Allergic rhinitis, also known as allergic rhinitis, is a common and frequent disease in otolaryngology. Its typical symptoms are sudden onset of nasal itching, sneezing, runny nose and nasal congestion. Some patients also have itchy eyes, itchy throat, and even asthma and skin allergy symptoms. The incidence rate in the general population is 10%-25%. With the deterioration of the environment, the incidence of the population is increasing year by year, and the use of Chinese medicine in the prevention and treatment of allergic rhinitis is also increasing year by year. Better use of Chinese medicine in the prevention and treatment of allergic rhinitis is imminent. However, in clinical practice, there are less pure actual or pure deficiency evidence, and the mis-mixing of cold and heat, upper heat and lower cold, and the disunity of local cold and heat with systemic cold and heat are often presented. Therefore, sorting out the problems arising from the identification of allergic rhinitis in Chinese medicine, as well as proposing some countermeasures, can improve the efficacy of Chinese medicine treatment.
Thinking about a: allergic rhinitis identification of the elaboration of all three organs away from the lung, spleen and kidney, the occurrence of the disease is mostly due to deficiency of the three organs of the lung, spleen and kidney, deficiency of positive qi, the couples are loose, the surface of the guard is not solid, wind and cold foreign gas invasion caused by the positive qi stored within, evil can not dry, qi deficiency for congested nose, qi deficiency even and Yang and Yang deficiency, qi deficiency is a mild disease. The identification of qi deficiency is manifested in the triggering factors of allergic rhinitis, such as cold stimulation is triggered, in case of temperature change is triggered, the former can be identified as qi deficiency, the latter can be deficient in the guard qi, the guard surface is not solid, such as in case of special substances and triggering such as dust, spicy smell, etc. There is no obvious identification significance. If you have symptoms of generalized cold, or if you wear more clothes than your peers, or if you get a cold first when there is climate change and your peers are fine, it also indicates a deficiency of lung yang and kidney yang, and a lack of consolidation of the body surface. Most of the allergic rhinitis have symptoms of excessive sweating, or sweating or night sweating when moving, suggesting that the couples are not solid. The lung is combined with the skin and hair, the couples have normal opening and closing functions, allergic rhinitis qi deficiency couples are not solid, the pores open, treatment on the one hand to fix the Wei Qi, at the same time to close the couples. The first thing you need to do is to use the yu ping feng san to fix the Wei Qi, deflate the dried peaches, and close the couples with beans. Pale nasal mucosa and pale and edematous nasal turbinates suggest deficiency of Yang in the lungs and kidneys. Congested nasal mucosa and congested and swollen turbinates are mostly heat contained in the lung meridian, but not absolutely. It needs to be identified according to the systemic symptoms. The second manifestation of the symptoms: ① nasal cold fear of cold and wind, nasal cold wind blowing sneeze frequently, but the whole body is not afraid of cold, dressing the same or even less than normal, this is the nasal symptoms and the whole body symptoms of cold and heat are not the same. Nasal examination of the nasal mucosa is often congested, this is the surface of the body is not solid, the coup is loose, there are signs of internal heat, is the surface deficiency of the real. The surface deficiency is reflected by the deficiency of the guard qi, the guard surface is not solid, the actual manifestation of the lung meridian contains heat, the clinical use of Yu Ping Feng San to fix the surface and desensitization soup (experience formula: comfrey, Xi Cao, g Datura, Mo dry lotus, etc.) to clear heat and cool blood desensitization. ② cold hands and feet, but the whole body is not afraid of cold, wearing the same clothes than normal people, may be Yang Qi deficiency, accompanied by Qi Qi is not smooth, less Yang Qi more difficult to fix the guard table; or Yang Qi is not deficient, but the Qi is suppressed, can not reach the muscle surface and caused, so the treatment in addition to warming Yang Qi need to be combined with the Tong Yang products. Professor Gan Zu Wang has used deer horn cream to achieve the purpose of warming and dispersing, or Allium sativum to promote yang.
Thinking about the third: the inconsistency between local cold and heat and systemic cold and heat: whether the systemic cold and heat symptoms match with local cold and heat manifestations. There is a general fear of cold, the nose is afraid of cold and wind, easy to catch a cold, wear more clothes than normal, this is Yang deficiency or the surface of the body is not solid performance; there is a general fear of heat, like cold drinks, dry mouth, constipation, frequent facial acne, red tongue and other symptoms, this is the internal heat of the actual symptoms. In nasal examination, the nasal mucosa is pale and edematous, the turbinates are edematous and enlarged, and the nasal passages are filled with clear snot. If the systemic manifestation is Yang deficiency, the local examination of nasal cavity is Yang deficiency and watery manifestation; if the systemic manifestation is actual evidence of internal heat, the local examination of nasal cavity is the manifestation of lung and stomach heat. The former pathogenesis is a weakness of Yang energy in the lung, spleen and kidney, and the surface of the body is not consolidated. In the latter case, the pathogenesis is heat in the lung and stomach, congestion of lung qi, and loss of lung orifices, so the treatment is based on clearing heat from the lung and cooling blood to desensitize. If the systemic symptoms are weak yang qi and the symptoms of deficiency of the guard surface, and the nasal cavity is characterized by heat in the lung and stomach, this is a sign of deficiency of the surface and internal heat, the treatment is to benefit qi to fix the surface and cool the blood to desensitize, using Yu Ping Feng San, Gui Zhi Tang to benefit qi to fix the surface and harmonize the Ying and Wei, and Desensitization Tang to cool the blood to desensitize. However, the amount of warming Yang products in the prescription should be reduced as appropriate. If the systemic symptoms include obvious internal heat evidence and the nasal cavity shows signs of Yang deficiency and watery flooding, the herbal medicine can either clear heat or warm Yang, which requires individualized treatment.
Symptoms of the Kidney meridian include fear of cold and lack of warmth in the extremities. If a patient with allergic rhinitis has symptoms of upper heat and lower cold, he can be considered for treatment with Wu Mei Wan.
Think 5: Allergic rhinitis in children is often related to the “spleen is always deficient, Yang is always surplus” physique of children, which is the basic physiology of children. The basic pathology of allergic rhinitis is the deficiency of the spleen, lungs and kidneys, which can be triggered by foreign air, cold air and temperature changes, and can easily heat up. Clinical symptoms include itchy nose and frequent sneezing, but the nose is often runny, mucousy, or even pus-like rather than clear. After the cloudy mucus disappears and the nasal ventilation improves, the patient is then treated by strengthening the spleen and benefiting the qi, supporting the righteousness and desensitization. Children often cannot express the efficacy of drugs correctly, and the amount of tissue use can often indicate the regression of the disease.
Countermeasure 1: Cold and heat can be identified by a single symptom, and although there are few symptoms, one or two characteristic symptoms can still be characterized. ① like ice drinking. Ice drinkers can often be seen drinking red wine with ice, and still drink cold beer in winter, with a sense of relief after drinking, without any discomfort. Such patients often have internal heat. If you are suffering from allergic rhinitis, you are often suffering from internal heat, so clinically, you need to clear the heat first and supplement the deficiency later. ②Young people with facial acne. This is often accompanied by bad breath, obvious bad breath in the mouth, and dry stools. This is a sign of heat accumulation in the spleen and stomach. If accompanied by allergic rhinitis, the mucous membrane of the nasal cavity is often congested and the turbinates are congested and swollen. Chinese medicine treatment is often to clear the lung and stomach heat first.
Countermeasure 2: Identification of true and false heat and cold, true heat and false cold or true cold and false heat can be identified from the following symptoms. Dry mouth can be caused by nasal congestion and open mouth breathing, or by heat and fluid injury or spleen deficiency. Dry mouth alone cannot determine the type of evidence, but the desire for cold or iced drinks, and the desire for warm drinks, the former mostly indicates internal heat, and the latter mostly indicates spleen deficiency, spleen deficiency, and the signs of fluid not on the support. Secondly, whether the stool is dry, whether there is no pain symptoms of internal qi, followed by whether there is a burning sensation in the urine, burning urine for the internal signs of contained heat, clear and long urine is cold, at the same time, the tongue quality, tongue moss color texture form, to identify the true and false cold and heat has a reference role.
Countermeasure three: detailed questioning and careful examination, comprehensive analysis, determine the disease mechanism. Ming dynasty Zhou Zhigang “Shen Zhai legacy”: “see the disease medical disease, the doctor’s big taboo. Cover the disease has a specimen, more of the disease is not seen and the standard disease to see, there is the opposite of the specimen does not match, if you see a certificate, that is, a medical evidence, there is bound to be a loss, only see a certificate and can seek the reason for its evidence, then the knowledge is carried forward. Professor Gan Zu Wang, the master of national medicine, always tells the patient to tell all the discomforts and then combined with the examination of the tongue, moss and pulse, to summarize a total disease mechanism for treatment, rather than a variety of diseases in each department to prescribe Chinese medicine to eat together. This is the key to removing falsehoods and preserving the truth.