Asthma
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About Asthma
Asthma is a very common condition. In the UK, 5.4 million people are currently receiving treatment for asthma, including 1.1 million children. There is a person with asthma in 1 in 5 households in the UK. Its typical symptoms are wheezing (a whistling noise in the chest), shortness of breath, coughing and a tight feeling in the chest caused by reversible obstruction of the airways as a result of inflammation or muscle spasm. Asthma may begin at any age and, if neglected, tends to recur and become chronic.
Asthma is a condition that affects the airways – the small tubes that carry air in and out of the lungs. Basically asthmatic attacks obstruct the flow of air to the lungs. People with asthma have airways that are almost always red and sensitive (inflamed). Their airways can react badly when they have a cold or other viral infection, or when they come into contact with an asthma trigger (something that sets off their symptoms). When this happens the muscles around the walls of the airways tighten and they become narrower. The lining of the airways swells and often produces a sticky mucus. As the airways narrow, the air has to squeeze in and out, and this is what causes the person with asthma to find it difficult to breathe.
Asthma may be allergic or non-allergic in origin. In allergic asthma, environmental allergens trigger the disease when inhaled or ingested. An asthma trigger is anything that irritates the airways and sets off the symptoms of asthma. Common triggers include colds or flu, cigarette smoke, exercise and allergies to things like pollen, furry or feathery animals or house-dust mite. Everyone's asthma is different and you will probably have several triggers.
Most modern cities have problems with air quality outdoors, and indoor air is subject to pollution by furnishings, household chemicals, cosmetics and pet dander. Casual use of insecticides, pesticides and herbicides on lawns and food crops, as well as indoor exposures at work and at home, have also affected a number of patients.
There is currently no evidence that traffic pollution causes asthma, although poor air quality can make your asthma worse.
Asthma, like its related allergic conditions eczema and hay fever, often runs in the family and may be inherited.
Possible Symptoms
During asthmatic attacks breathing becomes difficult and forced breathing becomes necessary. A wheezing sound appears, due to the rush of air through the narrowed airways. At the same time, a troublesome cough can develop.
Symptoms of allergy and hypersensitivity may affect the body in the sinuses, the airways, the mucous membranes, the lungs or the skin. Some individuals develop problems in all of these areas. Sinus symptoms may include congestion, watery or sticky discharges, pain and pressure. Sinus inflammation can also trigger facial headaches as well as migraine headaches and vascular headaches.
There is no hard and fast way of telling if you have asthma or not. This is partly because the symptoms can vary and may be similar to other respiratory conditions that are not asthma. Asthma symptoms include shortness of breath, wheezing, cough and chest tightness. Not everybody will have all these symptoms. A history of asthma, eczema or hay fever in the family may mean that your chances of developing asthma are slightly higher than those without.
If you suspect that you may have asthma, it is important to see your GP. Your GP will discuss your medical history and your current symptoms. She/he may want to measure your peak flow using a peak flow meter. A peak flow meter is a small hand-held device with a marker that slides up and down as you blow into it. The marker stops at the point when you blow hardest. Each time you use the meter (usually morning and evening) the result is marked on a chart. It can help along with keeping a record of your symptoms to give the doctor a better picture of how well controlled your asthma is. The doctor may decide to give you your own peak flow meter on prescription and ask you to keep a diary of readings before seeing him or her again.
Western Medicine View
There is no cure for Asthma, so different types of medication and tablets have been developed to help sufferers manage the condition.
Devices such as inhalers are commonly used. An inhaler ensures that very small amounts of medication are delivered directly into the lungs either to relax muscles or to calm inflammation in the airways and make them less likely to react badly to the environmental triggers of asthma. There are a variety of inhalers available. It is important that you use a device that you are comfortable with and can use properly. Your doctor or nurse will advise you on the most appropriate device and should demonstrate how to use it correctly.
There are two main types of asthma medication – relievers and preventers.
Reliever inhalers are usually blue. They act by opening up the airways causing the muscles to relax and therefore allowing you to breathe more easily. The reliever should only be used when the symptoms of asthma appear or, if recommended, before exercise. They do not reduce the inflammation in the airways. If you need to use your reliever more than once a day or 3-4 times per week this suggests that there is a degree of inflammation in your airways that requires preventer treatment.
Preventers usually come in brown, red or orange inhalers. They work over a period of time to calm inflammation in the airways and make them less likely to react badly when you come across an asthma trigger. They need to be taken regularly. Most preventers are inhaled corticosteroids. It is important to understand that corticosteroids are not the same as anabolic steroids used by athletes to improve their performance.
There are other types of medication that can be added to your reliever and preventer treatment if needed, such as preventer tablets and long-acting relievers.
Chinese Medicine View
In Chinese medicine, asthma is caused by excessive Phlegm resulting from weakened Spleen and Kidney, the two main organs responsible for the processing of body liquids. Chinese medicine distinguishes two general patterns of asthma, an Excess pattern and a Deficiency pattern. The former corresponds with acute asthma where one experiences a tight chest, severe shortness of breath, wheezing and often feels thirsty and feverish. The deficiency pattern occurs in chronic asthma, where patients complain of wheezing, sweating, general lassitude and cold hands and feet.
There are many factors that may trigger an asthma attack. Examples include the invasion of the external pathogenic factors, diet, emotional disturbances, congenital weakness and chronic illnesses.
In Chinese medicine, asthma is called Xiao Chuan, which means wheezing and dyspnea (shortness of breath), respectively. Chinese medicine classifies Xiao and Chuan as two separate illnesses with different treatments. Xiao (wheezing) is characterized by a whistling sound during breathing, increased respiration rate, dyspnea and inability to rest in a horizontal position. Chuan (shortness of breath) is characterized by dyspnea, constant opening of mouth to grasp air, raised shoulders, flared nostrils and inability to rest in a horizontal position. Patients with xiao (wheezing) generally will have chuan (shortness of breath), while patients with chuan (shortness of breath) may or may not have xiao (wheezing). In Western medicine, wheezing and shortness of breath are both considered as symptoms, which may be present in many different types of pulmonary syndromes such as asthma, acute bronchitis, chronic bronchitis and emphysema.
It is very common for patients who have recurrent asthma attacks to have Kidney Deficiency. When under attack, such patients are said to have Upper Excess with Lower Deficiency. Upper Excess refers to phlegm stagnation in the Lung and is characterizes by recurrent or continuous wheezing (which worsens after exertion), laboured inhalation and smooth exhalation, snoring sound in the throat, low-pitched rhonchi, audible wheezes, shortness of breath, a frail cough with scanty, thin, or frothy sputum, and a dry throat. Lower Deficiency refers to a deficiency of Kidney Qi (the Kidney's essential energy) or deficiency of Yang (the body's hot energy) and is characterized by difficult inhalation as Kidney cannot grasp and hold the air down. In addition, the patients may also have deficiencies of the Lung and the Spleen. Deficiency of the Lung is characterized by aversion to wind and spontaneous sweating while deficiency of the Spleen is characterized by increased production of phlegm and sputum. Patients may have red cheeks, red tongue with scanty coat. Pulse is thready and rapid.
External pathogenic factors, such as cold or heat, commonly induce asthma attacks. Lung dominates the Qi (the body's essential energy) and manifests on the skin. As the environment affects the skin, the change is reflected in the Lung. As the Lung is attacked, its function to regulate water passage becomes impaired, water begins to stagnate and phlegm starts to form. Asthma attacks due to the invasion of external pathogenic factors are most likely to occur when the temperature is cold or if there is a rapid change in weather. External pathogenic factors may also include pollen, cigarette smoke, and any other allergens.
Diet can also trigger an asthma attack. Raw and cold food may injure the Spleen and tend to contribute to the stagnation of fluid circulation and the increase in the production of phlegm. Heavy, sweet, and greasy food tends to create phlegm and heat in the body. Fish, crabs, shellfish and other seafood have also been noted to increase the likelihood of asthma attacks.
Congenital weakness and chronic illness are also common causes of asthma. Children with asthma generally have congenital Kidney Qi deficiency, while patients with chronic illness such as chronic cough and recurrent cold/flu, are also likely to have Lung deficiency.
The fundamental cause of asthma is the presence of phlegm. In Chinese Medicine, the passage of water is controlled by three organs, namely Lung, Spleen and Kidney. The Lung regulates the water passages in the body's Upper Burner section (Heart, Lungs, Pericardium, throat and head), the Spleen transports and transforms water in the Middle Burner section (Stomach, Spleen, Gall Bladder) and the Kidney dominates water metabolism in the Lower Burner (Liver, Kidneys, Instestines, Bladder). Imbalance of Yin and Yang (cooling bodily fluids and hot material energy, respectively) in any of these three organs may lead to stagnation of the water circulation, which then contributes to the production and storage of phlegm in the Lung. Storage of phlegm in the Lung becomes the main cause for recurrent asthma attacks.
Chronic asthma will lead to deficiency of Lung, Spleen and Kidney. Deficiency of the Lung means an inability of the Lung to inhale the air, and deficiency of the Kidney creates an inability of the Kidney to receive or grasp air. This will be complicated further if the Spleen is also deficient and there is an excess amount of phlegm that obstructs the airway. Overall, the condition becomes more and more complicated as the underlying syndrome represents a Deficient condition while the symptoms show an Excess condition.
Hot asthma occurs when heat attacks the Lung. In this case the Lung is no longer able to command Qi and control respiration. Patients generally experience a choking sensation, coughing spells and intercostal distention. Patients will also have phlegm as characterized by wheezing, crackling or moist rales and roaring sound in the throat from copious sputum that is thick and difficult to expectorate. Sputum is usually yellow but may be white in some cases where heat is not as prominent. It is common for patients to raise their shoulders to help breathing. Fever, irritability, perspiration, headache, thirst with desire to drink, flushed face and possible fever with aversion to cold are some of the symptoms of asthma due to heat. The tongue is red with yellow greasy coating. The pulse is superficial rapid or wiry.
Treatment Options
Acupuncture and Chinese herbs. It has been shown that Chinese Medicine can be effective at significantly relieving the symptoms of Asthma.
The treatment principle for the Excess pattern is to dissolve Phlegm whereas for the Deficiency pattern the priority is to strengthen and tonify the weakened Qi (the body's essential energy).
Allergic conditions such as asthma and hay fever are due to a deficiency in the immune system. A weakened or over-sensitive immune system makes one more susceptible to what Chinese medicine calls external pathogenic factors like pollen and other allergens. Treatment for asthma, therefore, also focuses on strengthening the immune system.
Acupuncture treatment for cold asthma should focus on sedating the Lung and eliminating the phlegm. The points should be sedated and left in place for 30 minutes. The point Renzhong REN 17 should be stimulated until the needling sensation disperses to both sides of the chest. Chize LU 5 should be needled against the flow of the channel. Feishu UB 13 and Fengmen UB 12 should be sedated for 2 minutes. For best result, cupping may be applied with acupuncture for these two points.
In addition to these main acupuncture points, supplement points should also be used to treat stuffy or runny nose.
There are typically two types of asthma, extrinsic and intrinsic - and both will respond to acupuncture. Intrinsic asthma is caused by factors such as chemicals, cold air, exercise, infection and emotional upset. Extrinsic asthma is allergy-related and is triggered by pollens, dust, moulds and animal dander.
During an asthma attack, the walls in the bronchioles of the lungs become swollen, or edematous. The smooth muscles of the walls constrict, narrowing breathing passages, and the bronchioles secrete excess mucus, creating obstructive plugs. During an allergy-related asthma attack, there is an increase of histamine and other inflammatory chemicals in the blood. In intrinsic asthma, there appears to be a hyper excitation of the parasympathetic nervous system. The result in both cases is swelling or edema of the mucosal walls of the bronchioles, increased bronchial smooth muscle contraction, and hyper secretion of bronchial mucus with obstructive mucus plugs.
Studies in China involving acupuncture have shown that needling the acupuncture point St 36 (Zusanli) on a healthy subject increased ventilation capacity by 6.6 percent. The maximal breathing capacity increased 20 percent, with a 22 percent increase in the volume of expiration. Acupuncture appears to act on the nervous system by relieving excitation of the parasympathetic nerves while raising the level of excitation of sympathetic nerves. This causes the bronchioles to expand and mucus membranes to contract, leading to improved breathing. Acupuncture also appears to reduce the level of inflammatory chemicals in the blood, thereby reducing allergic responses.
The effects of acupuncture are cumulative. After a series of treatments, one often notices a reduction in the frequency and severity of attacks. Acupuncture has the effect of strengthening a person's constitution and overall health so that their allergic response is reduced.
Chinese herbal formulas serve as a useful adjunct to acupuncture in relieving asthma. Many asthma formulas contain herbal ephedra (Ma Huang), which has the effect of expanding constricted bronchioles. Other herbs are used to reduce phlegm production, combat infection, and moisten the lungs and astringe coughing. There are many different types of asthma in Chinese medicine, and different herbal formulas have been created. It is best to consult a trained practitioner before selecting a formula.
The use of acupuncture and dietary therapy can be very helpful to reduce or eliminate the signs and symptoms of allergic and irritant asthma and sinus disease. Patients report that they can use fewer medications and feel better.
Acupuncture therapy and Chinese herbal medicine prepared from different roots, barks, flowers, and fruits, are appropriate alternatives for people who suffer from complex physical disorders like asthma. It is not well known, but emotional stress can also be a factor in asthmatic episodes, and Chinese medicine can also address these issues.
Asthma often is worse at certain seasons and at certain times of day. As with many chronic imbalances, treatment may require an ongoing effort from the patient and physician. Because there are different forms of asthma and each person may have a different imbalance, developing the correct, individualised, approach also takes time. Traditional physicians have learned that the best medicine results from a strong relationship between doctor and patient, with each taking personal responsibility for improving the patient's health.
Experience shows that natural methods of treatment like acupuncture help to reduce the suffering of common problems like asthma at a reasonable cost.
The clinical observation revealed that the asthmatic symptoms in most of the patients began to be improved after several acupuncture treatments with the dosage of the drug gradually reduced. Generally, the dose of cortisone per os was decreased by 2 mg every 10 days, while that of aerosol was controlled by the patients themselves according to the condition of the disease. The symptoms in most of the patients were markedly improved after 15 treatments, but the treatment should be continued for another 10 times to consolidate the curative effect.
Thus, each asthmatic patient needs to receive approximately 30 sessions of acupuncture treatment, lasting about 3 months. Thereafter, in order to prevent its relapse, the treatment should be administered 10 times each year in the summer season.
There were two child patients aged 5 and 7 years respectively, for them the above method of acupuncture treatment was difficult to use. Therefore, the auricular pressing method combined with cupping was adopted instead.
The auricular points selected were: Shenmen, Lung, Large Intestine, sensitive point, Pingchuan, Subcortex, and Kidney. 5 points were used each time, and pressed with the seeds of Vaccaria, which were changed every 3 days. The patients were asked to press each of the points themselves 3 times a day (each time by 20 pressings). And Dazhui (Du 14), Feishu (UB 13), Pishu (UB 20) and Shenshu (UB 23) were cupped for 5 min. each time. The auricular pressing and cupping therapies may also be added for adult patients to strengthen the curative effect. The 25 cases of hormone dependent bronchial asthma were treated by acupuncture, yielding a markedly effective rate of 56 percent with a total effective rate of 96 percent, indicating that good therapeutic results can also be expected in the Western countries for those cases that have already been treated with hormones.
Lifestyle Advice
Taking certain preventative measures in the home can lessen your chances of developing asthma, or reduce your symptoms. These steps include reducing the amount of dust in your home and can be achieved using simple measures like damp dusting and opening windows.
Smoking during pregnancy increases the chance of a child developing asthma.
For personalised advice on diet and lifestyle, please ask the doctor during your consultation.
Please be reminded that we offer free online health advice.
-> Click here to contact us using our 'Online Health Advice' Form
Case History
"I was very impressed by the immediacy of my improvement from your treatment. The increased feeling of well being and energy began after my initial visit to you and has been sustained throughout my course of treatment. My breathlessness is markedly reduced and continues to improve. I have already told family and friends of my pleasure in discovering the efficiency of your treatments. Also the informative discussions and explanations of your methods is helpful and reassuring."
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A woman had been suffering from asthma for ten years. The shortness of breath was usually the worst at night. Persistent feeling of cold was worse during cold weather. Tightness in the chest and no sputum. The diagnosis established that the Defensive Qi of the Lung and the Kidney was low. Acupuncture and herbal treatment were used. Before the treatment started, the patient used an inhaler twice a day (100mg in the morning and 200mg in the evening), after 4 weeks of treatment the inhaler was taken once a day (200mg, in the evening). After seven weeks of treatment, a 100mg dosage was used once a day. After ten weeks of treatment, the use of inhaler was no longer needed.
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"I came to AcuMedic with my son for the treatment of his eczema and minor asthma. The treatment prescribed was acupuncture and Chinese herbs. The treatment started in June and by the second week there was significant progress. We were away for four weeks and returned to conclude my son's treatment. His condition has improved dramatically. The eczema has almost (80 percent) disappeared and his overall health has become better allowing him to participate in activities which he found difficult previously. Thank you."
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"N. has been treated for asthma since May at AcuMedic. He is the 4th member of my family to be treated here. The herbal tea has been effective as he no longer takes his steroid inhaler. He still has asthma but is improving slowly."
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The patient (male, 23 years-old) had asthma for 8 years. It could occur at any time, no matter what season it was and what food he took, and it was especially aggravated at night. The patient was usually given treatment by Western medicine, but it only relieved it a time after which he was admitted into the hospital. He had cough, asthma and there was sound produced by the collection of sputum in the throat. It was difficult for him to lie down on his back. He had lassitude and loss of appetite. He had a pale complexion, his tongue was pale with whitish coating. The pulse was slippery and deep. There was breath-sound in both lungs. He was diagnosed as having an accumulation of cold phlegm obstructing the lung, also the Lung Qi couldn't disperse normally. The treatment focused on warming the lung and resolving the phlegm to promote the dispersion of the lung Qi. After a series of herbal and acupuncture treatments, asthma was greatly relieved and the other symptoms disappeared. After continuous administration for one month, the patient has been fully cured.
