Si Sesak Yang Bikin Susah

Rubrik : Kesehatan

Sumber :  http://www.jurnalbogor.com/?p=95485

Seimbangkan Paru, Normalkan Imunitas

Jurnal Bogor, 21 April 2010

Rubrik : Kesehatan

Bogor - Dalam dunia kedokteran, dada sesak dan napas mulai mengeluarkan bunyi ngik-ngik disebut asma. Namun pada pengobatan Cina, asma disebut xiao chuan, yang berarti mengi dan dispnea. Kemudian xiao chuan diklasifikasikan lagi sebagai dua penyakit terpisah dengan perlakuan berbeda. Menurut Pakar Natural Therapy M. Ferry Wong, xiao (mengi) dicirikan oleh bersiul saat bernafas, meningkatnya laju respirasi, dan ketidakmampuan untuk beristirahat dalam posisi horizontal. Sementara chuan (sesak nafas) ditandai dengan dispnea, konstan membuka mulut untuk menghirup udara, mengangkat bahu, dan hidung mengembang.

“Pasien dengan xiao (mengi) umumnya memiliki chuan (sesak napas). Sedangkan pasien chuan (sesak napas) mungkin tidak memiliki xiao (mengi). Dalam pengobatan barat, mengi dan sesak napas keduanya dianggap sebagai gejala yang mungkin hadir dalam berbagai jenis sindrom paru seperti asma, bronkitis akut, bronkitis kronis, dan emfisema,” jelas Ferry kepada Jurnal Bogor, kemarin.

Dalam pengobatan Cina, ada banyak faktor yang dapat memicu serangan asma. Contohnya diet, gangguan emosional, kelemahan bawaan, penyakit kronis, dan faktor patogen eksternal seperti dingin atau panas. ”Serangan asma akibat invasi faktor patogen eksternal paling mungkin terjadi ketika suhu dingin atau jika ada perubahan cepat dalam cuaca. Itu juga termasuk serbuk sari maupun asap rokok, ” ujar pria kelahiran Singkawang itu.
Diet juga dapat memicu serangan asma, karena makanan yang dingin dapat melukai limpa, cenderung memberikan kontribusi pada stagnasi sirkulasi cairan, dan peningkatan produksi lendir. “Makanan manis dan berminyak membuat dahak dan panas dalam tubuh, sehingga memicu terjadinya asma,” kata Ferry.

Sebetulnya, penyebab mendasar dari asma adalah adanya dahak. Dalam pengobatan Cina, bagian air dikendalikan oleh tiga organ yakni paru, limpa, dan ginjal. Lung mengatur bagian-bagian air di jiao atas, lien mengangkut dan mengubah air di tengah jiao, dan ginjal mendominasi metabolisme air di jiao rendah.“Ketidakseimbangan Yin dan Yang dalam salah satu dari ketiga organ dapat menyebabkan stagnasi sirkulasi air, yang kemudian berkontribusi dalam produksi dan penyimpanan dahak di paru-paru. Penyimpanan dahak di paru-paru itulah menjadi penyebab utama serangan asma berulang,” papar Ferry.

Intinya, pengobatan Cina memandang asma bukan sekedar menangani penyempitan saluran napas, tetapi ada sesuatu dibalik penyempitan napas itu. Jika pengobatan barat berpikir bagaimana membuat saluran menyempit tersebut kembali longgar, maka pengobatan Cina bertanya lebih dalam kenapa sampai menyempit? “Jadi dalam pengobatan Cina berusaha mencari cara untuk menyeimbangkan paru-paru agar tidak menyempit lagi. Jika ada rangsangan yang menyebabkan asma, karena rangsangan tersebut buat orang normal tidak menyebabkan sesak napas,” terangnya. 

Selain itu, pengobatan Cina berusaha menormalkan sistem imunitas tubuh, karena salah satu pemicu asma adalah sistem imunitas yang berlebihan merespon rangsangan tertentu, serta memungkinkan memberi pemulihan esensial, sehingga hasilnya lebih permanen. “Hanya terkadang memakan waktu lebih lama dan juga tergantung kondisi tubuh meresponnya,” pungkasnya.

M. Ferry Wong

Nasia Freemeta Iskandar

Sumber : http://www.jurnalbogor.com/?p=103197

Taklukan Dengan Akupunktur

Jurnal Bogor, 21 April 2010

Rubrik : Kesehatan

Menurut Ferry Wong, pengobatan dengan teknik akupuntur membagi penyakit asma menjadi dua macam, yaitu asma dingin dan panas. Asma dingin penyebabnya adalah faktor luar angin dingin atau yin. Seperti diketahui, menurut pengobatan tradisional Cina, dalam tubuh ada peredaran darah dan energi.

1. Asma Dingin

Bagian yang terganggu pada kasus asma dingin adalah fungsi qi atau energi, sehingga mengacaukan peredaran qi di paru-paru, sehingga terjadi sesak napas, pernapasan terganggu, tenggorokan berbunyi, riak encer, berwarna putih.Warna wajah pasien cenderung gelap kehijauan. Sebagai perbandingan, warna wajah orang sehat adalah cerah bercahaya.

Penderita asma yang sifatnya dingin ini biasanya tidak suka minum. Mereka hanya suka minuman hangat. Gejala lain asma dingin ini adalah sakit kepala, demam, tetapi tidak berkeringat. Terapi akupuntur untuk mengobati asma dingin adalah menghangatkan paru-paru dan mengusir angin yang menyebabkan tubuh jadi dingin.

2. Asma Panas

Adapun gangguan asma yang panas disebabkan oleh pola makan dan pola hidup. Penderita asma yang panas ini menyukai makanan terlalu asin, pedas, gurih, dan manis. Makanan memang perlu rasa supaya terasa enak, tetapi jangan berlebihan karena menyebabkan gangguan organ tubuh.Gara-gara pola makan dan hidup tak sehat itu, riak dingin berubah menjadi api atau panas, sehingga yin di dalam tubuh terluka ketika terjadi riak panas.
Gejala asma panas ini hampir sama, yaitu sesak napas, tenggorokan berbunyi, tetapi riak kental dan susah dikeluarkan. Penderita asma panas ini diterapi akupuntur untuk menguatkan paru-paru, menjernihkan panas, menghilangkan riak dan menormalkan aliran qi atau energi dalam tubuh. Bagian tubuh pasien asma yang akan ditusuk jarum adalah dekat tengkuk, punggung tangan dekat ibu jari dan telunjuk, serta siku bagian dalam.

(M. Ferry Wong)

Nasia Freemeta Iskandar

Sumber : http://www.jurnalbogor.com/?p=103211

Treatment of Asthma with Herbs and Acupuncture

by Dr. Alex Chen, L.Ac., O.M.D., Ph.D. and Dr. John Chen, L.Ac., O.M.D., Ph.D., Pharm.D.

WESTERN MEDICINE

DEFINITION :

Asthma affects approximately 15 million Americans today. It's a pulmonary disorder characterized by wheezing and dyspnea due to obstruction and inflammation of the airways. Asthma may be triggered by allergy, exertion, irritant particles, weather, psychological stress, etc.

ETIOLOGY :

There are many causes of asthma. Allergens such as pollens, smoke, alcohol, house dust and animal hair may trigger an asthma attack. Asthma may also be induced by non-allergy related factors such as exertion, cold air, stress, anxiety, crying, hearty laughing, and viral infection. Common morbidity associated with asthma include sinusitis, allergic rhinitis, gastroesophageal reflux, cardiovascular disease, diabetes, obesity, and hyperthyroidism.

CLINICAL MANIFESTATION :

In an asthma attack, there will be a combination of spasm of the bronchi, inflammation of the airways, and increased mucous secretion. In mild to moderate cases, the patients will experience shortness of breath, wheezing, hyperpnea, and use of accessory muscles (such as neck and chest muscles) to facilitate breathing. Anxiety and sweating are commonly seen in asthmatics as they struggle for air. In severe cases, the patients will experience marked respiratory distress, cyanosis, use of accessory muscles, wheezes, lethargy and possibly confusion. Patients with severe asthma may not have any wheezing as there is very little air moving in and out of the lungs.

DIAGNOSIS :

Asthma is diagnosed based on the characteristic episodes of wheezing, coughing, dyspnea or chest tightness interspersed with asymptomatic intervals. Objective confirmation is made with repeated spirometry tests performed over symptomatic and asymptomatic periods. Spirometry is a device that measures the breathing capacity of the lungs and is helpful in making the diagnosis, assessing the severity of the illness, and monitoring the effectiveness of the treatment.

TREATMENT :

Drug treatments of asthma include management of an acute attack and maintenance on a daily basis. Five groups of drugs are commonly used for treating asthma.

1. Beta-adrenergic Drugs : Beta-adrenergic drugs are bronchodilators that relax smooth muscle and widen the airways. They are commonly used for relieving sudden attacks of asthma and preventing exercise-induced asthma. Common examples of Beta-adrenergic drugs includes epinephrine (Primatene Mist or AsthmaHaler), isoproterenol (Isuprel), metaproterenol (Alupent), pirbuterol (Maxair), terbutaline (Brethaire) and albuterol (Proventil or Ventolin). Common side-effects of Beta-adrenergic drugs include increased Heart rate, nervousness, restlessness, headache and muscle tremors. 

2. Theophylline : Theophylline also relaxes bronchial smooth muscle and is commonly used to treat and/or prevent bronchial asthma. Common trade names of theophylline include Theo-Dur, Theo-24, Uniphyl and Slo-bid. Common side-effects of theophylline include nausea, vomiting, nervousness, restlessness, insomnia, and in severe cases, seizures and arrhythmia. 

3. Corticosteroids : Corticosteroids block the inflammatory response and reduce the asthma symptoms. Systemic corticosteroids (such as prednisone) may be used to treat acute asthma attack and inhalation of corticosteroids (such as Azmacort) may reduce the likelihood of asthma attack through desensitization to allergens. Though effective, long-term use of corticosteroids has a wide range of side-effects including but not limited to poor wound healing, decreased immunity, retarded growth in children, GI bleeding, hunger and weight gain. 

4. Cromolyn (Intal) : Cromolyn (Intal) inhibits the release of inflammatory substances from mast cells and is used to prevent but not treat asthma. When taken regularly, cromolyn (Intal) is especially helpful in patients who have exercise-induced asthma. Cromolyn (Intal) is relatively safe but has occasional side-effects such as cough and hoarseness. 

5. Anticholinergic Drugs : Anticholinergic drugs produce bronchodilation by preventing smooth muscle contraction. Anticholinergic drugs are less potent and have a slower onset of action in comparison with beta-adrenergic drugs. Examples of anticholinergic drugs include atropine and ipratropium (Atrovent).

    

ORIENTAL MEDICINE

DEFINITION :

In Chinese medicine, asthma is called "xiao chuan, " which means wheezing and dyspnea, respectively. Chinese medicine classifies xiao and chuan as two separate illnesses with different treatments. Xiao (wheezing) is characterized by a whistling sound during breathing, increased respiration rate, dyspnea and inability to rest in a horizontal position. Chuan (shortness of breath) is characterized by dyspnea, constant opening of mouth to grasp air, raised shoulder, flared nostrils and inability to rest in a horizontal position. Patients with xiao (wheezing) generally will have chuan (shortness of breath), while patients with chuan (shortness of breath) may or may not have xiao (wheezing). In Western medicine, wheezing and shortness of breath are both considered as symptoms which may be present in many different types of pulmonary syndromes such as asthma, acute bronchitis, chronic bronchitis and emphysema.

ETIOLOGY :

In Oriental Medicine, there are many factors that may trigger an asthma attack. Examples include the invasion of the external pathogenic factors, diet, emotional disturbances, congenital weakness and chronic illnesses.

PATHOLOGY :

The fundamental cause of asthma is the presence of phlegm. In Oriental Medicine, the passage of water is controlled by three organs, namely Lung, Spleen and Kidney. Lung regulates the water passages in the upper jiao, the Spleen transports and transforms water in the middle jiao, and Kidney dominates water metabolism in the lower jiao. Imbalance of Yin and Yang in any of these three organs may lead to stagnation of the water circulation, which then contributes to the production and storage of phlegm in the Lung. Storage of phlegm in the Lung becomes the main cause for recurrent asthma attacks.

DIFFERENTIAL DIAGNOSIS

ASTHMA ATTACK :

1. Asthma Due to Cold

   When cold initially attacks the Lung, the normal activity of the Lung to dominate Qi and control respiration will be disturbed. The pathogenic cold factor has a tendency to constrict the bronchi leaving the patient feeling congested in the chest. Patients will show hyperventilation, shortness of breath, tachypnea, tightness and a suffocating feeling of the chest. The Lung will be also lose its function to regulate the water passages and as a result, the formation of phlegm. Clinically, the phlegm is manifested as audible wheezing in the throat, high-pitched rhonchi, thin, white foamy sputum or tenacious, white sputum that is difficult to expectorate; amount can vary from scanty to profuse. Chills, intolerance to cold (cold temperature, cold food, drinks), absence of perspiration, headache, body aches and pain, grayish, and cyanotic complexion are general signs and symptoms of cold attacking the body. Tongue coating is usually white and greasy. The pulse is wiry and tight.

    

   HERBAL TREATMENT : ASMATROL (COLD)

   The herbal formula of choice is Asmatrol (Cold). It dispels cold, warms up the interior, eliminates phlegm and relieve bronchial spasm. The recommended dosage is 4-6 capsules TID.

   In Asmatrol (Cold), ephedrae (ma huang) and cinnamon twigs (gui zhi) dispel the cold factor, arrest wheezing and move water by smoothing the Qi flow of the Lung. Besides the bronchodiating effect, ephedrae (ma huang) can also promote urination and thus dispel the congested fluids in the Lung. Due to the cold, patients with water metabolism problems in the Lung will experience constriction and a sudden blockage of fluids. Mustard seed (bai jie zi), asarum (xi xin) and dry ginger (gan jiang) warm the Lung, dissolve congested fluid and help the Lung resume its normal function. Magnolia bark (hou po) is used to regulate the Lung Qi which is impeded by the congested fluids. Apricot seed (xing ren), lepidium (ting li zi), and pinelliae (ban xia) eliminate phlegm, transform congested fluids and reduce wheezing. Schizandra (wu wei zi) is used to protect the Lung by preventing the leakage of Qi. Lumbricus (di long) is used to relieve wheezing and dilate the bronchi. White peony (bai shao), containing paeoniflorin helps lumbricus (di long) achieve the antispasmodic effect on the smooth muscle of the bronchi. Baked licorice (zhi gan cao) supplements Qi, stops coughing, moderates spasms, alleviate pain and harmonizes the formula.

    

   ACUPUNCTURE

   MAIN POINTS :

   Feishu UB 13, Lieque LU 7, Fengmen UB 12, Tanzhong REN 17, and Chize LU 5.

   TECHNIQUE :

   Acupuncture treatment for cold asthma should focus on sedating the Lung and eliminating the phlegm. The points should be sedated and left in place for 30 minutes. Renzhong REN 17 should be stimulated until the needling sensation disperses to both sides of the chest. Chize LU 5 should be needled against the flow of the channel. Feishu UB 13 and Fengmen UB 12 should be sedated for 2 minutes. For best result, cupping may be applied with acupuncture for these two points.

   SUPPLEMENT POINTS :

   Shenzhu DU 12 and Dazhui DU 14 may be added for patients with headache and body ache. Yingxiang LI 20 and Shangxing DU 23 may be added for stuffy nose and runny nose.
    

2. Asthma Due to Heat

   When heat attacks the Lung, the Lung will no longer be able to dominate Qi and control respiration. Patients generally experience a choking sensation, coughing spells and intercostal distention. Patients will also have phlegm as characterized by wheezing, crackling or moist rales, roaring sound in the throat from copious sputum that is thick and difficult to expectorate. Sputum is usually yellow but may be white in some cases where heat is not as prominent. It is common for patients to raise their shoulders to help breathing. Fever, irritability, perspiration, headache, thirst with desire to drink, flushed face, possible fever with aversion to cold are some of the symptoms of asthma due to heat . The tongue is red with yellow greasy coating. The pulse is superficial rapid or wiry.

    

   HERBAL TREATMENT: ASMATROL (HEAT)

   The herbal formula of choice is Asmatrol (Heat). It clears Lung heat, dissolves phlegm and relieves asthma. The recommended dosage is 4-6 capsules TID.

   In Asmatrol (Heat), ephedrae (ma huang) facilitates the movement of Lung Qi and controls wheezing. Ephedrine and norephedrine in ephedrae (ma huang) have a prolonged bronchodialating effect. Gypsum (shi gao) clears Lung heat and neutralizes the warmth and diaphoretic effects of ephedrae (ma huang). Mulberry bark (sang bai pi) and lycium root bark (di gu pi), a pair also seen in Drain the White Powder (Xie Bai San), drain Lung heat and stop coughing and wheezing. Trichosanthes rind (gua lou pi) clears Lung heat, expands the chest, and dissolves the phlegm. Belamcanda (she gan) clears heat, relieves toxicity, and soothes sore throat due to heat and wheezing. Lepidium (ting li zi) drains the Lung, eliminates phlegm and reduces wheezing. Apricot seed (xing ren) stops coughing and calms wheezing. Lumbricus (di long) stops muscle spasm of the airways to relieve wheezing. A small amount of schizandra (wu wei zi) is used to inhibit the leakage of Lung Qi in order to prevent Qi loss. Baked licorice (zhi gan cao) moderates spasms, supplements Qi and harmonizes all the herbs in this formula.

    

   ACUPUNCTURE

   MAIN POINTS :

   Dazhui DU 14, Hegu LI 4, Tanzhong REN 17, Fenglong ST 40, Feishu UB 13 and Kongzui LU 6.

   TECHNIQUE :

   Acupuncture treatment for asthma due to heat should focus on disperse the Lung, clear heat, dissolve phlegm, and lower adverse rising Qi. Dazhui DU 14 and Feishu UB 13 are sedated for 2 minutes followed by immediate removal of the needles. The remaining points should be sedated and needles left in place for 20 minutes.

   SUPPLEMENT POINTS :

   Tiantu REN 22 and Dingchuan (Soothing Asthma) may be used if there is severe dyspnea. Yuji LU 10 and Daling P 7 are added if patients experience irritability and chest fullness. Zhaohai K6 and Taixi K3 are added if the patient is thirsty and drinks lots of water.
    

    

3. Asthma Due to Deficiency

   It is very common for patients who have recurrent asthma attacks to have Kidney deficiency. When under attack, such patients are said to have "upper excess with lower deficiency." "Upper excess" refers to phlegm stagnation in the Lung and is characterizes by recurrent or continuous wheezing (worsens after exertion), labored inhalation and smooth exhalation, snoring sound in the throat, low-pitched rhonchi, audible wheezes, shortness of breath, a frail cough with scanty, thin, or frothy sputum, and a dry throat. "Lower deficiency refers to Kidney Qi or Yang deficiency and is characterized by difficult inhalation as Kidney cannot grasp and hold the air down. In addition, the patients may also have deficiencies of the Lung and the Spleen. Deficiency of the Lung is characterized by aversion to wind and spontaneous sweating while deficiency of the Spleen is characterized by increased production of phlegm and sputum. Patients may have red cheeks, red tongue with scanty coat. Pulse is thready and rapid.

    

   HERBAL TREATMENT: ASMATROL (DEFICIENCY)

   The herbal formula of choice is Asmatrol (deficiency). It tonifies Kidney Yang, directs the rebellious Qi downward, arrest coughing, wheezing and eliminates excessive phlegm. The recommended dosage is 4-6 TID.

   In Asmatrol (deficiency), ephedrae (ma huang) expels exterior wind and relieves dyspnea. Ephedrine and norephedrine, two active ingredients of ephedrae (ma huang) are bronchodilators which can open the airway, relieve wheezing and dyspnea. Apricot seed (xing ren), perilla seed (su zi), and lepidium (ting li zi) reverse the uprising Lung Qi, eliminate phlegm, and relieve coughing and wheezing. Mustard seed (bai jie zi), gleditsia fruit (zao jiao), pinellia (ban xia), magnolia bark (hou po), and peucedanum (Qian hu) eliminate phlegm and relieve coughing and wheezing. Lumbricus (di long) stops muscle spasm of the airways to relieve wheezing. Schizandra (wu wei zi) tonifies the Lung and the Kidney to relieve wheezing. Raphanus (lai fu zi) tonifies the Spleen and reduces the production of phlegm. Citrus Peel (chen pi) dries up dampness and eliminates phlegm. To prolong inhalation, cinnamom bark (rou gui) warms the Kidney Yang and helps restore the Kidney's ability to grasp the Qi. Bupleurum (chai hu) regulates the Qi and tangkuei (dang gui) nourishes the blood in the Liver and indirectly treats coughing and other Qi-reversion symptoms by regulating the blood. Fresh ginger (sheng jiang) and perilla leaf (su ye) disperse coldness and dilate the Lung. Baked licorice (zhi gan cao) and jujube (da zao) harmonize the formula.

   Note on Phlegm:

   Since Phlegm is the fundamental cause of asthma, it is present in all types of asthma patients. For profuse, white or yellow sputum in the different types of asthma patients mentioned above, Citrus and Pinellia Combination (Er Chen Tang) can be added to dry dampness, transform phlegm and regulate Qi.

    

1. Lung Deficiency :

   Patients with Lung deficiency commonly have asthma attacks triggered by changes in weather or exposure to known allergens or viral infections. Prodromal symptoms resemble that of allergy which include sneezing, stuffy nose and rhinorrhea. During the remission stage, patients with chronic wheezing and dyspnea due to Lung deficiency may have mild symptoms of shortness of breath, low voice, frequent low, wheezing sound in the throat. Sputum is clear or white, scanty or sticky. Aversion to wind and spontaneous sweating are two key signs of Lung Qi deficiency. Patients in this category usually have low immune systems and are very susceptible to catching common colds. The tongue is usually red with thin white coat or scanty coating. The pulse is weak and thready, or thready and rapid.

   For maintenance, Astragalus & Siler Formula (Yu Ping Feng San) and Ginseng & Ophiopogon Formula (Sheng Mai San) and Ginseng and Aster Combination (Bu Fei Tang) are excellent formulas to tonify the Lung and prevent recurrent asthma attacks.

   Astragalus & Siler Formula (Yu Ping Feng San) tonifies Qi and strengthens the exterior. It is commonly used for patients who have Wei (Defensive) Qi deficiency characterized by spontaneous perspiration, aversion to cold, and frequent infection of common cold and flu.

   Ginseng & Ophiopogon Formula (Sheng Mai San) and Ginseng and Aster Combination (Bu Fei Tang) tonify the source Qi, nourish Yin, and generate body fluid. It is used for Qi and Yin deficiencies of the Lung with chronic asthma, cough, scanty sputum, shortness of breath, increased respiration, spontaneous perspiration and dry mouth.

    

2. Spleen Deficiency :

   Patients with Spleen deficiency commonly have asthma attacks triggered by improper dietary intake, such as that of cold or spicy foods. During the remission stage, there may have occasional shortness of breath, dyspnea, low voice, fatigue, poor appetite, epigastric distention, loose stool or diarrhea after intake of greasy or fried foods, and possible edema. Sputum is white, thick and copious. Tongue is pale with teethmarks. Coating is white or greasy. Pulse is thready and soft.

   The herbal formulas of choice to tonify Spleen deficiency are Major Six Herb Combination (Liu Jun Zi Tang) and Ginseng and Astragalus Combination (Bu Zhong Yi Qi Tang). Major Six Herb Combination (Liu Jun Zi Tang) tonifies the Spleen and dissolves the phlegm. It is used for patients with Spleen deficiency with residual phlegm in the Lung. Ginseng and Astragalus Combination (Bu Zhong Yi Qi Tang) tonifies the Middle Jiao and raises Yang in the body. It is used for patients with deficiency of both the Stomach and the Spleen Qi leading to sinking of the Yang.

   If the patient shows prominent water stagnation in the middle jiao manifesting in fullness in the chest and hypochondria, shortness of breath, profuse sputum, and palpitation, Hoelen and Atractylodes C

Source : http://www.acupuncture.com/conditions/asthma.htm