By: John K. Chen, Ph.D., Pharm.D., OMD, L.Ac.
A patient receiving acupuncture treatment
Phlegm primarily causes asthma in Oriental Medicine. Lung, Spleen, and Kidney regulate water in upper, middle, and lower jiao. Imbalanced Yin and Yang in these organs disrupt water circulation, forming phlegm in the Lung. Stored phlegm triggers recurrent asthma attacks. Chronic asthma depletes Lung, Spleen, and Kidney. Lung deficiency hinders air inhalation, while Kidney deficiency impairs air retention. Spleen deficiency exacerbates phlegm accumulation, thereby obstructing the airways. This creates a complex deficiency condition characterized by excessive symptoms.
1 a. Asthma Due to Cold:
Cold attacks disrupt Lung’s Qi and respiration control, constricting bronchi and causing chest congestion. Patients experience hyperventilation, shortness of breath, and tightness. Lung fails to regulate water passages, forming phlegm. Phlegm manifests as wheezing, high-pitched rhonchi, and white sputum. Chills, cold intolerance, and body aches appear. Grayish, cyanotic complexion emerges. Tongue coating turns white and greasy. Pulse feels wiry and tight.
Herbal Treatment: The herbal formula of choice dispels cold, warms up the interior, eliminates phlegm and relieve bronchial spasm.
Recommended Ingredients:Ephedrae and cinnamon twigs dispel cold, stop wheezing, and smooth Lung Qi flow. Ephedrae also promotes urination, clearing Lung fluids. Mustard seed, asarum, and dry ginger warm the Lung, dissolve fluids, and restore function. Magnolia bark regulates impeded Lung Qi. Apricot seed, lepidium, and pinelliae eliminate phlegm and reduce wheezing. Schizandra protects Lung Qi from leaking. Lumbricus relieves wheezing and dilates bronchi. White peony enhances the lumbricus’ antispasmodic effect. Baked licorice boosts Qi, stops coughing, and harmonizes the formula.
Main Points: Feishu UB 13, Lieque LU 7, Fengmen UB 12, Tanzhong REN 17, and Chize LU 5.
Technique: Acupuncture treatment for cold asthma should focus on sedating the Lung and eliminating the phlegm. The points should be sedated and left in place for 30 minutes. Renzhong REN 17 should be stimulated until the needling sensation disperses to both sides of the chest. Chize LU 5 should be needled against the flow of the channel. Feishu UB 13 and Fengmen UB 12 should be sedated for 2 minutes. For the best result, cupping may be applied with acupuncture for these two points.
Supplement Points: Shenzhu DU 12 and Dazhui DU 14 may be added for patients with headaches and body aches. Yingxiang LI 20 and Shangxing DU 23 may be added for stuffy nose and runny nose.
When heat attacks the Lung, the Lung will no longer be able to dominate Qi and control respiration. Patients generally experience a choking sensation, coughing spells, and intercostal distention. Patients will also have phlegm as characterized by wheezing, crackling, or moist rales, roaring sound in the throat from copious sputum that is thick and difficult to expectorate. Sputum is usually yellow but maybe white in some cases where heat is not as prominent. It is common for patients to raise their shoulders to help to breathe. Fever, irritability, perspiration, headache, thirst with desire to drink, flushed face, possible fever with aversion to cold are some of the symptoms of asthma due to heat. The tongue is red with yellow greasy coating. The pulse is superficial rapid or wiry.
The herbal formula of choice clears Lung heat, dissolves phlegm, and relieves asthma.
Recommended Ingredients: ephedrae (ma huang) facilitates the movement of Lung Qi and controls wheezing. Ephedrine and norephedrine in ephedrae (ma huang) have a prolonged bronchodilation effect. Gypsum (shi gao) clears Lung heat and neutralizes the warmth and diaphoretic effects of ephedrae (ma huang). Mulberry bark (sang bai pi) and lycium root bark (di gu pi), a pair also seen in Drain the White Powder (Xie Bai San), drain Lung heat and stop coughing and wheezing. Trichosanthes rind (gua lou pi) clears Lung heat, expands the chest, and dissolves the phlegm. Belamcanda (she gan) clears heat, relieves toxicity, and soothes sore throat due to heat and wheezing. Lepidium (ting li zi) drains the Lung, eliminates phlegm, and reduces wheezing. Apricot seed (xing ren) stops coughing and calms wheezing. Lumbricus (di long) stops muscle spasm of the airways to relieve wheezing. A small amount of schizandra (wu wei zi) is used to inhibit the leakage of Lung Qi in order to prevent Qi loss. Baked licorice (zhi gan cao) moderates spasms, supplements Qi, and harmonizes all the herbs in this formula.
Main Points: Dazhui DU 14, Hegu LI 4, Tanzhong REN 17, Fenglong ST 40, Feishu UB 13 and Kongzui LU 6.
Technique: Acupuncture treatment for asthma due to heat should focus on dispersing the Lung, clear heat, dissolve phlegm, and lower adverse rising Qi. Dazhui DU 14 and Feishu UB 13 are sedated for 2 minutes followed by immediate removal of the needles. The remaining points should be sedated and needles left in place for 20 minutes.
Supplement Points: Tiantu REN 22 and Dingchuan (Soothing Asthma) may be used if there is severe dyspnea. Yuji LU 10 and Daling P 7 are added if patients experience irritability and chest fullness. Zhaohai K6 and Taixi K3 are added if the patient is thirsty and drinks lots of water.
The herbal formula of choice tonifies Kidney Yang, directs the rebellious Qi downward, arrest coughing, wheezing, and eliminates excessive phlegm.
Recommended Ingredients: ephedrae (ma huang) expels exterior wind and relieves dyspnea. Ephedrine and norephedrine, two active ingredients of ephedrae (ma huang) are bronchodilators that can open the airway, relieve wheezing and dyspnea. Apricot seed (xing ren), perilla seed (su zi), and lepidium (ting li zi) reverse the uprising Lung Qi, eliminate phlegm, and relieve coughing and wheezing. Mustard seed (bai jie zi), gleditsia fruit (zao jiao), pinellia (ban xia), magnolia bark (hou po), and peucedanum (Qian hu) eliminate phlegm and relieve coughing and wheezing. Lumbricus (di long) stops muscle spasm of the airways to relieve wheezing.
Schizandra (wu wei zi) tonifies the Lung and the Kidney to relieve wheezing. Raphanus (lai fu zi) tonifies the Spleen and reduces the production of phlegm. Citrus Peel (chen pi) dries up dampness and eliminates phlegm. To prolong inhalation, cinnamom bark (rou gui) warms the Kidney Yang and helps restore the Kidney’s ability to grasp the Qi. Bupleurum (chai hu) regulates the Qi and tangkuei (dang gui) nourishes the blood in the Liver and indirectly treats coughing and other Qi-reversion symptoms by regulating the blood. Fresh ginger (sheng jiang) and perilla leaf (su ye) disperse coldness and dilate the Lung. Baked licorice (zhi gan cao) and jujube (da zao) harmonize the formula.
Note on Phlegm:
Since Phlegm is the fundamental cause of asthma, it is present in all types of asthma patients. For profuse, white, or yellow sputum in the different types of asthma patients mentioned above, Citrus and Pinellia Combination (Er Chen Tang) can be added to dry dampness, transform phlegm and regulate Qi.
Patients in the remission stage show no signs and symptoms of asthma, such as wheezing or dyspnea. Compared to when they are under attack, the patients appear completely different and usually manifest little or no symptoms. The treatment principle during the remission stage should focus on balancing the underlying deficiencies of the related internal organs, namely the Lung, the Spleen, and the Kidney. Depending on the severity, herbal treatment must continue for at least 6 months for maximum effectiveness.
Patients with Lung deficiency commonly have asthma attacks triggered by changes in weather or exposure to known allergens or viral infections. Prodromal symptoms resemble those of allergy, which include sneezing, stuffy nose, and rhinorrhea. During the remission stage, patients with chronic wheezing and dyspnea due to Lung deficiency may have mild symptoms of shortness of breath, low voice, frequent low, wheezing sound in the throat. Sputum is clear or white, scanty, or sticky. Aversion to the wind and spontaneous sweating are two key signs of Lung Qi deficiency. Patients in this category usually have low immune systems and are very susceptible to catching common colds. The tongue is usually red with a thin white coat or scanty coating. The pulse is weak and thready, or thready and rapid.
For maintenance, Astragalus & Siler Formula (Yu Ping Feng San) and Ginseng & Ophiopogon Formula (Sheng Mai San) and Ginseng and Aster Combination (Bu Fei Tang) are excellent formulas to tonify the Lung and prevent recurrent asthma attacks.
Astragalus & Siler Formula (Yu Ping Feng San) tonifies Qi and strengthens the exterior. It is commonly used for patients who have Wei (Defensive) Qi deficiency characterized by spontaneous perspiration, aversion to cold, and frequent infection of common cold and flu.
Ginseng & Ophiopogon Formula (Sheng Mai San) and Ginseng and Aster Combination (Bu Fei Tang) tonify the source Qi, nourish Yin, and generate body fluid. It is used for Qi and Yin deficiencies of the Lung with chronic asthma, cough, scanty sputum, shortness of breath, increased respiration, spontaneous perspiration, and dry mouth.
Patients with Spleen deficiency commonly have asthma attacks triggered by improper dietary intake, such as that of cold or spicy foods. During the remission stage, there may have occasional shortness of breath, dyspnea, low voice, fatigue, poor appetite, epigastric distention, loose stool, or diarrhea after intake of greasy or fried foods, and possible edema. Sputum is white, thick, and copious. The tongue is pale with teeth marks. The coating is white or greasy. Pulse is thready and soft.
The herbal formulas of choice to tonify Spleen deficiency are Major Six Herb Combination (Liu Jun Zi Tang) and Ginseng and Astragalus Combination (Bu Zhong Yi Qi Tang). Major Six Herb Combination (Liu Jun Zi Tang) tonifies the Spleen and dissolves the phlegm. It is used for patients with Spleen deficiency with residual phlegm in the Lung. Ginseng and Astragalus Combination (Bu Zhong Yi Qi Tang) tonifies the Middle Jiao and raises Yang in the body. It is used for patients with deficiency of both the Stomach and the Spleen Qi leading to the sinking of the Yang.
If the patient shows prominent water stagnation in the middle jiao manifesting in fullness in the chest and hypochondria, shortness of breath, profuse sputum and palpitation, Hoelen and Atractylodes Combination (Ling Gui Zhu Gan Tang) can be used.
Patients in this category are generally older or have a very chronic history of asthma. More patients in this category have Kidney Yang deficiency than Kidney Yin deficiency.
Asthma attacks for these patients are usually triggered by over-exertion or any minute changes in the weather, lifestyle, or the environment. The common symptoms of Kidney Yang and Yin deficiency include: short and accelerated respiration, labored inhalation with the key symptom of longer exhalation than inhalation; relief after a deep inhalation, interrupted respiration, cough with frothy or sticky sputum, frail appearance, weakness of the lower back and knees, withered shen and dyspnea after exertion. Patients with Kidney Yang deficiency, in addition to the above symptoms, will exhibit spontaneous perspiration, the coldness of the limbs and extremities, pale face, edema, a pale, tender, flabby tongue with a deep, slow pulse. In the case of Kidney Yin deficiency, the patient may have flushed cheeks, dryness of throat, irritation and perspiration with an oily texture, a skinny tongue with no coating, and a deep, thready, rapid pulse.
The best formula to tonify the Kidney Yang and Qi and prevent recurrent asthma attacks is Ginseng and Gecko Formula (Ren Shen Ge Jie San) and Rehmannia Eight Formula (Ba Wei Di Huang Wan). For Kidney Yin deficiency, Capital Qi Pill (Du Qi Wan or Qi Wei Du Qi Wan) combined with Ginseng and Ophiopogon Formula (Sheng Mai San) is recommended.
Main Points: Feishu UB 13, Pishu UB 20, Shenshu UB 23, Gaohuangshu UB 43, Qihaishu UB 24, Zusanli ST 36, Taixi K 3, Taiyuan LU 9, and Dingchuan (Soothing Asthma).
Acupuncture treatment for deficiency-type asthma should focus on tonifying the underlying deficiency, dissolve phlegm, and relieve asthma. Practitioners tonify Feishu UB 13 and Gaohuangshu UB 43, then apply cupping for 10 minutes. They tonify Pishu UB 20 and Shenshu UB 23, with or without moxa. They tonify Dingchuan (Soothing Asthma) and keep the needle in place for 20 minutes. Finally, they tonify all remaining points and leave needles in place for 30 minutes.
Practitioners use Neiguan P 6, Guanyuan REN 4, and Tanzhong REN 17 to treat shortness of breath and tachypnea. They add Yinxi H 6 and Houxi SI 3 if patients sweat easily after movement or light exercise. To tonify Lung Qi, they include Guanyuan REN 4. If Kidney deficiency prevents Qi grasping, they apply moxa on Guanyuan REN 4. For Heart Yang deficiency, they incorporate Neiguan P 6 and Tanzhong REN 17. To address chest oppression, they use Xuanji REN 21 and Shufu K 27. Finally, they employ Sanyinjiao SP 6 and Shangqiu SP 5 to tonify Spleen.
EAR ACUPUNCTURE for Asthma Acupuncture and Herbs
Main Points: Dingchuan, Adrenal, Lung, Trachea, Subcortex, Endocrine, and Sympathetic Nerve.
TECHNIQUE: Three to four points are selected for each treatment. Use strong stimulation techniques and leave the needle in place for 5 to 10 minutes.
PREVENTION
Asthma Acupuncture and Herbs, Traditionally in Chinese Medicine, Ephedrae (ma huang) is an indispensable herb in the treatment of many respiratory disorders, especially asthma. No other herb can substitute it. Chinese texts describe ephedrae (ma huang) with the function to facilitate the Lung Qi and relieve wheezing. Modern pharmacological research has confirmed the effectiveness of ephedrae (ma huang) with two main components namely ephedrine and norephedrine. They are sympathomimetics that stimulate both the Lung and the Heart receptors, resulting in bronchodilation, increased heart rate, and high blood pressure.
Asthma Acupuncture and Herbs. This article serves as a reference for licensed healthcare practitioners, who require professional training for safe, effective herbal use. Manufacturers sell herbal products exclusively to licensed practitioners. The article fully discloses each herbal formula’s advantages and disadvantages, enabling informed decisions by doctors and patients. Structure & Function Claims: The article presents information accurately, truthfully, and without misleading claims. Modern research supports all claims, with references provided throughout. However, the FDA mandates this statement: These statements lack FDA evaluation. These products do not diagnose, treat, cure, or prevent any disease.
Dr. John Chen is a recognized authority on Western pharmacology and Chinese herbal medicine and is the herbal consultant for Evergreen Herbs. He graduated from the University of Southern California (USC) School of Pharmacy and South Baylo University of Oriental Medicine. He also received extensive post-graduate training in China, specializing in herbology and internal medicine.
Academically, he is an assistant professor at the University of Southern California (USC) School of Pharmacy, Yo San University, Emperor’s College, and Los Angeles Chiropractic College. Professionally, he is a member of the Herbal Medicine Committee for the American Association of Oriental Medicine (AAOM) and an herbal consultant for the California State Oriental Medicine Association (CSOMA).
Furthermore, Dr. Chen has written numerous books, published articles in various journals, and delivered seminars at universities, state organizations, and national associations. In 1998, USC invited Dr. Chen as a guest speaker at the Bergen Brunswig annual convention, where over 400 pharmacists and doctors attended. In 1999, the Discovery Channel interviewed him as a traditional Chinese medicine expert for a six-hour documentary on alternative medicine. That same year, the Los Angeles Times chose Dr. Chen for the Festival Honorary Committee and as the Herbal Medicine speaker at the First Annual Festival of Health. In 2000, the University of Arizona appointed him academic advisor for its Integrative Medicine Program. He also appeared on the Discovery Health Channel as an Oriental Medicine expert consultant. Additionally, the American Academy of Medical Acupuncture selected him for the editorial board of Medical Acupuncture in 2000.
Resources:
– SOURCE: Dr. John Chen is available for medical consultation through Evergreen Herbs and Medical Supplies
https://www.acufinder.com/Acupuncture+Information/Detail/Treatment+of+As…