TCM Acupuncture and Massage

Chapter 41 Respiratory System Diseases (1)
cold
An overview of the disease

([-]) Relevant knowledge

Commonly known as a cold, a cold is an exogenous disease caused by exposure to pathogenic wind or viruses, causing lung dysfunction, nasal congestion, runny nose, sneezing, headache, chills, fever, general malaise and other main clinical manifestations.Cold is a very common disease.All can fall ill all the year round, with winter, spring season is more.This disease is not only closely related to the occurrence and development of cough and the acute attack of chronic cough and asthma, but also related to the development and deterioration of various diseases such as palpitations, chest pain, edema, and arthralgia.It poses the greatest threat to children, the elderly and the infirm.Especially the common cold, often outbreaks, rapid infection, sudden onset, severe symptoms, and even death, must be actively prevented and controlled.

([-]) Etiology and pathogenesis

1. Traditional Chinese Medicine

Traditional Chinese medicine believes that the location of a cold is mainly in the lungs.The lung governs the skin and hair, and the fur is warmed and moistened due to the function of the lungs. If the skin and hair are affected, the lung defense function will be out of balance; the lung opens to the nose, and the lung qi is unfavorable.It is mainly related to the following two aspects.

(1) Fengxie: It is the main cause of cold.Its pathogenicity is closely related to sudden changes in climate, exposure to rain and cold, and cold after sweating.Sudden changes in climate, abnormal cold and heat, and increased temperature difference can all increase the incidence of this disease.When wind evil invades the human body, it often does not hurt people alone, but in different seasons, it often brings other seasonal auras together to cause disease.It mostly causes the common cold, mainly with general symptoms.

(2) Epidemic virus: mainly refers to the contagious epidemiological virus invading the human body and causing disease, which is mostly caused by the unhealthy qi of the four seasons and the prevalence of the epidemic qi.It mostly causes a common cold, mainly with systemic symptoms.

2. Modern Medicine
Common colds are mostly viral, and bacterial is less common, and mostly secondary to viral infection.The common cold is different from influenza.

(1) Common cold: caused by rhinovirus, coronavirus, parainfluenza virus, adenovirus, etc., mainly local symptoms.

(2) Influenza: It is caused by feeling the influenza virus, mainly with systemic symptoms.

([-]) Clinical manifestations

The onset of common cold is rapid, with nasal congestion, runny nose, sneezing, headache, cough, aversion to cold, fever, and general malaise as the main clinical manifestations.Symptoms are often diverse, with itching, dryness, and discomfort in the nose and throat as early symptoms, followed by sneezing, nasal congestion, and runny nose.In mild cases, the lung orifice is violated, the symptoms are not serious, and it is easy to recover; in severe cases, high fever, cough, chest pain, and lung health symptoms appear.

Shixing cold has a sudden onset, severe systemic symptoms, high fever, body temperature can reach 39-40°C, and body aches. After the fever subsides, pulmonary symptoms such as nasal congestion, runny nose, sore throat, and dry cough become obvious.In severe cases, high fever persists, shortness of breath, cyanosis of the lip and nails, and even hemoptysis. Some patients may suffer from coma and delirium, and children may have convulsions and transmission changes.

([-]) Diagnosis

1. The clinical manifestations are mostly nasal passages and hygienic symptoms at the beginning.Itching and discomfort in the nose and throat, nasal congestion, runny nose, sneezing, hoarseness, aversion to wind, aversion to cold, etc.The nasal mucus starts as clear water, and after 2 to 3 days, the nasal mucus becomes thicker, followed by fever, cough, sore throat, sore limbs and discomfort.Some patients are sick with the spleen and stomach, and manifest symptoms such as chest tightness, nausea, vomiting, loss of appetite, and loose stools.The common cold is common, and it is epidemic. Many people suddenly get sick at the same time and spread rapidly. The first symptoms are common aversion to cold and fever.At the beginning, the systemic symptoms were severe but the pulmonary symptoms were not prominent. After 39 to 40 days, obvious nasal congestion, runny nose, sneezing, coughing, and sore throat appeared.If it is sporadic, it is difficult to diagnose because it is similar to the early symptoms of many febrile diseases, but timely grasp of the epidemic situation is helpful for diagnosis.

2. The course of the disease is caused by the mouth, nose or fur. The course of the disease is relatively short, 3 to 7 days, and the common cold generally does not change.

3. The onset seasons are all four seasons, more common in winter and spring.

4. The examination can be combined with routine examinations such as blood analysis, which is conducive to diagnosis.

([-]) Treatment

The treatment of the common cold is mainly general treatment and symptomatic treatment, and then appropriate application of antibiotics.Influenza should also be given antiviral treatment.In the meantime, it can be combined with traditional Chinese medicine treatment to improve the curative effect.

1. General treatment: rest in bed, drink plenty of water, give liquid or semi-liquid diet, rinse mouth with warm salt water or warm boiled water after eating, and keep nasopharynx and oral cavity clean and hygienic.Influenza patients should be quarantined for 1 week or until the main symptoms disappear.

2. For symptomatic treatment, antipyretic and sedatives can be given to those with high fever and irritability. Analgin, luminal, etc. can be used as appropriate.Those with significant high fever and severe vomiting should be given appropriate rehydration.

3. The main function of the application of sulfonamides and antibiotics is to prevent and treat secondary bacterial infections.Sulfa and antibiotics may be considered in the following situations: ① Secondary bacterial infection; ② Those with a history of rheumatism; ③ Young children and the elderly with poor resistance, especially those with chronic heart and lung diseases.

4. Antiviral therapy

(1) Ribavirin (ribavirin): It has curative effect on various types of influenza viruses, and 24% of the patients' body temperature returned to normal within 73 hours of drug treatment, with few side effects.Nasal drops with 0.5% solution, and 2 mg tablets in the mouth at the same time, once every 2 hours, after the fever is reduced to 1 times a day, for 4 consecutive days.

(2) Amantadine and methylamantadine: only effective against influenza A virus.Its mechanism is to inhibit virus proliferation, reduce the amount of detoxification in patients, and shorten the detoxification period and course of disease.Early medication is effective.Oral amantadine 0.1 g, 2 times a day, 4-5 mg/kg/day for children, divided into 2 times for a total of 3-5 days.There are side effects such as dry mouth, dizziness, drowsiness, insomnia and ataxia.Compared with amantadine, methylamantadine has higher curative effect, longer half-life and fewer side effects.The therapeutic dose is 0.1 g, 2 times a day, orally.

5. Traditional Chinese medicine treatment Qingreganmao Granules, Yinqiaojiedu Tablets, Sangju Ganmao Tablets, Ganmaoqing, Antiviral Oral Liquid, etc. can reduce symptoms and shorten the course of the disease.

([-]) Prevention

The only known effective way to prevent colds is to wash your hands frequently, especially in the cold winter months, and to avoid contact with people who have a cold.Most experts don't think bed rest is necessary for recovery from a cold, but staying home can help minimize the spread of the virus by limiting the infected person's contact with other people.Most colds clear up in 3 days to 1 week.

[-]. Point massage

([-]) Acupuncture therapy

1. Take acupuncture points
Main points: Fengchi, Hegu, Lieque, Dazhui.

Acupoints: add Yingxiang for nasal congestion; add Taiyang for headache; add Shaoshang for sore throat; add Quchi for high fever.

2. Locate the wind pool—the nape, under the occipital bone, the depression between the sternocleidomastoid muscle and the upper end of the trapezius muscle.Hegu—the radial edge of the midpoint of the second metacarpal.Lie Que—Cross the mouth of a tiger with both hands, and the tip of the index finger reaches the place.

Dazhui—on the posterior midline, in the depression under the spinous process of the seventh cervical vertebra.Yingxiang - next to the midpoint of the outer edge of the alar nose, in the nasolabial fold.The sun—the midpoint between the tip of the brow and the outer canthus of the eyes, in the depression one inch backward.Shaoshang—the radial side of the distal joint of the thumb, 7 cun from the corner of the nail.Quchi—the lateral side of the cubital crease, the midpoint of the line connecting the lateral end of the cubital crease and the lateral epicondyle of the humerus when the elbow is flexed.

([-]) Self-massage
1. Quickly wipe the palms of the hands and rub the palms of the hands against each other quickly, up to 300 times per minute, until the hands are hot and the heat is transmitted to the upper limbs.

2. Massage the face with a hot hand on the forehead, first counterclockwise from the forehead to the head, ears, and jaw, and then go around to the opposite side and return to the forehead.

3. Pushing the nose Use the middle fingers and ring fingers of both hands to quickly push and rub up and down on both sides of the nose (Yingxiang point), about 200 times per minute. The force should not be too strong, so that the heat can be transmitted to the nasal cavity.

4. Press and knead Yingxiang Use the index fingers of both hands to press the Yingxiang acupoint respectively, and massage for 1 minute to make the place feel sore and swollen.

5. Vibrate Fengchi Press the Fengchi acupoint firmly with the thumbs of both hands, and vibrate regularly to make it produce obvious soreness. Vibrate for 1 minute.

6. Lift and pinch the earlobe Use the thumb and forefinger of both hands to pinch the earlobe. While kneading, do circular lifting. It is better to make the earlobe feel sore and the root of the ear not hurt. After doing this, the whole ear will become red and hot.Lift and knead for 1 minute.

7. Knead Dazhui, lower your head slightly, and use your middle finger to knead vigorously at Dazhui acupoint, with the degree of skin flushing, for about 2 minutes.

cough
An overview of the disease

([-]) Relevant knowledge

Cough is caused by the invasion of the lung system by exogenous evils caused by the six exogenous pathogens, or the dysfunction of viscera, internal injury to the lungs, the lung qi is not clear, and the main clinical manifestations are cough and expectoration.It is a protective reflex action of the human body.Pathological secretions in the respiratory tract and foreign bodies entering the respiratory tract from the outside can be excreted by the action of the cough reflex.However, if it affects work and rest due to frequent irritating cough, it loses its protective significance.

([-]) Etiology and pathogenesis

Cough is the main symptom of respiratory system disease, according to its pathogenesis, it can be divided into exogenous cough and internal injury cough.

1. Exogenous cough Exogenous cough is caused by the invasion of exogenous pathogens.Its onset is mostly due to the evil of exogenous wind-cold and wind-heat, which enters through the mouth, nose and fur.The lungs combine with the skin and fur, open to the nose, and the lungs are protected by evil, so the lung qi is blocked and suppressed, and the clearing is abnormal, resulting in coughing.

2. Internal injury cough Internal injury cough is caused by dysfunction of viscera.The onset is mostly due to other visceral diseases, involving the lungs and causing cough, such as spleen deficiency and dampness, the dampness gathers into phlegm, which stains the lungs, and the lung qi cannot be lowered; Loss of cleanliness can lead to coughing.

No matter the cough caused by exogenous pathogenic factor or internal injury, it all involves the lungs and is caused by the deficiency of lung qi and loss of Xuansu.It can be seen that cough is a pathological reaction produced by internal and external disease pathogens invading the lungs in order to expel the pathogens and expel them externally.

([-]) Clinical manifestations

Cough can fall ill all the year round, and it is more common when the climate is cold and changeable in winter and spring, and the incidence rate is high in children and the elderly and infirm.It is mostly caused by the failure of lung qi to disperse, loss of xuansu, and upward reversal of lung qi, with cough and expectoration as the main symptoms.Cough and expectoration caused by exogenous pathogenic factors are mostly accompanied by fever, headache, aversion to cold, etc. The onset is rapid and the course of disease is short; cough caused by internal injuries generally has no exogenous symptoms, slow onset, long course of disease, often accompanied by visceral dysfunction syndrome.The specific disease can be deduced according to the nature of the cough, the time and rhythm of occurrence, and the tone.

1. The nature of the cough Cough without sputum or very little sputum is called dry cough. It is common in the early stages of acute pharyngitis and acute bronchitis, pleurisy, and mild tuberculosis.When coughing with sputum is called wet cough, it is common in pneumonia, chronic pharyngitis, chronic bronchitis, bronchiectasis, lung abscess and cavitary tuberculosis.

2. The time and rhythm of the cough The cough that occurs suddenly is mostly caused by acute upper respiratory tract inflammation (especially caused by inhalation of irritating gases) and foreign bodies in the trachea or bronchi.Long-term chronic cough is more common in chronic respiratory diseases, such as chronic bronchitis, bronchiectasis, chronic lung abscess, and cavitary tuberculosis.Paroxysmal cough can be seen in whooping cough, bronchial lymph node tuberculosis, or cancer compressing the tracheal bifurcation.In chronic bronchiectasis and lung abscess, patients often cough intensified when they get up in the morning or lie down at night (that is, when they change their positions), and then expectoration.

3. The tone of coughing Hoarse coughing is caused by inflammation or tumor of vocal cords, which can be seen in laryngitis, laryngeal tuberculosis, and laryngeal cancer.Barking cough is more common in epiglottis, laryngeal disorders, or tracheal compression.A low-voiced cough can be seen in extremely debilitated or vocal cord paralyzed patients.A metallic tone cough can be due to direct compression such as a mediastinal tumor, aortic aneurysm, or bronchial carcinoma.

(End of this chapter)