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Abstract: A 34-year-old patient had recurrent bronchial asthma attacks for 5 years, which must occur every spring and summer. During the attacks, a sound like a water chicken can be heard in the throat, which can be accompanied by cough, sputum and chest tightness. After he came to our hospital to complete relevant examinations, he was diagnosed as: Western medicine diagnosis: acute attack of bronchial asthma; Chinese medicine diagnosis: croup. He was given western medicine treatment and supplemented with Chinese medicine for evidence-based management. After treatment, the result was good and no recurrence.
Basic information】Male, 34 years old
Disease Type】Bronchial asthma (Western medicine), croup (Chinese medicine)
Hospital】Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine
Time of consultation】June 2017
Treatment plan】Chinese herbal medicine treatment (Erxian Tang plus reduction) + Western medicine treatment (salmeterol ticapone powder inhaler)
Treatment period】1 month of outpatient treatment, 3 months of follow-up
Treatment effect] The patient’s asthma did not recur within 3 months, and the effect was good.
I. Initial consultation
The patient had a history of allergic rhinitis since childhood, and one day 5 years ago, due to the inhalation of pollen, he developed a croupy sound in his throat like that of a water fowl. However, the patient had not been treated systematically, and since then, the symptoms have been worsening gradually in the past three years. This attack started 3 months ago after he got cold, and the local community health service center had no effect of antibiotics. When he came to my clinic: chest tightness, shortness of breath, cough with phlegm, white sputum, unfavorable sputum discharge, sleep, and bowel regulation. ¬¬¬Tongue is light red, coating is thin and white, pulse is sunken and thin. Auscultation: both lungs were full of croup, no wet rales could be heard. Pulmonary function: positive airway reversibility test. Western medicine diagnosis: acute attack of bronchial asthma, Chinese medicine diagnosis: croup (deficiency of lung and kidney).
(Positive airway reversibility test)
II. Treatment history
The patient had been suffering from acute exacerbation for 3 months, and was currently treated with salmeterol ticapone powder inhaler as an anti-inflammatory and antispasmodic treatment, but the symptoms were not completely controlled. The patient was diagnosed as having deficiency of lung and kidney according to his symptoms and tongue and pulse, and was given a formula to warm the kidney and promote yang, and to calm the asthma with Qi. The patient complained that the chest tightness and shortness of breath was relieved after 3 doses, and the phlegm was easily discharged, and the phlegm tumor disappeared. So adjust the above, reduce the bone fructus, Ge Gen, Di Long, Shi Wei, Bai Guo Ren, add fried Atractylodes Macrocephala, Poria, Zhe Bei Mu, Qian Hu, water decoction. After taking the above prescription asthma basic control, sputum reduction, back pain relief, continue to consolidate half a month of treatment.
III. Treatment effect
After the above treatment, the patient was followed up after 3 months, no more attacks of shortness of breath for 3 months, and the pulmonary function test was normal. The patient’s salmeterol ticapone powder inhaler was gradually reduced under the doctor’s guidance. During the change of seasons, the patient paid attention to keeping warm and avoiding colds, as well as avoiding inhalation of pollen and other substances that can cause acute asthma attacks. Patients should maintain a normal life and work status at the 3-month follow-up after treatment.
IV. Notes
I am glad that the patient’s symptoms have improved after treatment, and I remind the patient that because bronchial asthma can be completely relieved with standard treatment and does not affect normal life, I tell the patient not to be nervous. However, it is because the early symptoms of bronchial asthma patients can be completely relieved or the patients have mild symptoms during acute attacks, which are easily ignored by patients. Some patients repeatedly spray short-acting β2 agonists by mouth, which leads to arrhythmia, hand tremors and other adverse reactions, so asthma patients must regulate the medication under the guidance of doctors and gradually reduce the dosage, and do not increase or decrease the medication at will. Usually cold (especially viral infections), exercise, inhalation of pollen, dust and other allergens may cause acute asthma attacks, so patients should pay attention to the conditions that can cause their acute asthma attacks in their daily life and record them if necessary. Patients should also keep a short-acting β2 agonist within their reach, so that they can use it in time in case of an acute attack.
V. Personal insight
The patient in this paper had an attack of bronchial asthma due to pollen inhalation, and the application of western medicine compounded salmeterol ticapone powder inhaler was not effective. Our hospital gave a combination of Chinese and Western medicine treatment, the advantages of which are: firstly, it can speed up the relief of the patient’s symptoms, and secondly, it helps the patient to reduce and stop the hormone. The patient’s clinical symptoms were significantly relieved after supplemented with herbal conditioning. It should be noted that even in mild asthma, there is a risk of death in acute attacks, so standardized treatment of asthma must be taken seriously, regular follow-up is important, and medication reduction and discontinuation must be done under the guidance of a doctor.