Dear Friends and Patients:
Have a nice summer!
Now, it is the time for our News Letter 7. We will describe the bronchitis and its medical and acupuncture treatments in the News Letter 7. Please enjoy the info we provide, it might help you for your family members or friends. You may call our office at 203-637-7720 for further info.
Best wishes,
Jun Xu, M.D and Hong Su Xu, C.M.D.
News Letter, Vol. 1 (7), July, 2009, © Copyright
Jun Xu, M.D. Lic. Acup., Hong Su, C.M.D., Lic. Acup.
www.rmac.yourmd.com; www.drxuacupuncture.co
Rehabilitation Medicine and Acupuncture Center
1171 East Putnam Avenue, Building 1, 2nd Floor
Greenwich, CT 06878
Tel: (203) 637-7720
Case Discussion: Asthma
Jimmy S is a 12-year-old boy who came to my office after a sudden onset of shortness of breath and tightness in the chest. In addition he said he had occasional pain and trouble in sleeping and, by listening to his lungs, I heard audible wheezing. He sometimes had coughs as well, and his mother reported he first developed these symptoms when he was 2 years old. The incidents happened mostly in cold weather, and sometimes when he ran or participated in sports. At these times he had difficulty in breathing, often coughed or wheezed and all this together brought about a diagnosis of asthma. His doctor prescribed an inhaler and other medication, which, for a while, made his asthma better. However, for the past decade, though he used these asthma-aids, he still had frequent attacks. These made him miss classes which bothered him, as he wanted to keep up with his schoolmates. His primary care physician could give him no further help, at which time he consulted me.
What causes asthma?
Asthma is an inflammation and constriction of the lungs and airways, including brachial tubes. Asthma is usually triggered by cold, allergens, including dust, mould, perfume, fur, etc, respiratory infection such as the common cold and physical activity such as exercise, cold air and irritants such as smoke. Certain medications also can trigger asthma, such as aspirin and non-steroid anti-inflammatory drugs, as well as strong emotion, stress, gastroesophageal reflux disease, menstrual cycles and allergic reactions to certain foods. After exposure to these irritants, the airways produce extra mucus that blocks them and makes the brachial wall muscle tighten and constrict, which causes all the symptoms of asthma such as cough, shortness of breath and wheezing. If symptoms become worse, some patients will get an infection which will produce yellowish sputum and this infection will cause more severe symptoms. Asthma is usually worse in the morning and late at night. In between asthmatic episodes, symptoms have been known to disappear or improve, but this does not mean the asthma has gone away, which is why Jimmy S has had these symptoms for more than ten years.
Resource: http://www.rainbowskill.com/wp-content/uploads/2009/03/asthma1.jpg
There are four types of asthma:
- Allergic asthma, caused by the airway inflammation when exposed to allergens, such as dust, mould, smoking, fur, perfume, food, etc.
- Exercise-induced asthma, which is triggered by vigorous activity.
- Cough-variant asthma, which produces a chronic and persistent cough, sometimes called a habitual cough, without shortness of breath.
- Occupational asthma, caused by exposure to certain stimulants, such as certain chemicals, oils, gas, etc. in the workplace.
From the Western point of view, the treatment of asthma includes two types of medication:
- Bronchodilators such as beta-agonist, albuterol and salmeterol and also anticholinergics such as ipatropium. These two types of medications can dilate the respiratory tubes and open the lungs to air.
- Corticosteroid. The inhaled corticosteroid is recommended for most patients and is most effective for the respiratory tract and with minimal effect on the rest of the body at normal doses. These are good for short-term relief if inhaled or given by injection to speed up the resolution of airway inflammation.
It is strongly recommended for people with asthma to carry their inhalers with them, in case any emergency happens to them. The above precaution sometimes plays a role of life or death. However, for a long term treatment, the Chinese medicine might help more.
Chinese Medicine Diagnosis and Treatment
Asthma is characterized by repeated attacks of paroxysmal dyspnea with wheezing. It can be divided into two types, deficiency and excess.
Type I: Excess
1. Wind-cold type. This kind of asthma attack is due to the invasion of wind-cold pathogen from environment which impairs the smooth flow of the lung qi (energy), injures the skin and hair and makes the lung respiratory tract, especially the bronchial tract, closed or restricted. Since the lung and the body surface defense system are weakened, the lung qi fails to disperse and descend which leads to a cough.
2. Phlegm-heat type. This type asthma is due to the failure of the spleen in transformation and transportation resulting in the production of phlegm from accumulated dampness, finally ending in retention of phlegm which turns into heat or excessive fire of the lung which evaporates the fluids which caused the accumulation of phlegm. The phlegm stays in the lungs with hotness, causing the lung energy to stagnate, which causes the impairment of the lung’s proper function, then causes asthma.
Type II: Deficiency
- Lung deficiency. A prolonged and protracted cough usually weakens and injures the lung energy, and strain of an internal lung and respiratory muscle can also bring about deficiency of the lung energy. In either case, shortness of breath and dyspnea may occur.
- Kidney deficiency. Since the kidney is the energy resource of the human body, longstanding asthma, overwork and other factors will affect the kidney function, therefore, if kidney deficiency is present, its energy cannot support lung functions, which will induce weakness of the kidney and make an asthma attack that much more severe.
Treatment:
- For wind-cold type the principal is to eliminate the exogenous pathogens as well as improve the lung’s function and enrich the lung’s energy.
Prescription: UB13 Fei Shu, UB12 Feng Men, Du14 Da Zhui, Lu 7 Lie Que, LI 4 He Gu.
Acupressure tips for patients:
- The most important points are UB 12, UB 13 and Du 14.
- Press UB 13 for 5 min with both your knuckles, then UB 12 for another 5 min, alternate for about 3 times might help you to reduce the asthmatic symptom and the patient might feel relief from the acupressure self treatment.
Acupuncture tips for practitioners:
- Electrical stimulation on UB 12, UB 13 and Du 14.
- Ultra Red Heating Lamp on UB 12, UB 13 and Du 14 for 20 to 30 min.
3. UB13 and UB12 are located in the vicinity of the lung, which will greatly improve the lung’s function and energy and will protect the lung from the exogenous pathogens attacking. They will clear the lung and eliminate the wind. DU14, Lu 7 and LI4 function to eliminate the wind-cold and clear the lung, therefore soothing the asthma.
- Phlegm heat: Because phlegm heat shows signs of mild infection of the lung, there are more points to choose from for eliminating the exogenous pathogens such as wind heat.
Prescription: UB13 Fei Shu, EX-B1 Ding Chuan, Ren 22 Tian Tu, and Lu 5 Chi Ze , St 40 Feng Long.
Acupressure tips for patients:
- Press hard on bilateral EX-B1 Ding Chuan for 5 min, then UB 13 Fei Shu for 5 min, alternate for 2 sessions.
- Ren 22 Tian Tu may also help to decrease the asthma after pressing for about 5 min.
Acupuncture tips for practitioners:
- No heating lamp.
- Use all above 5 points and electrical stimulation for 20 to 30 min. If they are pairs, you should use the paired points also.
3. Lu 5 Chi Ze is very important to reduce the phlegm heat and soothe the brachial smooth muscle. Fenlong S40 is a point of strengthening the spleen function which resolves the problem of phlegm.
4. UB13 Fei Shu is applied to clear the lung and regulate the flow of energy. Ren 22 Tian Tu causes the energy to subside and resolves the problem of phlegm, as well as eliminating excessive heat. Dingchaun is the point which causes a cessation of wheezing and makes breathing much easier.
Type II: Deficiency Type:
Lung deficiency: The lung is the vital internal organ to regulate respiration. Lung energy deficiency leads to the easy entry of the pathogens, and causes asthma. The goal is to improve the lung energy and efficiency and decrease the chance of the body being attacked by exogenous pathogens.
Prescription: UB13 Fei Shu, Lu 9 Tai Yuan, St 36 Zu San Li and Sp 3 Tai Bai.
Table 3-3
Acupressure Tips for patients:
- For long term health care, always press St 36 and UB 13, even you do not have any illness; these two points will protect you from the attack of external pathogenesis.
- Lu 9 and Sp 3 for acute attack.
Acupuncture Tips for practitioners:
- Heating Lam should be used for St 36 and UB13.
- Electrical stimulation for LU 9 and Sp 3.
- Lu 9 Tai Yuan is the beginning point of the lung meridian and is able to reinforce the lung energy. UB13 Fei Shu, used in both acupuncture and moxibustion, can strengthen the lung energy, and St 36 Zu san li S36 is the key point of the stomach meridian, which can greatly improve the immune system and energy of the entire human body.
- Sp 3 Tai Bai is the first point of the spleen meridian. The spleen can greatly improve the lung’s breathing function, therefore, Sp 3 can both clean out the phlegm and relax the smooth muscle of the brachial tract. St 36 and SP 3 combined will strengthen the lung and improve the function of the spleen and stomach.
Kidney Deficiency:
The kidney is the energy manufacturer of the entire human body. Any lessening of its function will cause a decrease of the immune function and energy flow of daily activity. For this reason it is necessary to strengthen the kidney. UB13 Fei Shu, REN17 Tan Zhong, K3 Tai Xi and UB23 Shen Shu, and REN 6 Qi Hai are selected.
Table 3-4
Acupressure Tips for patients:
- UB 23 is the key point to press.
- UB 13 and Ren 17 will greatly help in strengthening the kidney function.
Acupuncture Tips for practitioners:
- Heating Lamp should be used for UB 23 and UB 13.
- Electrical stimulation for UB23, Ren 17 and Ren 6.
- Ki 3 Tai Xi strengthens the primary energy of the kidney and, when combined with UB23 Shen Shu, the original point adjacent to the kidney, it will greatly enhance the Ki 3 functions. REN17 Tan Zhong is one of the most important energy points in the eight influential points and UB13 Fei Shu is the back-shu point of the lung which reinforces energy and smoothes out ragged breathing. Ren 6 Qi Hai is an important point to reinforce lung energy and recreate energy in the lower lung respiratory track and also strengthens the kidney and primary energy.
Tips for patients and practitioners:
Asthma attacks usually happen in fall, winter and spring, and only occasionally in the summer. Based on traditional Chinese medicine, summer is the most important season to reinforce the kidney and spleen Yang energy. I insist patients having treatments during the summer. I use not only acupuncture but also moxibustion, i.e. Moxa during summer. One treatment in summer is probably the equivalent of four or five treatments at any other season. Utilizing the previously cited points in acupuncture, it is possible to alleviate chronic asthmatic symptoms by strengthening the energy and improving function of spleen, as well as that of the stomach and kidneys. In this way it is possible to relieve, or even eradicate future attacks.
Jimmy S received a dozen treatments from me during the first summer. During the school year, he worked very hard at his studies. His summer treatments helped him so much that he only needed to consult me each summer for a few visits.