In recent years, with the improvement of industrialization and the change of human environment, the population has become more allergic to pollen, dust and mites, and allergic diseases have increased year by year, which seriously affects people’s health. The incidence of allergic rhinitis is about 43.6% in Taiwan, about 20% in the United States, and 8.7-24.1% in AR in central cities of China. This figure is almost close to the global incidence rate of 10%-40%. It also imposes a serious economic burden on humans and society, with the United States expected to spend about 100 million dollars annually on the National Health Service (NHS) for the treatment of allergic rhinitis, and Europe expected to spend an estimated €100-150 million annually in direct costs, and an estimated €100-200 million in indirect costs. Therefore, allergic rhinitis is a major topic being tackled by the World Health Organization.
Allergic rhinitis (AR) is an allergic inflammation of the mucous membrane of the nasal cavity presented by the re-exposure of the body to allergens, with nasal itching, recurrent sneezing, runny nose and nasal congestion as the main symptoms. The current treatment of AR is mainly based on the removal of exposure to external allergens such as dust and mites, and the use of histamine H1 receptor antagonists, sympathetic amine vasoconstrictors and corticosteroids. However, in a large number of clinical observations, it was found that there are some problems with western medicine treatment: first, antihistamines cannot completely relieve the symptoms in some patients, especially AR patients with combined vasomotor rhinitis, and it is difficult to avoid side effects such as salivation in effective cases; second, although local hormones are effective, the side effects are still undeniable if hormones are used for a long time. In this case, Chinese medicine has shown its unique efficacy in the treatment of AR. Therefore, how to treat AR with “complementary or alternative therapy” or integrated therapy of Chinese medicine is a very important exploration model in the world medical community today.
AR belongs to the category of “congested nose” in Chinese medicine. The earliest discussion of “congested nose” can be traced back to the Western Zhou Dynasty, as stated in the Book of Rites and Orders of the Month: “In the autumn season, the people will be sick with congested nose and sneeze”. Jing Yue Quan Shu said: “Where the wind and cold nasal congestion to cold closed couples, the meridians congestion congested sneeze.” The lung heat is nasal snot”; “Ling Shu evil qi viscera disease shape”: “twelve meridians, three hundred and thirty-five complexes, its blood gas are out of the face and go to the empty orifices, the gas out of the nose and for smell.” In the “Summary of Internal Medicine, Volume 23 on the loss of vital energy, internal injuries and external sensations”: “This spleen and lung Qi deficiency can not realize the couples.” The “Suwen Xuanming Five Qi Chapter”: “Kidney is owed for sneezing.” , “Su Wen Zhi Zhen Yao Da Lun”: it is said that “Shao Yin Si Tian Min disease epistaxis, sneezing and vomiting …….” Therefore, throughout the schools of thought, the cause of congested nose is mostly “wind, cold and heat”, the location of the disease is in the “lung, spleen and kidney”, and the evidence is mostly divided into lung deficiency and cold, fire and heat offending the lung, spleen and lung qi deficiency and yuan yang weakness, etc. The treatment principle is to benefit the qi and fix the surface, dispel wind and cold, warm the yang and fix the surface, and treat the symptoms. The treatment principle is to benefit the qi and consolidate the exterior, dispel wind and cold, warm the yang and consolidate the exterior, warm the spleen and tonify the kidney.
The famous contemporary TCM ENT experts Gan Zuwang, Tian Daofa, Zhu Xiangcheng, Yu Yangju, Xiong Dajing, Zhang Chonghua, etc. have different schools of thought on “congested nose”, which are roughly divided into three categories: 1, the theory of volatile heat in the lung Gan Lao on the basis of the “three causes” doctrine, the The “four diagnoses” expanded to look, smell, ask, cut, check the “five diagnoses”. On the basis of the principle of “treating with evidence”, he examined the color and congestion in the nose and treated the disease, i.e. “treating with evidence and disease”: “treating with evidence and disease, treating with disease, treating with evidence, recognizing disease and evidence “We also classify “congested nose” into lung deficiency and cold, lung spleen qi deficiency, kidney yang deficiency, and lung meridian heat, and according to the examination of nasal signs, they are classified into four types: common, light, medium, and heavy, and the corresponding prescriptions are given according to the comprehensive diagnosis. After years of clinical practice, Dr. Gan believes that besides the causes of deficiency and cold, heat in the lung meridian is a common and important cause of AR. If the five organs are diseased, the qi is out of order, depression is internal, depression for a long time generates heat, or people who are addicted to pungent, spicy, fried, stir-fried, smoking, alcohol, it will develop into the fire of five wills, summarizing the effective dispel wind desensitization of the cut off allergy soup formula plus reduction.
2, endowment deficiency, kidney Yang deficiency theory Tian Lao according to “Su Wen Xuan Ming five qi” said “five qi disease …. The kidneys are deficient and are snotty” and “The secret recipe for the treatment of evidence and class formulas Volume 10”, “clear snot is caused by cold brain and cold lung, and it is appropriate to use the genera of horsetail, aconite, eucommia and dry ginger”, then he believes that congested nose is mostly due to cold deficiency, and that the deficiency in the function of the internal organs is the first (deficiency of endowment), followed by wind and cold. In the same way, Zhu emphasizes the identification of the internal organs and the overall regulation, and according to the ancient saying that “the injury of the five organs must affect the kidneys”, “the lesions of the internal organs are damaged over time and must affect the kidneys. “The localized lesions are the manifestation of the deficiency of the internal organs. The theory of “kidney as the root of the innate nature” is supported by the method of tonifying the kidney to adjust the body’s yin and yang to resist the invasion of disease and evil. “In addition, Yu believes that “congested nose” is caused by the deficiency of the lung, spleen, and kidney, and the wind evil takes advantage of the deficiency.
3.Lung deficiency and cold sensation, the theory of the external guard is not solid Xiong Lao, according to the “Ling Shu Ben Shen Lun” said: “deficiency of lung qi will lead to nasal congestion” and “Wai Tai Secret Essentials” said: “the lung is taken by the wind and cold, then the nasal qi is not harmonious, fluid congestion” method, that the evil qi curbs the lung, the lung is not clear, fluid The main pathogenic mechanism is the deficiency of lung qi and cold, weakness of qi and blood, deficiency of ying and guanxi, lack of solidity of the couples, feeling of wind and cold, obstruction of yang qi, poor blood flow, and the use of “Huangqi Guizhi Wuwu Tang” of “Jin Kui Yao”. “The main formula of “Huangqi Guizhi Wuwu Tang” (Astragalus, Gui Zhi, Peony, Ginger and Jujube) and Wulong granules is added and subtracted to treat external sensations and internal injuries. The lung is open to the nose, the lung is insufficient, the surface is not solid, the couples are loose, the wind takes advantage of the deficiency and enters, the nasal orifices are unfavorable. Therefore, it is important to benefit the lung qi and consolidate the surface guard.