The description of asthma symptoms could date back to as early as the era of Huangdi Neijing (The Inner Canon of Huangdi) in China. Unfortunately, ancient theories on herbs for asthma vary from doctor to doctor in history, as far as the pathogenesis and remedies are concerned. Similarly, the same flat learning curve goes to the counterpart in the western world too. In comparison, multiple similarities would be found easily between them. So, identifying the mutual limitations would be extremely useful for improving both of them from the definition to the final cures.
What is asthma?
The understanding about this disease between west and east is quite different. Here are the brief introductions from the perspectives of both west medicine and Traditional Chinese Medicine (TCM).
Define asthma and allergies in west viewpoint
Currently it is widely believed that bronchial asthma is induced by environmental and host (genetic) factors. Genetics present well in many patients suffering from asthma attack by a higher risk in their relatives as well. Actually survey data has shown that others with biological ties are much easier to be attacked. Most of them, often accompanied with allergic rhinitis and atopic dermatitis, are allergic to some certain medicine, common airborne allergens like mites, pollens, pets, molds, and some certain foods like nuts, milk, peanut, and seafood, etc. Unfortunately, tell you the facts that up to this day the causes still remain not fully known. However, some have been proven are allergic reaction, chronic airway allergic inflammation (AAI), airway hyperresponsiveness (AHR) or Bronchial hyperresponsiveness (BHR), disorder of nervous regulation in the airway, epigenetic mechanism, respiratory syncytial virus, neural signal transduction mechanisms, and airway remodeling and the interactions, etc.
Understand what causes asthma from TCM
The name of Xiao Chuan was initially introduced in Dan Xi Xin Fa (Zhu Danxi’s Central Methods, literally, “heart” methods). But similar terms describing the symptoms, like abnormal rising of Qi and gasp, were way earlier in Huangdi Neijing (The Inner Canon of Huangdi). Chinese medicine believes that the root cause lies in deficiency combined with underlying chronic phlegm in lung. On top of exogenous pathogenic attacks, eating disorders, disorders in minds and emotions, and overstrains causing internal damage, it will lead to retention of phlegm in airway and adverse rising of lung Qi, which in turn induce these symptoms and signs. Clinically it divides into the attack stage and chronic remission stage (symptom-free for very long periods), in which different herbs for asthma should be used respectively.
Treatments of asthma
Modern and traditional treatments for this disease are quite different at first sight. But after going into it a little bit deeper, you will find that actually they see eye to eye on many levels. Modern medicine achieves remarkable growth on researches of allergies, bronchial spasm, inflammation, and cell adhesion molecules. And Zhu Danxi advocated strengthening vital Qi as priority in chronic remission stage while purgating the pathogenic Qi in the attack stage. What’s more, he also mapped out the therapeutic principles like symptomatic treatment in acute condition, radical treatment in chronic case, and treating both manifestation and root causes in between, which have something similar to classification and long term stewardship in modern medicine.
Dispel pathogenic wind and antianaphylaxis
Earlier modern medicine came up with the notion of immunoglobulin E (IgE) and underlined the importance of antianaphylactic treatment. Researches in west believe that specific allergy related Immunoglobulin E (IgE) would be produced in plasmocyte of respiratory tract’s mucosa after initially contacting allergens, which makes the body sensitised. Contacting antigen again would induce immediate allergic reaction and thus asthma. Honestly, there is no such a concept of allergy at all in Chinese herbal remedies but the associated one is wind pattern. Its sudden, paroxysmal and repetitive properties are coincided with mobility and changeableness in wind. Being the primary pathogen, wind comes from vicious Qi in nature and imbalance in body’s zang-fu viscera, Qi blood, and Yinyang. Now the pharmacological studies show that wind-dispelling herbs improve cellular immune function, reduce body’s stress response to allergens, fight off histamine, and resist anaphylaxis inflammation, etc.
Regulate Qi and attenuate airway hyperresponsiveness
Modern medicine went through a few phases to understand this disease well, like inhalers, receptor (asthmatic attack induced by loss of balance between AMP/cGMP and PGF2α/PGE2), and then airway hyperresponsiveness (AHR). Airway hyperresponsiveness (AHR) is such the major feature that attenuation is one of the vital cures. TCM alternative medicine holds the view that the attacks are mainly caused by jamming lung Qi, breach of duty of dispersing and descending lung Qi, and reversed flow of Qi upwardly.
Transform phlegm and eliminate chronic airway allergic inflammation
In recent years people come to realize that chronic airway allergic inflammation is the basic pathology, which present with a variety of inflammatory cellular infiltrate especially eosnophils, thickening of lung airway walls, mucosal hyperemia and edema, airway stenosis and spasm, epithelial cell injury and loss, and increasing capillary exudation and producing mucus secretion. Obviously the exudation, secretion, and castoff cells are the main sources of phlegm. So, modern medicine believes that anti-inflammatory therapy, glucocorticoids and inhalers, is the radical cure. In TCM, the corresponding herbs-for-asthma treatment rules are transforming phlegm, adopting different phlegm-clearing methods according to the specific properties.
Remove blood stasis and anti-adhesive molecules
TCM believes that chronic diseases would transform to collaterals and result in blood stasis in the end, which is also one of important causes of asthma. In the west, the finding of cell adhesion molecules was once viewed as the fourth milestone for asthma cures following allergies, bronchial spasm, and inflammation theories. In addition, today’s research shows that herbs for promoting blood circulation perform well on multiple tasks, such as to dissolve fibrin in sputum, improve microcirculatory diaturbance and inflammatory lesions, inhibit platelet adhesion and aggregation and synthesis of thromboxane A2, fight inflammation and allergies, stabilize the mast cell membrane, eliminate mucosa edema, repair epithelial injury, remodel airway, and clear oxygen free radicals, etc.
Tonics and body immunity function
Many TCM practitioners advocate strengthening and consolidating body resistance through tonifying lung, spleen and kidney. This is because this condition goes through a process from excess to deficiency, presenting a decline in lung function and weakness of immune system. The changes of lung Qi affect the wax and wane of defensive Qi, nutrient Qi, and primordial Qi. Lung is the host of Qi while kidney the root of Qi so that chronic asthma is bound to implicate kidney. Therefore, tonifying these three zangs is the priority in order to get rid of it from the root.
Chinese herbs for asthma
Common asthma herbs, in adults and in children, are as follows based on different TCM patterns.
(1). Jamming lung heat
Shi Gao (Gypsum), Ma Huang (Ephedra), Xing Ren (Apricot Seed), Huang Qin (Baical Skullcap Root, Scutellaria), Sang Bai Pi (Mulberry Root Bark), Ting Li Zi (Descurainia Seeds), Niu Bang Zi (Great Burdock Fruit, Arctium), Qian Hu (Hogfennel Root), Di Long (Earthworm), Yu Xing Cao (Houttuynia), Ma Dou Ling (Birthwort Fruit), Pi Pa Ye (Loquat Leaf), Jin Qiao Mai (Rhizoma Fagopyri Cymosi), Gua Lou (Trichosanthes Fruit), Hai Ge Ke (Clam Shell), Xuan Fu Hua (Inula Flower), Bai Qian (Cynanchum Rhizome), and Ling Yang Jiao (Antelope Horn).
(2). Cold fluid retained in lung
Ma Huang (Ephedra), Gan Jiang (Dried Ginger Root), Xi Xin (Chinese Wild Ginger), Gui Zhi (Cinnamon Twig), Su Zi (Purple Perilla Fruit), Chen Xiang (Aloeswood), Wu Wei Zi (Schisandra Fruit/Seed), Hou Po (Magnolia Bark), Rou Gui (Dried Cinnamon Bark), and Ci Shi (Magnetite).
(3). Turbid phlegm obstructing lung
Chen Pi (Tangerine Peel), Ban Xia (Pinellia Rhizome), Fu Ling (Poria, China Root), Su Zi (Purple Perilla Fruit), Bai Jie Zi (White Mustard Seed), Lai Fu Zi (Radish/Turnip Seeds), Xuan Fu Hua (Inula Flower), Zao Jia (soap pod or gleditsia fruit), and Bai Qian (Cynanchum Rhizome).
(4). Dyspnea due to deficiency of lung and kidney
Ren Shen (Ginseng Root), Ge Jie (Gecko), Dong Chong Xia Cao (Cordyceps), Hu Tao Ren (Walnut Nut), Wu Wei Zi (Schisandra Fruit/Seed), Bu Gu Zhi (Psoralea Fruit), Zi He Che (Dried Human Placenta), Shan Yu Rou (Asiatic Cornelian Cherry Fruit), Chen Xiang (Aloeswood), Ci Shi (Magnetite), Zhong Ru Shi (Stalactite, Calcite), He Zi (Myrobalan Fruit, Terminalia, Chebula), Liu Huang (Sulphur), and Hei Xi (Plumbum).