Sinusitis Flashcards
Compare Sinusitis/Nasal Congestion to Rhinitis
Unlike Rhinitis…does not have itchiness or sneezing typical of rhinitis
More supraorbital and maxillary pain than rhinitis
What is the etiology of sinusitis/nasal congestion?
- External pathogens
Wind Heat or Wind Cold transforming into Heat is most common cause of Sinusitis
Wind Cold without Heat is common cause of Nasal Congestion - Liver Qi stagnation
Heat rising to sinuses, drying fluids, causing congestion - Phlegm Heat
Overconsumption of Heating or Phlegm producing substances, rich, greasy foods and alcohol; antibiotic clear Heat but repeated use retains Phlegm and Damp - Lung and Spleen Qi Deficiency
Overwork, excessive worry, irregular eating habits, consumption of cold, raw foods - Kidney deficiency
Chronic conditions, older persons; if hereditary, atopic conditions in childhood
Nasal congestion, or copious clear/white watery discharge, discomfort, stuffiness in nose and sinuses; less/loss of smell; fever and chills; aversion to Cold; frontal or occipital h/a
T: normal, thin white coat
P: floating, tight
TX: Disperse Wind Cold, redirect Lung Qi, open nose
LU 7, LI 4, LI 11, Yin Tang, GV 23, BL 2, Bi Tong;
Xin Yi San
Wind Cold
Wind Cold invades exterior and Lungs, disrupts descent of normal fluids of the Lung system causing blocked sinuses and nose. Often precedes 2º infections, Wind or Phlegm heat
Sticky yellow or green purulent, malodorous mucus discharge from nose, congestion; inflamed, swollen nasal mucosa, less/loss of smell, nasal voice; frontal h/a, maxillary pain; cough, yellow sputum; thirst; fever/chills
T: normal, yellow coat P: floating and/or rapid TX: Expel Wind, clear Heat TW 5, LI 4, GB 20, LI 11, GV 23, BL 2, LI 20, Yin Tang, Tai Yang, Bi Tong Cang Er Zi San
Wind Heat
Wind Heat or Cold becoming hot, invades Lungs disrupting drainage of Lung fluids from sinuses causing inflammation and congestion
Chronic inflammation, congestion, sinus pressure or pain, postnasal discharge, worse with stress; frontal, temporal h/a, neck shoulder tension; red eyes; facial flushing; irritable; hypochondriac tension; bitter taste
T: red edges, red spots, thin yellow coat
P: wiry, possibly rapid
TX: Soothe Liver Qi, clear Heat, open nose
LIV 2, 3; LI 4, GB 20, SI 3, GV 23, BL 2, LI 20, Yin Tang, Tai Yang, Bi Tong
Dan Zhi Xiao Yao San
Stagnant LV qi plus heat
Chronic stress, smoking, sedentary work contributes to stagnation, overtime Heat that ascends, lodging in the sinuses, inflammation
Thick, sticky, copious yellow/green discharge, malodorous; congestion, less smell; inflamed nasal mucosa; violent frontal, maxillary or temporal h/a; bitter taste; dry throat; dizziness, dreaming; irritable; dry stools, constipation; feverishness
T: red, yellow coat
P: wiry, rapid
TX: Clear Fire from Liver/GB, resolve damp, open nasal passages
TW 5, LI 4, GB 20, LIV 2, GB 39, GV 23, BL 2, LI 20 Yin Tang, Tai Yang, Bi Tong
Long Dan Xie Gan Tang
LV/GB Fire
Acute aggravation of Liver Qi Stagnation + Heat presents with acute/severs sinus infection
Copious, sticky, yellow/green discharge; inflamed mucosa; less/loss of smell; vertigo, dizziness; woolly head, frontal h/a; heaviness, aches; lethargy, fatigue; epigastric, abdominal distention, poor appetite, loose, sluggish stool
T: red, greasy yellow coat
P: soft, slippery, rapid
TX: Clear, transform Phlegm Heat, open the nose
LI 4, 11, 20; GB 20; SP 9; GB 39; GV 23; BL 2; Yin Tang,
Tai Yang, Bi Tong
Dan Xi Bi Yuan Fang Dan Xi’s Nasal Formula
Phlegm Heat
Acute or sub-acute, prolonged congestion; exacerbated by rich, heating foods, alcohol; Wind Heat attack; Spleen damage from antibiotics, bitter cold herbs;
Chronic nasal and sinus congestion, or discharge or copious thin white or sticky mucus, may smell, exacerbated by wind and cold; if congestion, worse at night, lying down pale swollen mucosa, less smell, SOB, soft voice, fatigue, spontaneous sweating; waxy, pale complexion; weak cough, thin white sputum
T: pale, thin white coat
P: weak, forceless
TX: Tonify, warm Lung Qi, Disperse Cold, open nose
LU 9; ST 36; LI 20, 4; GV 20; GV 23; Yin Tang (w/moxa over ginger), Bi Tong;
BL 2, 13; GB 20
Wen Fei Zhi Liu Dan Warm Lungs, Stop Flow Special Pill
LU qi deficiency
Follows recurrent sinusitis or rhinitis that have weakened Lung Qi, fluids fail to descend, accumulating in upper respiratory tract and sinuses
Chronic, congestion, loss of smell sense; follows hot type sinus issues treated by antibiotics; phlegm hardens blocking nose; chronic copious sticky nasal mucous, congestion, worse at night, lying down, better w/activity; pale swollen mucosa; woolly head; heavy tired limbs; fatigue; poor appetite; abdominal distention; pale complexion; diarrhea, loose;
T: pale, thin or thick white
P: moderate, weak
TX: Tonify Spleen, facilitate ‘raising of the clear Yang, descending of the turbid Yin’
LI 20, 4; GV 20, 23, Yin Tang, Bi Tang; BL 2, 20; GB 20
ST 36, 40; SP 3-
Bu Zhong Yi Qi Tang/Shen Ling Bai Zhu San
SP qi deficiency
Chronic nasal discharge, worse with cold; less smell, dizziness, tinnitus; poor memory; slow minded; sore back, spine; graying; pale; edema of lower extremities
TX: Tonify Kidney, supplement Jing, benefit brain, stop discharge
BL 23, 15; GV 4, 20; CV 4, 6; GB 39; Yin Tang, Bi Tong
Moxa for Jing & Yang def.; ginger slices, Yin Tang;
Yin Def.: Liu Wei Di Huang Wan, Sheng Mai San
Yang Def: You Gui Wan
Qi or Jing: Bu Nao Wan Brain Tonic Pills
KD deficiency
Incessant, chronic mucous, typical of Kidney def. is part of systemic failure of fluid movement and metabolism; from long term sinusitis, congenital of acquired KD weakness
Chronic pattern that involves Jing, weakness manifests as Yin or Yang def.
Chronic nasal congestion, post nasal drip, sticky yellow or white mucus; hard, dark or purple mucous membranes; loss of smell; End result of long term chronic pathology of sinus and nasal passages; mucous membranes appear dark, swollen;
T: dark red or purple, brown or purple spots
P: wiry, thready, or choppy
TX: Harmonize Qi, Blood, eliminate stasis
LI 20, 4; GV 20, 23; Yin Tang, Bi Tong, BL 2, 17; GB 20
Dang Gui Shao Yao San
Blood stasis
