Respitrol (Cold) ™
* Respiratory disorders with cold manifestations: wheezing, dyspnea, shortness of breath, coughing
* Wind-cold or Lung cold with sinus congestion, sneezing, watery eyes, and watery or white nasal discharge, white sputum
* Wheezing and/or dyspnea with intolerance to cold (temperature, food or drinks), grayish and cyanotic complexion of the face and body, chills, and absence of perspiration
* Used as immediate relief for sneezing and clear nasal discharge in people who are exposed to cold weather (i.e., rain or snow) or cold water (i.e., swimmers or divers)
WESTERN THERAPEUTIC ACTIONS
* Bronchodilating and antiasthmatic effects to relax the bronchial smooth muscle and relieve wheezing and dyspnea
* Antitussive effect to suppress cough
* Expectorant effect to eliminate phlegm
* Antibiotic action to treat bacterial and viral infections in the respiratory tract
CHINESE THERAPEUTIC ACTIONS
* Dispels cold, warms the interior
* Eliminates phlegm
* Regulates qi circulation to relieve wheezing and dyspnea
Take 4 to 6 capsules three times a day with warm water on an empty stomach. For maximum effectiveness, start taking Respitrol (Cold) with the first sign of respiratory discomfort.
Bai Shao (Radix Paeoniae Alba)
Cang Er Zi (Fructus Xanthii), dry fried
Gan Jiang (Rhizoma Zingiberis)
Gui Zhi (Ramulus Cinnamomi)
Hou Po (Cortex Magnoliae Officinalis)
Jie Zi (Semen Sinapis)
Ku Xing Ren (Semen Armeniacae Amarum)
Pi Pa Ye (Folium Eriobotryae)
Wu Wei Zi (Fructus Schisandrae Chinensis)
Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle)
Zi Su Zi (Fructus Perillae)
Zi Wan (Radix et Rhizoma Asteris)
Lung inflammation and infection are two conditions that often occur together. Lung inflammation refers to the swelling of airways causing symptoms such as wheezing, dyspnea, chest tightness, cough, and presence of phlegm. Lung infection refers to invasion of the respiratory tract by micro-organisms such as bacteria, viruses, and fungi. If these lung inflammation and infection disorders are not properly treated, then the lung’s structures and functions will be adversely affected, causing conditions such as mucus hypersecretion, mucus plugging, mucosal edema, loss of elasticity in the airways, peribronchial fibrosis, enlarged alveolar space, and loss of airway support. Chronic lung inflammation and infection with compromised functions and structures is generally described as Lung cold in traditional Chinese medicine.
Respitrol (Cold) is formulated to treat cold-type respiratory disorders, including but not limited to, chronic asthma, chronic obstructive pulmonary disease, bronchitis, pneumonia, and inflammation and infection of the respiratory tract. Diagnostic signs and symptoms of cold include chills, clear watery nasal discharge, sneezing, intolerance to cold, absence of fever, and grayish and cyanotic complexion of the face and body. Respitrol (Cold) contains herbs with functions to dispel cold, warm the interior, eliminate phlegm, and regulate qi circulation.
In this formula, Ku Xing Ren (Semen Armeniacae Amarum) and Hou Po (Cortex Magnoliae Officinalis) eliminate phlegm, transform congested fluids, and reduce wheezing. Zi Wan (Radix et Rhizoma Asteris) expels wind and relieves dyspnea, chest discomfort, and wheezing. Gui Zhi (Ramulus Cinnamomi) works synergistically with Bai Shao (Radix Paeoniae Alba) to tonify and harmonize the qi in the wei (defense) and ying (nutritive) levels. Due to cold, water metabolism of the Lung may be impaired leading to a sudden blockage of fluids in the upper jiao. Gan Jiang (Rhizoma Zingiberis), Jie Zi (Semen Sinapis), Zi Su Zi (Fructus Perillae) and Cang Er Zi (Fructus Xanthii) warm the Lung, dispel the cold factor, arrest wheezing, and move water by regulating the qi flow of the Lung. Wu Wei Zi (Fructus Schisandrae Chinensis) is used to protect the Lung by preventing the leakage of qi. Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle) and Bai Shao (Radix Paeoniae Alba) relieve bronchial spasms, alleviate pain, and harmonize the formula.
CAUTIONS & CONTRAINDICATIONS
* This formula is contraindicated during pregnancy and nursing.
* Patients with severe or acute asthma attacks may need additional herbal or drug treatment.
* Patients with heat- or deficient-type respiratory disorders should use Respitrol (Heat) or Respitrol (Deficient), respectively. See Supplementary Formulas for maintenance treatment of respiratory disorders.
* The Cang Er Zi (Fructus Xanthii) used in this formula has been carefully dry fried at high temperature until they appear dark brown or slightly charred, as dictated by the Chinese Materia Medica. Dry frying is necessary because this process simultaneously increases the effect [by enhancing the extraction of active compounds] and decreases the side effects [by destroying the undesired glycosides]. Nonetheless, because Cang Er Zi (Fructus Xanthii) is metabolized by the liver and eliminated by the kidneys, individuals with pre-exiting liver or kidney diseases should not take this formula.
* Respitrol (Heat) or Respitrol (Cold) should be taken for respiratory disorders with wheezing, dyspnea, and shortness of breath. When the condition stabilizes, use Respitrol (Deficient) and Cordyceps 3 during the remission stage of chronic respiratory disorders to strengthen the underlying constitution of the patient. Respitrol (Deficient) should not be taken during the acute stage of any respiratory disorder. Furthermore, Cordyceps 3 is also very beneficial to strengthen the Lung and the Kidney, the two organs that are responsible for controlling respiration. Therefore, it is extremely important to ensure that the patient is compliant with taking Respitrol (Deficient) and/or Cordyceps 3 to reduce the frequency and severity of asthma attacks.
* Respitrol (Cold) is suitable for common cold or influenza due to wind-cold. However, if the wind-cold transforms into wind-heat or Lung heat, Lonicera Complex or Respitrol (Heat) should be used, respectively.
* In cases where the patient is having an acute attack and the medication or inhaler is not readily available, two cups of coffee, hot cocoa, and chocolate bars are good alternatives to help alleviate symptoms of wheezing or dyspnea. Caffeine has a similar effect as the popular asthma drug theophylline.
Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:
* Pulse within a pulse or a constricting pulse, a pulse in which it feels like there is a bundle of thin, straight tight wires within the artery, on the right cun.
* Yangwei pulse, a pulse extending distally from the right cun towards the thumb. It is one of the eight extra meridian pulses.
* For allergies, sinus headache, nasal obstruction, and white watery nasal discharge, combine with Magnolia Clear Sinus.
* For allergies, sinus headache, nasal obstruction, and sticky yellow nasal discharge, combine with Pueraria Clear Sinus.
* For coughing, add Respitrol (CF).
* For infection of ear, nose, and throat, add Herbal ENT.
* To enhance the overall antibacterial function, add Herbal ABX.
* To enhance the overall antiviral function, add Herbal AVR.
* For profuse, thick, yellow phlegm with chest congestion, combine with Pinellia XPT.
* With more underlying damp and phlegm accumulation with Spleen qi deficiency, add Pinellia Complex.
* For thirst, dry mouth and throat, add Nourish (Fluids).
* Immune + can be used as a maintenance formula for patients with underlying Lung deficiency manifesting in a weak immune system, recurrent colds and flu triggering asthma attacks.
* To tonify the overall constitution of the body, take Imperial Tonic on a daily basis.
* Fengfu (GV 16), Fengchi (GB 20), Hegu (LI 4), Geshu (BL 17), Lieque (LU 7), Qihu (ST 13), Zhongfu (LU 1)
* Apply moxa to Dingchuan (Extra 6), Gaohuang, and Feishu (BL 13)
Classic Master Tung’s Points:
* Dingke (T 44.28)*, Dajian (T 11.01), Zhongjian (T 11.05), Linggu (T 22.05), Dabai (T 22.04), Renshi (T 33.13), Dishi (T 33.14), Tianshi (T 33.15), Shuitong (T 1010.19), Shuijin (T 1010.20), Zhenjing (T 1010.08), Libai (T 44.12), Yunbai (T 44.11). Bleed Sihuawai (T 77.14) or nearby dark veins. Bleed before needling for best result.
* Chest stuffiness: Linggu (T 22.05), Dabai (T 22.04), Tianshi (T 33.15), Dishi (T 33.14), Renshi (T 33.13), Zhenjing (T 1010.08), Shangli (T 1010.09)
Master Tung’s Points by Dr. Chuan-Min Wang:
* Common cold, flu
§ Cold type: Needle Fenjin (T 44.01), Huofuhai (T 33.07). Bleed Ganmaosan (T DT.12).
§ Heat type:Needle Dabai (T 22.04), Linggu (T 22.05), Sanchasan (T 22.17)*. Bleed Wuling (T DT.04).
§ Kidney type: Shuitong (T 1010.19), Shuijin (T 1010.20)
§ Heart type: Renshi (T 33.13), Dishi (T 33.14), Tianshi (T 33.15)
§ Lung type: Simazhong (T 88.17), Simashang (T 88.18), Simaxia (T 88.19)
Balance Method by Dr. Richard Tan:
* Left side: Shugu (BL 65), Jiexi (ST 41), Zusanli (ST 36), Jingqu (LU 8)
* Right side: Gongsun (SP 4), Sanyinjiao (SP 6), Hegu (LI 4)
* Left and right sides can be alternated from treatment to treatment.
* Bronchi, Lung, Adrenal Gland, Prostate Gland. Apply ear seeds to these points on both ears.
Auricular Medicine by Dr. Li-Chun Huang:
* Bronchial asthma: Bronchus, Trachea, Lung, Chest, Stop Asthma, Sympathetic, Adrenal Gland, Allergic Area, Endocrine. Bleed Ear Apex.
* Common cold: Lung, Internal Nose, Throat (Larynx, Pharynx)
§ For fever, bleed Ear Apex and Helix 1 to 6.
§ For dizziness, add Dizziness Area.
§ For pain and soreness all over the body, add Liver and Spleen. Bleed Helix 4.
§ For cough, add Trachea, Bronchus, and Stop Asthma.
* Bronchitis: Bronchus, Trachea, Lung, Spleen, Stop Asthma, Sympathetic. Bleed Ear Apex.
* Bronchiectasis: Bronchus, Lung, Chest, Stop Asthma, Allergic Area, Sympathetic, Adrenal Gland, Spleen
* Emphysema: Sympathetic, Allergic Area, Chest, Lung, Bronchus, Stop Asthma, Spleen, Kidney, Endocrine
* Cough: Trachea, Bronchus, Lung, Shenmen, Occiput, Stop Asthma, corresponding points of pain. Bleed Ear Apex.
* Eliminate all cold and raw foods and beverages from the diet as they constrict the bronchial tubes causing spasms.
* Since asthma may be allergy related, eliminate foods from the diet that commonly cause allergy, such as milk, eggs, shellfish, fish, and nuts. Sulfites – used commonly in restaurants to preserve salads, french fries, and avocado dips – are also linked to asthma attacks.
* White radish is an excellent food to relieve cough. Take 1 white radish, approximately the size of a fist and cut it into thin slices. Mix it with 1 tablespoon of maltose and 1 cup of water and cook for 20 minutes. Serve the radish and the juice when they cool to room temperature. Another easier method is to mix the slices of white radish with honey. Wait for 30 minutes and drink the fluids that are secreted from the radish.
* Lemon juice with honey is also very effective to relieve cough.
* A diet low in spicy, raw, greasy, and sweet foods is also recommended.
* Avoid the following cooling foods: tofu, tomato, celery, asparagus, bamboo, seaweed, kelp, cucumber, gourd, luffa, oranges, pear, banana, mustard leaf, potherb mustard, cactus, Chinese kale, napa, bamboo sprout. Most melons (such as watermelon), nightshades (eggplant, potato, bell and spicy peppers, tomato), bitter melon, grapefruit, papaya and pineapple are too cold for the Spleen. Therefore, it’s best to eat sparingly or not at all. Long-term use of cold fruits and vegetables like the ones listed above may be damaging to the Spleen. To make the property more neutral, one can add about 20 pieces of Gou Qi Zi (Fructus Lycii) when cooking them.
The Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:
§ Recommendations: apricot kernels, almonds, walnuts, basil, carrots, pumpkins, sunflower seeds, loofah, squash, figs, and daikon.
§ Cut the top out of a small winter melon, remove the seeds, fill with molasses. Close the top with cheesecloth, and steam. Eat daily for seven days.
§ Take an unpeeled orange, pierce with a chopstick and roast until the peel blackens. Remove the peel and eat the fruit; one orange daily for seven days.
§ Mix 1/2 cup fig juice with 1/2 cup lukewarm water and drink daily.
§ Avoid mucus-producing foods, cold foods, fruits, salads, all shellfish, dairy products, watermelon, bananas, mung beans, salty foods, cold weather, and especially ice cream.
* Common cold (wind-cold)
§ Recommendations: ginger, garlic, mustard greens and seeds, grapefruit peel, cilantro, parsnip, scallions, cinnamon, basil, soupy rice porridge, and eat as little as possible so as not to burden the system with a lot to digest.
§ Lightly boil the following for five minutes: garlic, ginger, green onion, basil, mustard, or cinnamon. Drink the tea, go to bed and prepare to sweat.
§ Drink cilantro and green tea.
§ Drink scallion and basil tea.
§ Make tea from dried grapefruit peel.
§ Avoid shellfish, heavy proteins and fats, meats, and all vinegars.
* Avoid exposure to pollen, dust, and drastic changes in temperature. Regular exercise with herbal therapy is the key to complete recovery.
* For asthma patients, vacuum and central heating filters should be changed frequently to keep dust, mold, and dust mites to a minimum. Installation of an air purifier is recommended for patients who have family members with infectious respiratory disorders. It is recommended to replace carpets with hard surface floors to prevent dust, molds, and other allergens from being trapped in the carpet. Bleach such as Clorox can be used to clear mold and fungus. Animal dander is also a major factor in causing allergies in patients. All contact (direct and indirect) with allergens should be avoided if possible to prevent allergic reactions.
* Patients should be advised to stop smoking, and stay away from secondhand smoke.
* Patients should strengthen their immune system and body resistance in between asthma attacks. A balance of exercise and rest is important. Alternation of hot and cold water in the shower is also effective to desensitize the body to changes in temperature. Herbs that enhance the immune system, such as Cordyceps 3 or Immune +, should also be taken on a regular basis.
* Patients are strongly encouraged to use hypo-allergenic products, and avoid those that contain artificial or chemical additives.
* C.C., a 28-year-old male, presented with chronic asthma. Symptoms included tightness of the chest, loud wheezing, cough, and yellowish phlegm. The TCM diagnosis was wind-heat, and the patient was prescribed Respitrol (Cold) at four capsules three times a day. This is an ongoing cure, in which each time the cough during asthma attacks gets less, as well as the phlegm and wheezing. He also took the herb at the beginning of a cold and it worked well for that too. Submitted by A.I., Hilo, Hawaii.
* B.F., a 55-year-old male, presented with cough, thick nasal discharge, headache, and fatigue. The tongue was pale, flabby, and slightly purple. The pulse was slow. He was diagnosed with common cold and wind-cold invasion. Magnolia Clear Sinus, Respitrol (Cold) and Herbal ABX were prescribed. The patient reported that the sinus cleared in three days. Submitted by B.F., Newport Beach, California.
PHARMACOLOGICAL AND CLINICAL RESEARCH
Respitrol (Cold) is formulated to treat chronic respiratory disorders with cold signs and symptoms, such as wheezing, dyspnea, shortness of breath, watery or white nasal discharge, white sputum, intolerance to cold, grayish and cyanotic complexion of the face and body, chills, and absence of perspiration. Respitrol (Cold) contains herbs with a wide range of therapeutic effects, including antiasthmatic, bronchodilating, anti-inflammatory, expectorant, antitussive, and antibiotic functions.
Respitrol (Cold) has a marked effect to treat asthma, wheezing and dyspnea because many herbs in this formula have marked antiasthmatic and bronchodilating effects. For example, Ku Xing Ren (Semen Armeniacae Amarum) has an inhibitory effect on the respiratory center in the brain, thereby exerting its antiasthmatic effects. Hou Po (Cortex Magnoliae Officinalis) has a stimulating effect on the respiratory system to relieve wheezing and dyspnea. Magnolol and honokiol, two compounds from Hou Po (Cortex Magnoliae Officinalis), exert their antiasthmatic effect by relieving muscle spasms and inhibiting smooth muscle contraction in the trachea., Wu Wei Zi (Fructus Schisandrae Chinensis) has been shown to stimulate the lungs to increase the depth of respiration. It also reverses respiratory depression associated with morphine. Most importantly, Gan Cao (Radix et Rhizoma Glycyrrhizae) has a remarkable anti-inflammatory effect to reduce swelling and inflammation in the lungs. The proposed mechanism of anti-inflammatory action includes decreased permeability of the blood vessels, antihistamine functions, and decreased sensitivity to stimuli. The anti-inflammatory influence of glycyrrhizin and glycyrrhetinic acid is approximately 1/10th that of cortisone.
Respitrol (Cold) also contains herbs that treat associated symptoms of respiratory disorders. For example, Jie Zi (Semen Sinapis) has an expectorant effect to facilitate discharge of phlegm and sputum. Pi Pa Ye (Folium Eriobotryae) and Cang Er Zi (Fructus Xanthii) have good antitussive effects to suppress coughing., Gan Cao (Radix et Rhizoma Glycyrrhizae) has antitussive and expectorant effects to relieve coughing and chest congestion. In addition, Gui Zhi (Ramulus Cinnamomi) illustrates an antiallergic effect to serum IgE, histamine, and tumor necrosis factor-α. Lastly, Pi Pa Ye (Folium Eriobotryae) demonstrates antiallergic and anti-inflammatory effects through its inhibitory effect on the mast cells and the pro-inflammatory cytokines. This herb can be used to treat chronic bronchitis by inhibiting the inflammatory cytokine and mediator induction from alveolar macrophages. Ursolic acid, one active component from Pi Pa Ye (Folium Eriobotryae), is especially effective in the treatment of pulmonary inflammation as it inhibited lipopolysaccharide-induced cytokines and inducible enzyme production in lung epithelial cells.
Respitrol (Cold) utilizes many herbs with antibiotic effects (antibacterial, antiviral and antifungal) to treat lung infections. Herbs with antibacterial effects include Zi Wan (Radix et Rhizoma Asteris), Hou Po (Cortex Magnoliae Officinalis), Bai Shao (Radix Paeoniae Alba), Gan Cao (Radix et Rhizoma Glycyrrhizae), and Wu Wei Zi (Fructus Schisandrae Chinensis). Zi Wan (Radix et Rhizoma Asteris) has an inhibitory influence against E. coli, Bacillus dysenteriae, Bacillus proteus, Salmonella typhi, Bacillus paratyphosus, Pseudomonas aeruginosa, and Vibrio cholerae. Hou Po (Cortex Magnoliae Officinalis) has an inhibitory effect against Streptococcus matuans, Staphylococcus aureus, Bacillus subtilis, Diplococcus pneumoniae, and Bacillus dysenteriae.,, Furthermore, piperitylmagnolol and honokiol, two compounds from Hou Po (Cortex Magnoliae Officinalis), exhibited antibacterial activities against vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) in a time- and concentration-dependent manner. Bai Shao (Radix Paeoniae Alba) has been shown to have an inhibitory action against Bacillus dysenteriae, E. coli, Salmonella typhi, Pseudomonas aeruginosa, Staphylococcus aureus, beta-hemolytic streptococcus, and Diplococcus pneumoniae. Gan Cao (Radix et Rhizoma Glycyrrhizae) inhibits the growth of Staphylococcus aureus, Mycobacterium tuberculosis, E. coli, amoebae and Trichomonas vaginalis. Lastly, Wu Wei Zi (Fructus Schisandrae Chinensis) has an inhibitory effect in vitro against Staphylococcus aureus, Bacillus anthracis, Salmonella typhi, Bacillus dysenteriae, Diplococcus pneumoniae, Vibrio cholerae, and Pseudomonas aeruginosa. Herbs with antiviral effects include Gui Zhi (Ramulus Cinnamomi) and Zi Wan (Radix et Rhizoma Asteris). These two herbs both have an inhibitory effect against influenza viruses., Finally, herbs with antifungal activities include Ku Xing Ren (Semen Armeniacae Amarum), Jie Zi (Semen Sinapis) and Gui Zhi (Ramulus Cinnamomi).,,
Clinically, the herbs in Respitrol (Cold) have been used with great success to treat various types of respiratory disorders. One study uses Wu Wei Zi (Fructus Schisandrae Chinensis) in a formula to effectively treat 50 patients with asthma. Another study shows that use of Ku Xing Ren (Semen Armeniacae Amarum) in Xing Su San (Apricot Kernel and Perilla Leaf Powder) is effective to treat coughing due to wind-cold in 50 patients. Ku Xing Ren (Semen Armeniacae Amarum) also illustrates a 96.8% rate of effectiveness for treatment of chronic tracheitis in 124 patients (23 reported complete recovery, 66 reported marked effectiveness, 31 experienced some improvement, and 4 had no response). The rate of effectiveness is 96.8%. Lastly, use of Zi Su Zi (Fructus Perillae), Jie Zi (Semen Sinapis) and Lai Fu Zi (Semen Raphani) shows a marked effect for treatment of chronic and stubborn coughs. Out of 40 patients, the study reported marked improvement in 62.5%, and moderate improvement in 37.5%.
In summary, Respitrol (Cold) is an excellent formula to treat respiratory disorders with cold manifestations. Not only does it have good therapeutic effect to treat respiratory tract inflammation and infection, it also contains many herbs to relieve the associated symptoms.
Treatment of wheezing and dyspnea is generally divided into acute and chronic management. In Western medicine, acute wheezing and dyspnea are treated by bronchodilators that open the airways and reverse obstruction. Chronic wheezing and dyspnea are managed by use of several categories of drugs, including bronchodilators, corticosteroids, theophylline, and cromolyn. Western medicine is extremely effective in treating acute wheezing and dyspnea, as use of bronchodilators [such as Proventil or Ventolin (albuterol) inhalers] generally reverses airway obstruction within minutes. However, Western medicine is not as successful in long-term management and prevention of wheezing and dyspnea. These drugs do not change the underlying condition of the disease, nor do they improve the constitution of the patient. Therefore, the long-term prognosis is often characterized by successful suppression of acute wheezing and dyspnea, but no change in frequency or severity of recurrent wheezing and dyspnea.
In TCM, wheezing and dyspnea are treated based on the urgency of the disease presentation and the underlying condition of the patients. Urgency refers to the acute or chronic nature of the disease, while underlying condition refers to the fundamental constitution of the patients. By addressing both the disease and the fundamental constitution, the use of herbs achieves both immediate and prolonged effects.
Both drugs and herbs are effective for the treatment of wheezing and dyspnea. Generally speaking, drugs are more effective for acute conditions, as they are more potent, and can be delivered via inhalation or intravenous injection to achieve a faster onset of relief. However, long-term treatment of wheezing and dyspnea with drugs is often less than optimal, as these drugs tend to create tolerance and dependence. Furthermore, they do not change the course of illness, and do not reduce the frequency and severity of recurrent attacks. On the other hand, herbs are better for long-term prevention and management of wheezing and dyspnea. Herbs strengthen the body and enhance its own ability to treat wheezing and dyspnea. However, use of herbs may not be appropriate for acute asthma because they are less immediately potent than some pharmaceuticals, and have a slower onset of action. In conclusion, optimal treatment of wheezing and dyspnea does not require choosing between drugs or herbs, but may be gained by embracing the benefits of both, by using drugs for acute treatment and herbs for long-term healing and prevention.
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