Throat pain






Prescription



Main formula



Jing fang bai du san


Schizonepeta and Ledebouriella Powder to Overcome pathogenic Toxin. This formula dispels Wind-Cold and relieves the External symptoms. Generally speaking, when Wind-Cold is dispelled, throat pain together with these External symptoms will disappear by themselves. In this formula, there is a very important herb, Jie Geng Radix Platycodi 10g, which disperses the Lung-Qi, relieves the cough, benefits the throat and relieves the throat pain. Pang Da Hai Semen Sterculiae Scaphigerae 5 pieces, Xing Ren Semen Pruni Armeniacae 10g and Zi Su Zi Fructus Perillae Frutescentis 10g could be added into the prescription to increase the benefits to the throat and relieve the pain.


Alternative formulas



Ma huang tang


Ephedra Decoction. This formula is indicated in nasal pain due to severe invasion of Wind-Cold with lack of sweating. Jie Geng Radix Platycodi 10g and Pang Da Hai Semen Sterculiae Scaphigerae 5 pieces could be added to benefit the throat and relieve the throat pain.


Gui zhi tang


Cinnamon Twig Decoction.This formula is indicated in nasal pain due to slight invasion of Wind-Cold with sweating. Jie Geng Radix Platycodi 10g, Xing Ren Semen Pruni Armeniacae 10g and Pang Da Hai Semen Sterculiae Scaphigerae 5 pieces could be added to benefit the throat and relieve the throat pain.


Xiao qing long tang


Minor Bluegreen Dragon Decoction. This formula dispels the Wind-Cold, eliminates damp-Phlegm and relieves the asthma. When it is used to treat the throat pain due to Wind-Cold invasion, Jie Geng Radix Platycodi 10g and Pang Da Hai Semen Sterculiae Scaphigerae 5 pieces could be added to relieve the throat pain.


Modifications





1. If there is much swelling in the throat, add Bai Bu Radix Stemmonae 10g to regulate the Lung-Qi and reduce the swelling


2. If there is an aversion to cold, add Ma Huang Herba Ephedrae 10g to disperse the Lung-Qi and dispel Wind-Cold


3. If there is a fever, add Gui Zhi Ramulus Cinnamomi 10g to dispel Cold and reduce the fever


4. If there is a headache, add Bai Zhi Radix Angelicae Dahuricae 10g and Man Jing Zi Fructus Viticis 10g to dispel Wind-Cold and sedate the headache


5. If there is much cough and expectoration of white phlegm due to invasion of the Lung by Wind-Cold, add Zi Wan Radix Asteris 10g to disperse the Lung-Qi and dispel the Wind-Cold.


Patent remedy


Jing Fang Bai Du Pian Schizonepeta and Ledebouriella Tablet to Overcome Pathogenic Influences.



Acupuncture Treatment




Main points


TE-5 Waiguan, LI-4 Hegu, BL-12 Fengmen, BL-13 Feishu, LU-7 Lieque, GB-20 Fengchi, LI-17 Tianding and ST-10 Shuitu. Reducing method is used on these points and even method is applied on the last two points. Moxibustion should be used on the first five points.


Explanations





▪ LI-4, the Source point of the Large Intestine channel, and LU-7, the Connecting point of the Lung channel, open the skin pores, promote sweating and dispel Wind-Cold. Also, LU-7 is a good point to disperse the Lung-Qi and benefit the throat, and is indicated in throat pain due to invasion of External factors. Conventionally, LU-7 is a very good point for treating all problems due to disturbance of the Lung system resulting from invasion of External factors


▪ TE-5, the Connecting point of the Triple Burner channel, BL-12 and GB-20 dispel the Wind, eliminate the Cold and relieve the External symptoms


▪ BL-13, the Back Transporting point of the Lung, disperses Lung-Qi, relieves External invasion and benefits the throat


▪ LI-17 and ST-10, the local points, are used to dispel Wind-Cold, benefit the throat and relieve the throat pain.

Moxibustion could warm the channel and collaterals, dispel the Wind-Cold and relieve the throat pain.



Alternative points


LU-1 Zhongfu, LU-5 Chize, LU-6 Kongzui, ST-9 Renying and BL10 Tianzhu, etc.


Modifications





1. If there is a severe pain and swelling in the throat, and difficulty in swallowing and speaking, add CV-23 to reduce the swelling and relieve the throat pain


2. If there is a cough with white phlegm due to invasion of Wind-Cold to the Lung, add LU-1 to disperse the Lung-Qi and relieve the cough


3. If there is throat pain with asthma, add CV-22 to descend the Lung-Qi and relieve the asthma


4. If there is a stuffed-up nose and white nasal discharge, add LI-20 and BL-2 to clear the nasal passage and relieve the nasal blockage


5. If the throat is red, add LU-10, the Spring point of the Lung channel, to clear Heat and relieve the redness in the throat


6. If there is generalised body pain with a cold feeling, add BL-58, the Connecting point of the Bladder channel, and BL-62, the Confluence point of the Yang Heel Vessel, to dispel Wind-Cold and relieve the body pain


7. If there is hoarseness, add LU-11 and CV-21 to open the collateral of the Lung and improve the voice


8. If there is headache, add Extra Yintang and GV-16 to dispel Wind-Cold and stop the headache.


Case History



A 34-year-old man had been suffering from throat pain for about 2 weeks. He was diagnosed in the hospital as having acute laryngitis, and was given injections of antibiotics. The throat swelling improved, but his throat was still painful. When he arrived at the clinic he had a slight fever, and other symptoms, such as aversion to cold, a cough with itching in the throat, a poor appetite, a red tongue with a dry, yellow coating and a rapid pulse.


Diagnosis


Invasion of External Wind-Cold.


Principle of treatment


Promote Qi circulation, dispel Wind and Cold and relieve the pain.


Herbal treatment




Jing fang bai du san





Schizonepeta and Ledebouriella Powder to Overcome pathogenic Toxin


Jing Jie Herba Schizonepetae 6g


Fang Feng Radix Ledebouriellae 6g


Qiang Huo Rhizoma seu Radix Notopterygii 6g


Chen Pi Pericarpium Citri Reticulatae 10g


Su Ye Folium Perillae 10g


Chai Hu Radix Bupleuri 6g


Jiang Can Bombys Batryticatus 10g


Jie Geng Radix Platycodi 5g


Xing Ren Semen Armeniacae Amarum 10g


Zhi Qiao Fructus Aurantii 6g


Gan Cao Radix Glycyrrhizae 5g


Explanations





▪ Jing Jie, Fang Feng and Qiang Huo promote sweating and dispel pathogenic Wind-Cold.


▪ Chai Hu invigorates the Qi and Blood circulation and stops the pain


▪ Jie Geng and Xing Ren disperse the Lung-Qi and stop the cough


▪ Su Ye and Jiang Can dispel Wind, arrest itching and stop the cough


▪ Zhi Qiao and Chen Pi promote the circulation of Qi in the ches.


▪ Gan Cao harmonises the actions of the other herbs in the formula.

After 10 days of treatment, the cough and throat pain disappeared.





Invasion of Wind-Heat



Symptoms and signs


Symptoms and signs of Wind-Heat invasion are acute pain with a burning feeling, obvious swelling and redness in the throat, accompanied by a slight aversion to cold and wind, fever, a runny nose with a yellow discharge, headache, sweating, thirst, restlessness, generalised body pain, a thin and yellow tongue coating and a superficial and rapid pulse.


Principle of treatment


Dispel the Wind, clear the Heat, reduce the swelling and relieve the pain.

Herbal Treatment




Prescription



Main formula



Yin qiao san


Honeysuckle and Forsythia Powder. This formula could be used to dispel Wind-Heat, subside the swelling, benefit the throat and relieve the throat pain. Jie Geng Radix Platycodi 5g, Pang Da Hai Semen Sterculiae Scaphigerae 5 pieces, Tu Niu Xi Radix Achyranthis 10g, Pu Gong Ying Herba Taraxaci 10g and Zi Hua Di Ding Herba Violae 10g could be added into the prescription to relieve the throat pain.


Alternative formula



Sang ju yin


Mulberry Leaf and Chrysanthemum Decoction. This formula is indicated in cough due to invasion of Wind-Heat to the Lung. When it is used to treat the throat pain resulting from invasion of Wind-Heat, some other herbs could be added into the prescription, such as Zhi Zi Fructus Gardeniae 10g, Pang Da Hai Semen Sterculiae Scaphigerae 5 pieces, Pu Gong Ying Herba Taraxaci 10g and Zi Hua Di Ding Herba Violae 10g could be added into the prescription to relieve the throat pain.


Modifications





1. If the throat is red and swollen owing to invasion of Wind-Heat, add Ban Lan Gen Radix isatidis 15g to clear the Heat, eliminate Toxin and reduce the swelling


2. If there is a cough and expectoration of yellow phlegm due to invasion of the Lung by Wind-Heat, add Qian Hu Radix Peucedani 10g and Zhe Bei Mu Bulbus Fritillariae Thunbergii 10g to disperse the Lung-Qi and dispel the Wind-Heat


3. If there is a high fever, add Chai Hu Radix Bupleuri 15g and Shen Ma Rhizoma Cimicifugae 10g to clear Heat and reduce the fever


4. If there is much headache, add Chuan Xiong Rhizoma Ligustici Chuanxiong 10g and Man Jing Zi Fructus Viticis 15g to dispel Wind-Heat and sedate the headache


5. If there is much thirst, add Xuan Shen Radix Scrophulariae 15g to nourish the Body Fluid and relieve the thirst.


Patent remedy


Yin Qiao Jie Du Pian Honeysuckle and Forsythia Tablet to Overcome Toxins.


Acupuncture Treatment




Main points


LI-2 Erjian, LI-4 Hegu, LI-11 Quchi, BL-12 Fengmen, LU-7 Lieque, LU-10 Yuji, LI-17 Tianding and ST-10 Shuitu. Reducing method is used on these points and even method is applied on the last two points.


Explanations





▪ LI-4 and LI-11, the Source point and the Sea point of the Large Intestine channel respectively, dispel the Wind, clear the Heat and reduce the fever.


▪ BL-12 dispels the Wind and clears the Heat so as to relieve the External symptoms.


▪ LU-7, the Connecting point of the Lung channel, dispels the Wind-Heat from the Lung system, harmonises the collateral and relieves the throat pain.


▪ LI-2 and LU-10, the Spring point from the Large Intestine channel and Lung channel respectively, clear the Heat in the throat strongly, reduce the swelling and relieve the throat pain.


▪ LI-17 and ST-10, the local points, are used to dispel Wind-Heat, benefit the throat and relieve the throat pain.


Alternative points


LU-1 Zhongfu, LU-5 Chize, LU-6 Kongzui, LU-8 Jingqu, ST-9 Renying and BL10 Tianzhu, etc.


Modifications





1. If there is a high fever and severe throat pain, then bleeding, add LI-1 and LU-11, the Well (Jing) point from the Large Intestine channel and Lung channel respectively, to clear the Heat, reduce the fever, and relieve the throat pain


2. If there is difficulty in speaking and swallowing due to a swelling in the throat, add CV-21 and CV-22 to reduce the swelling and benefit the throat strongly


3. If there is a cough with a yellow nasal discharge due to failure of the Lung in dispersing Qi, add BL-13, the Back Transporting point of the Lung, LU-1, the Front Collecting point of the Lung, and LU-5, the Sea point and Water point of the Lung channel, to disperse the Lung-Qi and relieve the cough


4. If there is a blocked nose, add LI-20 and BL-2 to clear the nose and relieve the nasal blockage


5. If there is a headache, add Extra Yintang and GV-16 to dispel Wind-Heat and stop the headache.


Invasion of Wind-Dryness



Symptoms and signs


Invasion of Wind-Dryness comprises two types: Wind-Cold-Dryness and Wind-Heat-Dryness.

Common symptoms and signs: acute throat pain with an obvious dry feeling, a slight swelling and redness in the throat, accompanied by a slight aversion to cold, a low-grade fever, thirst, a dry cough, scanty phlegm expectoration, a slight headache, a thin and dry tongue coating and a superficial pulse.

Wind-Heat-Dryness: obvious aversion to heat, fever, thirst, dry stool, running nose with yellow phlegm, cough with expectoration of yellow and sticky phlegm, red tongue or red tip of the tongue, thin, yellow and dry coating, superficial and rapid pulse.


Principle of treatment


Dispel the Wind, moisten the Dryness, reduce the swelling and relieve the pain.

Herbal Treatment




A. Prescription for Wind-Cold-Dryness




Xing su san


Apricot Kernel and Perilla Leaf Powder. This formula dispels Wind-Cold, disperses the Lung-Qi, relieves the Dryness in the throat and stops the cough. It also has some effect in relieving the throat pain due to invasion of Wind-Cold-Dryness. Pang Da Hai Semen Sterculiae Scaphigerae 5 pieces and Mai Men Dong Radix Ophiopogonis 10g could be added into the prescription to relieve the throat pan.


Modifications





1. If the throat is swollen, add Jiang Can Bombyx Batyticatus 10g and Chan Yi Periostracum Cicadae 6g to dispel Wind and reduce the swelling


2. If there is obvious thirst or a dry mouth, add Xuan Shen Radix Scrophulariae 10g to nourish the Yin of the Lung and the Stomach and relieve the thirst


3. If there is a fever, add Chai Hu Radix Bupleuri 10g to reduce the fever


4. If there is much headache, add Chuan Xiong Rhizoma Ligustici Chuanxiong 10g and Man Jing Zi Fructus Viticis 10g to dispel Wind and sedate the headache


5. If there is a dry cough with itching in the throat, add Tian Hua Fen Radix Trichosanthis 10g and Chuan Bei Mu Bulbus Fritillariae Cirrhosae 10g to dispel the Dryness, disperse the Lung-Qi and relieve the dry cough.


B. Prescription for Wind-Heat-Dryness




Sang xing tang


Mulberry Leaf and Apricot Kernel Decoction. This formula has functions to dispel the Wind, Heat and Dryness, nourish the Body Fluid, benefit the throat, and relieve the cough and throat pain. Huang Qin Radix Scutellariae 10g, Pang Da Hai Semen Sterculiae Scaphigerae 5 pieces and Mai Men Dong Radix Ophiopogonis 10g could be added into the prescription to relieve the throat pan.


Modifications





1. If the throat is red and swollen, add Pu Gong Ying Herba Taraxaci 10g and Zhu Ye Herba Lophatheri 10g to clear the Heat and reduce the swelling


2. If there is thirst due to invasion of Wind-Dry-Heat, add Xuan Shen Radix Scrophulariae 10g to nourish the Yin of the Lung and the Stomach and relieve the thirst


3. If there is a fever, add Chai Hu Radix Bupleuri 10g to clear Heat and reduce the fever


4. If there is a headache, add Ju Hua Flos Chrysanthemi 10g and Man Jing Zi Fructus Viticis 10g to dispel Wind-Dry-Heat and sedate the headache


5. If there is a cough and expectoration of yellow phlegm due to invasion of the Lung by Wind-Dry-Heat, add Gua Lou Fructus Trichosanthis 10g and Zhe Bei Mu Bulbus Fritillariae Thunbergii 10g to dispel the Wind, Dryness and Heat, disperse the Lung-Qi and relieve the cough


6. If there is constipation, add Gua Lou Ren Semen Trichosanthis 15g and Sheng Di Huang Radix Rehmanniae Recens 15g to moisten the Large Intestine, promote the defecation and relieve the constipation.


Patent remedy


Qing Fei Yi Huo Pian Clear Lungs Restrain Fire Tablet.


Acupuncture Treatment




Main points


LI-4 Hegu, BL-12 Fengmen, TE-5 Waiguan, LU-7 Lieque, LU-8 Jingqu, LU-5 Chize, LI-18 Futu and ST-11 Qishe. Reducing method is applied on these points except LU-8 and LU-5, on which tonifying method is used, and even method is applied on LI-18 and ST11.


Explanations





▪ LI-4, the Source point of the Large Intestine channel, BL-12, and TE-5, the Connecting point of the Triple Burner channel, dispel External pathogenic factors and relieve the External symptoms


▪ LU-7, the Connecting point of the Lung channel, dispels the External factors from the Lung system, harmonises the collateral of the Lung and relieves the throat pain


▪ LU-8 and LU-5, the Metal point and the Water point from the Lung channel are used here to promote secretion of Body Fluids in the Lung system, moisten the throat, relieve the Dryness and relieve the throat pain


▪ LI-18 and ST-11 are used as the local points to harmonise the channels and collaterals in the throat and relieve the throat pain.


Alternative points


LU-1 Zhongfu, LU-6 Kongzui, ST-9 Renying, ST-10 Shuitu, ST-41 Jiexi, BL10 Tianzhu and SP-6 Sanyinjiao, etc.


Modifications





1. If there is a fever and severe throat pain due to invasion of Wind-Heat-Dryness, add LU-10 and LI-2, the Spring points of the Lung channel and Large Intestine channel respectively, to clear the Heat and reduce the fever and swelling


2. If the throat is obviously swollen, then use bleeding method at LI-1 and LU-11 to clear Heat, reduce fever and relieve the throat pain


3. If there is difficulty in speaking and swallowing due to swelling in the throat, add CV-21 and CV-22 to reduce the swelling and benefit the throat strongly


4. If there is a cough with a yellow nasal discharge due to failure of Lung to disperse the Qi, add BL-13, the Back Transporting point of the Lung, and LU-1, the Front Collecting point of the Lung, to disperse the Lung-Qi and relieve the cough


5. If the nose is blocked, add LI-20 and BL-2 to clear the nose and relieve the nasal blockage


6. If there is a feeling of spasm or blockage in the throat due to invasion of Wind-Cold-Dryness, add CV-23 and moxibustion on LI-4, LU-7, BL-12 and BL-13 to dispel the Wind-Cold and Dryness and warm the collateral.


Case History



A 41-year-old woman had been suffering from throat pain for a month. She had complained of throat pain with a dry sensation when she caught a cold one month previously. She had suffered from chronic bronchitis 1 year before this and was treated with antibiotics. She generally catches colds very easily. Also, she had a low-grade fever, dizziness, a dry cough with itching in her throat, a dry mouth, dry stools, tiredness and a pale complexion. Her tongue was red with a dry yellow coating. Her pulse was superficial and weak at Lung position.


Diagnosis


Deficiency of Qi and Yin with invasion of Wind-Heat-Dryness.


Principle of treatment


Nourish the Qi and Yin, clear Heat, moisten Dryness and relieve the pain.


Acupuncture treatment


KI-6, SP-6, GB-20, LU-7, LI-4 and CV-23. Even method was used for these points. Treatment was given every other day for a week.


Explanations





▪ KI-6, the Confluence point of the Yin Heel Vessel, and LU-7, the Connecting point of the Lung channel and the Confluence point of the Directing Vessel, are used to promote the Qi circulation in the Lung, nourish the Qi and Yin, benefit the throat and relieve the throat pain


▪ SP-6, the crossing point of the three Yin channels of the foot, nourishes the Yin and benefits the throat


▪ GB-20 is a patent point to dispel Wind, Heat and Dryness and relieve the throat pain


▪ LI-4, the Source point of the Large Intestine channel, is used to relieve the throat pain


▪ CV-23 is the patent point to regulate the Qi circulation in the throat and relieve the throat pain.

After 3 weeks of treatment, her throat pain was relieved. One year later when she returned to the clinic she stated that she had suffered no more throat pain since the last treatment.

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Jun 19, 2016 | Posted by in PAIN MEDICINE | Comments Off on Throat pain

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