What is asthma?
Asthma is a condition that affects the airways – the small tubes that carry air in and out of the lungs. People with asthma have airways that are almost always red and sensitive (inflamed). Their airways can react badly when they have a cold or other viral infection, or when they come into contact with an asthma trigger (something that sets off their symptoms). When this happens the muscles around the walls of the airways tighten and they become narrower. The lining of the airways swells and often produce a sticky mucus. As the airways narrow, the air has to squeeze in and out, and this is what causes the person with asthma to find it difficult to breathe. Asthma symptoms can include coughing, wheezing, shortness of breath or a tight feeling in the chest.
Asthma affects more than 5.1 million people in the UK, including one in eight school children and one in 13 adults. With the correct treatment, support and advice, most people with asthma can lead full and active lives.
What are the things that can set off, or trigger asthma symptoms?
A trigger is anything that irritates the airways and sets off the symptoms of asthma. Common triggers include colds or 'flu, cigarette smoke, exercise and allergies to things like pollen, furry or feathery animals or house-dust mite. Everyone's asthma is different and you will probably have several triggers.
What causes asthma?
Asthma, like its related allergic conditions eczema and hay fever, often runs in the family and may be inherited.
There are probably a number of other, environmental, factors that contribute to someone developing asthma – many aspects of modern lifestyles, such as housing and diet, might be responsible. We also know that smoking during pregnancy increases the chance of a child developing asthma. There is currently no evidence that traffic pollution causes asthma, although poor air quality can make your asthma worse.
How can I tell if I have asthma?
There is no hard and fast way of telling if you have asthma or not. This is partly because the symptoms can vary and may be similar to other respiratory conditions that are not asthma. Asthma symptoms include shortness of breath, wheezing (a whistling noise in the chest), cough and chest tightness. Not everybody will have all these symptoms. A history of asthma, eczema or hay fever in the family may mean that your chances of developing asthma are slightly higher than those without.
If you suspect that you may have asthma, it is important to see your doctor. Your doctor will discuss your medical history and your current symptoms. She/he may want to measure your peak flow using a peak flow meter. A peak flow meter is a small hand-held device with a marker that slides up and down as you blow into it. The marker stops at the point when you blow hardest. Each time you use the meter (usually morning and evening) the result is marked on a chart. It can help along with keeping a record of your symptoms to give the doctor a better picture of how well controlled your asthma is. The doctor may decide to give you your own peak flow meter on prescription and ask you to keep a diary of readings before seeing him or her again.
Is there a cure for asthma?
Unfortunately, there isn't. However, a lot of extremely important asthma research is being carried out at the moment – much of it funded by the National Asthma Campaign. Researchers are tackling asthma from many directions: indoor and outdoor pollution, allergies, gene therapy, cell biology and chemical structures to name but a few. The results of their work will help us understand much more about how and why this common condition develops. It might also lead to even more effective asthma treatments – and an even better quality of life for everyone who has asthma.
Current research is suggesting that taking certain preventative measures in the home can lessen your chances of developing asthma, or reduce your symptoms. These steps include reducing the amount of dust in your home and can be achieved using simple measures like damp dusting and opening windows.
How is asthma treated?
Medication can come in the form of inhalers and tablets, although currently inhalers are more common. An inhaler ensures that very small amounts of medication are delivered directly into the lungs. There are a variety of inhalers available. It is important that you use a device that you are comfortable with and can use properly. Your doctor or nurse will advise you on the most appropriate device and should demonstrate how to use it correctly.
There are two main types of asthma medication – relievers and preventers.
Reliever inhalers are usually blue. They act by opening up the airways causing the muscles to relax and therefore allowing you to breathe more easily. The reliever should only be used when the symptoms of asthma appear or, if recommended, before exercise. They do not reduce the inflammation in the airways. If you need to use your reliever more than once a day or 3-4 times per week this suggests that there is a degree of inflammation in your airways that requires preventer treatment.
Preventers usually come in brown, red or orange inhalers. They work over a period of time to calm inflammation in the airways and make them less likely to react badly when you come across an asthma trigger. They need to be taken regularly. Most preventers are inhaled corticosteroids. It is important to understand that corticosteroids are not the same as anabolic steroids used by athletes to improve their performance.
There are other types of medication that can be added to your reliever and preventer treatment if needed, such as preventer tablets and long-acting relievers.
Oriental Medicine and Asthma
Definition: In Chinese medicine, asthma is called "xiao chuan, " which means wheezing and dyspnea, respectively. Chinese medicine classifies xiao and chuan as two separate illnesses with different treatments. Xiao (wheezing) is characterized by a whistling sound during breathing, increased respiration rate, dyspnea and inability to rest in a horizontal position. Chuan (shortness of breath) is characterized by dyspnea, constant opening of mouth to grasp air, raised shoulder, flared nostrils and inability to rest in a horizontal position. Patients with xiao (wheezing) generally will have chuan (shortness of breath), while patients with chuan (shortness of breath) may or may not have xiao (wheezing). In Western medicine, wheezing and shortness of breath are both considered as symptoms, which may be present in many different types of pulmonary syndromes such as asthma, acute bronchitis, chronic bronchitis and emphysema.
Etiology: In Oriental Medicine, there are many factors that may trigger an asthma attack. Examples include the invasion of the external pathogenic factors, diet, emotional disturbances, congenital weakness and chronic illnesses.
Pathogenic factors: External pathogenic factors, such as cold or heat, commonly induce asthma attacks. Lung dominates the Qi and manifests on the skin. As the environment affects the skin, the change is reflected in the Lung. As the Lung is attacked, its function to regulate water passage becomes impaired, water begins to stagnate and phlegm starts to form. Asthma attacks due to the invasion of external pathogenic factors are most likely to occur when the temperature is cold or if there is a rapid change in weather. External pathogenic factors may also include pollen, cigarette smoke, and any other allergens.
Diet: Diet can also trigger an asthma attack. Raw and cold food may injure the Spleen and tend to contribute to the stagnation of fluid circulation and the increase in the production of phlegm. Heavy, sweet, and greasy food tends to create phlegm and heat in the body. Fish, crabs, shellfish and other seafood have also been noted to increase the likelihood of asthma attacks as well.
Congenital weakness: Congenital weakness and chronic illness are also common causes of asthma. Children with asthma generally have congenital Kidney Qi deficiency. On the other hand, chronic illness, such as patients with chronic cough and recurrent cold/flu, are likely to have Lung deficiency.
Pathology: The fundamental cause of asthma is the presence of phlegm. In Oriental Medicine, the passage of water is controlled by three organs, namely Lung, Spleen and Kidney. The Lung regulates the water passages in the upper jiao, the Spleen transports and transforms water in the middle jiao, and the Kidney dominates water metabolism in the lower jiao. Imbalance of Yin and Yang in any of these three organs may lead to stagnation of the water circulation, which then contributes to the production and storage of phlegm in the Lung. Storage of phlegm in the Lung becomes the main cause for recurrent asthma attacks.
In addition to the phlegm, chronic asthma will lead to deficiency of Lung, Spleen and Kidney. Deficiency of the Lung creates an inability of the Lung to inhale the air, and deficiency of the Kidney creates an inability of the Kidney to receive or grasp air. This will be complicated further if the Spleen is also deficient and there is an excess amount of phlegm that obstruct the airway. Overall, the condition becomes more and more complicated as the underlying syndrome represents a "deficient" condition and the symptoms an "excess" condition.
Main Points: Feishu UB 13, Lieque LU 7, Fengmen UB 12, Tanzhong REN 17, and Chize LU 5.
Technique: Acupuncture treatment for cold asthma should focus on sedating the Lung and eliminating the phlegm. The points should be sedated and left in place for 30 minutes. Renzhong REN 17 should be stimulated until the needling sensation disperses to both sides of the chest. Chize LU 5 should be needled against the flow of the channel. Feishu UB 13 and Fengmen UB 12 should be sedated for 2 minutes. For best result, cupping may be applied with acupuncture for these two points.
Supplement Points: Shenzhu DU 12 and Dazhui DU 14 may be added for patients with headache and body ache. Yingxiang LI 20 and Shangxing DU 23 may be added for stuffy nose and runny nose.
Asthma Due to Heat
When heat attacks the Lung, the Lung will no longer be able to dominate Qi and control respiration. Patients generally experience a choking sensation, coughing spells and intercostal distention. Patients will also have phlegm as characterized by wheezing, crackling or moist rales, roaring sound in the throat from copious sputum that is thick and difficult to expectorate. Sputum is usually yellow but may be white in some cases where heat is not as prominent. It is common for patients to raise their shoulders to help breathing. Fever, irritability, perspiration, headache, thirst with desire to drink, flushed face, possible fever with aversion to cold are some of the symptoms of asthma due to heat. The tongue is red with yellow greasy coating. The pulse is superficial rapid or wiry.
Asthma Due to Deficiency
It is very common for patients who have recurrent asthma attacks to have Kidney deficiency. When under attack, such patients are said to have "upper excess with lower deficiency." "Upper excess" refers to phlegm stagnation in the Lung and is characterizes by recurrent or continuous wheezing (worsens after exertion), laboured inhalation and smooth exhalation, snoring sound in the throat, low-pitched rhonchi, audible wheezes, shortness of breath, a frail cough with scanty, thin, or frothy sputum, and a dry throat. Lower deficiency refers to Kidney Qi or Yang deficiency and is characterized by difficult inhalation as Kidney cannot grasp and hold the air down. In addition, the patients may also have deficiencies of the Lung and the Spleen. Deficiency of the Lung is characterized by aversion to wind and spontaneous sweating while deficiency of the Spleen is characterized by increased production of phlegm and sputum. Patients may have red cheeks, red tongue with scanty coat. Pulse is thready and rapid.
Asthma and Acupuncture
We all recognize the symptoms of asthma, wheezing, phlegmy rattling - because we all know someone who suffers from it. It occurs as recurrent attacks ranging from mild to life-threatening, and unfortunately, certain forms of it get worse during the seasons many of us enjoy most - spring and summer. Fortunately, relief can be obtained with acupuncture and Chinese herbs.
There are typically two types of asthma, extrinsic and intrinsic - and both will respond to acupuncture. Intrinsic asthma is caused by factors such as chemicals, cold air, exercise, infection and emotional upset. Extrinsic asthma is allergy-related and is triggered by pollens, dust, moulds and animal dander.
During an asthma attack, the walls in the bronchioles of the lungs become swollen, or edematous. The smooth muscles of the walls constrict, narrowing breathing passages, and the bronchioles secrete excess mucus, creating obstructive plugs. During an allergy-related asthma attack, there is an increase of histamine and other inflammatory chemicals in the blood. In intrinsic asthma, there appears to be a hyper excitation of the parasympathetic nervous system. The result in both cases is swelling or edema of the mucosal walls of the bronchioles, increased bronchial smooth muscle contraction, and hyper secretion of bronchial mucus with obstructive mucus plugs.
Studies in China involving acupuncture have shown that needling the acupuncture point St 36 (Zusanli) on a healthy subject increased ventilation capacity by 6.6%. The maximal breathing capacity increased 20%, with a 22% increase in the volume of expiration. Acupuncture appears to act on the nervous system by relieving excitation of the parasympathetic nerves while raising the level of excitation of sympathetic nerves. This causes the bronchioles to expand and mucus membranes to contract, leading to improved breathing. Acupuncture also appears to reduce the level of inflammatory chemicals in the blood, thereby reducing allergic responses.
The effects of acupuncture are cumulative. After a series of treatments, one often notices a reduction in the frequency and severity of attacks. Acupuncture has the effect of strengthening a person's constitution and overall health so that their allergic response is reduced.
Chinese herbal formulas serve as a useful adjunct to acupuncture in relieving asthma. Many asthma formulas contain herbal ephedra (Ma Huang), which has the effect of expanding constricted bronchioles. Other herbs are used to reduce phlegm production, combat infection, and moisten the lungs and astringe coughing. There are many different types of asthma in Chinese medicine, and different herbal formulas are appropriate. It is best to consult a trained practitioner before selecting a formula.
Acupuncture and Asthma and TCM
Asthma, allergy, wheezing and shortness of breath can be addressed with the help of acupuncture and Chinese herbal medicine. In modern day China, this style of individualized treatment is known as TCM, or traditional Chinese medicine.
Asthma is a syndrome of airway inflammation and constriction which affects the patient with cough, wheezing and shortness of breath. Both allergy and viral infections can trigger an asthmatic episode, as well as exposure to directly irritating substances such as smoke and cosmetic fragrances. Cold and exercise-induced asthma have also been described, as has asthma from exposure to salicylates in aspirin and artificial colours and flavours. Asthma and allergy symptoms are increasing in our society, and often require treatment with powerful drugs that can cause a variety of side effects.
Allergy to inhaled pollutants and pollen also contribute to asthmatic diseases. Most modern cities have problems with air quality outdoors, and indoor air is subject to pollution by furnishings, household chemicals, cosmetics and pet dander. Casual use of insecticides, pesticides and herbicides on lawns and food crops, as well as indoor exposures at work and at home, have also affected a number of patients.
Symptoms of allergy and hypersensitivity may affect the body in the sinuses, the airways, the mucous membranes, the lungs or the skin. Some individuals develop problems in all of these areas. Sinus symptoms may include congestion, watery or sticky discharges, pain and pressure. Sinus inflammation can also trigger facial headaches as well as migraine headaches and vascular headaches.
The use of acupuncture and dietary therapy can be very helpful to reduce or eliminate the signs and symptoms of allergic and irritant asthma and sinus disease. Patients report that they can use fewer medications and feel better.
Acupuncture therapy and traditional herbal medicine prepared from different roots, barks, flowers, and fruits, are reasonable alternatives for people to evaluate when they suffer from complex physical disorders like asthma. It is not well known, but emotional stress can also be a factor in asthmatic episodes, and Oriental medicine can also address these issues.
Asthma often is worse at certain seasons and at certain times of day. As with many chronic imbalances, treatment may require an ongoing effort of the patient and physician. Because there are different forms of asthma and each person may have a different imbalance, developing the correct, individualised, approach also takes time. Traditional physicians have learned that the best medicine results from a strong relationship between doctor and patient, with each taking personal responsibility for improving the patient's health.
Experience shows that traditional methods of treatment like acupuncture help to reduce the suffering of common problems like asthma at a reasonable cost. One solution to the many problems facing our medical system today is to look to the success of the past in other cultures.
The clinical observation revealed that the asthmatic symptoms in most of the patients began to be improved after several acupuncture treatments with the dosage of the drug gradually reduced. Generally, the dose of cortisone per os was decreased by 2 mg every 10 days, while that of aerosol was controlled by the patients themselves according to the condition of the disease. The symptoms in most of the patients were markedly improved after 15 treatments, but the treatment should be continued for another 10 times to consolidate the curative effect.
Thus, each asthmatic patient needs to receive approximately 30 sessions of acupuncture treatment, lasting about 3 months. Thereafter, in order to prevent its relapse, the treatment should be administered 10 times each year in the summer season. It is worthy to mention that, by example, there was a female patient who suffered from anaphylactic asthma induced by dog's hair. She received 10 sessions of acupuncture treatment with no improvement. In this case, the acupuncture treatment should not be given any longer.
There were another two child patients aged 5 and 7 years respectively, for them the above method of acupuncture treatment was difficult to use. Therefore, the auricular pressing method combined with cupping was adopted instead.
The auricular points selected were: Shenmen, Lung, Large Intestine, sensitive point, Pingchuan, Subcortex, and Kidney. 5 points were used each time, and pressed with the seeds of Vaccaria, which were changed every 3 days. The patients were asked to press each of the points themselves 3 times a day (each time by 20 pressings). And Dazhui (Du 14), Feishu (UB 13), Pishu (UB 20) and Shenshu (UB 23) were cupped for 5 min. each time. The auricular pressing and cupping therapies may also be added for adult patients to strengthen the curative effect. The 25 cases of hormone dependent bronchial asthma were treated by acupuncture, yielding a markedly effective rate of 56% with a total effective rate of 96%, indicating that good therapeutic results can also be expected in the western countries for those cases that have already been treated with hormones.
Acupuncture – a closing note
Acupuncture as a therapeutic intervention is widely practiced. While there have been many studies of its potential usefulness, many of these studies provide equivocal results because of design, sample size, and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, such as placebos and sham acupuncture groups. However, promising results have emerged, for example, showing efficacy of acupuncture in adult post-operative and chemotherapy nausea and vomiting and in post-operative dental pain. There are other situations such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofacial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma where acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Further research is likely to uncover additional areas where acupuncture interventions will also be useful.
Always seek health advice from your doctor, or local Health Outlet. AcuMedic will be very pleased to offer advice regarding difficulties with this condition. Please see our  Clinic
Please note that although we are confident that our treatments will help the majority of our patients, we cannot absolutely guarantee a cure as the needs and difficulties of each patient can differ greatly
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