I. Features of clinical treatment in Chinese medicine
1. Holistic
The holistic nature is expressed in the comprehensive treatment (including disease, evidence and symptoms) of the patient rather than the disease. The holistic nature of treatment is rooted in the holistic concept of TCM, that is, human physiology is a complete and unified multi-system multi-level integrated organism, and human pathological changes are the sum of the interactions and interactions between disease-causing factors and anti-disease forces, local and overall, internal organs and body surfaces, organs and internal organs, and qi, blood and fluids. Therefore, TCM treatment focuses not only on the specific causes of the disease, but also on the adjustment and restoration of the body’s vital energy, as well as the pathological changes that occur at specific stages of the disease development process, and the improvement of the patient’s symptoms and signs, either by comprehensive treatment or by prioritization, so as to finally achieve a full range of healing or improvement of the disease, evidence and symptoms. It is not “treating the head when the head aches and treating the foot when the foot hurts” or “stopping the cough when you see it”, but a comprehensive and integrated treatment for the cause of the disease, combined with the whole.
2.Individualization
Modern epistemology believes that the more highly developed and complex things are, the more obvious the individual differences are under the common overall properties. Human is the most complex organism in nature, except for natural attributes, but also has more complex socio-psychological attributes. For example, individual genetic, physical, psychological, and personality traits. In addition, the external environment differs from patient to patient, including the natural environment (climate, geography, biology, etc.) and the social environment (social status, economic conditions, lifestyle, etc.).
3.Tuning the plain
Chinese medicine emphasizes that the purpose of treatment is “to be peaceful for a period of time”, that is, the balance of yin and yang, qi and blood, and the coordination of the functions of the internal organs, which includes the meaning of “order” in modern system theory. It means that the disease is the result of the evil prevailing over the positive, imbalance of yin and yang, imbalance of qi and blood, and the function of internal organs is either hyper or hypo or disorderly, then the treatment is to restore the body to the original structure and function of the “orderly” state.
Second, the advantages of Chinese medicine treatment of respiratory system diseases
1, all kinds of cough (including post-cold cough, acute and chronic bronchitis, etc.)
2, all kinds of colds and viral infections
3.Stable stage (remission) of chronic obstructive pulmonary disease
4, treatment of bronchial asthma.
5, interstitial lung fibrosis.
6. bronchiectasis, etc.
C. Characteristics of Chinese medicine treatment for cough
Cough is a common clinical condition. Modern medicine believes that “coughing is a nerve reflex process. When the vagus nerves distributed in the ears, nose, pharynx, larynx, bronchi, pleura and various parts of the internal organs are stimulated by inflammation, allergy and other factors, they can cause coughing through nerve transmission to the cough center. The Nei Jing? It is said in the Book of Cough that “all the five viscera and six internal organs cause coughing, not only the lungs”. In terms of treatment, the previous generations believed that to stop coughing when you see it is the next step. It can be seen that in ancestral medicine, the first thing to do for cough is to make a clear diagnosis and then treat it with evidence, opposing the idea of simply stopping the cough. Both Chinese and Western medicine consider a clear diagnosis to be the first problem in treating cough. After the basic diagnosis of the cause of cough has been clarified, Chinese medicine has its own way of identifying evidence for the diagnosis and treatment of cough.
The first way is to identify external sensations and internal injuries.
External coughs are mostly new, with rapid onset and short duration, and are often accompanied by superficial evidence of lung health.
Internal injury coughs tend to be long-standing, often recurrent and long-lasting, and may be accompanied by other organ symptoms.
It should be said that external coughs are more difficult to treat than internal coughs, and the so-called “chronic cough hurts the lungs” means that internal coughs have a real transformation into a deficiency. People often think that Chinese medicine is effective in treating chronic coughs, so they come to Chinese medicine when the initial treatment does not work well or when the cough persists for a long time. In fact, most coughs are caused by excessive fatigue and cold, and as Chinese medicine says, “When the righteousness exists within, the evil cannot dry out” and “When the evil comes together, its qi must be deficient”, and because of the high number of social functions after a cough, lack of attention to diet, or premature use of astringent and nourishing drugs (including sedatives). The cough is prolonged due to the fact that there are many social functions after the cough, lack of attention to diet, or premature use of astringent and nourishing drugs (including cough suppressants and some creams), resulting in a closed door and no outlet for the evil. Chinese medicine is most concerned with the treatment of diseases according to the situation. If we can grasp the evidence and disperse it, it will be as effective as a rafter. Don’t underestimate this cough, as some patients have a chronic cough that is prolonged for a long time and turns into chronic bronchitis, and some patients develop wheezing or even typical asthma. Severe coughing can even lead to syncope, the so-called “cough syncope syndrome”, and I have treated several such patients, some of whom had coughs that seriously affected their work and life.
The symptoms are cough, itchy pharynx, or slight cold, little or no sputum, red tongue, white fur, and floating pulse. Treatment starts with draining the wind and promoting the lung. The selected formula is Stop Coughing San and San Hei Tang. The medicine uses roasted ephedra, almonds, licorice, anterior hu, orris, suzi, half summer, Chen Pi, cicada, and dong hua. If the external cold is heavy, add Gui Zhi and Hsio Xin if the sputum is thin or foamy. For those with wind-heat or wind-heat, the sputum is sticky and thick, with unpleasant coughing and vomiting, remove Ephedra, Su Zi, Sempervivum, Chen Pi and Radix et Rhizoma. Add silver flower, burdock, mulberry skin, peppermint, scutellaria, and dabei. If the cough is without sputum or the sputum is small and difficult to be coughing out, and it occurs in autumn, it is a wind-dry cough. The treatment starts with draining the wind, clearing the lung and moistening the dryness, and the proposed formula is Mulberry Apricot Soup and Clear the Dryness and Save the Lung Soup with addition and subtraction, which can be accompanied by Chuanbei, rhizome and pollen. In some patients, the cough does not go away after months, mostly after an external sensation, and despite repeated application of anti-inflammatory, cough suppressant and phlegm-reducing western drugs, the effect is very little, and the symptoms include frequent coughing, itching and choking of the throat, little sticky white or yellow sputum, increased coughing when inhaling cold wind or irritating smoke, or even red face and tears, and vomiting. On detailed examination of the condition, we can see that some of the patients have chronic congestion in the pharynx and hyperplasia of lymphatic follicles in the posterior wall, which is equivalent to chronic pharyngitis combined with acute bronchitis; some of the patients may belong to atypical asthma or variant asthma. According to the evidence, we draw on the experience of the sages and closely follow the pathogenesis of wind-heat and wind-dryness. The treatment is based on the formula of dispelling, calming and clearing. The medicine uses mulberry leaf, mulberry white peel, almond, maitong, scutellaria, cicada, orris, bai qian, roasted ephedra, raw clam shell, scape seed, winter melon seed, licorice, etc. The clinical evidence. Every get effective. If the cough is prolonged without sputum and the throat is itchy, we can add Centipede, Centipede, Ume, etc. to dispel wind and relieve spasm, astringent lung and stop cough. If the cough leads to pain in the throat, it is a “liver cough”, so add green peel, heliotrope shell and aromatic herb as appropriate; if the cough causes drowning, it is a “cough of the bladder”, so add qiangwu as appropriate. If the person coughs at dusk, the deficiency fire is floating in the lungs, so the treatment should be to nourish Yin and astringent lungs. If the person coughs in the afternoon, it is mostly due to Yin deficiency, and the treatment should be to nourish Yin and lower the fire, using raw earth, rehmannia, asparagus, maitong, angelica, white peony, Zhi Mu, gua wu ren and Chuan Bai Mu. If the lung is deficient in prolonged cough, benefit the qi and replenish the blood by adding ginseng, astragalus, aconite, angelica, aster, asparagus, white peony, etc. If the cough is prolonged and coughing. Add angelica and aster, taking the meaning of “warmth for those who work”. If the morning cough is characterized by phlegm, it is due to spleen deficiency, so it is appropriate to add dry ginger to Six Gentlemen’s Soup.
IV. Treatment characteristics of Chinese medicine in the stable phase of chronic obstructive pulmonary disease (remission)
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease characterized by incomplete and reversible airway airflow limitation. The airflow limitation is usually progressive and is accompanied by an abnormal inflammatory response of the lungs to toxic particles or gases. Its high prevalence and high mortality rate make it a common disease in our country. Because of its slow progression, it severely affects patients’ ability to work and quality of life.
The onset of COPD is mainly related to exposure to risk factors such as smoking, atmospheric pollution, occupational dust and chemicals, and infections. Its main symptoms are chronic cough, sputum production, and progressive dyspnea.
The treatment of COPD has always been a difficult and worthwhile issue to explore. Although current Western medical treatments are effective in relieving symptoms and complications, few drugs and methods have been reported to effectively stop and reverse the progressive trend of the disease. Especially in the stable phase of COPD, western medical treatment mainly consists of bronchodilators (including β2 agonists, anticholinergics, theophylline, and combinations of these drugs), glucocorticoids, exercise training, and long-term oxygen therapy.
TCM can interrupt the COPD disease chain in multiple ways and aspects by treating patients with stable COPD through evidence-based treatment and comprehensive conditioning, targeting their pathophysiological changes, thus relieving the disease, reducing the number and extent of acute attacks, and achieving improved quality of survival and life expectancy.
The advantages of TCM in the treatment of stable COPD are as follows.
(1) Regulating the immune function of the body.
The reduced immune function of COPD patients is one of the reasons why they are prone to recurrent infections. Pharmacological studies have confirmed that ginseng, Astragalus and Atractylodes have the ability to improve cellular and humoral immunity, enhance the body’s resistance to various harmful gases, and promote protein and ribonucleic acid synthesis. During the stabilization period, through the treatment of supporting the root, it can regulate the immune mechanism of the body, improve the immunity of the respiratory tract and prevent the recurrence of infection, in order to stop the increase of pulmonary artery pressure caused by repeated infection and prevent the occurrence of pulmonary heart disease and further deterioration of cardiopulmonary function.
(2) Regulate the function of the endocrine system of the body.
The study proved that the function of endocrine system is obviously reduced when the kidney is deficient, and the three target gland axes of hypothalamus-pituitary-adrenal gland (thyroid and gonad) are disordered, and there are different degrees of disorder in different target glands and different links. The treatment of kidney supplementation in the stable stage can promote the function of adrenal cortex and improve the excitability of hypothalamus-pituitary-adrenal gland which is inhibited by exogenous hormones, so as to improve the body’s ability to resist disease.
(3) Improve microcirculation.
COPD patients all have different degrees of microcirculatory disorders and have a tendency to thrombosis; according to Chinese medicine, blood stasis is also an important pathological change in COPD. Blood activating drugs can improve cardiac function, dilate pulmonary vessels, reduce pulmonary hypertension and improve blood supply to important organs; blood activating drugs can enhance patients’ anti-hypoxia ability, increase blood oxygen supply to tissues and organs, and reduce damage to important organs caused by ischemia and hypoxia.
(4) Anti-inflammatory, antispasmodic, anti-cough and expectorant effects.
(5) Improving nutritional status.
Due to long-term chronic hypoxia, COPD patients put their gastrointestinal tract in a state of chronic ischemia and hypoxia, and the gastrointestinal tract is dysfunctional, which leads to decreased appetite, bloating, diarrhea and other digestive system symptoms, directly affecting the nutritional status and quality of survival of patients. Spleen-healthy Chinese medicine can promote cellular uptake and utilization of glucose, inhibit oxygen radical production, block the effect of free radicals on nuclear radicals and proteins, and promote cellular utilization of sugar and protein synthesis, thus improving the overall nutritional status of COPD patients, enhancing respiratory muscle function, improving lung ventilation, reducing a series of damages caused by hypoxia, improving survival quality and prognosis; by improving nutritional status, it also By improving the nutritional status, it also improves the body’s ability to resist disease and reduces recurrent disease attacks.
(6) Reduce the socio-economic burden. At present, the clinically commonly used western pharmaceutical preparations are expensive, and the long-term treatment of COPD has limited the treatment of western medicine; Chinese medicine has received great attention due to abundant resources, low price and few side effects.
In summary, TCM has many advantages in the treatment of COPD in the stable phase, and is a means and method based on the pathophysiology of TCM, which reduces the toxic side effects of western drugs. It not only effectively relieves the symptoms of chronic cough, sputum production and dyspnea, but also improves the immunity of patients, improves their nutritional status, enhances their resistance to disease, reduces the recurrence and exacerbation of the disease, thus delaying and stopping the development of the disease, promoting the recovery of the patient’s organism, and fundamentally improving the quality of survival of patients.
Chronic obstructive pulmonary disease chronic extension: when the symptoms are taken into account, such as long-lasting lung and card deficiency, dense phlegm and dampness, cough with turbid phlegm, white color and easy to cough, poor energy, treatment to nourish the qi and strengthen the spleen, dry dampness and resolve phlegm, often with Six Gentlemen’s Soup plus reduction; Radix et Rhizoma Ginseng, Atractylodes Macrocephalae, Poria, roasted licorice, system of Semen, orange red, roasted aster, Bai Bu, white mustard seed, fried lycopodium, roasted soursop. The poor nasal plus Jiao Sanxian, yam spontaneous sweating easy to catch a cold plus astragalus. If the disease is prolonged lung and kidney deficiency, descending the deficiency, coughing and asthma, breathing more and sucking less, moving is particularly bad, the treatment of external kidney gas with blood circulation, commonly used wheat flavor Dihuang Tang plus reduction: Mai Dong, Wu Wei Zi, Sheng Sun Ginseng, Cornu Cervi Pantotrichum, Poria, Dan Pi, Ze Xie Di, mealybug powder, Zi He Che powder (punch), almond, Dan Shen. Add Zhi Mu for kidney yin deficiency; add bone marrow for kidney yang deficiency, etc.
Clinical practice proves that in the treatment of cough and asthma, especially in the treatment of chronic cough and asthma, it is very important to support the root of the problem, which can improve the resistance of cough and asthma patients and reduce recurrence. As the saying goes, “if the righteousness is kept inside, the evil cannot dry up”. The clinical situation is based on the strengths and weaknesses of the lungs, spleen and kidneys. It also distinguishes the primary and secondary importance of the three organs of the lung, spleen and kidney, as well as the deficiency of qi, blood and yang in the human body. Perform tonification. “In the kidney is deficiency”, moving is asthma, clinical use of mealybug, Zihecha, Shu Di, Wu Wei Zi, Shen Xiang, walnut meat, Kan Navel, etc. to supplement the kidney and nourish the qi. It has been observed that some patients with chronic asthmatic bronchitis insist on taking kidney qi pills and cordyceps powder, and their condition remains stable for a long time. The earth and gold are mutually reinforcing, and the spleen and lung are mutually supportive. To treat the lung without forgetting to manage the spleen, we can often use ginseng, astragalus, yam, atractylodes, poria, etc. to benefit the qi and strengthen the spleen. In addition, the author often uses Atractylodes macrocephala and Atractylodes macrocephala to enhance the efficacy of drying dampness and resolving drinks. If the patient is easy to catch a cold, he or she also has lung deficiency, so he or she should take Wu Ping Feng San often. Or I may add Kidney Qi Jiu and Jin Shui Liu Jun Decoction to the above medicine. Or prepare pills, or boil the cream formula, adhere to long-term use, quite effective. I have used Zi He Che and its dried powder to supplement the treatment of juvenile asthma, the treatment is worth the development of youth, after years of use, asthma competition for many years without making.
Commonly used drugs during the stable period
Radix Codonopsis pilosulae, Rhizoma Atractylodis Macrocephala, Poria, Radix Salviae Miltiorrhiza, Radix Astragali, Radix Cinnamomi, Radix Paeoniae Alba, Radix Aconiti, Radix Bupleurum, Radix Sulforaphus, Radix Rehmanniae Praeparata, Radix Cornu Cervi Pantotrichum, Radix Lycii, Radix Cantharum.
V. Characteristics of Chinese medicine treatment for bronchial asthma
The aim of modern medical treatment of bronchial asthma is to control symptoms and eliminate airway inflammation. Although there are bronchodilators, immunosuppressants, gene therapy and other methods, there are many such and such problems, and there is still no ideal drug selection, which can not yet solve the problems of its onset and development.
Since ancient times, Chinese medicine has been based on the prevention and treatment principles of “prevention before illness”, “early treatment of illness” and “prevention of change after illness”. Asthma has the characteristic of recurrent attacks, so this principle must be followed to “prevent the disease before it happens”, instead of just taking remedial measures, which is in line with the original purpose of medical treatment.
Chinese medicine summarizes the pathological basis of asthma as the deficiency of the proper qi of the lung, spleen and kidney, resulting in the blockage of qi, phlegm and stasis in the airways.
In acute attacks, the first step is to eliminate the evil and treat the symptoms; in remission, it is important to strengthen the deficiency to consolidate the root.
To consolidate the root, we need to benefit the spleen and lung, nourish the kidney qi, eliminate the source of disease, and achieve the purpose of disease prevention and treatment.
For asthma caused by external sensation, it is advisable to take Yu Ping Feng San to benefit the qi and strengthen the surface and prevent external invasion of evil.
If the spleen and stomach are weak and food injury causes asthma, we should control the diet and use drugs that regulate the spleen and stomach and eliminate food to help transportation, such as Baohe Pill.
For those who are emotionally disharmonized, prone to anger or depression when they move, or who have a weak heart and are easily frightened and have attacks, in addition to relieving their emotions and concerns, they should take medicines to regulate the liver and qi and harmonize their emotions.
For those who are prone to attack due to deficiency of Qi and Yang, they should warm up Qi and Yang; for those who have attack due to phlegm and stasis, it is advisable to use medicines that activate blood circulation and remove dampness and phlegm, etc., all of which can eliminate hidden problems and prevent recurrence.
It is especially worth mentioning that for “persistent asthma”, such as hormone-dependent asthma and hormone-resistant asthma in modern medicine, Chinese medicine has unique therapeutic effects.
In the treatment of hormone-dependent asthma, the use of kidney tonic method is always sought among yin and yang, and is specifically summarized into five methods.
Nourishing Yin and lowering fire can counteract Cushing’s sign-like side effects.
warming yang and tonifying the kidney to facilitate hormone withdrawal and reduction.
Nourishing Yin first and then Yang can make hormone withdrawal and reduction smooth.
Tonicizing both yin and yang and regulating both qi and blood can reduce hormone dependence.
The combination of cold and heat and harmonization of yin and yang can reduce hormone dosage.
Since qi stagnation and qi rebellion is the main pathogenesis of asthma, the treatment of hormone-dependent asthma should pay attention to regulating the liver to benefit the lung. Since Qi deficiency, phlegm obstruction and blood stasis are the key to recurrent asthma attacks and difficult to be cured, the prescriptions for patients with Spleen deficiency in hormone-dependent asthma should be selected according to the importance of Qi deficiency, phlegm obstruction and blood stasis. The method of lung management is to use the medicines of declaring, descending, warming, clearing, tonifying, moistening and astringent to regulate the qi, remove phlegm, tonify the lung qi and nourish the lung yin so that the declaring and descending function of the lung can be normalized. Because asthma is located in the lung, the deficiency of the positive and the evil can affect the lung and cause the disease to develop, therefore, in the treatment of hormone dependent asthma, regardless of the treatment of the symptoms and the root cause, the lung medicine must often be used in combination.
To treat the root of the disease, it is advisable to warm the middle and strengthen the transportation in order to eliminate the source of phlegm; to supplement the lung and benefit the yuan in order to increase the strength of resistance to the disease.
Zi He Che, Jilin Ginseng, Lu Dang Ginseng, Fried Atractylodes Macrocephala, Poria, Su Zi, Dong Hua, Radix Angelicae Sinensis, Gui Zhi, Paeonia lactiflora, Pericarpium Citri Reticulatae, Fructus Sempervis, Roasted Chicken Gold, Jiao Liu Qu, Golden Hair Gum, Deer Antler Gum.