Asthma, a chronic inflammatory disorder of the airways. It is characterized .by episodic airway narrowing, increased air-way reactivity to a variety of stimuli, and pharmacologic or spontaneous reversibility. The inflammatory response involves mast cells, T lymphocytes, and eosinophils, which produce multiple soluble mediators (e. g. , cytokines, leukotrienes, and bradykinins).
An imbalance in proinflammatory versus in-hibitory cytokines may be a fundamental part of the pathogen-esis of asthma. The histologic findings in asthma are airway cellular infiltration, epithelial disruption, mucosal edema, and mucus plugging. The trigger or stimulus that provokes the in-flammatory response may be exposure to extrinsic allergens or intrinsic host factors with no identifiable external cause. Even in people with no history of asthma, viral respiratory infection is occasionally associated with increased airway reactivity for several weeks to months after resolution of the infection; some of these persons develop chronic asthma. When a clear envi-ronmental trigger for asthmatic attacks can be identified, it can be avoided, or, in some cases, irnmunotherapy can desensitize the patient to the allergen. Some nonallergic factors that can precipitate or exacerbate asthma include postnasal drip, gastroesophageal reflux disease, exposure to cold, exercise, exposure to gases or fumes, emotional stress, hormones, and respiratory infections.
Diagnosis in Traditional Chinese Medicine
In traditional Chinese medicine, asthma is attributable to the categories of ".riao" and "chuan".
1. Notice whether there is an allergic history of the pa-tient and his family. For patients with histories of allergic rhinitis and urticaria, the disease is easy to be diagnosed.
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 pre-sent if pulmonary infection coexists. Termination of the episode is frequently accompanied by a cough with profuse, mucoid sputum.
Differentiation and Treatment of Common Syndromes in Traditional Chinese Medicine
1. Asthma of cold Type:
Clinical manifestations: 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 method: Ventilating the lung and expelling pathogenic cold, eliminating phlegm to relieve asthma.
Recipe: Belamcanda and Ephedra Decoction with addi-tional ingredients:
Ingredients:
Rhizoma Belamcandae 10g
Herba Ephedrae 3g
Herba Asari 10g
Rhizoma Pinelliae 6g
Fructus Schisandrae 12g
Radix Asteris 12g
Flos Farfarae 10g
Rhizoma Zingiberis Reeens 5pieces
Fructus Ziziphi Jujubae 10g
Semen Armeniacae Amarum 10g
Fructus Perillae 10g
Administration: The decoction of a dose is 200ml. Take equal shares in the morning and evening.
Modification: In case of chill, add Ramulus Cinnamomi 10g;In case of severe asthma, add Semen Lepidii seu Descu-rainiae 10g and Lumbricus 10g.
