TCM Acupuncture and Massage

Chapter 42 Respiratory System Diseases (2)
([-]) Diagnosis

1. Noisy cough, or accompanied by itchy throat and expectoration.

2. Exogenous cough, acute onset, may be accompanied by symptoms such as cold and heat; internal injury cough, often due to repeated attacks of exogenous pathogenesis, the course of disease is longer, cough and wheezing.

3. In the acute phase, the total number of peripheral blood leukocytes and neutrophils increased.

4. On auscultation, thickened breath sounds in both lungs can be heard, or accompanied by scattered dry and wet sounds.

5. X-ray examination of the lungs is normal or the lung markings are thickened.

([-]) Treatment

The treatment of cough includes three aspects: general treatment, anti-inflammatory treatment and symptomatic treatment.

1. General treatment includes rest, keeping warm, and drinking plenty of water.

2. Systemic application of antibiotics such as sulfonamides or penicillins.Mainly to avoid secondary respiratory infections.

3. Symptomatic treatment
（1）发热时可服用阿斯匹林0.3～0.6g，或消炎痛25mg，每日3次。

(2) When the cough is frequent and without sputum, Kebiqing 25mg can be taken, 3 times a day.

(3) When the phlegm is thick and difficult to spit out, you can take Bisouping 16mg orally, 3 times a day.

（4）伴哮鸣音时可口服氨茶碱0.1～0.2g 或舒喘灵2～4mg，每日3次。

([-]) Prevention

1. Carrying out physical exercise and cold-resistant training to enhance physical fitness and prevent colds are effective measures to prevent coughs.

2. It is also very important to do a good job in labor protection, prevent harmful gases, acid mist and dust from escaping, and reduce and avoid stimulation of upper respiratory chemical factors.

3. Smoking is an important cause of chronic bronchitis, and smoke will also bring harm to the surrounding people. We should vigorously publicize the dangers of smoking and educate young people to stop smoking.

4. For the pathogenic factors of cough, strengthen personal hygiene, including physical exercise, breathing and cold-resistant exercises, to enhance physical fitness and prevent colds.Improve environmental sanitation, deal with "three wastes" and eliminate air pollution.

[-]. Point massage

([-]) Acupuncture therapy

1. Take acupuncture points
Main points: Tiantu, Dingchuan, Lieque, Feishu.

Acupoints: add Hegu for aversion to cold and fever; add Neiguan for chest tightness; add Fenglong and Zusanli for excessive phlegm.

2. Locate Tiantu—in the middle of the suprasternal fossa.Dingchuan - 0.5 cun away from Dazhui point.

Lie Que - the tiger's mouth of both hands crosses naturally and straightly, at the point where the index finger reaches.Feishu—below the spinous process of the third thoracic vertebra, 1.5 cun laterally.Hegu—the back of the hand, the midpoint of the second metacarpal, the radial edge.Neiguan—inner forearm, 2 cun above the transverse wrist crease, between the two tendons.

Fenglong—8 cun above the lateral malleolus, two transverse fingers outside the anterior crest of the tibia.

Zusanli - 3 inches below the calf's nose, one finger outside the anterior crest of the tibia.

([-]) Self-massage
1. Hook the Tiantu acupoint Hook the Tiantu acupoint with your index finger for 1 minute.

2. Knead Tanzhong. Overlap the palms of both hands, focus on the Tanzhong acupoint with the heels of the palms, and knead slowly for 1 minute.Then rub 30 times from top to bottom from Tanzhong to xiphoid process.

3. Knead the Zhongfu and Yunmen acupoints respectively with the index finger for 1 minute.

4. Pinch the upper limbs of Dazhui, hug the head and neck backward, and use the middle fingers of both hands to pinch Dazhui acupoint lightly for 1 minute at the same time.

5. Knead the ribs and knead the ribs on both sides with your thumb for 1 minute.

6. Hold Hegu and pinch the Hegu point of the other hand with the thumb and index finger relatively, and press hard for 1 minute.

7. When the patient is sitting or lying prone, others rub the bladder meridian on both sides of the back for 2 minutes, rubbing until reddish and slightly hot.

8. Pat the back and chest, cross your hands, and pat the back for 5 minutes.Then return your hands to the front, and lightly pat the left and right chest with empty fists for 5 minutes.

9. Wipe your face. Rub your hands together. After you get hot, wipe your face along the sides of your nose. The focus is on the Tongtong and Yingxiang acupoints. You can rub it lightly for about 30 times.

10. Knead the three acupoints of Fengchi, Taiyang, and Dingchuan with the middle finger of the thumb and knead for 1 minute each, until the soreness is moderate.

11. Rubbing the Dazhui acupoint rubbing the Dazhui acupoint on the back of the neck with the index, middle and ring fingers for 1 minute, until the degree of fever is felt.

asthma
An overview of the disease

([-]) Relevant knowledge

In traditional Chinese medicine, asthma is the general term for wheezing and wheezing. The sound of phlegm in the throat is wheezing, and shortness of breath is not enough to breathe.It is due to persistent phlegm submerged in the lungs, which is caused by phlegm obstructing the airway, causing lung failure to ventilate and descend, and airway constriction and acute airway constriction.During the attack, the main clinical manifestations are wheezing in the throat, shortness of breath, and even wheezing and inability to lie down.In modern medicine, asthma belongs to the category of bronchial asthma.Asthma is a wheezing disease mainly characterized by small bronchospasm.The main clinical manifestations are paroxysmal dyspnea with wheezing, with wheezing in both lungs on auscultation, characterized by prolonged expiratory period.It can fall ill all year round, and it is more common when the climate is cold and changeable in winter and spring.There are approximately 1.5 million asthmatics worldwide.There are as many as 18 people who die from asthma every year.It has become a major chronic disease that seriously threatens human health.In my country, the prevalence rate of asthma is 1%, and children can reach about 3%. There are about 1000 million asthma patients in the country.

([-]) Etiology and pathogenesis

Traditional Chinese medicine believes that the occurrence of asthma is due to the persistent phlegm lying in the lungs, which is often attracted by exogenous factors, diet, emotion, fatigue and other inducements, resulting in phlegm blocking the airway, the lungs fail to descend, and the airway is constricted.The internal cause is phlegm retention.The incentives are climate, diet, emotions, fatigue and other factors.

According to modern medicine, the causes of asthma attacks are complex.Mainly, after people with allergies contact the antigen, the smooth muscle spasms immediately, which is an immediate asthmatic reaction.What is more common is that many patients develop asthma after several hours or even tens of hours of exposure to antigens, which is called delayed asthmatic response, which is the result of airway allergic inflammation.Airway mucosal edema, inflammatory cell infiltration, increased gland secretion, mucociliary clearance dysfunction, and intraluminal mucus plug obstruction are also important mechanisms for asthma attacks.

([-]) Clinical manifestations

Paroxysmal wheezing in the throat, shortness of breath and difficulty, even wheezing and unable to lie down.The disease is paroxysmal, generally in the evening, night, and early morning.Premonitory symptoms often include nasal itching, itchy throat, sneezing, runny nose, coughing, and chest tightness before the onset.Symptoms of the attack are that the patient suddenly feels chest tightness, suffocation, coughing, shortness of breath immediately, and prolonged exhalation, accompanied by wheezing. Cold extremities.

According to different onset conditions, it can be divided into the following three types: 1. Inhalation type (also known as exogenous) has clear seasonality, childhood onset, and family history of allergies.Before the onset, there are often itchy nose, itchy throat, and even itchy eyes and ears.Remission period is asymptomatic.Blood eosinophils and IgE increased.

2. The infectious type (also known as endogenous) has no obvious seasonality, and most of the causes are repeated upper respiratory tract or lung infections.Often occurs in adulthood.At the time of onset, it was accompanied by cough, purulent sputum, elevated autocytocyte count in blood, and normal IgE.It is more common in rural areas of our country.

3. The mixed type has the characteristics of both types. It has a long medical history.Elderly patients are often complicated by chronic bronchitis, which is difficult to distinguish from wheezing chronic bronchitis.

([-]) Diagnosis

1. Wheezing in the throat during the attack, dyspnea, even opening the mouth and lifting the shoulders, unable to lie down, or bruising of the lips and nails.

2. It is recurrent. "It is often induced by factors such as sudden changes in climate, improper diet, emotional disorders, and fatigue. Before the onset, there are often auras such as nasal itching, sneezing, coughing, and chest tightness."

3. Have a history of allergies or family history.

4. Wheezing and wheezing can be heard in both lungs, or accompanied by damp squeaking.

5. Eosinophils can be increased in blood routine, and eosinophils can be seen in sputum smears.

6. There is generally no special change in chest X-ray examination, and signs of emphysema can be seen after prolonged illness.

([-]) Treatment

It mainly includes the following aspects: 1. Elimination of the cause should avoid or eliminate allergens and other non-specific stimuli that cause asthma attacks, and remove various inducing factors.

2. When controlling acute asthma attacks, antispasmodic, anti-inflammation, and removal of airway mucus plugs should be taken into account to keep the airway unobstructed and prevent secondary infection.Generally, adrenomimetic drugs, theophylline (xanthine) drugs, anticholinergic drugs, calcium antagonists, adrenal glucocorticoids, disodium cromoglycate, ketotifen and other drugs can be used alone or in combination.

3. To promote expectoration, expectorants can be used, or aerosol inhalation, mechanical expectoration and other treatments can be used, and infection should be actively controlled.

4. Treatment of severe asthma Those with severe asthma who are critically ill or complicated must be rescued in a timely and reasonable manner.

5. The purpose of treatment in the remission period is to consolidate the curative effect, prevent or reduce recurrence, and improve respiratory function.Desensitization therapy may be done to lessen or reduce asthma attacks.

Or give disodium cromoglycate, inhalation of becodone aerosol, or oral administration of ketotifen, which has a strong anti-allergic effect and a good preventive effect on exogenous asthma.Others such as astemizole, terfenadine, and tranister are all H1 receptor antagonists, and have no central sedative effect, so they can be used as preventive drugs.And enhance physical fitness, participate in necessary physical exercise, improve health knowledge to prevent this disease, and stabilize emotions.

([-]) Prevention

1. Eliminate phlegm from chronic diseases, and should be the first task to prevent asthma attacks.

2. Advise them to maintain a good mood in terms of life adjustment, and avoid contact with irritating gases and dust, pollen, food, medicine and other suspicious foreign objects that can easily cause allergies.

3. The usual diet should be light and nutritious, and avoid cold, fat, sweet, thick, spicy, fishy, ​​etc.

4. It is advisable to quit smoking and alcohol.

5. Encourage patients to choose Tai Chi, Neiyanggong, Baduanjin, walking or jogging, breathing gymnastics and other methods for long-term exercise according to their personal physical conditions to enhance their physical fitness and prevent colds.

6.每晚临睡前以2～3个生核桃肉（连核桃肉的紫衣），与1～3片生姜一同细嚼，嚼烂后咽下，若同时加1片生晒参则效果更佳。

7. Conditionally, 3 grams of placenta powder can be swallowed by humans (or animals).Taking it from August to November every year can prevent asthma attacks.

[-]. Point massage

([-]) Acupuncture therapy

1. Select acupoints Tiantu, Zhongfu, Tanzhong, Dazhui, Dingchuan, Fengmen, Feishu, Kongzui, Neiguan, Taiyuan, Hegu, Zusanli, Fenglong.

2. Locate the celestial process - the neck, the front midline, and the center of the suprasternal fossa.Zhongfu—outside and above the chest, 6 cun lateral to the anterior midline, level with the first intercostal space.

Tanzhong—chest, on the front midline, the midpoint of the line connecting the two nipples.Dazhui—on the posterior midline, in the depression under the spinous process of the seventh cervical vertebra.Dingchuan - 0.5 cun from the side of Dazhui.

Throttle—back, under the spinous process of the second thoracic vertebra, 1.5 inches laterally.

Feishu—back, below the spinous process of the third thoracic vertebra, 1.5 cun laterally.

Kongzui—on the inner side of the forearm, 7 cun above the transverse crease of the wrist, on the line connecting Chize and Taiyuan.

Neiguan—Inner side of forearm, 2 cun above the transverse wrist crease, between the two tendons.Taiyuan—the radial side of the transverse wrist crease, where the radial artery pulses.Hegu—the midpoint of the radial border of the second metacarpal.Zusanli - 3 inches below the calf's nose, a finger across from the front edge of the tibia.

Fenglong—8 inches above the tip of the lateral malleolus, two fingers apart from the front edge of the tibia.

([-]) Self-massage
1. Wipe the Lung Meridian Use the thenar of the palm to rub the front edge of the inner sides of the arms (Lung Meridian), and then use the thumb, index, and middle fingers to pinch Quchi, Hegu, and Jianjing for 1 minute each.

2. Rub the chest and abdomen with both hands to generate heat, rub the chest and abdomen with palms flat, from top to bottom, from the sky, through Tanzhong and Zhongwan, until Qihai and Guanyuan, rub for 3 minutes.Focus on Tanzhong and Zhongwan.

3. Take Fengchi and Dingchuan pinch the Fengchi and Dingchuan points with your thumb, middle and index fingers for 1 minute each.

4. Acupuncture Press the aforementioned acupoints one by one, taking the degree of soreness as the degree, and each acupoint for 1 minute.

5. Pat Dazhui point repeatedly for 1 minute.

(End of this chapter)