Chronic Respiratory Failure
Respiratory failure is a clinical syndrome caused by severe impairment of pulmonary ventilation and/or gas exchange for various reasons, such that effective gas exchange cannot be maintained. It leads to hypoxemia (O₂), with or without carbon dioxide (CO₂) retention, and consequently to a series of physiological and metabolic disturbances. Clinically, respiratory failure is classified by course as acute or chronic. Chronic respiratory failure is often secondary to chronic respiratory disease and is most commonly associated with chronic obstructive pulmonary disease (COPD). This clinical syndrome usually develops gradually and follows a prolonged course; the body often has some capacity to compensate. It may worsen due to causes such as infection, resulting in an acute exacerbation of chronic respiratory failure that can be life-threatening. In traditional Chinese medicine (TCM), this condition falls within the categories of “dyspnea” (喘证) and “dyspnea with collapse” (喘脱).
TCM Pattern Differentiation and Medication Reference
|Common Symptoms
Clinical description:
Cough with yellow phlegm, labored and rapid breathing, dry and bitter taste in the mouth, and constipation. Red tongue with a yellow, greasy coating; slippery, rapid pulse.
In plain language:
- Cough with yellow, relatively thick phlegm
- Rapid breathing and a tendency to feel short of breath
- Dry mouth and a bitter taste
- Hard stools and constipation
- The tongue appears red, with a yellow, relatively thick and sticky coating
- The pulse feels relatively fast and slippery (as noted during a practitioner’s examination)
|Treatment approach
Clinical description:
Clear lung heat, transform phlegm, relieve cough, and ease wheezing.
In plain language:
- Clear phlegm and inflammation in the lungs, helping make phlegm thinner and easier to cough up, and easing a sticky or blocked feeling in the throat and chest tightness
- Reduce coughing and ease shortness of breath and rapid breathing, so breathing may feel steadier and easier
|Related products
The products below are provided for information only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Clinical description:
Repeated coughing and labored breathing, sticky phlegm, a bland taste in the mouth without thirst, and difficulty passing stools. Dusky tongue with a greasy coating; wiry and slippery, or deep and rough pulse.
In plain language:
- Repeated bouts of coughing, with rapid breathing and shortness of breath
- Thick, sticky phlegm that is difficult to cough up
- A bland taste in the mouth and little thirst
- Difficulty passing stools and a tendency toward constipation
- The tongue appears dusky, with a relatively thick, sticky coating
- The pulse feels taut and slippery, or deep and somewhat rough (as noted during a practitioner’s examination)
|Treatment approach
Clinical description:
Transform phlegm, ease wheezing, promote blood circulation, and resolve blood stasis.
In plain language:
- Loosen sticky phlegm so it becomes thinner and easier to cough up, easing coughing, shortness of breath, and difficulty breathing.
- Promote blood circulation and address stagnation, helping ease discomfort such as chest tightness or pain and bluish or dusky discoloration.
|Related products
The products below are provided for information only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Clinical description:
Clouded consciousness, labored breathing, and rattling phlegm. Dusky tongue with a greasy or watery-slick coating; slippery pulse.
In plain language:
- Slowed responses and confusion
- Rapid breathing
- A rattling sound from phlegm in the throat, as if it is blocked with phlegm
- The tongue appears dusky
- The tongue coating is relatively thick and sticky, or appears wet and glossy
- The pulse feels slippery (as noted during a practitioner’s examination)
|Treatment approach
Clinical description:
Expel phlegm and open the orifices.
In plain language:
- Clear thick, sticky phlegm and loosen the obstruction, helping the throat and airways feel more open and easing rattling phlegm, chest tightness, and difficulty coughing phlegm up
- Clear the pathways said to be “misted” by phlegm, helping qi and blood flow more freely and supporting alertness and responsiveness
|Related products
The products below are provided for information only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Clinical description:
Fatigue and weakness, shallow and quiet breathing, weak coughing of phlegm, and dry mouth. Pale-dusky, tender tongue with little coating; fine, weak pulse.
In plain language:
- Low energy, easy fatigue, and weakness
- Shallow breathing and a soft speaking voice
- Weak cough when bringing up phlegm, with a sense that it cannot be fully cleared
- Dry mouth and a desire to drink
- The tongue appears pale and dusky, with a relatively soft texture
- Very little tongue coating
- The pulse feels fine and weak (as noted during a practitioner’s examination)
|Treatment approach
Clinical description:
Tonify qi and nourish yin; stabilize collapse.
In plain language:
- Support energy and nourish body fluids, easing weakness, dry mouth, night sweats, and restlessness, and supporting resilience
- Stabilize a state of extreme weakness or impending collapse, helping address serious signs such as profuse sweating, very shallow breathing, and cold hands and feet
|Related products
The products below are provided for information only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Clinical description:
Weak cough and wheezing, worsened by exertion, poor appetite, and sweating. Pale-dusky tongue with a thin coating; weak, deficient pulse.
In plain language:
- Cough and difficulty breathing, with little strength
- Symptoms become more noticeable after activity
- Poor appetite and difficulty eating
- Easy sweating
- The tongue appears pale and dusky, with a very thin coating
- The pulse feels weak and lacking in strength (as noted during a practitioner’s examination)
|Treatment approach
Clinical description:
Tonify the kidneys and strengthen the spleen; benefit the lungs.
In plain language:
- Support energy and nourish body fluids, easing weakness, dry mouth, night sweats, and restlessness, and supporting resilience
- Stabilize a state of extreme weakness or impending collapse, helping address serious signs such as profuse sweating, very shallow breathing, and cold hands and feet
|Related products
The products below are provided for information only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Clinical description:
Clouded consciousness without loss of awareness, extremely faint breathing, sweating, and cold limbs. Pale, swollen tongue; feeble pulse that is nearly imperceptible.
In plain language:
- Confusion and markedly reduced responsiveness
- Extremely shallow breathing
- Profuse sweating and cold hands and feet
- The tongue appears pale and slightly swollen
- The pulse is extremely weak and almost imperceptible (as noted during a practitioner’s examination)
|Treatment approach
Clinical description:
Restore yang, secure yin, and rescue from collapse.
In plain language:
- Quickly support yang and help stabilize body temperature, breathing, and heartbeat in cases of cold hands and feet, a pale complexion, or extremely faint breathing
- Also help conserve the body’s fluids (yin) and reduce profuse sweating and loss of strength
|Related products
The products below are provided for information only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
References
- Lin Lin, Zhang Zhongde. TCM Clinical Diagnosis and Treatment of Respiratory Diseases [M]. 3rd ed. Beijing: People’s Medical Publishing House, 2013.
- Luo Yunjian, Sun Sulun. Guidelines to the Characteristics and Advantages of TCM Clinical Treatment [M]. Beijing: People’s Medical Publishing House, 2007.
- Zhang Hongchun. Commentary on TCM Clinical Diagnosis and Treatment Guidelines: Respiratory Diseases Volume [M]. Beijing: China Press of Traditional Chinese Medicine, 2015.
- Chinese Pharmacopoeia Commission. Pharmacopoeia of the People’s Republic of China: Clinical Medication Guide—Chinese Patent Medicines and Single-Herb Preparations Volume [M]. Beijing: China Medical Science Press, 2015.
- Fang Laiying, Jin Shiyuan, Li Qiangou. 2011 Edition Prescription Formulary for Medical Institutions in Beijing: Chinese Medicine Volume [M]. Shanghai: Second Military Medical University Press, 2011.