Kai Chen Ph.D. in
Chinese Medicine
TCM Dr. in British Columbia, Canada
205 Burnside Road East, Victoria, B.C. V9A 1A4 Canada
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TCM Dr. in British Columbia, Canada 205 Burnside Road East, Victoria, B.C. V9A 1A4 Canada |
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Chronic Obstructive Pulmonary
Disease (COPD) Chronic obstructive pulmonary disease (COPD) is characterized by chronic obstruction of airflow out of the lungs. It causes poor gas exchange in the lungs leading to decreased oxygen levels in the blood, increased carbon dioxide levels, and shortness of breath. It is comprised primarily of two related diseases - chronic bronchitis and emphysema. Chronic bronchitis is an inflammation and swelling of the lining of the airways that leads to narrowing and obstruction of the airways. The inflammation also stimulates production of mucous, which can cause further obstruction of the airways. Obstruction of the airways, especially with mucus, increases the likelihood of bacterial lung infections. Emphysema is permanent enlargement of the alveoli due to the destruction of the walls between alveoli. The destruction of the alveoli walls with their elastic fibers reduces the elasticity of the lung overall. Loss of elasticity leads to the collapse of the bronchioles, obstructing airflow out of the alveoli. Air becomes "trapped" in the alveoli and reduces the ability of the lung to shrink during exhalation. The reduced expansion of the lung during the next breath reduces the amount of air that is inhaled. As a result, less air for the exchange of gasses gets into the lungs. TCM Etiology and pathology In TCM, it related to the categories of Kesou (Cough) or Tanyin (Phlegm blocking), etc. The development of COPD is not only related with external pathological factors (EPF) invading, but also function disorders in lung, spleen and kidney. Repeated EPF invading or long time smoking often course organs deficiency, furthermore, the deficiency course EPI more frequently and easily invading. Therefore in the later stage or in the seniors the basic pathologic change often is root (Ben) deficiency with branch (Biao) excessive. TCM
Differentiation and treatment 1.
Recurrent acute stage In the stage, the clinic signs are
similar as acute bronchitis, caused by EPF invading. (1)
Interior retention of phlegm with exopathic cold
Clinical
manifestation: Cough with profuse white or watery phlegm, dyspnea, or
accompanied with chill and fever, headache or whole body pain, light red tongue
body with white fur, superficial and tense pulse Treatment
principle: Dispersing cold and soothing lung qi, removing phlegm and
stopping cough Herbal
prescription: Modified Xiaoqinglong Tang (Minor decoction of green dragon) Acupuncture:
Fengchi (GB21), Fengmen(BL12), Feishu(BL13), Daiyuan(LU8) and Hegu(LI4) (2)
Stagnation of heat- phlegm Clinical
manifestation: Bad cough with yellow and sticky phlegm, often not easy
expectorated, or dyspnea, or accompanied with fever, throat pain, headache, and
red tongue body with yellow fur, rapid pulse Treatment
principle: Clearing heat and soothing lung qi, removing phlegm and
stopping cough Herbal
prescription: Modified Qingjin Huatan Tang (Clearing heat from lung and
transforming phlegm formulae) Acupuncture:
Dazhui (DU14), Quchi (LI11), Chize(LU5), Hegu(LI4), Feishu(BL13)
2.
Chronic Procrastination Stage Patient has cough, or phlegm or
dyspnea more than one month. The
syndromes often are root deficiency and branch excessive.
The treatment principle is tonify Zheng and dispersing EPF. (1)
Phlegm-dampness blocking the lung Clinical
manifestations: Cough with profuse thin and white sputum, cheat fullness,
body heavy feeling, and big tongue body with white or yellow greasy fur,
slippery pulse Treatment
principle: Drying dampness and clearing phlegm
to stop cough Herbal
prescription: Modified Erchen Tang (Two old drugs decoction) and Sanzi Yangqin
Tang (Decoction with three seeds) Acupuncture:
Feishu(BL13), Pishu(BL20), Taiyuan(LU8), Zusanli(ST36), Fenglong(ST40) (2)
Invasion of the lung by liver fire Clinical
manifestations: Paroxysmal dry- spasm cough, or with scanty and blood-tinged
sputum, hypochondria pain, irritability, red face and eyes, red tongue with
yellow fur, taut and rapid pulse Treatment
principle: Dispersing heat in the liver, clearing fire, moistening the
lung to stop cough Herbal
prescription: Modified Danzhi Xiaoyao San (Ease powder added Peony Bark and
Capejasmine) and Xiebai San(Lung-heat
expelling powder) Acupuncture:
Ganshu(BL18), Feishu(BL13),
Yuji(LU10), Zhigou(SJ6)), Xingjian(Liv2) (3) Lung
yin deficiency Clinical
manifestations: Dry cough, or with scanty and blood-tinged sputum, dry mouth
and thirsty, or lover fever in the afternoon or at night, or night sweating, red
tongue with yellow fur, thin and rapid pulse Treatment
principle: Tonifying yin and dispersing phlegm, moistening the lung to
stop cough Herbal
prescription: Modified Baihe Gujin
Tang (Lily decoction for strengthening the lung) Acupuncture:
Feishu(BL13), Shenshu(BL23), Gaohuang(BL43), Taisi(KI3), Tiantu(RN22),
Chize(LU5) 3. Clinic
Remission Stage Patient has no symptoms, or very
mild cough or phlegm more than two months.
In this stage, in some new and middle age patients do not have any
symptoms, but in chronic and seniors patients, the main syndromes are root
deficiency. The main treatment
principle also should tonify Zheng qi to enhance body resistance ability. (1) Lung
and spleen qi deficiency Clinical
manifestation: Fatigue, spontaneous sweating, short breath, aversion wind,
recurrent catching cold, poor appetite, pale face, pale tooth print tongue body
with white fur, weak pulse
Treatment principle: Tonifying spleen and lung qi Herbal
prescription Liu Junzi Tang (The Six Noble Ingredients Decoction) and Yupingfeng
San (Jade Screen Powder) Acupuncture:
Feishu(BL13), Pishu(BL20), Zusanli(ST36), Qihai(RN6), Gaohuang(BL43), Tanzhong
(RN17) (2)
Kidney yang deficiency Clinical
manifestation: Short breath, cold limbs, lower back weak and cold, or
accompanied with impotence, or period disorders, or frequent night urination,
pale tongue with white fur, deep and weak pulse Treatment
principle: Tonifying kidney yang Herbal
prescription: Shenqi Wan (Bolus for tonifying the kidney-qi) Acupuncture:
Pishu (BL20), Shenshu (BL23), Feishu (BL13), Zhongfu (LU1), Qihai (RN6),
Guanyuan (RN4), Zusanli(ST36), Fenglong(ST40)
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