Obstructive emphysema refers to the expansion of the distal part of terminal bronchioles (including respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli), accompanied by destruction of alveolar walls. It is induced by factors such as atmospheric pollution, smoking, and chronic lung infections, leading to chronic bronchitis, which further develops into this condition. Bronchial asthma and pulmonary fibrosis can also gradually evolve into this disease. This condition falls under the category of “asthma” in traditional Chinese medicine, specifically “deficient asthma.”
[Clinical Manifestations]
1. Long-standing history of coughing and phlegm, symptoms often worsen in winter. As the disease progresses, gradually developing shortness of breath, breathlessness, and chest tightness, exacerbated by exertion.
2. When complicated with acute respiratory infection, coughing, phlegm, and shortness of breath rapidly worsen, possibly accompanied by breathing difficulties, cyanosis, and pulmonary hypertension.
3. In advanced stages, respiratory failure and right heart failure may develop.
[Diagnosis]
1. Middle-aged or elderly individuals over 40 years old with a history of chronic cough and wheezing, showing progressively worsening signs such as shortness of breath, breathing difficulty, and cyanosis.
2. Barrel-shaped chest, hyperresonance on percussion, downward displacement of liver dullness border, weakened breath sounds and speech sounds, prolonged expiration, and occasionally dry or wet rales heard bilaterally. Cardiac dullness border decreases, heart sounds are dull and distant.
3. X-ray examination: increased transparency in both lungs, fine and sparse vascular markings in the outer lung fields. Heart shadow is vertically narrow and elongated, diaphragmatic dome flattened.
4. Pulmonary function testing: residual volume/total lung capacity exceeds 35%. First-second forced expiratory volume/forced vital capacity less than 60%, or maximum voluntary ventilation below 80% of predicted value. Uneven gas distribution, alveolar gas concentration higher than 2.5%.
5. This condition should be differentiated from diffuse pulmonary interstitial fibrosis, chronic pulmonary heart disease, and other diseases.
[Treatment]
Traditional Chinese Medicine Treatment
(1) Deficiency of Lung, Spleen, and Kidney Qi and Yin: shortness of breath, exacerbated by movement, breathlessness, coughing, little sticky phlegm, dry mouth, hot palms and soles, spontaneous sweating, night sweats, pale red tongue with little coating, fine, rapid, and weak pulse.
Treatment: Tonify lung, strengthen spleen, nourish kidney, tonify qi, and nourish yin.
Formula: Tai Zi Shen 15g, Mai Dong 30g, Wu Wei Zi 10g, Shu Di 15g, Shan Yu Rou 15g, Shan Yao 15g, Dan Pi 10g, Fu Ling 30g, Ze Xie 10g, Bai He 30g, Sheng Huang Qi 30g, Dan Shen 30g, Chuan Bei Fen 6g (taken orally).
Patent Medicine: Mai Wei Di Huang Wan, Sheng Mai Oral Liquid.
(2) Deficiency of Lung, Spleen, and Kidney Yang: long-standing shortness of breath, inhaling longer than exhaling, worsened by exertion, clear and thin phlegm, cold aversion, fatigue, lower back and knee soreness, facial and limb edema, bluish-gray lips, pale tongue with white coating, deep, fine, and weak pulse.
Treatment: Tonify lung, strengthen spleen, warm kidney, collect qi, and relieve asthma.
Formula: Ren Shen 10g, Bai Zhu 10g, Sheng Huang Qi 30g, Fu Ling 15g, Shu Fu Zi 6g, Shu Di 15g, Shan Yu Rou 15g, Shan Yao 15g, Dan Pi 10g, Fu Ling 15g, Ze Xie 10g, Xian Ling Pi 10g, Zi He Che 10g, Dan Shen 30g, Mai Dong 30g, Chuan Bei Fen 6g (taken orally).
Patent Medicine: Bai Ling Capsule, Jin Kui Shen Qi Wan.
(3) During infection phase, treat as acute bronchitis with syndrome differentiation.
(4) Traditional Chinese Medicine Formulas and Acupuncture Treatment
① 50g of American Ginseng, 2 pairs of Gecko, 30g of Winter Worm, 10g of Saffron, 50g of Fritillary Bulb, ground into powder and placed in capsules, 3–4 capsules per dose, 3 times daily. Used for preventive treatment.
② Moxibustion: Select Lung Yu, Ge Shu, Pi Yu, and Shen Yu points, use ginger-separated moxibustion, 3–5 moxa cones per point, once daily.
[Prevention and Care]
1. Engage in physical exercise and respiratory training.
2. Avoid catching colds and emotional stress.
3. Avoid smoking, alcohol, rich food, and exposure to irritating gases.
4. Cook porridge with red dates, yam, lily bulbs, and walnut kernels.
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