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Asthma/Xiào Chuăn
Asthma/Xiào Chuăn is a common illness characterized by repeated attacks of paroxysmal dyspnea with
wheezing.
Xiào and Chuăn refer to different clinical manifestations that historically were considered separate diseases
in Chinese medicine.
Xiào is translated as wheezing and is characterized by short, rapid breathing with wheezing.
Chuăn is translated as breathlessness or panting and is characterized by labored breathing to the point that
the patient cannot lie flat, breathing through the mouth, raising the shoulders and flaring of the nostrils
during inspiration.
The classic state: “Chuăn is characterized by the manner of the breathing; Xiào is characterized by the
sound of the breathing.”
Clinically, Xiào and Chuăn often present together and are difficult to differentiate, and in recent centuries
have been considered to be one condition; for this reason, they are discussed together in relation to asthma,
though in fact other biomedical disorders such as bronchitis, pneumonia, and COPD (to name a few) may
have a similar presentation.
Etiology and Pathogenesis
-Exogenous pathogenic factors: Wind-Cold, Wind-Heat, pollen, dust, and smoke can invade the Lungs and
stir up latent Phlegm. Together, these exogenous pathogens plus Phlegm obstruct Lung Qi and impair its
dispersing and descending, resulting in asthma.
-Improper diet: excessive consumption of cold, raw, sweet, or greasy food impairs the Spleen’s function of
transformation in transportation. Over time, this can result in the production of Phlegm, which gets stored
in the Lungs.
-Emotional stress: anger, irritability, depression, or frustration can result in Liver Qi stagnation leading to
upward counter flow of Qi. This, in turn, can impair the dispersing and descending function of the Lungs.
-Aging, congenital vacuity, chronic illness, or overwork: these etiologies can result in Lung and Kidney
vacuity. Zheng Qi vacuity can allow for invasion of exogenous pathogens; furthermore, Qi vacuity causes
impairment of fluid metabolism, resulting in the production of Phlegm.
For the appropriate treatment of Asthma/Xiào Chuăn, a clear distinction must be made between acute
exacerbations and the chronic, remission phase.
In general, during the acute phase one follows the article of treating the Branch manifestations by expelling
pathogenic factors, transforming Phlegm, and restoring the dispersing and descending function of Lung Qi.
During the acute phase it is imperative to differentiate between Cold and Heat patterns.
During the chronic phase, treatment is focused on the Root and attention is paid to supplementing the
Zheng Qi, particularly that of the Lungs, Spleen, or Kidneys.
In some cases, Root and Branch may need to the addressed simultaneously.
Pharmacotherapy for Asthma/Xiào Chuăn
Long-term Control Medications
Quick Relief Medications
• Inhaled corticosteroids (e.g., Azmacort, Vanceril, • Leukotriene modifiers (e.g., Singulair and Long-acting bronchodilators (e.g., Serevent) Mast cell inhibitors (e.g., Cromolyn sodium • Aminophylline or theophylline (not as commonly Acupuncture for Asthma/Xiào Chuăn
Acute Phase:
Basic Points: CV22, Dingchuan, CV17, LU1, ST40, BL17, PC6
Points based on pattern:
Cold: LU7, LI4, BL12
Heat: LU5, LU6, GV14
Cupping on upper back and chest.
Plum Blossom needle: lightly tap along the paraspinal muscles of the upper back and/or along the course of
the Lung channel (thenar eminence, forearm) and bilaterally over the SCM muscle until skin is red.
Remission Phase:
Basic Points: BL13, LU9, CV17, ST40, LU1, Ding Chuan
Points based on pattern:
LU Qi Xu: CV6, BL43, ST36, SP3
SP Qi xu: BL20, ST36, SP3, CV12
KI xu: BL23, KI3, CV6, CV4
Summer moxibustion: apply 3-5 cones of moxa on sliced ginger to BL13, BL43, GV14, BL20, BL23 until
skin becomes red at each point. Do this daily, with 10 times equaling 1 course of treatment. Do one course
each month for three months before the asthma season begins ( i.e., fall/winter). PARQ conferencing is
essential.
Cupping: sliding cups along upper back until skin becomes dark red. Do this once a week, four times
equaling 1 course of treatment. Do this two months before the asthma season begins.
Suppurative moxibustion: direct, rice grain moxa at BL12, BL13, BL43, GV14, ST36. PARQ conferencing
is essential and care must be taken that skin does not become infected.
Herbal Therapy for Asthma/Xiào Chuăn
Supurative herbal therapy: Bai Jie Zi 12g Yan Hu Suo 12g Xi Xin 12g Gan Sui 12g She Xiang 0.15g Grind the above herb into a fine powder, mix with fresh ginger juice, shape into small cones and apply with a plaster onto the following points: BL13, BL43, and GV14; remove after two hours. Apply three times in August, ideally over consecutive days. Many modern TCM respiratory specialists add Wind-extinguishing, insect medicinals to formulas for the treatment of acute asthma. These include Quan Xie, Wu Gong, Di Long, Jiang Can, and Chan Tui. Their use is based on the statement that, “Enduring disease enters the collaterals.” From a modern pharmacological perspective, these herbs have spasmolytic properties. TCM Pattern Differentiation
Cold-Phlegm
rapid breathing with wheezing at a feeling of force and oppression in the chest, cough with scanty, clear or
white sputum; symptoms aggravated by exposure to cold
Additional Symptoms: dull, pale/bluish-white complexion, no thirst or desire for warm drinks, aversion to
cold and cold limbs
Tongue: white, moist coat
Pulse: wiry, tight or floating, tight or slippery, tight
Treatment Principles: Warm the Lungs, scatter Cold, transform Phlegm, calm wheezing
Herbal Treatment:She Gan Ma Huang Tang(Belamcanda-Ephedra Decoction)
[Ma Huang (Ephedra stem) 12 g, Xi Xin (Asarum) 9g, Sheng Jiang (Fresh Ginger rhizome) 12g,She Gan
(Belamcanda rhizome) 9g, Ban Xia (Pinellia tuber) 9g, Zi Wan (Aster root) 9g, Kuan Dong Hua (Coltsfoot)
9g, Da Zao (Jujube) 3pcs., Wu Wei Zi (Schisandra fruit) 3g]
Phlegm-Heat
loud wheezing with breathlessness, choking cough with rattling sound in the throat, fake, sticky, yellow
sputum that is difficult to expectorate
Additional Symptoms: sweating, irritability, anxiety, thirst, headache, sensation of heat
Tongue: read with yellow, greasy coat
Pulse: slippery, rapid or slippery, wiry
Treatment Principles: Clear Heat, restore the descending of Lung Qi, transform Phlegm, stop wheezing
Herbal Treatment: Ding Chuan Tang (Panting Stabilizing Decoction)
[Ma Huang (Ephedra herb) 9g, Zi Su Zi (Perilla seed) 6g, Kuan Dong Hua (Tussilago flower) 9g, Xing Ren
(Apricot kernel) 4.5g, Sang Bai Pi (Mulberry root bark) 9g, Huang Qin (Scutellaria root) 4.5g, Fa Ban Xia
(Processed Pinellia tuber) 9g, Bai Guo (Ginkgo seed) 9g, Gan Cao (Licorice root) 3g]
Lung Qi Vacuity
chronic, slight wheezing sound in the throat, slight cough with thin, clear sputum, shortness of breath
Additional Symptoms: spontaneous sweating, weak voice, fatigue, aversion to wind or worsening of
symptoms with exposure to wind, tendency to catch colds, stuffy or runny nose with clear discharge
Tongue: pale with thin, white coat
Pulse: weak
Treatment Principles:Supplement the Lungs and consolidate the exterior
Herbal Treatment: Yu Ping Feng San
[Huang Qi (Astragalus root) 30g, Bai Zhu (Atractylodis rhizome) 60g, Fang Feng (Saposhnikovia root)
60g]
Spleen Qi Vacuity
chronic, slight wheezing sound in the throat, slight cough with thin, clear sputum, shortness of breath
Additional Symptoms: poor appetite, epigastric and abdominal distention, loose stool, fatigue
Tongue: pale with white, moist or thin, greasy coat
Pulse: weak or soft
Treatment Principles: Supplement the Spleen, boost Qi,transform Phlegm
Herbal Treatment: Liu Jun Zi Tang (Six Gentlemen Decoction)
[Dan Shen (Codonopsis root) 3g, Bai Zhu (Atratylodes rhizome) 6g, Fu Ling (Poria) 6g, Zhi Gan Cao
(Honey Prepared Licorice) 3g, Ban Xia (Pinellia tuber 3g, Chen Pi (Tangerine peel) 3g]
Kidney Qi Vacuity (Kidneys not Grasping the Qi)
chronic, slight wheezing sound in the throat, shortness of breath, more difficulty inhaling than exhaling,
symptoms worse with fatigue or exertion
Additional Symptoms: sore and weak low back and knees, tinnitus, spontaneous sweating (aversion to
cold with cold limbs and impotence if more Yang vacuity)
Tongue: pale
Pulse: deep, weak
Treatment Principles: Supplement the Kidneys, boost the Qi, stop wheezing
Herbal Treatment: Jin Gui Shen Qi Wan (Golden Coffer Kidney Qi Pill)
[Shu Di Huang (Cooked Rehmannia root) 24g, Shan Zhu Yu (Cornus fruit) 12g, Shan Yao (Dioscorea root)
12g, Ze Xie (Alisma tuber) 9g, Mu Dan Pi (Moutan root bark) 9g, Fu Ling (Poria) 9g, Rou Gui (Cinnamon
bark) 3g, Pao Fu Zi (Blast-fried Aconite) 3g]
Kidney Yin Vacuity
chronic, slight wheezing sound in the throat, shortness of breath, more difficulty inhaling than exhaling,
symptoms worse with fatigue or exertion
Additional Symptoms: sore and weak low back and knees, tinnitus, sensation of heat, night sweating,
malar flush, insomnia
Tongue: red with scanty coat
Pulse: thin, rapid
Treatment Principles:Supplement the Kidneys, nourish Yin, drain Fire, stop wheezing
Herbal Treatment: Zhi Bai Di Huang Wan (Anemarrhena, Phellodendron, and Rehmannia Pill)
[Shu di huang (Cooked Rehmannia root) 24g, Shan zhu yu (Cornus fruit) 12g, Shan yao (Dioscorea root)
12g, Ze xie (Alisma tuber) 9g, Mu dan pi (Moutan root bark) 9g, Fu ling (Poria) 9g, Zhi mu (Anemarrhena
root) 9g, Huang bai (Phellodendron bark) 9g]

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