To treat atrophic rhinitis, we should first emphasize syndrome differentiation. Lack of body fluid nourishment in the nasal cavity leads to dryness, mucosal atrophy and even skeletal atrophy. Body fluid due to yin deficiency involves lung, spleen and kidney. The lung starts from the water and is enlightened by the nose, so the disease is closely related to the lung; Spleen is the biochemical source of qi, blood and body fluid, and controls muscles. If the spleen is weak, the body fluid can't be transported upward, and the muscles are thin, which is often vulnerable to dampness and turbidity. Kidney water is dirty, containing true yin and true yang, storing essence to produce marrow, nourishing bones, and kidney deficiency leads to exhaustion of body fluid and bone flaccidity. Clinically, the following three types of syndromes are common.
Lung dryness and fluid injury
The nose is dry, or feels burning and painful, or if it is smoked, the nose is thin, sticky and difficult to blow, often forming scabs, or the nose is congested and bloody, with thin turbinate, red mucosa and empty nasal cavity. Accompanied by dry cough with little phlegm, weakness of speech, dry throat pain, dry mouth and thirst, dry skin, chapped hair, red tongue with little fur, and rapid pulse. Treatment should be nourishing yin and moistening lung, such as Qingzao Jiufei Decoction and Shashen Maidong Decoction. Drugs such as Mulberry Leaves, Gypsum Fibrosum, Almond, Loquat Leaves, Adenophora adenophora, Ophiopogon japonicus, Polygonatum odoratum, Dendrobium, Rhizoma Phragmitis, Trichosanthis Radix, etc. The general dosage is 10g, and gypsum and reed rhizome are 30g each. It would be better if 3 grams of persimmon cream could be added. It can also be used with loquat leaf cream, which is simple and effective. However, it should be noted that loquat leaf cream is different from "loquat cream", which is made of pulp and should not be used.
Spleen deficiency and dampness resistance
The nose has a fishy smell, yellow or green, which is not easy to blow out, or mixed with snot and scab. Nose digging often causes nosebleed, pale nasal mucosa and atrophy of turbinate. Accompanied by dizziness, such as head wrapped with cloth strips, excessive and sticky phlegm in the throat, loss of appetite, abdominal distension and loose stool, pale and fat tongue with teeth marks, white and greasy fur and weak pulse. It is advisable to strengthen the spleen and eliminate dampness. Commonly used prescriptions are Shen Ling Baizhu Powder and Huoxiang Zhengqi Powder. The former is used for invigorating the spleen and eliminating dampness, and is used for people who have no smelly nose and greasy tongue coating, such as Codonopsis pilosula, Atractylodes macrocephala, Poria, Chinese yam, white lentils, Coicis Semen, Alisma orientale and talc. The latter focuses on aromatization and dampness, and is used for people with smelly nose and greasy fur. Pogostemon cablin, Eupatorium odoratum, Pericarpium Citri Tangerinae, Rhizoma Pinelliae Preparata, Fructus Crataegi, Massa Medicata Fermentata, Fructus Amomi, etc. Generally, it is about 65,438+00g, while Amomum villosum is light and Magnolia officinalis is warm and dry, and the dosage is about 3g.
When using this method, we should also pay attention to three points: (1) Strengthening the spleen and eliminating dampness are complementary, and hyperactivity of spleen will lead to the increase of clear yang and the decrease of turbid yin. So sometimes two prescriptions can be used together. (2) It is best to use ginseng to strengthen the spleen and replenish qi, but those who are wet and turbid are afraid of their love for evil, which can be mastered according to the tongue coating. Codonopsis pilosula can be used for those with clean tongue coating; If the tongue coating is slightly greasy, use Radix Pseudostellariae; If the fur is obviously greasy, it is not suitable to use ginseng, but using platycodon grandiflorum is also beneficial to nourish the clear and reduce turbidity. In addition, Cimicifuga rhizome, Radix Puerariae, etc. can also be added to the prescription to promote the qi of clearing yang. (3) One or two menstrual drugs, such as Flos Magnoliae and Radix Angelicae Dahuricae, can be added to the nose where the lesion is located, and the latter, such as Rhizoma Acori Graminei, Aristolochia and Fructus Lipuidambaris, need not be too much, and the dosage is 3-5g.
Kidney deficiency and water dryness
Persistent illness, stuffy nose, dry nose, smelly nose, atrophy of turbinate and common nosebleed. Accompanied by emaciation, dizziness, tinnitus, mental fatigue, forgetfulness, fever in hands and feet, red tongue with thin coating and rapid pulse. Suitable for nourishing yin and tonifying kidney, the commonly used prescriptions are Baizhi Huangtang and Baihe Gujin Decoction. Raw and cooked Radix Scrophulariae, Mulberry, Cornus officinalis, Radix Polygoni Multiflori Preparata, Semen Sesami Niger, Fructus Ligustri Lucidi, Lily, Rhizoma Anemarrhenae, Cortex Phellodendri, etc. It would be nice if some "flesh and blood products" such as tortoise shell, tortoise shell, antler glue and pig spinal cord could be added. It will be more helpful to tonify kidney and yin. You can eat some American ginseng if you can. After a period of treatment, after the symptoms are relieved, you can take Chinese patent medicine to consolidate the curative effect. Liuwei Dihuang Pill and Erzhi Pill are commonly used.
In addition to oral administration of traditional Chinese medicine, the following external treatments can be used for various syndromes.
(1) Drop a small amount of sesame oil or honey into the nose, or dip a cotton swab into the nose. Before taking the medicine, it is advisable to wash the nasal cavity with warm physiological saline or potassium permanganate solution (1: 2000-5000) to remove the nasal scab, once a day 1-2 times.
(2) Peeling almond, mashing it into paste, decocting it with Glycyrrhiza uralensis Fisch, and applying it to nasal cavity.
(3) Apply Coptidis Rhizoma ointment to nasal cavity.
At the same time of treatment, we should also pay attention to prevention and nursing. First of all, we should try our best to improve the living environment and avoid heat, smoke and chemical gases. Workers in harsh environments should take protective measures such as sprinkling water or wearing slightly wet masks. Secondly, patients are forbidden to drip ephedrine, nasal drops and other vasoconstrictors, so as not to aggravate the condition. In addition, quitting smoking and drinking habits and eating less spicy food such as pepper, garlic, mustard and ginger are also of great significance to the prevention of this disease.