onset, nasal congestion, runny nose, shortness of breath with weak voice, or frequent grade I "frog-like sounds" in the throat, coughing with thin white phlegm, pale complexion. Tongue texture pale red with thin white coating, pulse thin and weak or deficient and soft. Tonify the lung and replenish qi to strengthen the exterior. Modified Jade Screen Powder combined with Pulse-Reinforcing Powder. Astragalus Root 30–60g, White Atractylodes Rhizome 12g, Saposhnikovia Root 10g, Tangshen 15g, Ophiopogon Tuber 10g, Glehnia 15g, Schisandra Fruit 10g, Lily Bulb 15g. For aversion to wind and cold, add Cinnamon Twig 10g, Fresh Ginger Rhizome 3–5 slices, Chinese Date 7 pieces; for exterior deficiency with spontaneous sweating, add light wheat 12g, oyster shell 30g (to be decocted first).
5. Spleen Qi Deficiency︰Usually eats less, experiences abdominal distension and fullness, loose stools, or is prone to diarrhea after consuming greasy foods, often triggered by improper diet. Mental fatigue and lack of strength, shortness of breath insufficient for speaking, weak and timid voice. Tongue texture pale or swollen, coating greasy or white and slippery, pulse thin and weak. Treatment involves invigorating the spleen and resolving phlegm. Modified Chen Xia Liu Jun Zi Tang (Six Gentlemen Decoction): Dried Tangerine Peel 10g, Pro Formula Pinellia 10g, Tangshen 15–30g, White Atractylodes Rhizome 12g, Poria 15g, Astragalus Root 15–30g, Fresh Ginger Rhizome 3–5 slices, Chinese Date 7 pieces. For excessive phlegm and dampness, add Coix Seed 20g, Atractylodes Rhizome 10g. For gastric stuffiness and poor appetite, add Aucklandia Root 10g, Villous Amomum Fruit 10g (to be decocted later).
6. Kidney Qi Deficiency︰Usually short of breath, worsening with exertion, inhalation insufficient for exhalation, flusteredness, vertigo, tinnitus, soreness and weakness in the lower back and knees, prone to asthma after exertion, or fear of cold with cold limbs, spontaneous sweating, pale complexion, pale and swollen tongue with tooth marks, deep and thin pulse; or flushed cheeks with night sweats, vexing heat in the chest, palms, and soles, red tongue with scant coating, thin and rapid weak pulse. Tonify the kidney and absorb qi. Golden Chamber Kidney Qi Pill combined with Ginseng Root and Tokay Gecko Powder with modifications. Prepared Aconite Root 12g (to be decocted first), Cassia Bark 10g, Prepared Rehmannia Root 15g, Asiatic Cornelian Cherry Fruit 12g, Chinese Yam 20g, Poria 15g, Moutan Bark 6g, Alisma 10g, Red Ginseng 10g (stewed separately), Tokay Gecko Powder 5g (to be taken orally). For significant kidney yang deficiency, add Psoralea 10g, Epimedium Herb 15g, Deer Horn Slices 5g; for severe kidney yin deficiency, remove warming and tonifying ingredients and add Ophiopogon Tuber 30g, Chinese Angelica 10g, Tortoise-Plastron Glue 10g (melted).