* Chronic and deficient respiratory diseases, such as asthma, respiratory allergies, occupational lung diseases, and environmental lung diseases
* Chronic respiratory disorders characterized by compromised breathing functions and damaged lung structures
* General symptoms and signs of deficiency including shortness of breath characterized by difficult inhalation but normal exhalation, wheezing and shortness of breath that becomes worse with physical exertion, snoring sounds in the throat due to phlegm accumulation, low-pitched rhonchi, audible wheezes, frail cough with sputum, dry throat, aversion to wind, spontaneous sweating, red cheeks, red tongue with scanty coating, and a thready, rapid pulse.
WESTERN THERAPEUTIC ACTIONS
* Antiasthmatic and bronchodilating effects to treat wheezing, dyspnea and asthma
* Antitussive function to stop coughing
* Expectorant function to eliminate sputum and phlegm
* Anti-inflammatory effect to reduce the swelling and inflammation in the lung
CHINESE THERAPEUTIC ACTIONS
* Relieves wheezing, arrests cough
* Eliminates phlegm
* Tonifies the Lung and the Kidney
* Tonifies the Kidney to grasp the qi downward
Take 3 to 4 capsules three times daily on an empty stomach with warm water. This formula may be taken continuously on a long-term basis for the maintenance and prevention of asthma.
Chai Hu (Radix Bupleuri)
Chen Pi (Pericarpium Citri Reticulatae)
Dang Gui (Radix Angelicae Sinensis)
Dong Chong Xia Cao (Cordyceps)
Hou Po (Cortex Magnoliae Officinalis)
Jie Zi (Semen Sinapis)
Ku Xing Ren (Semen Armeniacae Amarum)
Lai Fu Zi (Semen Raphani)
Rou Gui (Cortex Cinnamomi)
Ting Li Zi (Semen Descurainiae)
Wu Wei Zi (Fructus Schisandrae Chinensis)
Zao Jiao Ci (Spina Gleditsiae)
Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle)
Zi Su Ye (Folium Perillae)
Zi Su Zi (Fructus Perillae)
Chronic respiratory diseases are chronic diseases of the airways and other structures of the lung. Common examples include asthma, respiratory allergies, occupational lung diseases and environmental lung diseases. Causes of chronic respiratory diseases include tobacco smoking, indoor air pollution, outdoor air pollution, allergens, and occupational risks and vulnerability. As a result of chronic respiratory illness, the breathing functions become compromised and the lung structures are damaged, leading to Lung deficiency, as described in traditional Chinese medicine.
Respitrol (Deficient) is formulated to treat deficient-types of respiratory disorders, including but not limited to, asthma, respiratory allergies, occupational lung diseases, environmental lung diseases, and other chronic and debilitating respiratory disorders. Diagnostic signs and symptoms of deficiency include dyspnea, shortness of breath, wheezing, difficulty with inhalation, fatigue with dyspnea on mild physical exertion, and weak and chronic types of respiratory illnesses. Respitrol (Deficient) contains herbs with functions to tonify the Kidney, regulate qi circulation, and eliminate phlegm.
Ku Xing Ren (Semen Armeniacae Amarum), Zi Su Zi (Fructus Perillae), Zi Wan (Radix et Rhizoma Asteris), Jie Zi (Semen Sinapis) and Ting Li Zi (Semen Descurainiae) direct Lung qi downwards, eliminate phlegm, and relieve coughing and wheezing. Wu Wei Zi (Fructus Schisandrae Chinensis) is an astringent herb that prevents the leakage of Lung qi. Lai Fu Zi (Semen Raphani) tonifies the Spleen and reduces the production of phlegm. Chen Pi (Pericarpium Citri Reticulatae) and Zao Jiao Ci (Spina Gleditsiae) are expectorants to eliminate the storage of phlegm. To prolong inhalation, Rou Gui (Cortex Cinnamomi) and Dong Chong Xia Cao (Cordyceps) warm the Kidney yang and restore its ability to grasp qi downward. Hou Po (Cortex Magnoliae Officinalis) and Chai Hu (Radix Bupleuri) regulate qi and relieve chest congestion. Dang Gui (Radix Angelicae Sinensis) nourishes the blood. Zi Su Ye (Folium Perillae) disperses coldness and dilates the Lung. Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle) harmonizes the formula.
CAUTIONS & CONTRAINDICATIONS
* This formula is contraindicated during pregnancy and nursing.
* Patients with heat- or cold-type respiratory disorders should use Respitrol (Heat) or Respitrol (Cold), respectively. Please refer to Supplementary Formulas for maintenance treatment of respiratory disorders.
* Patients with severe or acute asthma attacks may need additional herbal or drug treatment.
* This herbal formula contains herbs that invigorate blood circulation, such as Dang Gui (Radix Angelicae Sinensis). Therefore, patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (warfarin), should use this formula with caution, or not at all, as there may be a higher risk of bleeding and bruising.,,
* Respitrol (Heat) or Respitrol (Cold) should be taken for respiratory disorders with wheezing, dyspnea and shortness of breath. When the condition stabilizes, take Respitrol (Deficient) and/or 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.
* 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.6
* For maintenance and prevention of asthma attack, use with Cordyceps 3.
* For coughing, add Respitrol (CF).
* For infection of ear, nose and throat, add Herbal ENT.
* For thirst, dry mouth and throat, add Nourish (Fluids).
* Take with Immune + to enhance immunity.
* To treat cold-type respiratory disorders with chills, clear nasal discharge, sneezing, nasal congestion, use Respitrol (Cold).
* With more underlying damp and phlegm due to Spleen qi deficiency, add Pinellia Complex.
* With more inflammation in the Lung, add Astringent Complex.
* Zusanli (ST 36), Fenglong (ST 40), Feishu (BL 13), Dashu (BL 11), Shanzhong (CV 17), Shenshu (BL 23), Chize (LU 5), Kongzui (LU 6), Taixi (KI 3), Qihai (CV 6)
* Apply moxa to Guanyuan (CV 4), Mingmen (GV 4), and Dingchuan (Extra 6).
Classic Master Tung's Points:
* Dingke (T 44.28)*, Chongzi (T 22.01), Fugesan (T 44.30)*, Dabai (T 22.04), Tianshi (T 33.15), Dishi (T 33.14), Renshi (T 33.13), Feiqiyi (T 44.25)*, Feiqier (T 44.26)*, Huofuhai (T 33.07), Quling (T 33.16), Zhongjian (T 11.05), Tianhuangfu [Shenguan] (T 77.18), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21)
* 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:
§ 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: Neiguan (PC 6), Kongzui (LU 6), Lingdao (HT 4), Fenglong (ST 40), Zusanli (ST 36)
* Right side: Sanjian (LI 3), Piani (LI 6), Jiaoxin (KI 8), Sanyinjiao (SP 6), Zhongfeng (LR 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:
* 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.
* Snoring, apnea: Trachea, San Jiao, Lower Lung, Pharynx, Larynx, Sympathetic, Nasopharynx, Chest, Mouth, Esophagus, Teeth and Larynx
* 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.
* Avoid mucus-producing foods such as sugar, fried or greasy foods, dairy products including cheese, food additives (MSG, metabisulfite), white flour products, and junk food. Increase onion and garlic intake in the diet. A diet low in spicy, raw, greasy, and sweet foods is also recommended.
The Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:
§ Recommendations: apricot kernels, almonds, walnuts, basil, carrots, pumpkins, winter melon, sunflower seeds, loofah, squash, figs, and daikon.
§ Mix 1/2 cup fig juice with 1/2 cup lukewarm water and drink daily.
§ Cut the top out of a small winter melon, remove the seeds, and 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; eat one orange daily for seven days.
§ Drink fresh fig juice three times 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, and soupy rice porridge. 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.
* Patients with emphysema should avoid cigarettes and secondhand smoke. Avoid air pollution, dust, mold, fur, animal dander, chemicals, or artificial fragrances.
* It is helpful to maintain a stable temperature environment. Avoid sudden and extremes of temperature, including heat, cold, humidity, or dryness whenever possible.
* 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 Immune + or Cordyceps 3, should also be taken on a regular basis.
* 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.
* J.D., a 41-year-old female, presented with asthma, allergies, and phlegm in the lungs. Additional symptoms included stress, weight gain, and fatigue. Coughing was triggered by lying down on her back at night and she would wake up in the morning with opaque mucus and yellow phlegm. The Western diagnosis was asthma and chronic bronchitis. The TCM diagnosis was Lung, Spleen and Kidney qi deficiencies with phlegm occupying the lung and nasal passages. This condition was treated with Respitrol (Deficient) at four spoonfuls twice daily. Patient did not take the herbs consistently, but completed the amount in three months. After taking them, her allergies improved, lungs became clearer, only flaring up if she caught a cold, and her energy increased. The patient was very pleased with the herbs and their results. Submitted by M.M., Alameda, California.
* S.F., a 74-year-old female, presented with chronic breathing difficulty. It was especially worse with exertion such as walking up stairs. Dry wheezing sounds and hoarse throat were also present. No phlegm was expectorated as noted by the patient. Blood pressure was 128/88 mmHg and heart rate was 80 beats per minute. The practitioner diagnosed the condition as Lung and Kidney yin deficiencies as well as Spleen qi deficiency. Respitrol (Deficient) was prescribed at three capsules three times a day. With taking Respitrol (Deficient) for two weeks, the patient was able to stop using her oxygen tank during the day. She could take deeper, easier breaths; however, she still has difficulty walking up stairs. With the patient being a type 2 diabetic, it was also noted that her fasting blood sugar levels had improved since taking this formula. Submitted by L.M., Lafayette, Colorado.
* D.D., a 72-year-old male, presented with shortness of breath and cough with frothy, clear white sputum. It was noted that this patient was diabetic, post-stroke, with a heart function of 77%, and creatinine level of 1.8 mg/dL. Objective findings included left leg hot to the touch, right leg cold to the touch, and difficulty with inhaling. He had recently taken two rounds of antibiotics. The practitioner diagnosed this condition as Kidney not grasping the qi, Lung and Spleen qi deficiencies with phlegm accumulation; his Western diagnosis was COPD. For treatment he was given a combination of Cordyceps 3, Respitrol (Deficient), Circulation (SJ) and Neuro Plus, just one bottle at a time. The patient gradually improved, getting stronger each week and continued taking the herbs for about three months. Submitted by T.W., Perrysburg, Ohio.
* J.N., a 59-year-old female, presented with a chronic, dry hacking cough. Additional symptoms included shortness of breath, dry hair and nails. Blood pressure was 120/80 mmHg and heart rate was 78 beats per minute. The practitioner diagnosed this condition as Lung and Kidney qi and yin deficiencies. Respitrol (Deficient) and Nourish (Fluids) were prescribed. As a result of taking the herbs, the cough became looser and not as painful. She was also able to cough a little sputum up and improvement of her hair and nails was also seen. Submitted by J.M., Breckenridge, Colorado.
* A 17-year-old male student presented with wheezing, shortness of breath and a dry, non-productive cough. It was worse with exertion and exposure to cold. He was extremely thin and unable to gain weight. The practitioner diagnosed the patient’s condition as rebellious Lung qi with deficient Kidney not grasping Lung qi. The Western diagnosis was chronic asthma. After taking Respitrol (Deficient), he was able to restrain his wheezing and keep it under control. Utilization of his inhaler was reduced from three to four times a day to once or twice a week. While on Respitrol (Deficient), the patient also received acupuncture treatments twice a week for two weeks followed by once a week for two weeks. Submitted Anonymously.
PHARMACOLOGICAL AND CLINICAL RESEARCH
Respitrol (Deficient) is designed to treat chronic respiratory diseases characterized by compromised breathing functions and damaged lung structures, such as asthma, respiratory allergies, occupational lung diseases, and environmental lung diseases. It is formulated using herbs with antiasthmatic effects to relieve wheezing and dyspnea, antitussive effects to stop coughing, and expectorant effects to eliminate phlegm and sputum.
Respitrol (Deficient) has a marked effect to treat asthma, wheezing and dyspnea because many herbs in this formula have marked antiasthmatic and bronchodilating effects. For example, Chen Pi (Pericarpium Citri Reticulatae) has an antiasthmatic effect to suppress airway hyper-responsiveness in asthma. 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 trachea., Dang Gui (Radix Angelicae Sinensis) also alleviates bronchospasm to treat wheezing and dyspnea. Zi Su Ye (Folium Perillae) reduces secretions from the bronchioli to promote bronchodilation and relieve bronchospasm. Wu Wei Zi (Fructus Schisandrae Chinensis) has been shown to stimulate the lungs to increase the rate and depth of respiration. It also reverses respiratory depression associated with morphine. Furthermore, Gan Cao (Radix et Rhizoma Glycyrrhizae) has a remarkable anti-inflammatory effect to reduce swelling and inflammation in the lungs. The proposed mechanism of its 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. Lastly, Dong Chong Xia Cao (Cordyceps) has significant influences on the respiratory tract to treat asthma by dilating and relaxing the bronchial muscles. The mechanism of this action is attributed to the stimulation and increased production of adrenal gland hormones.
In addition to treating the cause, Respitrol (Deficient) is also formulated with herbs that treat the associated symptoms. For example, Jie Zi (Semen Sinapis) has an expectorant effect to facilitate the discharge of phlegm and sputum. Gan Cao (Radix et Rhizoma Glycyrrhizae) has antitussive and expectorant effects to relieve coughing and chest congestion. Pi Pa Ye (Folium Eriobotryae) has good antitussive effect to suppress coughing. Zi Su Ye (Folium Perillae) and Pi Pa Ye (Folium Eriobotryae) demonstrate antiallergic and anti-inflammatory effects. The mechanisms of action for Zi Su Ye (Folium Perillae) include decreased mast cell and eosinophil infiltration, reduced histamine levels, and inhibited expressions of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α. The mechanisms of action for Pi Pa Ye (Folium Eriobotryae) include inhibitory effect on the mast cells and the pro-inflammatory cytokines. Furthermore, Pi Pa Ye (Folium Eriobotryae) 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 inhibits lipopolysaccharide-induced cytokines and inducible enzyme production in lung epithelial cells.
Clinically, the herbs in Respitrol (Deficient) have been used with great success to treat various types of respiratory disorders. In one study, 656 patients with chronic tracheitis were treated with Dong Chong Xia Cao (Cordyceps) three times daily for 40 days with good results. In another study, administration of 6 grams of Dong Chong Xia Cao (Cordyceps) three times daily for four weeks showed a 93% effective rate in treating 43 patients with allergic rhinitis. In addition, one study used Wu Wei Zi (Fructus Schisandrae Chinensis) in a formula to effectively treat 50 patients with asthma. Another study showed that use of Ku Xing Ren (Semen Armeniacae Amarum) in Xing Su San (Apricot Kernel and Perilla Leaf Powder) was effective to treat coughing due to wind-cold in 50 patients. Ku Xing Ren (Semen Armeniacae Amarum) also illustrated 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 was 96.8%. Lastly, Zi Su Zi (Fructus Perillae), Jie Zi (Semen Sinapis) and Lai Fu Zi (Semen Raphani) are three herbs commonly used together to treat various respiratory tract disorders, including but not limited to bronchitis, bronchial asthma, emphysema, pediatric asthma, and spasms of the diaphragm. In one study, use of these three herbs showed marked effect for the 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 (Deficient) is an excellent formula to treat chronic respiratory disorders, as it contains herbs to dilate the bronchi, reverse airway obstruction, and relieve related symptoms.
Treatment of respiratory diseases is generally divided into acute and chronic management. In Western medicine, acute respiratory diseases are treated by bronchodilators that open the airways and reverse obstruction. Chronic respiratory diseases are managed by several categories of drugs, including bronchodilators, corticosteroids, theophylline, and cromolyn. Western medicine is extremely effective in treating acute respiratory diseases, 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 respiratory diseases. 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 respiratory symptoms, but no change in frequency or severity of recurrent respiratory diseases.
In TCM, respiratory diseases 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 respiratory diseases. 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 respiratory diseases 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 respiratory diseases. Herbs strengthen the body and enhance its own ability to manage respiratory diseases. 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 respiratory diseases 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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