Asthma in TCM: A history
In the ancient Chinese text, ‘The Yellow Emperor’s Classic of Chinese Medicine, (Neijing Suwen), in a translation by Ni (1995 p.45), the first mention of asthma is under the chapter of ‘Dysfunction of the Five Zang and Viscera. It states, “If we see a white colour on the face, and at the same time the pulse is rapid, floating and empty, deficient in the upper and excessive in the lower, and the patient has anxiety with spasms, this is because the qi is stuck in the chest. This is asthma and lung deficiency. The lung deficiency is called bi/obstruction of the lungs, and the cause is drinking wine and indulging in sexual activities afterward”.
Ni (1995 p.132-133), continues on the subject of asthma “when one cannot lie flat without experiencing asthma, it is due to water stagnation. Water is normally processed as jin ye and circulated throughout the body before excretion via the kidneys. When the kidneys are diseased and the bladder cannot excrete water stagnates. Then it moves back upward and distresses the lungs and bronchioles. When the patient lies down, the water blocks off the bronchioles, causing asthma. Kidney yang is deficient and cannot transport the water. Yang is depleted through movement, and this is why dyspnoea results from exertion. The lung dominates respiration, while the kidney grasps the qi. In kidney yang deficiency the qi is not grasped and rebels upward, resulting in asthma”.
“In the case of one who wheezes whether sleeping or moving, the kidneys cannot grasp qi and have water stagnation. In conclusion, for both the patient who cannot lie in a prone position without asthma, and the patient who cannot move without asthma, the kidneys are much involved”.
Though there is no differentiation between childhood and adult asthma here most aspects of the current understanding of asthma (such as kidney, spleen, lung, phlegm, anxiety with spasms) are all written here in this ancient text.
Let us now look at two recent studies on asthma to see how effective asthma may be when analysed through western methods of studies.
1. Immunomodulatory Effects of Acupuncture in the Treatment of Allergic Asthma: A Randomized Controlled Study, (Joos et al. 2000, P. 519-525).
In a randomized, controlled study we investigated immunologic effects of Chinese acupuncture on patients with allergic asthma.
Patients and Methods: The effects of acupuncture treatment given according to the principles of TCM were compared with those of acupuncture treatment using points not specific for asthma.
Results: In the TCM group, significantly more patients indicated an improvement in general well-being (79% in the TCM group versus 47% in the control group) after acupuncture treatment.
Conclusion: The results imply that asthma patients benefit from acupuncture treatment given in addition to conventional therapy. Furthermore, acupuncture performed in accordance with the principles of TCM showed significant immune-modulating effects.
2. Acupuncture in children and adolescents with bronchial asthma: a randomised controlled study, (Scheewe et al. 2011, p. 239-246).
Objective: A randomised controlled trial to evaluate the immediate effects of acupuncture as an add-on therapy in in-patient rehabilitation of children and adolescents with bronchial asthma.
Patients and methods: Study based on 46 acupuncture patients and 47 control patients.
In addition to the regular treatment, the participants of the intervention group received a total of 12 acupuncture sessions with duration of 30 min over a period of 4 weeks. The standard acupuncture points were BL 13, REN 17, and LU 7.
Results: With acupuncture, the peak expiratory flow variability differs significantly (p < 0.01) from that of the control patients’ group. Moreover, the acupuncture group differs significantly in their rehabilitation response at the time of discharge concerning perceived anxiety (STAIC-S). The lung function tests do not present differences between groups.
Conclusion: Acupuncture treatment made an improvement of peak expiratory flow variability and anxiety decreased. Acupuncture showed to be an option of potential supportive therapy for relieving symptoms in childhood asthma in the borderline zone of the risk of side effects of inhaled steroids and long-acting beta-2-mimetics.
These two studies show positive results and that acupuncture can be of assistance in the lessening of asthmatic symptoms. Both studies state that more research in the area is required.
In conclusion it can be said that WM and TCM both have similar views on the signs, symptoms and some etiology of paediatric asthma, such as blockage of airways with phlegm, bronchial spasm and obstruction. Both describe the breathlessness and wheezing and anxiety and panic that accompanies an asthma attack, they also agree that there are external and internal causes for this disease, for example allergens and heredity.
Currently asthma in children and adults is prevalent in the West and is on the increase in developing countries. Childhood and adult asthma have similar signs and symptoms but can have different etiologies; an example is that TCM childhood asthma may involve immunisations and accumulation disorder. Childhood asthma is more likely to resolve with treatment than adult asthma.
Treatment of asthma by WM involves primarily bronchodilators and steroids, which in TCM terms may acerbate the disease.
Asthma is recognised and discussed in the ancient TCM texts including the ‘The Yellow Emperor’s Classic of Chinese Medicine’. The modern treatment of both paediatric and adult asthma has evolved from these texts, and current studies show that this ancient medicine still can benefit asthma sufferers today.
Joos, S, Schott, C, Hua, Z, Volker, D, Eike, M 2000, ‘Immunomodulatory Effects of Acupuncture in the Treatment of Allergic Asthma: A Randomized Controlled Study, PubMed (Online), Dec; 6(6):519-25., viewed 19 October 2013, <http://www.ncbi.nlm.nih.
go/pubmed/11152056>
Ni, M 1995, The Yellow Emperor’s Classic of Medicine: a new translation of Neijing Suwen with commentary/Maoshing Ni, 1st edn, Shamballa Publications, Inc., Boston, MA.
Scheewe, S, Vogt, L, Minakawa, S, Eichmann ,S, Welle, S, Stachow, R, Banzer, W 2011, ‘Acupuncture in children and adolescents with bronchial asthma: a randomised controlled study’, PubMed (Online), Oct;19(5):239-46. doi: 10.1016/j.ctim.2011.07.002. Epub 2011 Aug 26, viewed 23 October2013, <http://www.ncbi.nlm.nih.gov/pubmed/21944653>
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