Bronchiectasis is known as a permanent abnormal dilatation or widening along with advanced thickening of one or more of the bronchial tubes. This may 
affect a single segment, lobe or be multi-lobular. It is a pulmonary disorder which is often diagnosed by recurrent infections and results in the inability to properly clear mucous. This inability leads to frequent bacterial infections of the lungs. Bronchiectasis may be caused by secondary lung disease and etiology is still unfounded in many cases. Cystic fibrosis and some cases of pneumonia result in bronchiectasis.
Often patients will show signs of a chronic, ongoing cough with purulent copious amounts of sputum or phlegm. One way of describing the phlegm is a three layer separation with the top as frothy, turbid greenish mucous in the middle layer, and thick pus at the bottom. The cough may last months to years. Other signs may include hemoptysis, chest pain, fatigue, wheezing, and even weight loss. It is a chronic respiratory disease that often leads to a poor quality of life if not treated properly.
There is an estimated 139 cases per 100,000 in United States adults. It is slightly more prevalent in women with the average age between 60 and 70 years old. There has been about 70,000 newly diagnosed cases each year. According to Chest Journal, studies have shown some correlation of COPD and asthmatic patients with variables of 28-51% correlation depending on study performed. Also, 65% had NTM (nontuberculous infections) in North America. Nontuberculous mycobacteria such as M.avium, M. abscessus, and M. Intracellulare have shown the most clinical correlation in the past. However, in newly diagnosed patients, only 1.9% are having NTM causes. This is revealing in so much is yet to learn relating to the etiology of this disease.
Western medicine most often incorporates antibiotics, steroids, and bronchodilators as the main course of action in treatment. This may also involve macrolide antibiotics and lung transplantation. Whereas, Eastern medicine has treated bronchiectasis based off of clinical manifestations for cough, lung abscess, and pulmonary hemorrhage protocols. Often patients present with a pre-existing spleen and lung deficiency. Also, other similarities with this disease may include blood statis obstructing the lung, emotional stresses, exterior pathogenic influences, and yin deficiency with empty fire.
Basic patterns seen with bronchiectasis include as mentioned above in similar constitutional deficiencies such as yin deficiency with empty fire, other resulting patterns developed are phlegm-dampness accumulation in the lungs, along with phlegm-heat, and also liver fire insulting the lungs.
So treatment protocol varies depending on individual assessment of patient with bronchiectasis. One presenting with yin deficiency with empty fire, a need to nourish the yin, clear heat, moisten the lung and stop coughing is mandatory. With liver fire insulting the lung, clearing/purging liver heat, while cooling the blood to stop blooding is implemented in the protocol. With phlegm-heat or with phegm-damp accumulation, the significance is placed on drying dampness, transforming phlegm, benefiting the spleen qi, and/or clearing heat.
Both Eastern and Western share the major goals of treatment of bronchiectasis to be to improve the overall quality of life, stop progression of disease, limiting exacerbations, and improving lung function. In Henan Jiyuan Municipal Hospital of TCM, a study showed pharmaceutical drugs of a ciprofloxacin antibiotic along with the mucoytic, ambroxol, revealed subpar performance in comparison to Chinese Medicine utilizing herbal formula Modified Bu Zhong Yi Qi Tang incorporated with acupuncture.
FEV1% improvement over 40% and PEF variable rate in less than 15%. {Fan hj. Effects of Bu Zhong Yi Qi Decoction Combined with Acupuncture Lung Ventilation Function and Daily Living Ability in Patients with Steady-state Bronchiectasis. Journal of North Pharmacy, 2019, 04:136-137}.
In Eastern Medicine, the efficacy of the this formula is explained due to the underlying cause of spleen qi deficiency is treated along with the modifications made to clear phlegm-heat or damp-phlegm depending on assessment, along with those who may present with blood tinged sputum or hemoptysis adding herbal modifications such as ou jie, san qi, or bai mao gen. This treatment is generally given two to three months at ample dosing.
So, overall, despite the type of disease or diagnosis; the body is treated by nourishing the deficiencies and removing the excesses or stagnations. This is done in Eastern Medicine through herbal remedies and acupuncture pressure points which signals the body to do exactly this. This is what we refer to as balancing the body by allowing the body to heal itself by creating the pathway for it do so. Call today for your Telehealth or office visit!
