4-1 Dyspnea (Chuan, 喘 )

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1 4-1 Dyspnea (Chuan, 喘 ) Concept Breathing with difficulty (open wide mouth, raise shoulders) Etiology and pathogenesis Climatic factors Phlegm fluid Emotion Chronic diseases Exertion Over sex Diagnosis Symptoms: History: cough, wheezing Triggers: Principle of treatments Excess: eliminate pathogens Deficiency: LU and KI 1

2 Treatments 1. During attacks 1) Wind cold Clinical manifestations: breathlessness, distending and fullness in the chest, cough, clear and white sputum, associated with headache, no sweats, aversion to cold, or fever, no thirst, thin, and white and slippery coating, superficial and tense pulse Principle of treatment: expel wind cold and disperse LU The formulas: Ma huang tang Ma huang Gui zhi Xi ren Zhi gan cao 2) Phlegm heat in LU Clinical manifestations: breathlessness, cough, distending and pain in the chest, sticky and yellow sputum, or blood in the sputum, or irritability and heat in the chest, fever, sweats, thirst with the preference of cold drinks, red face, dry throat, dark urine, or constipation, yellow or sticky coating slippery and rapid pulse Principle of treatment: clear and purge heat and phlegm The formulas: Sang bai pi tang Sang bai pi Huang qin Huang lian Zhi zi Xin ren Bei mu Ban xia Su zi 3) Phlegm and dampness in LU Clinical manifestations: breathlessness, fullness and distending sensation in the chest, cough, 2

3 clear and sticky sputum, difficult to expectorate, nausea, poor appetite, sticky sensation in the mouth, no thirst, thick, white ad sticky coating, and a slippery pulse Principle of treatment: eliminate phlegm and send adverse flow qi downward The formulas: Er chen tang and san zi yang qin tang Er chen tang Ban xia Chen pi Fu ling Zhi gan cao Sheng jiang Wu mei San zi yang qin tang Su zi Bai jie zi Lai fu zi 4) Water attacking the heart and LU Clinical manifestations: breathlessness, cough, hard to lying down, clear and white sputum, palpitation, edema of the face, eyes, and limbs, scanty urine, aversion to cold, cold extremities, dark blue lip and face, swollen and dark tongue body, white and slippery coating, and a deep and thready pulse Principle of treatment: warm yang and purge water, purge the accumulation and relieve asthma The formulas: Zhen wu tang and ting li da zao xie fei tang Zhen Wu Tang Fu ling Sheng jiang Bai zhu Bai shao 3

4 Ting li da zao xie fei tang Ting li zi Da zao 5) Liver qi attacking LU Clinical manifestations: often triggered by emotional irritations, sudden rapid breath, fullness sensation in the chest and chest pain, feeling a substance in the throat, or insomnia, palpitation, depression, thin tongue coating, and string pulse Principle of treatment: relieve the liver qi stagnation and send qi downward The formulas: Wu muo yin zi Chen xiang Bin lang Wu yao Mu xiang Zhi shi 2. In between attacks 1) Lung qi deficiency Clinical manifestations: breathlessness, low voice, snore, coughing with low sound, clear and thin sputum, spontaneous sweats, aversion to wind, easy to catch cold, pale tongue, soft and weak pulse Principle of treatment: tonify LU and benefit qi The formulas: Bu fei tang and yu ping feng san Bu fei tang Ren shen Huang qi Shu di huang Wu wei zi Zi wuan 4

5 Sang bai pi Yu ping feng san Bai zhu Huang qi Fang feng 2) Kidney qi deficiency Clinical manifestations: chronic wheezing and breathlessness, short breath, more breathing in and less breathing out, breathlessness after activities, losing control of urine due to coughing, or dripping urination, blue complexion, cold limbs, pale tongue and thin coating, weak and thread pulse or deep and weak pulse Principle of treatment: tonify KI to hold qi The formulas: Jing gui shen qi wan and shen ge san Jin gui shen qi wan Rou gui Fu ling Ze xie Mu dan pi Shan zhu yu Shan yao Shu di huang Shen ge san Ren shen Ge jie 3) Exhaustion due to asthma 5

6 Clinical manifestations: severe wheezing and breathlessness, or even open the mouth and shrug the shoulders, could not lying down, severe breathlessness triggered by slight activities, palpitation, irritability, blue face and lips, severe sweating, superficial and large pulse without root, or irregular Principle of treatment: tonify yang and consolidate the exhaustion, astringe KI qi The formulas: Shen fu tang and hei xi dan Shen fu tang Ren shen Hei xi dan Hei xi Liu huang Chuan lian zi Hu lu ba Mu xiang Rou dou kou Yang qi shi Chen xiang Xiao hui xiang Rou gui Bu gu zhi Prognosis Prevention and general advices Avoid stress or emotional irritations Avoid eating hot and spicy food or sweet and greasy food Quit smoking or alcohol Exercise Prevent the common cold Summary During attacks Wind cold Phlegm and heat in LU Phlegm and dampness in LU Water attacking the heart and LU 6

7 In between attacks Liver qi attacking LU Lung qi deficiency Kidney qi deficiency Exhaustion due to asthma Self tests What does it mean chuan? Describe the etiology and pathogenesis of chuan Describe the differentiation of syndromes of chuan Describe the treatment of chuan. Case study: 1. Male, 45y, Asthma and oppressed feeling of chest suddenly occurred 2 days ago, productive cough with thin white phlegm, aversion to cold, thin white coating, floating and tense pulse. Diagnosis: Syndrome pattern: Treatment principle: Formula and herbs: 2. Female, 65y. Chronic cough for 10 years, accompanied by shortness of breath 3 years, susceptible to cold which soon trigger asthma, Yesterday, she caught cold which flared up asthma. She experienced rapid, shallow and difficult respiration, feeble voice, spontaneous sweating, and nausea. Pale tongue and thin and white coating; weak pulse. Diagnosis: Syndrome pattern: Treatment principle: Formula and herbs: 7

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