Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease characterized by airflow limitation, which is not completely reversible and progressive. It is a common and frequent disease of the respiratory system, with a high prevalence and mortality rate. It has a high prevalence and mortality rate. It seriously affects the patient’s ability to work and quality of life due to progressive lung function loss. The disease is closely related to chronic bronchitis and emphysema. Chronic bronchitis is a chronic, nonspecific inflammation of the bronchial walls. Chronic bronchitis can be diagnosed if a patient has cough and sputum for more than 3 months per year, with two or more consecutive years of onset, and if other known causes of chronic cough can be excluded. Emphysema, on the other hand, refers to an abnormal and persistent dilatation of the distal air spaces of the terminal fine bronchi in the lungs with destruction of the alveolar walls and fine bronchi without significant pulmonary fibrosis. Chronic obstructive pulmonary disease is diagnosed when patients with chronic bronchitis and/or emphysema have restricted airflow on pulmonary function tests that are not fully reversible.
I. Internal Chinese medicine
(A) Chinese medicine identification
1.Phlegm in the lungs
Main symptoms: shortness of breath, cough, thin sputum.
The main symptoms: fever with aversion to cold, cold back without sweat, thirst with little or no thirst with hot drinks, and a blue complexion.
Moss and pulse: white and smooth tongue coating, tight pulse.
2.Phlegm and turbidity in the lung
Main symptoms: cough, wheezing, sputum, white and sticky, or foamy.
Main symptoms: tiredness and fatigue, facial deficiency, shortage of breath, slight exertion, abdominal plagiocephaly, loose stools.
Moss and pulse: light tongue, thin and greasy moss or cloudy moss, moist and slow or slippery pulse.
3.Lung and spleen deficiency
Main symptoms: cough with phlegm, white and sticky or foamy, shortness of breath and wheezing, immediately after slight exertion.
Secondary symptoms: fear of wind and easy to sweat, abdominal lumpiness and lack of energy.
Moss and pulse: light tongue, thin and greasy moss or cloudy moss, thin and slippery pulse.
4.Lung and kidney deficiency
Main symptoms: shallow and short breathing, low voice and timid breath, or even opening the mouth and lifting the shoulders, unable to lie down by resting.
Concurrent symptoms: cough, white sputum like foam, coughing and vomiting, chest tightness and panic, cold and sweating, or soreness and weakness of the waist and knees, clear and long urine, or residual draining of urine.
Moss and pulse: pale or dull purple tongue, sunken and weak pulse, or with knotted generation.
5.Qi deficiency with phlegm clotting and blood stasis
Main symptoms: coughing and wheezing with phlegm, shortness of breath when moving, more breathing and less inhalation, breath cannot be continued, blue and purple face, lips and claw nails, etc.
Secondary symptoms: shortness of breath, chest tightness.
Moss and pulse: Tongue texture, greasy coating, thin and slippery pulse, or knotted generation.
(B) Treatment by type
(1) Phlegm in the lung
Treatment: Warming the lung and dispersing cold, relieving symptoms and dissolving drinks.
Formula: Xiao Qing Long Tang with reduction. Main herbs: Gui Zhi 10g, Bai Shao 12g, Gan Jiang 6g, Ma Huang 5g, Fa Han Xia 10g, Zhe Bei Mu 10g, Xiao Xin 6g, Wu Wei Zi 5g, Gan Cao 6g.
Addition and reduction: If phlegm is heard, coughing and asthma cannot lie down, add 10g of Draba draba, 10g of jujube to remove the lung and expel drinks; if irritable and red, choking and coughing with yellow phlegm, add 30g of gypsum and 30g of rhizome to clear the lung and resolve phlegm.
(2) Phlegm and turbidity congestion of the lung
Treatment: Eliminating phlegm and lowering Qi, strengthening the spleen and purging the lung.
Formula: Su Zi Descending Qi Soup combined with San Zi Nourishing Parent Soup with addition and subtraction. Su Zi 10g, Fa Han Xia 10g, Hou Pu 10g, Qian Hu 10g, Cinnamon (later down) 3g, White Mustard Seed 10g, Lycopodium 10g, Atractylodes Macrocephalae 10g, Poria 10g.
Addition and subtraction: if there is much phlegm and shortness of breath, chest fullness and inability to lie down, add Dracaena Scoparia 10 g to relieve lung and resolve phlegm; if there is deficiency of lung and spleen qi, spontaneous sweating, shortness of breath, weakness and not much phlegm, add Astragalus membranaceus 15 g and Wu Wei Zi 6 g to benefit qi and fix the table. If the symptoms are accompanied by irritable heat in the chest, dry throat, yellow fur, but no acute exacerbation such as fever, cough and wheezing, etc., it is appropriate to add products to clear and moisten the lung, such as Sangbai Pi, Guadua Pi, ZhiMu, ChuanBeiMu and TianShenFen.
(3) Deficiency of both lung and spleen
Treatment: Strengthening the spleen, resolving phlegm, and benefiting the lung and lowering Qi.
Formula: Six Jun Zi Tang with Yu Ping Feng San, plus or minus. Radix Codonopsis Pilosulae 10g, Poria 10g, Radix Fructus Panax 10g, Pericarpium Citri Reticulatae 10g, Atractylodes Macrocephala 10g, Cinnamon (later) 3g, Astragalus Membranaceus 15g, Fenfeng 6g, Radix Angelicae Sinensis 10g, Salviae Miltiorrhizae 15g.
Addition and subtraction: If the cough is accompanied by thin sputum, add Ziziphiopogon, Zanthoxylum, Su Zi, Belladonna, etc. to warm the lung and stop coughing and asthma; if the deficiency is on the side of yin, add Sha Shen, Yu Zhu, Lily, etc. to nourish the lung and nourish yin; if there is little food, loose stool, and a feeling of falling Qi, it is appropriate to use “Tonic Zhong Yi Qi Tang” with addition and subtraction to nourish the lung and spleen and lift the sunken Qi; if If the lung is deficient in asthma, it is often seen together with kidney deficiency when the condition is serious, and if necessary, it can be combined with products that tonify the kidney and nourish the qi. The lung and kidney are treated together with mealybug, pecan meat, purple river carp, dogwood, and rehmannia.
(4) Deficiency of both lung and kidney
Treatment: Tonifying the lung and nourishing the kidney, lowering Qi and calming asthma.
Formula: Tonify the lung, pacify asthma and consolidate the essence of the lung, and add and subtract Kidney Qi Pill. Radix et Rhizoma Ginseng 15g, Radix Astragali 15g, Radix Macrocephalae 10g, Fructus Schisandrae 10g, Radix Rehmanniae (later) 3g, Radix Rehmanniae 10g, Semen Bidentatae 10g, Aster 10g, Cornu Cervi Pantotrichum 10g, Semen Cuscutae 10g.
Addition and subtraction: In case of lung deficiency with cold, fear of cold and pale tongue, add 6g of Radix et Rhizoma Pseudostellariae (first decoction), 3g of Cinnamon (later), 6g of Dry Ginger, 30g of Belladonna when warming the lung and dispersing cold; in case of Yin injury, low-grade fever, red tongue and little coating, add 10g of Asparagus, 10g of Yu Zhu and 12g of Radix et Rhizoma to nourish Yin; in case of obvious phlegm, cough with large amount of sputum, white color and greasy coating, add 10g of Atractylodes Macrocephala, 10g of Hou Pu, 10g of Almond and 10g of White Mustard Seed. 10g; for stagnation of blood in the heart, the neck pulse is very mobile and the face and lips are blue, add Angelica sinensis 10g, Chuanxiong rhizome 6g, Safflower 6g, Salvia miltiorrhiza 15g to invigorate the blood and open the veins.
(5) Qi deficiency, phlegm stagnation and blood stasis
Treatment: To resolve phlegm and subdue rebellion, to benefit Qi and resolve stasis.
Formula: Su Zi Descending Qi Soup combined with Tonic Lung Soup with Addition and Subtraction. Radix et Rhizoma Ginseng 6g, Radix Astragali 15g, Radix Su Zi 10g, Radix Panax Notoginseng 10g, Radix Coix Coix Seed 30g, Pericarpium Citri Reticulatae 10g, Cinnamon 5g, Radix Angelicae Sinensis 10g, Radix Salviae Sinensis 10g, Rhizoma Chuanxiong 10g, Radix Paeoniae Alba 10g, Radix Glycyrrhiza Uralensis 5g.
(C) Indications
Patients with chronic obstructive pulmonary disease (COPD) in the stable stage and chronic extension.
(IV) Dosing time
Generally, the herbal soup is taken at the beginning of the three volts of the lunar calendar in summer every year until the end of the last volt.
(V) Points to note
Winter and summer treatment should be carried out according to the specific evidence of the disease and the nature of cold, heat, deficiency and reality, and combined with the individual physical state of the patient. At the same time, we should pay more attention to the seasonal characteristics of summer, from the diet, drugs and living to consider the following points.
1. Be careful with pungent and dry products to prevent injury to yin. The hot summer climate, easy to hurt Yin, and spicy warm and dry products easily lead to internal heat, dark depletion of Yin essence, should be careful with cinnamon, pepper, aniseed, cumin, fresh cinnamon or litchi, dog meat, mutton and so on.
2, avoid taking a lot of cold products. Summer heat, often easy to drink cold, if a large number of cold products, it is easy to cause damage to the Yang, the spleen and stomach weakness, and even loss of Yang Qi, light diarrhea, abdominal pain, nausea and vomiting, the heavy Yang deficiency caused by persistent illness.
3, careful to eat a lot of fat, sweet and greasy products. Summer is prone to summer heat and humidity, the evil of dampness and heat is easy to attack the body, if you take a lot of fatty and sweet products will lead to the combination of internal and external dampness and heat evil attack the body.
Two, acupuncture point dressing
Winter disease and summer treatment acupressure is a kind of external treatment method for treating and preventing diseases by applying drugs on specific acupuncture points on the body in summer. Since the 1950s, it has been widely carried out in 30 provinces, cities and autonomous regions in China. From the relevant research data published in the past 20 years, the drugs used and the acupuncture points applied are not the same. Whether there is a universal basic formula and acupuncture points and their addition and subtraction changes has become the main problem to be solved in the first place by formulating the relevant operation specifications and conducting in-depth clinical research.
(I) Indications
Chronic obstructive pulmonary disease is characterized by phlegm-drink, phlegm-dampness, phlegm-deficiency, and deficiency of qi and yang in the lung, spleen and kidney.
(B) Contraindications
1.Patching area with skin trauma, skin ulcer, skin infection.
2, allergic to the ingredients of the applied medicine or dressing.
3.Keloid.
4.Patients coughing up thick yellow sputum and hemoptysis.
5.Pregnant women.
6.Patients whose doctors think it is not suitable for use.
(C) Caution group
1, combined with AIDS, tuberculosis or other infectious diseases, etc.
2.Patients with combined diabetes, hematological diseases, malignant hypertension, severe cardiovascular and cerebrovascular diseases, severe liver and kidney dysfunction, bronchiectasis, malignant tumors, etc.
3, acute exacerbation or exacerbation of COPD.
(D) operation specification
1.Drug composition
White mustard seed, Yanhuo, Gansui, Hossein and ginger are used as the basic prescription, which can be combined with previous clinical experience and regional characteristics for addition and subtraction. The drugs commonly used in combination and reduction are musk, ephedra, cinnamon, cumin, etc. At present, musk is mostly replaced by artificial musk.
2.Material concoction
White mustard seed, Yanhuosuo, Gansui and Hossein are used as authentic herbs, and the drugs are used raw, among which white mustard seed should be used raw to strengthen its transdermal absorption of other drugs. Topical application of white mustard seed can cause skin heating, redness, and even blistering. Clinically, the proportion of white mustard seeds in the drug can be adjusted to ensure both clinical efficacy and safety of the drug.
3.Drug preparation
The drug preparation process is required to be carried out in a sterile, clean and room temperature environment or completed in the special preparation room of the local medical institution. Drug preparation method: use clean herbs, dry the drug, crush, pass 80-120 mesh sieve, set aside. Preparation method of ginger juice:Ginger is selected, washed, crushed, and squeezed in three layers of sterile gauze to extract juice. Local hospitals can modulate the concentration of ginger juice according to the original experience and regional characteristics, by adding the right amount of distilled water to make its concentration between 50% and 100%. The medicine should be prepared on the same day of use, or made in advance and set aside in the refrigerator.
4.Patching method
First, the patching site with 75% ethanol or iodine volt conventional disinfection, and then take the diameter of 1 cm, the height of 0.5 cm or so of the ointment, the drug on the acupuncture point, with 5 cm × 5 cm of desensitizing tape fixed.
5.Patching time
Generally in summer every year, the first day of the first, middle and last days of the three volt days of the lunar calendar is applied (if the middle volt is 20 days, an additional time can be applied at an interval of 10 days). During the three volt days can also be compressed, with an interval of 7~10 days between each 2 compresses.
6.Patching time
1）Adults can apply the medicine for 3~6h each time.
(2) The specific duration of the patching time depends on the patient’s skin reaction. At the same time consider the patient’s personal constitution and tolerance ability, generally to the extent that the patient can tolerate, the patient can take it off if he/she feels there is obvious discomfort at the patch.
7.Course of treatment
A course of treatment is 3 years of continuous application. After the course of treatment, the patient can continue to apply the patch to consolidate or improve the therapeutic effect.
8.Patching area
Lung Yu is the basic acupuncture point for winter and summer treatment, and the main companion acupuncture points are Tanzhong, Dazhi, Dingmao, and Anzhi.
(V) Skin reactions and treatment after application
Normal skin reaction and its treatment
Local skin flushing, burning, mild tingling, or small blisters may appear, and very rarely large blisters may appear. Most of the patient’s skin will remain pigmented for a period of time. If small blisters appear on the patching site, no special treatment is usually necessary and they should be allowed to absorb naturally; or moist burn cream should be applied topically to reduce discomfort. For large blisters, a sterile needle should be used to puncture the bottom, drain the fluid, and disinfect to prevent infection. Broken blisters should be disinfected and then wrapped with sterile gauze to prevent infection.
(F) Adverse skin reactions and treatment methods
After the patching, the local skin appears serious redness, large blisters, ulceration, pain, skin allergy and hypothermia. Local skin redness and swelling after patching, can be applied externally Peppermint cream, dermatological cream, etc. to slow down the stimulation; skin local blisters or ulcers should avoid scratching, protect the trauma or apply scalding ointment, universal oil, erythromycin ointment, etc. Skin allergies can be treated with topical anti-allergy creams. If there is a larger and more severe skin erythema, blistering and itching, the medication should be stopped immediately and symptomatic treatment should be carried out. Those who have systemic skin allergy symptoms should go to the hospital for treatment in time.
If the blisters are too large, or if there is purulent secretion in the blisters, or if there is skin breakdown, exposure of subcutaneous tissue, or bleeding, treatment should be sought at a hospital.
In all the above cases, patients should pay attention to keep the local area dry, do not rub or scratch the local area, and do not use bathing products or apply other anti-itch drugs to prevent further stimulation of the local skin.
(VII) Precautions
1. For the medicine applied, it should be fixed firmly to avoid displacement or dislodgement.
2. Attention should be paid to prevent local infection when blisters appear.
3.For those who are allergic to adhesive tape, desensitizing adhesive tape or bandage can be used to fix the applied medicine.
4.For the residual ointment on the skin, it should be washed with water only and should not be scrubbed with irritating objects such as gasoline or soap.
5, the prepared drug should not be placed too long, the drug should be airtight, low-temperature storage.
6, during the treatment period, prohibit the consumption of cold, seafood, spicy stimulating food.
7. For the chronically ill, weak and thin people, the amount of medication should not be too large and the time of application should not be too long, and close attention should be paid to the changes in the condition and any adverse reactions during the application.