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Allergies

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Allergies

Introduction

Allergic rhinitis is the inflammation of the nasal mucous membrane. The causes are usually air-borne allergens, such as dust, feathers, molds, animal fur, etc. According to its clinical features, allergic rhinitis may be classified into two types: perennial allergic rhinitis and seasonal allergic rhinitis (also known as hay fever). The main symptoms are paroxysmal nasal itchiness, nasal obstruction, watery nasal discharge, and sneezing. Some patients also experience acute conjunctivitis with lacrimation and itching.

Etiology/Pathogenesis

Allergic rhinitis has various causes and the pathogenesis is rather complicated. Scholars/practitioners have attempted to explain the disease's mechanism based on their own clinical experiences. For example, Wu argues that the disease is closely related to phlegm. Based on TCM's theory of differentiation of symptoms and signs, the disease may be divided into three syndromes: 1) deficiency of the lung and retention of phlegm, 2) deficiency of the spleen-yang, and 3) deficiency of the kidney-yang. (1) Yang, et al., on the other hand, argues that the fundamental pathogenesis of allergic rhinitis is deficiencies of the lung, spleen, and kidney. Other factors that play a role include weakened superficial resistance, pathogenic wind, and interior heat and dampness. (2) Hence the principle for treating the disease should be to reinforce qi and regulate blood, and to dispel and warm wind, while clearing away heat and ridding dampness.

Primary Treatments with Chinese Medicinal Herbs

Xin Qin Ke Li

Ingredients: Xi Xin (Wild Ginger), Huang Qi (Astragalus Root), Cang Er Zi (Xanthium), Jing Jie (Schizonepeta), and Bai Zhu (White Atractylodes)

Clinical Application:
The formula is used to treat allergic rhinitis, chronic paranasal sinusitis, and the common cold. Zhao used a semi-conductor laser therapeutic apparatus in combination with this formula to treat 40 cases of allergic rhinitis, and reported a total effective rate of 97.5%. (3) Li treated 32 cases of allergic rhinitis with this formula and achieved satisfactory results. (4) To study the effect of this formula on allergic rhinitis using a larger sample, eight hospitals in Shanghai, China, treated 367 cases of allergic rhinitis with this formula, and reported a total effective rate of 80.1%. (5)

Other Treatments with Chinese Medicinal Herbs

Xiao Chai Hu Tang

Liu treated 65 cases of allergic rhinitis with the herbal formula Xiao Chai Hu Tang. A control group was treated with chlorphenamine. The following tests were done on both groups before and after their respective treatments: allergen nasal mucosa provocation test, blood eosinophil count, nasal discharge eosinophil count, and measurement of IgA and IgE in nasal secretions. The data showed that there were statistically significant differences (p

Xiao Qing Long Tang

Pan, et al. treated 30 cases of allergic rhinitis with Xiao Qing Long Tang, and obtained good therapeutic results. After 3-10 days of treatment, 21 cases showed full recovery, 7 cases improved, 2 cases with no response. The total effective rate was 93.3%. The Chinese medicinal formula used in the therapy consists of Ma Huang (Ma-Huang), Gui Zhi (Cinnamon Twig), Bai Shao (White Peony Root), Gan Jiang (Ginger), Xi Xin (Wild Ginger), Wu Wei Zi (Schizandra), Ban Xia (Pinella), Gan Cao (Licorice), Cang Er Zi (Xanthium), Bai Zhi (Angelica), and Xin Yi (Magnolia). The above single herbs were decocted in water for oral administration, and taken one dose per day. (6)

Dang Gui Yin

Ge, et al. treated allergic rhinitis with Dang Gui Yin. The formula contains: Dang Gui (Dang Gui), Chuan Xiong (Cnidium), Bai Shao (White Peony Root), Sheng Di (Rehmannia Root), Jing Jie (Schizonepeta), Fang Feng (Siler), Bai Ji Li (White Tribulus), Zhi Shou Wu (processed Fleece-flower Root), Huang Qi (Astragalus Root), and Gan Cao (Licorice). Modifications were made to suit patients' particular conditions. Of the 72 cases treated, 52 cases significantly improved; 15 cases improved; and 5 cases with no response. The total effective rate was 93%. A follow-up conducted one year after the treatment found no relapses for 25 cases. (7)

Bi Min Shu San

Yu, et al. treated 116 cases of allergic rhinitis with Bi Min Shu San. The formula consists of He Shou Wu (Fleece-flower Root), Han Lian Cao (Eclipta), Xin Yi Hua (Magnolia Flower), Ku Shen (Sophora Root), Wu She (Zaocys), Wu Mei (Mume), Fang Feng (Siler), Xi Xin (Wild Ginger), and Gan Cao (Licorice). Of the 116 cases treated, 77 had their clinical symptoms under control, 19 cases showed significant improvement, 9 cases showed improvement, and 11 cases with no response. The total effective rate was 90.52%. (8)

Yi Qi Kang Min Chong Ji

Ma, et al. treated 56 cases of perennial allergic rhinitis with Yi Qi Kang Min Chong Ji, a formula containing: Huang Qi (Astragalus Root), Bai Zhi (Angelica), Fang Ji (Stephania), Wu Mei (Mume), and Gan Cao (Licorice), etc. A control group was treated with chlorphenamine. The effective rate for the treatment group was 86.7%, slightly higher than that of the control group, but without statistical significance. However, the difference in the improvement in pulmonary ventilation function between the two groups was significant (P

Other Treatments

Hao, et al. applied auricular point sticking therapy to treat 37 cases of allergic rhinitis. The following otopoints were treated: Liver, Fengxi, Shenmen, Internal Nose, External Nose, and Adrenal Gland. Vaccariae seeds were stuck at these points. Patients were asked to press the stuck seeds by themselves three times a day, 3 minutes each time. After 1-2 courses of treatment, 16 cases fully recovered, and 21 cases significantly improved. The total effective rate was 100%. (9)

An treated 62 cases of allergic rhinitis with acupoint injection. After routine disinfection of the skin, a syringe with a No. 5 needle was slowly punctured perpendicularly to a depth of 1 cun at point Da Zhui (D14), and 1 ml (2mg) of dexamethasone was slowly injected into the tissue. Of the 62 cases treated, 47 cases showed significant improvement, 15 cases showed some improvement. The total effective rate was 100%. (10)

Zou treated 64 cases of perennial allergic rhinitis with massage. He pushed and pressed the neck muscles with thumbs, until a warming sensation was felt. Then he pressed with fingers at points Fengchi (G20), Fengfu (Du16), Jianjing (G21), and Tianzong (SI11) until a pronounced local sensation of soreness was felt. A control group was treated with astemizole orally, 10 mg per day before going to bed. One month constitutes a treatment unit. After 2 treatment units, of the treatment group, 12 cases showed full recovery, 44 cases showed some effect, and 8 cases showed no response. The total effective rate was 87.50%. Of the control group, 4 cases showed full recovery, 40 cases showed improvement, and 20 cases showed no effect. The total effective rate was 75%. The difference was statistically significant (P

Acupunture & Acupressure

Acupuncture Treatment
Chen treated 35 cases of allergic rhinitis with acupuncture and reported satisfactory results. The acupuncture needle was inserted at acupoint Yintang (EX-HN3), with tonification achieved by lifting, thrusting and twirling the needle until the needling sensation was felt from the tip of the nose to the nasal cavity. The needle was retained for 20 minutes. All the patients received treatment once a day with ten days as one treatment course. After one or two courses of treatment, 12 cases were fully recovered, 14 cases significantly improved, 6 cases improved, and 2 cases with no response. The total effective rate was 94.1%. (11)

Liu, et al. applied acupuncture and moxibustion to treat allergic rhinitis. Needles were first inserted into both sides of the following points: Yingxiang (LI20), Yintang (EX-HN3), Feishu (B13), Taiyuan (L9), and Zusanli (S36). The needling method was as follows: first, puncturing obliquely at point Yingxiang (LI20), and puncturing subcutaneously downward until needling sensation was felt and reached the tip of the nose and the nasal cavity; then, needling at Feishu (B13), Taiyuann (LU9), and Zusanli (S36) with tonification by lifting, thrusting and twirling the needles, and retaining the needles for 30 minutes; while the needles were retained, moxibustion with moxa sticks was used at Yingxiang (LI20) and Yintang (EX-HN3) alternately for 15 minutes. The results: among 35 cases treated, 12 cases showed full recovery, 15 cases showed significant improvement, 6 cases showed improvement, and 2 cases showed no response. The total effective rate was 94.2%. (12)

Combined Modality Therapy
Wen combined auricular point sticking and warm needling therapies to treat 50 cases of allergic rhinitis. The following otopoints were selected to receive treatment: Lung, Internal Nose, External Nose, Adrenal Gland, Endocrine, Hypersensitivity Area, Spleen, Kidney, and Shenmen. At the selected otopoints and alternating ears, a paste made of Semen Vaccariae was applied and kept in place for between 2-3 days. A unit of treatment called for applying the paste ten times. The warm needling therapy called for puncturing subcutaneously at point Feishu (B13) with a 1.5 cun (1 cun=33 1/3 milimeters) filiform needle, connecting the needle with a needle-warming apparatus, and retaining the needle for 30 minutes. One unit of treatment consisted 10 needling sessions. After 1-3 units of treatment, 23 cases fully recovered, 22 cases significantly improved, and the remaining 5 cases improved. The total effective rate was 100%. (13)

Yu, et al. treated 30 cases of allergic rhinitis with a combination of acupuncture and massage therapy. Yingxiang (LI20) and Biyuan were selected as the main acupoints to receive treatment. Acupuncture and massage were alternated at each acupoint every other day. In addition, acupoints Feishu (B13), Hegu (LI4), Zusanli (S36) were punctured once daily. Of the 30 cases treated, 5 cases fully recovered. 21 cases improved, and the remaining 4 cases showed no response. The total effective rate was 86.7%. (14)

References

  1. Wu Cheng Shan. Shaanxi Journal of TCM. 1996;17(12):544-545.
  2. Yang Zai Gang, et al. Journal of Guiyang Colledge of Chinese Herbs. 1989;(2):22-24.
  3. Zhao Gui Lan. China Journal of Integrated Otorhinolaryngology. 1999;7(3):148.
  4. Li Qi Qing, et al. Journal of Anhui College of TCM. 1995;14(4):35.
  5. Shanghai Journal of TCM. 1984;(7):20.
  6. Pan Feng Jun, et al. Inner Mongolia Journal of TCM. 1998;17(4):14-15.
  7. Ge Ying Ye, et al. Sichuan Journal of TCM. 1999;17(2):486.
  8. Yu Tian Ying, et al. Xinjiang Journal of Traditional Chinese Medicine. 1999;17(3):37-38.
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  10. An Chang. Xinjiang Journal of Traditional Chinese Medicine. 1999;17(1):39-40.
  11. Chen De Cheng. China Journal of Acupuncture. 1998;18(6):360.
  12. Liu Lan, et al. Journal of Traditional Chinese Medicine. 1999;27(1):52.
  13. Wen Rui Hua. China Journal of Acupuncture. 1998;18(6):361.
  14. Yu Xue ping, et al. China Journal of Acupuncture. 1998;18(6):361.