ATROPHIC RHINITIS (OZAENA)

Clinical Manifestations	Nasal obstruction Continuous or sustained nasal congestion Thick, sticky, yellow nasal discharge Transient, declining sense of smell or loss of sense of smell Generally severe frontal, maxillary or temporal headache Distention in the head Reduced memory T: Red C: Yellow or white P: Rapid
Treatment Principle	Dispel Lung Heat Disseminate Lung Qi Drain pus Unblock the Orifices (especially the nose)
Herb Formulas	Xin Yi Qing Fei Yin Cang Er Zi San modified
Points	UB-7, UB-3, DU-24, Yintang, LI-20 through to Bitong, LI-4, SJ-5, GB-20 For severe sinus congestion: UB-2 For sore throat: PC-6, ST-9 To Clear Heat (reduce fever): LI-11, DU-14, ST-44 To soothe and clear Heat from the Lungs: LU-5, LU-10 To regulate Lung Qi and stop cough and asthma: UB-13, DU-13, Dingchuan To strengthen weak or elderly patients: ST-36, UB-20, REN-6 LI-20, LI-4, Yintang, LU-1, UB-13 DU-23, Yintang, LI-20, LI-4, GB-20, UB-12, LU-7 For Wind: UB-12, GB-20, LI-4, SJ-5, LI-20 Ear: Inner nose, Forehead, Tip of the nose, Lung

Clinical Manifestations	More severe Unable to smell Headache Deficient memory Strong odor inside nose May be able to squeeze out green or yellow chunky chunks from the nose Dry, hacking cough with little or no sputum Flushed face Sputum is difficult to expectorate Restlessness Maybe hemoptysis Hiccups Cough may cause chest pain Dyspnea Dry or sore throat Upper respiratory tract infection Hoarse voice Asthma	Dry lips and mouth Fever Shortness of breath Hemoptysis Constipation Thirst Dry skin and hair Dryness in nose Sensation of fullness in chest Epistaxis Hypochondriac pain Chills and fever Headache Anhidrosis Irritability Itching T: Red tip, dry C: Thin, yellow, or White and dry, or None P: Superficial, maybe rapid or Big and weak or Deficient, big and rapid
Treatment Principle	Eliminates Dryness Nourish Kidney and Lung Yin Moistens the Lungs
Herb Formulas	Qing Zao Jiu Fei Tang
Points	UB-7, UB-3, DU-24, Yintang, LI-20 through to Bitong, LI-4, LU-7, GB-20 For severe sinus congestion: UB-2 For sore throat: PC-6, ST-9 Points to nourish Lung Yin: UB-13, UB-17, UB-43, LU-1, LU-9, LU-7 + KI-6, LU-6, LU-5, LU-10, ST-36 Points to reinforce Kidney Yin and Subdue Yin Deficiency Fire: KI-3, KI-6, UB-23

Clinical Manifestations	Ciliated columnar epithelium of the nasal mucosa is replaced by stratified squamous epithelium. Atrophy of mucosa, turbinal bones, seromucinous glands Most commonly seen in females Tends to appear during puberty Can occur as early as 12 months of age The nasal cavities become roomy and are filled with foul smelling crusts which are black or dark green and dry Expiration painful and difficult Foul smell from the nose Nerve elements (responsible for the perception of smell) have become atrophied Patients usually complain of nasal obstruction despite the roomy nasal cavity Epistaxis may occur when the dried discharge (crusts) are removed Septal perforation of the nasal vestibule can occur Dermatitis of the nasal vestibule can occur Nose may show a saddle nose deformity Atrophic rhinitis is also associated with similar atrophic changes in pharynx and the larynx producing symptoms pertaining to these structures Hearing impairment can occur due to eustachian tube blockage causing middle ear effusion
Treatment Principle	Generate Fluids Moisten Dryness Nourish Yin Clear Heat
Herb Formulas	Zeng Ye Tang
Points	UB-7, UB-3, DU-24, Yintang, LI-20 through to Bitong, LI-4, LU-7, GB-20 For severe sinus congestion: UB-2 For sore throat: PC-6, ST-9 Points to nourish Lung Yin: UB-13, UB-17, UB-43, LU-1, LU-9, LU-7 + KI-6, LU-6, LU-5, LU-10, ST-36 Points to reinforce Kidney Yin and Subdue Yin Deficiency Fire: KI-3, KI-6, UB-23

Clinical Manifestations	Dry, itchy, painful nose Throat dryness Development of a white curd-like membrane in the throat that is difficult to scrape off Dry mouth and throat worse at night Soft or hoarse voice Low back and legs sore and weak Night sweats Malar flush Afternoon fever Sterility Spermatorrhea Sore and swollen throat Asthma Dry nose and lips Low grade fever Raspy breathing resembling wheezing Five sole heat	Cough with dry or little Phlegm May be fever Blood flecked Phlegm Irritability Insomnia Steaming bones White complexion Maybe a red face Skinniness Shortness of breath (maybe exertional) Urgent panting Allergies Seminal emission with dreams Diminished urination Feeling miserable and agitated with fever T: Red and dry C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Clear the Lungs
Herb Formulas	Yang Yin Qing Fei Tang
Points	UB-7, UB-3, DU-24, Yintang, LI-20 through to Bitong, LI-4, SJ-5, GB-20 For severe sinus congestion: UB-2 For sore throat: PC-6, ST-9 To Clear Heat (reduce fever): LI-11, DU-14, ST-44 To soothe and clear Heat from the Lungs: LU-5, LU-10 To regulate Lung Qi and stop cough and asthma: UB-13, DU-13, Dingchuan To strengthen weak or elderly patients: ST-36, UB-20, REN-6 LI-20, LI-4, Yintang, LU-1, UB-13 DU-23, Yintang, LI-20, LI-4, GB-20, UB-12, LU-7 For Wind: UB-12, GB-20, LI-4, SJ-5, LI-20 Ear: Inner nose, Forehead, Tip of the nose, Lung