"Chronic obstructive pulmonary disease" refers to the disturbances of cardiopulmonary functions and the limitation of physical activities caused by long-term chronic bronchitis, bronchial asthma and pulmonary emphysema with the repeated onset. The following section discusses the rehabilitation measures of the disease at the remission stage.
Syndrome differentiation and treatment
Asthenia of the lung
It manifests spontaneous sweating, aversion to wind, susceptibility to common cold, short breath, low voice, or mild cough with dyspnea, white, clear and thin sputum, thin fur, thready and weak or feeble and large pulse. In the case of concurrent yin deficiency, the commonly-seen manifestations include cough with chocking, scanty and sticky sputum, dry throat and mouth and red tongue. It is advisable to tonify the lung and consolidate defensive qi. The prescription used is the modified Yupingfeng Powder (Jade-Screen Powder). In the case of concurrent yin deficiency, this prescription is used in combination with Shengmai Powder (Pulsation-Promoting Powder) with modification.
Asthenia of the spleen
It manifests poor appetite, epigastric fullness, loose stool, or susceptibility to diarrhea due to ingestion of greasy food, short breath with dyspnea, thin and greasy or white and slippery fur, pale tongue, thready and soft pulse. In the case of concurrent yang deficiency, the manifestations include cold body and limbs, cold sensation in the middle abdomen and regurgitation of clear water. It is advisable to strengthen the spleen and resolve phlegm. The prescription used is the modified Liujunzi Decoction (Decoction of Six Ingredients). In the case of concurrent yang deficiency, add Guizhi (Ramulus Cinnamomi) and Ganjiang (Rhizoma Zingiberis).
Asthenia of the kidney
It manifests short breath with dyspnea at ordinary times aggravated by activities, unsmooth respiration, palpitation, dizziness, tinnitus, lumbar soreness and flaccidity of knees which easily occur after physical overstrain. In the case of marked yang deficiency, the manifestations include aversion to cold, cold limbs, spontaneous sweating, pale complexion, whitish fur, tender and enlarged tongue, deep and thready pulse; in the case of yin deficiency, the manifestations include flushing of zygomatic region, dysphoria with smothery sensation, sticky sweat, red tongue with a little fur, thready and rapid pulse. It is advisable to strengthen the kidney and regulate inspiration. In the case of marked yang deficiency, use the modified Jinkui Shenqi Bolus; in the case of marked yin deficiency, use the modified Liuwei Dihuang Bolus (Bolus of Six Drugs Including Rehmannia) and Qiwei Duqi Bolus.
Regulating emotions and recreation therapy
Please refer to the relevant part in the section of "Coronary heart disease". On this basis, select the singing therapy additionally, or practice singing coordinatively with abdominal breathing.
Select walking and setting-up jogging. At the beginning, it is advisable to walk and jog alternately. Then, extend the time for jogging and shorten the time for walking gradually. Finally, realize the transition from walking to the whole distance jogging completely. Keep the training until mild short breath occurs every time.
Persist in practicing abdominal breathing at usual times. The method is as follows. Relax the shoulder and back, and concentrate the mind. Then, exhale and inhale air in the proper order. Inspire until the cheeks bulge and expire until the cheeks restore the normal state. Next, adopt the flute-playing method of exhaling air. Namely, contract the lips to form the flute-playing posture. At this time, exhale air slowly via the narrowed degree of lip-rounding. Meanwhile, contract the abdominal muscle and push the diaphragm upwards. Keep self training with this method until a perfect command is achieved.
Seawater bath The seawater pressure, seawater lash and swimming movement can deepen breathing to enhance the respiratory function. If the seasonal condition permits, take seawater bath once a day or once every other day. The duration is not advisable to exceed 30 minutes.
Cave bath The air in the cave is fresh and contains a large number of negative oxygenic ions. This can keep the nasopharyngeal mucosa moist, relax the bronchus, improve the pulmonary ventilation function and increase blood oxygen. Accordingly, the method is applicable to the patients with this disease.
Sunbath Adopt the general sunbath, but long duration is not advisable. Besides, it is suitable to apply ultraviolet radiation, first on the whole body, then on the acupoints. As for the latter, apply ultraviolet radiation on the chest [-Tiantu (CV 22) and Danzhong (CV 17)], back [Dazhui (GV 20), Feishu (BL 13), Gaohuang (BL 43) and Geshu (BL 17)] and waist EShenshu (BL 23) and Mingmen (GV 4)-] alternately. In the case of profuse sputum, add Zusanli (ST 36) and Fenglong (ST 40); in the case of susceptibility to common cold, add Hegu (LI 4) and Yongquan (KI 1).
Acumox and massage
Acupuncture: As for acumox, select Feishu (BL 13), Pishu (BL 20), Shenshu (BL 23), Gaohuang (BL 43), Qihai (CV 6), Zusanli (ST 36), Taiyuan (LU 9), Taixi (KI 3) and Mingmen (GV 4). Each time, select three to five acupoints from the above ones, once every other day. Use the reinforcing manipulation. Or select one pair of Jiaji acupoints from the first to sixth thoracic Jiaji acupoints and inject 0.5 to 1 ml of placental injection in each acupoint. Exchange the acupoints from the upper ones to the lower ones.
As for the ear acupuncture therapy, select Fei (MA-IC 1), Pi, Shen, Xin, Qiguan (MA- IC 2), Yanhou (MA- T 3), Ershenmen (MA -TF 1), Sanjiao (MA-IC 4) and Neifenmi (MA- IC 3). Apply the therapy once a week and use the needle-embedding method on three to five acupoints.
Moxibustion: Select Dazhui (GV 14), Fengmen (BL 12), Feishu (BL 13), Danzhong (CV 17), Shenshu (BL 23) and Qihai (CV 6). Apply the moxibustion with the wheat-grain-sized moxa cone in dog days. Use three to five moxa cones for each acupoint. Apply moxibustion once every ten days. Three times make up one course of treatment.
Massage: It is advisable to grasp and lift the back and spine, tighten the chest, rub and press the subhypochondriac region, knead Fengchi (GB 20) and Mingmen (GV 4), pinch Hegu (LI 4) and knead Xuehai (SP 10).
Wiping the chest Wipe the region from one lateral shoulder to the subhypochondriac corner of the other side from the upper part to the lower part in an oblique line with the hands alternately for ten times respectively.
Patting the upper back Pat the region from the bilateral pulmonary apexes along the thorax from the upper part to the lower part for ten times with the hands alternately and respectively (one time refers to one pat from the upper part to lower part).
Pounding the back Form empty fists with the hands and then pound the back. When exhaling air, pound the back from the interior part to the exterior part with the empty fists. Simultaneously, bend the back slightly forwards. When inhaling air, pound the back from the exterior part to the interior part. Meanwhile, throw out the chest. This is a cycle. Repeat the cycle for ten times.
Massaging Danzhong (CV 17) Massage Danzhong (CV 17) clockwise and anticlockwise respectively for 36 times with the palm. Then, massage the relevant acupoints according to the specific concurrent symptoms. In the case of cough and difficult expectoration, knead and press Tiantu (CV 22) [The thumb should knead and press the internal surface of the manubrium of sternum from Tiantu (CV 22) until soreness and distension appear]; in the case of short breath, tap Dingchuan (EX- B 1); in the case of profuse sputum, clench the fist and pound Fenglong (ST 40) with the dorsal parts of the interphalangeal joints of hands.
In the case of pulmonary asthenia, select Huangqi Paste ( Paste of Radix Astragali seu Hedysari ); in the case of splenic asthenia, select Renshen Lianrou Gruel (Gruel of Radix Ginseng and Semen Nelumbinis ) ; in the case of renal asthenia, select Wuweizi Paste (Paste of Fructus Schisandrae ) and Thick Soup of Baiyangshen (Thick Soup of Ren Caprae seu Ovis) respectively. The prescriptions of the dietary therapy are:
Siren dizi Gruel (Four-Kernel Gruel with Egg) One share of Baiguoren ( Semen Ginkgo) and Tianxingren ( Semen Armeniacae ) respectively, two shares of Hutaoren (Semen Juglandis) and shelled peanut respectively. Grind the ingredients into powder and mix the powder evenly. Cook a bowl of gruel with 20 g of the powder, one egg and a proper amount of round-grained nonglutinous rice. Drink the gruel in every early morning. The ingestion of this gruel lasts for half a year.
Eggs Soaked in Wuweizi (Fructus Schisandrae) Decoction Decoct 250g of Wuweizi (Fructus Schisandrae) in 3 kg of water for 30 minutes. When the decoction becomes cool, soak 20 eggs in it. The eggs will turn soft in six days. Eat one egg respectively in the morning and the evening after soaking the egg in hot water for five minutes to remove the shell.
Stew 50 g of pork with 30 g of Luxiancao (Herba Pyrolae) to be eaten at a draught.
External application of drugs on acupoints
Grind 20 g of Baijiezi ( Semen Sinapis Albae ) and Yanhusuo ( Rhizoma Corydalis ) respectively, 10 g of Gansui ( Radix Euphorbiae Kansui) and Xixin (Herba Asari) respectively into powder. Then, add 0.6g of Shexiang (Moschus) to the powder and mix them evenly. Mix the drug with fresh ginger juice in three different times of the three ten-dog-day periods respectively and apply the mixed drug on Feishu (BL13), Gaohuang (BL43) and Bailao (EX). Keep the drug on the acupoints for one to two hours, once in every ten days.