Community-Acquired Pneumonia
Community-acquired pneumonia (CAP) refers to an infectious inflammation of the lung parenchyma (including the alveolar walls, or pulmonary interstitium in the broader sense) acquired outside a hospital. This includes pneumonia caused by pathogens with a defined incubation period that develops during that period after hospital admission. Pneumonia acquired in hospital and developing after discharge is excluded. CAP can occur at any time of year, but is more common in winter and spring. In TCM theory, it often occurs when the body’s healthy qi is insufficient due to overexertion, chronic illness, or advanced age and frailty, allowing invasion by wind-heat or wind-cold that transforms into heat internally. At onset, the main pattern is an exterior heat pattern caused by pathogens attacking the lung and defensive qi. If pathogenic heat is not resolved, it may penetrate inward or transmit directly to the pericardium. During the course of the condition, it may transform into fire, generate phlegm, and injure fluids and consume qi, producing various patterns. The recovery stage is often characterized clinically by dual deficiency of qi and yin or deficiency of lung and spleen qi. If treatment is inappropriate or pathogenic heat is severe, a critical pattern may occur in which the pathogen overwhelms the body’s healthy qi. In TCM, this condition falls within the categories of “wind-warmth lung-heat” and “cough.”
TCM Pattern Identification and Medication Reference
|Common Symptoms
Clinical description:
Fever; dry cough or scant sputum; sputum that is white and sticky or yellow and difficult to expectorate; dryness and heat in the nasal passages; dry, sore throat. Red tongue tip; thin, white and dry or thin yellow coating; floating or floating and rapid pulse.
In everyday terms:
- Fever
- Dry cough or little sputum
- White, sticky or yellow sputum that is difficult to cough up
- Dry, hot feeling in the nose
- Dry, sore throat
- The tip of the tongue appears somewhat red
- A thin, dry, white tongue coating or a thin yellow coating
- A pulse that feels relatively superficial or fast (as noted by a clinician during examination)
|Treatment Approach
Clinical description:
Disperse wind and clear heat; clear the lung and transform phlegm.
In everyday terms:
- Disperse external “wind-heat” from the body’s exterior, clear heat, and ease discomforts such as fever, headache, sore throat, and nasal congestion.
- Clear “heat” and phlegm-dampness from the lungs, helping loosen sputum so it may be easier to cough up and easing cough, chest tightness, and shortness of breath to support more comfortable breathing.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and leaflet, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Fever, aversion to cold, no sweating or aching limbs, cough, white and sticky or yellow sputum, dry mouth and thirst. Red tongue; yellow or yellow, greasy coating; rapid or floating and rapid pulse.
In everyday terms:
- Fever
- Feeling cold or having chills
- No sweating or aching throughout the body
- Cough
- White, sticky or yellow sputum
- Dry mouth and thirst
- The tongue appears somewhat red
- Yellow or somewhat sticky, thick tongue coating
- A fast pulse, or a pulse that feels superficial and fast (as noted by a clinician during examination)
|Treatment Approach
Clinical description:
Disperse wind and cold; clear the lung and transform phlegm.
In everyday terms:
- Disperse external wind-cold from the body’s exterior and ease discomforts associated with catching cold, such as chills, aches in the head and body, and nasal congestion.
- Clear phlegm-dampness from the lungs, helping loosen sputum so it may be easier to cough up and easing cough, chest tightness, and shortness of breath to support more comfortable breathing.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and leaflet, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Fever, cough, yellow or sticky sputum, chest pain, thirst, dark urine, and hard stools. Red tongue; yellow or yellow, greasy coating; rapid or slippery and rapid pulse.
In everyday terms:
- Fever
- Cough
- Yellow or thick, sticky sputum that is difficult to cough up completely
- Chest pain
- Thirst and a desire to drink more water
- Urine that appears yellow
- Hard stools or constipation
- The tongue appears somewhat red
- Yellow or thick, sticky tongue coating
- A relatively fast pulse or one that feels somewhat slippery (as noted by a clinician during examination)
|Treatment Approach
Clinical description:
Clear heat and resolve toxins; diffuse the lung and transform phlegm.
In everyday terms:
- Clear heat and inflammation and dispel internal “toxic heat” (a TCM concept associated with inflammation), easing discomforts such as fever, a red, swollen, painful throat, thirst, and feeling hot and restless.
- Promote the flow of lung qi and loosen thick phlegm, helping make sputum easier to cough up and easing cough, chest tightness, and shortness of breath to support more comfortable breathing.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and leaflet, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Cough, shortness of breath, copious white sticky or foamy sputum, epigastric fullness and discomfort, and poor appetite. Pale tongue; white, greasy coating; slippery or wiry-slippery pulse.
In everyday terms:
- Cough
- Some shortness of breath
- A lot of white, sticky or foamy sputum
- Fullness or discomfort in the upper abdomen (a feeling of stomach fullness)
- Poor appetite or difficulty eating
- The tongue appears somewhat pale
- White, somewhat sticky and thick tongue coating
- A pulse that feels slippery or taut (as noted by a clinician during examination)
|Treatment Approach
Clinical description:
Dry dampness and transform phlegm; diffuse and direct lung qi downward.
In everyday terms:
- Dispel excess “dampness” in the body and loosen thick phlegm, helping make sputum easier to cough up and easing chest tightness and a sticky feeling in the mouth.
- Promote the flow of lung qi and its downward movement, easing cough, shortness of breath, and labored breathing to support more comfortable breathing.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and leaflet, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Cough, shortness of breath, fatigue, easy sweating, poor appetite, and reduced food intake. Pale tongue; thin white coating; deep, thready or weak pulse.
In everyday terms:
- Cough
- Some shortness of breath
- Easy fatigue and low energy
- Becoming sweaty with even slight activity
- Poor appetite and eating less
- The tongue appears somewhat pale
- Thin white tongue coating
- A deep, thready pulse or one that feels thready and weak (as noted by a clinician during examination)
|Treatment Approach
Clinical description:
Tonify the lung and strengthen the spleen; boost qi and secure the exterior.
In everyday terms:
- Support lung function and regulate the spleen and stomach to improve energy and resistance, encourage appetite and smoother digestion, and ease discomforts such as excess phlegm, fatigue, and abdominal bloating.
- Replenish “healthy qi” and support the body’s exterior defenses to reduce easy sweating, sensitivity to drafts, and susceptibility to colds, and reduce the chance of recurrence.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and leaflet, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Shortness of breath or fatigue that worsens with activity; dry cough with scant sputum or difficulty expectorating; night sweats or easy sweating. Tongue pale or red, with a thin, scant or patchy coating; thready and rapid pulse.
In everyday terms:
- Shortness of breath or low energy, more noticeable after activity
- Dry cough with little sputum, or a persistent feeling that the cough does not clear completely
- Night sweats or sweating easily during the day
- The tongue appears somewhat pale or red
- A very thin or scant tongue coating, or areas where the coating is patchy or missing
- A thready and somewhat fast pulse (as noted by a clinician during examination)
|Treatment Approach
Clinical description:
Boost qi and nourish yin; moisten the lung and transform phlegm.
In everyday terms:
- Support energy and nourish the body’s fluids to ease discomforts such as fatigue, dry mouth, night sweats, and feeling hot and restless.
- Moisten the lungs and loosen thick phlegm, helping make sputum easier to cough up and easing dry cough with little sputum, dry and sore throat, chest tightness, and shortness of breath.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and leaflet, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Cough, labored breathing, restlessness, and possibly altered mental status. Deep-red tongue; slippery and rapid or thready pulse.
In everyday terms:
- Cough
- Rapid breathing or feeling unable to catch one’s breath
- Restlessness and agitation
- In severe cases, confusion or unusual responses
- The tongue appears very red or deep red
- A pulse that feels relatively fast and slippery, or thready (as noted by a clinician during examination)
|Treatment Approach
Clinical description:
Clear the heart and cool the nutritive level; transform phlegm and open the orifices.
In everyday terms:
- Clear internal “heart fire” and cool the blood level, helping address high fever, agitation, dry mouth and thirst, and skin redness, while preserving energy and body fluids.
- Loosen stubborn phlegm and clear the “passages” obstructed by phlegm, easing copious phlegm, chest tightness, and rattling sounds in the throat, and addressing symptoms such as confusion and slowed responses.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and leaflet, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Shortness of breath or weak breathing, altered mental status, pale complexion, profuse sweating, and cold extremities. Pale or deep-red tongue; faint, thready or rapid pulse.
In everyday terms:
- Very short or weak breathing
- Possible confusion or unusual responses
- Pale complexion
- Heavy sweating
- Cold hands and feet
- The tongue appears pale or deep red
- A very thready, weak pulse or a very fast pulse (as noted by a clinician during examination)
|Treatment Approach
Clinical description:
Boost qi and restore yin; restore yang and secure collapse.
In everyday terms:
- Support energy and preserve the body’s fluids, addressing signs such as extreme weakness, dry mouth, and night sweats.
- Quickly warm and support yang qi and stabilize breathing and heartbeat, addressing dangerous signs such as cold extremities, heavy sweating, and confusion as the body undergoes a critical state.
|Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and leaflet, and use under the guidance of a physician or pharmacist.
References
- Chinese Thoracic Society, Chinese Medical Association. Guidelines for the Diagnosis and Treatment of Community-Acquired Pneumonia[J]. Chinese Journal of Tuberculosis and Respiratory Diseases, 2006, 29(10): 651-655.
- Lionel A Mandell, Richard G Wunderink, Antonio Anzueto, et al. Infectious Disease Society of America/American Thoracic Society Consensus Guidelines on the Management of Community Acquired Pneumonia in Adults[J]. Clinical Infectious Disease, 2007, 44(S2): S27-72.
- Chen Haozhu, Lin Guowei, Wang Jiyao. Practical Internal Medicine[M]. 14th ed. Beijing: People’s Medical Publishing House, 2013.
- Pulmonary Diseases Committee, Internal Medicine Branch, China Association of Chinese Medicine. TCM Guidelines for the Diagnosis and Treatment of Community-Acquired Pneumonia (2011 Edition)[J]. Journal of Traditional Chinese Medicine, 2011, 52(21): 1883-1887.
- Wang Chen, Wang Jian’an. Internal Medicine[M]. Beijing: People’s Medical Publishing House, 2015.
- Ge Junbo, Xu Yongjian. Internal Medicine[M]. Beijing: People’s Medical Publishing House, 2013.
- Chinese Pharmacopoeia Commission. Pharmacopoeia of the People’s Republic of China: Clinical Medication Guide, Volume on Chinese Patent Medicines[M]. Beijing: China Medical Science Press, 2010.