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[Introduction]
Nasosinusitis, one of the commonly encountered dis-eases in the five sensory organs due to inflammation of the nasosinusal mucus, is either acute or chronic. Usually chronic nasosinusitis is more common. The clinical mani-festations are profuse nasal thick discharge, nasal obstruc-tion, headache or vertigo, and hyposmia. This disease pertains to the conception of "nasosinusitis" in TCM caused by accumulation of pathogenic factors in the nasal cavity due to failure of pulmonary qi to disperse resulting from exogenous pathogenic cold and heat attack; or by failure of qi and blood to nourish the nose due to asthenia of the spleen and lung.
[Syndrome differentiation]
1. Sthenia syndrome
Nasal discharge of thick snivel with yellow color and foul smell, anosmia, or accompanied by fever, cough, headache and rapid pulse if there is exuberant heat in the lung meridian; or accompanied by headache, bitter taste in the mouth, dry throat, dysphoria, susceptibility to rage, reddish tongue with yellow fur and taut and rapid pulse if there is stagnant heat in the gallbladder meridian; or accompanied by heaviness of the head and lassitude of the body, distension and oppression in the chest and epi-gastrium, anorexia, reddish tongue with yellow and greasy fur and soft pulse if there is damp-heat in the spleen meridian.
2. Asthenia syndrome
Nasal obstruction with whitish and thick nasal dis-charge, hyposmia, or accompanied by dizziness, cold body and limbs, shortness of breath and weakness, light-col-ored tongue with thin fur as well as weak and slow pulse if there is asthenia-cold in pulmonary qi; or accompanied by lassitude of the limbs, sallow complexion, reduced appe-tite and abdominal distension, loose stool and clear urine, light-colored tongue with whitish fur and slow and rapid pulse.
[Treatment]
1. Body acupuncture
Prescription: Yingxiang (LI 20), Hegu (LI 4) and Yintang (EX-HN 3).
Modification: For sthenia syndrome, Taiyang (EX-HN 5 ) is added; if there is heat in the lung meridian, Dazhui (GV 14) and Lieque (LU 7) are added; if there is stagnant heat in the gallbladder meridian, Fengchi (GB 20) and Xingjian (LR 2) are added; if there is stagnant heat in the spleen meridian, Zusanli (ST 36) and Yin-lingquan (SP 9) are added. For asthenia syndrome, Zu-sanli (ST 36) is added; if there is asthenia-cold in pulmo-nary qi, Feishu (BL 13) and Taiyuan (LU 9) are added; if spleen qi is asthenic, Pishu (BL 20) and Weishu (BL 21) are added.
Performance: For sthenia syndrome, reducing nee-dling technique is used without moxibustion; Yingxiang (LI 20) is needled obliquely toward the inner region; Yintang (EX-HN 3 ) is needled horizontally downward with rotating technique for reducing purpose; Taiyang (EX-HN 5) is pricked for bloodletting. For asthenia syn-drome, Yingxiang (LI 20) and Yintang (EX-HN 3) are needled with mild reinforcing and reducing techniques, the rest of the acupoints are needled with reinforcing technique with needle-warming moxibustion or with moxa-roll moxibustion.
2. Ear acupuncture
Prescription: Internal Nose (TG4), Lung (C014), Forehead (AT1) and Lower Tragus (TG2).
Performance: Each time 3 - 4 acupoints are needled with medium stimulation. The needles are retained for 30 minutes. Or 2 - 3 acupoints are selected for embedment of needles. Or Wangbuliuxingzi (Semen Vaccariae) is used for auricular acupressure alternatively on both ears 3 – 4 times a day.
