Nose & Sinus Dysfunction - Traditional Chinese Medicine (TCM) Information

Sources:
1. The Practice of Chinese Medicine - The Treatment of Diseases with Acupuncture and Chinese Herbs 2nd Ed - Giovanni Maciocia
2. A Manual Of Acupuncture - Peter Deadman
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Sinusitus
The condition of sinusitis corresponds to the Chinese Medical category of Bi Yuan (Nose Pool) or Nao Lou (Brain Discharge).
Pathology - repeated invasions of Wind (Cold or Heat) impairing descending of Lung-Qi in the nasal passages causing fluid to stagnate in the nose and sinuses. Long term stagnation can lead to Phlegm and Heat, manifesting as a yellow, purulent nasal discharge.
Diet with an excessive consumption of greasy-hot foods leading to Phlegm and Heat may predispose a person to sinusitis.
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Patterns of Disharmony

  • Wind-Heat
  • Lung-Heat
  • Liver and Gall Bladder Fire
  • Stomach and Spleen Damp Heat
  • Qi and Blood Stagnation
  • Lung and Spleen Qi deficiency
  • Liver and Kidney Yin deficiency

Wind-Heat - Exterior/Excess condition - stuffed nose, yellow-sticky or purulent nasal discharge, headache, diminished sense of smell, aversion to cold and fever.
Tongue - Red sides and/or front
Pulse - Floating, rapid
Corresponds to an acute attack of sinusitis following an invasion of Wind-Heat.
Treatment principle - release the Exterior, expel Wind-Heat and restore the dispersing and descending of Lung-Qi
Acupuncture Points - LI11, LI4, LI20, Yingxiang, BL2, Bitong, Du23, BL12 - Reducing method (Maciocia)
Nose, nasal congestion/obstruction - LU1, LI20, SI2, BL3, BL4, BL5, BL6, BL8, BL9, BL10, BL12, BL58, BL67, GB15, GB16, GB18, GB19, KI22, DU20, Du22, Du25, DU27, Bitong, Yintang - with discharge; LU7, LI4, LI19, LI20, BL7, GB20, DU23, DU24, DU26 (Deadman)

Lung-Heat - Interior/Excess condition - Sticky-yellow or purulent nasal discharge, tenderness over maxiallary sinuses, flushed face, feeling of heat, thirst, headache. Occurs with repeated Wind-Heat invasion as impaired descending function of Lungs, thus fluid stagnates in the sinuses, giving rise to Phlegm-Heat.
Tongue - Red with sticky-yellow coating
Pulse - Slippery and full, mostly on right position
Treatment principle - Restore the diffusing and descending of Lung-Qi, clear Lung-Heat
Acupuncture Points - LI11, LI4, LU10, LU7, LI20, BL2, Bitong, Du14 - Reducing method (Maciocia) LU5, LU10 (Deadman)

Liver and Gall Bladder Fire - Interior/Excess condition - Yellow-purulent discharge, bloodshot eyes, red face, headache on temples and cheeks, dizziness, a bitter taste, dry stools, irritability.
Tongue - Red with redder sides, sticky-yellow coating
Pulse - Wiry, Slippery and Rapid
Treatment principle - Drain Liver and Gall Bladder Fire, restore the descending of Lung Qi
Acupuncture points - LV2 (drains Liver Fire), GB43 (drains Gall Bladder Fire), LU7 (restores the descending of Lung Qi), LI4 (open nose and sinuses), Bitong (open nose and sinuses), BL2 (opens the frontal sinuses), GB15 (local point to clear the Gall Bladder channel. Affects the eyes and sinuses - Reducing Method (Maciocia)


Stomach and Spleen Damp Heat - Interior/Excess condition - Sticky-yellow nasal discharge, red cheeks, thirst, dry lips, impaired sense of smell, a feeling of heaviness and muzziness of the head, frontal headache, sticky taste, feeling of oppression of the chest and epigastrium.
Tongue - sticky-yellow coating in the center
Pulse - Slippery
Treatment principle - Clear Heat, resolve Dampness, harmonize the Stomach, tonify Spleen.
Acupuncture Points - Ren 12 & BL 20(tonify Spleen & resolve Dampness), Ren9, SP9 & BL22 (resolve Dampness), LI11 (resolve Damp Heat), LI4 (opens the nose and harmonizes the Stomach), Ren13 (harmonize the Stomach & regulates the Upper Burner), Bitong & BL2 (open the nose and sinuses. (Maciocia)

Qi and Blood Stagnation
- Interior/Excess condition - Sticky, white or yellow nasal discharge, headach, facial pain that may be worse at night, nasal mucosa inflamed and hypertrophied, polyps.
Tongue - Purple
Pulse - Wiry or firm
(this pattern seen in chronic sinusutis conditions in middle aged people)
Treatment Principle - Invigorage Blood, eliminate stasis, move Qi.
Acupuncture Points - Lu7 & LI4 (regulate the ascending and descending of Qi in the head and help open orifices), LI20, BL2 & Yintang (local points to open sinuses and relieve inflamation), ST8 (local point to open orifices of the head), PC6 (invigorates Blood and eliminate stasis in Upper Burner), Liv3 & Sp10 (invigorate Blood and eliminate stasis). (Maciocia)

Lung and Spleen Qi deficiency - Interior/Deficiency - White-sticky nasal discharge without smell, stuffy nose, diminished sense of smell, feeling of heaviness of the head, facial pain, inflamed and hypertrophied nasal mucosa, polyps, tiredness, poor appetite, losse stools, weak voice, propensity to catching colds.
Tongue - Pale
Pulse - Weak
Treatment Principle - Tonify Lung and Spleen Qi, resolve Dampness, open sinuses
Acupuncture points - LU7 and LI4 (regulate the ascending and descending of Qi in the head and help open the orificies), LI20, BL2 & Yintang (local points to open sinuses and relieve inflammation), St8 (local point to open orifices of the head), St36, PC6 and BL20 (tonify Spleen Qi - Ren12 also tonifies Lung Qi), BL13 (tonifies Lung Qi). (Maciocia)

Liver and Kidney Yin deficiency - Interior/Excess - Runny but scanty nasal discharge, diminished sense of smell, headaches felt inside of skull, dizziness, tinnitus, lower backache, night sweating, inflamed nasal mucosa but not hypertrophied.
Tongue - without coating
Pulse - Floating, Empty
Treatment principle - Nourish Liver and Kidney Yin, open the sinuses
Acupuncture points - LU7 and LI4 (regulate the ascending and descending Qi in the head and help open orifices, LI20, BL2 and Yintang (local points), St8 (local point), Ren4, SP6, Liv* and KI3 (nourish Liver and Kidney Yin). (Maciocia)

Nasal Polyps

Larger polyps can affect breathing and diminish the sense of smell. May cause dull headaches or snoring. Nasal polyps result from inflammation of the nasal mucosa. Signs and symptoms include:
  • runny nose
  • persistent stuffiness
  • chronic sinus infections
  • diminished sense of smell
  • dull headaches
  • snoring

Usually treated with corticosteroid spray or surgery; when excised they frequently return.

Lung Heat with stagnation - Interior/Excess condition - Red, shiny, soft and slippery polyps, diminished sense of smell, yellow-sticky discharge, headache
Tongue -Red with yellow coating
Pulse - Overflowing - Rapid
Treatment principle - Clear Lung Heat, invigorate Blood, open the nose and sinuses.
Acupuncture points - LU7 and LI4 (open nose and sinuses, Lu5 (clear Lung Heat), LI11 (clears Heat), BL2, zdy8 and Bitong (local points open nose and sinuses), P6 (invigorates Blood). (Maciocia)

Damp Phlegm with stasis - Interior/Excess condition - White, sticky, shiny, soft polyps, diminished sense of smell, white sticky or runny nasal discharge, headache, feeling of heaviness of the head, a feeling of oppression of the chest, expectoration of sputum.
Tongue - Swollen, sticky coating
Pulse - Slippery
Treatment principle - Resolve phlegm, soften hardness, dissolve nodules
Acupuncture points - LU7 and LI4 (open the nose and sinuses), BL2, St8 and Bitong (local points to open nose and sinuses), CV12, CV9, SP6, SP9 & St40 (Resolve phlegm). (Maciocia)

Lung and Spleen Qi defiiency with Damp Phlegm - Interior/deficiency-excess - White, shiny polyps which return after surgery, diminished sense of smell, runny or sticky nasal discharge, a feeling of oppression in the chest, expectoration of sputum, tiredness, loose stools, poor appetite, weak voice, propensity to catching colds.
Tongue - Pale, Swollen, sticky coating
Pulse - Weak and slightly Slippery of Soggy
Treatment principle - Tonify Lung and Spleen Qi, resolve Phlegm, dissolve nodules
Acupuncture points - LU7 and LI4 (open the nose and the sinuses), BL2, St8 and Bitong (local points to open the nose and sinuses), CV9, Sp6, Sp9 and St40 (resolve Phlegm), CV12, St36 and BL20 (tonify Spleen Qi), LU9 and BL13 (tonify Lung Qi). (Maciocia)

Other points that benefit the nose: (Deadman) - DU23 - Actions - benefits the nose and eyes, eliminates wind, benefits the head and face and dispels swelling, calms the spirit; indications - nasal obstruction and discharge, nasal obstruction accompanied by headache, inability to distinguish the fragrant from the foul, nasal polyps, clear nasal discharge, rhinitis, ceaseless bleeding from the nose and mouth. Combinations - Obstruction of the nose with inability to distinguish the fragrant from the foul; DU23, DU20, DU22, BL6.
BL6 - Eliminates wind and clears heat; clears the head and benefits the eyes and nose
Nose, nasal discharge - SJ22, DU20, Bitong, Yintang; clear (discharge) BL6, BL12, DU21, DU23, DU25, DU26; clear and ceasless (discharge) DU24; in children DU22; incessant turbid GB5; profuse LI20, BL7, yellow ST45
Nose, nasal congestion/obstruction - LU1, LI20, SI2, BL3, BL4, BL5, BL6, BL8, BL9, BL10, BL12, BL58, BL67, GB15, GB16, GB18, GB19, KID22, DU20, DU22, DU25, DU27, DU28, Bitong, Yintang; with aversion to cold - GB15; with headache - DU23; with discharge - LU7, LI4, LI19, LI20, BL7, GB20, DU23, DU24, DU26.
Drinker's nose - DU25
Polyps - LU7, LI19, LI20, DU22, DU23, DU25, DU28, Bitong
Stuffy - SJ16