Chronic sinusitis treated with Traditional Chinese Medicine

Photo Cred: Julian Paolo Dayag/Unsplash

By Melissa Carr, BSc, DrTCM

While it may not seem a big deal to have a stuffy or runny nose, for those who struggle with chronic sinusitis, the challenge can be much more troublesome. Symptoms include headaches, ear pain, tenderness and swelling on the face, upper jaw and tooth pain, postnasal drip, cough, sore throat, dizziness, reduction in sense of smell or taste, loss of appetite, fatigue, and a general sense of malaise.

The main forms of conventional treatment include antihistamines, corticosteroids (nasal sprays, oral, or injected), and antibiotics, but none of those really gets to the source of the problem. Allergies, infection, regular exposure to pollutants, nasal polyps, and deviated septum are some of the potential reasons, but Traditional Chinese Medicine (TCM) has its own diagnostic system to assess and treat chronic sinusitis.

External Causes and Prevention of Chronic Sinusitis

For many, the start to sinusitis is external factors—the result of a viral or bacterial pathogen or an inhaled allergen or irritant. From a TCM perspective, these vectors are carried in by Wind, so we diagnose Wind-Heat if there are also signs of fever, sore throat, and yellow mucus or Wind-Cold if there are body aches, clear runny mucus, and sneezing. Superficial Wind-Heat and Wind-Cold can cause acute sinusitis, but if improperly treated, the pathogen can go deeper into the body, affecting the lungs and potentially turning into a chronic sinusitis.

While it may be too late for those already struggling with chronic sinusitis, you can educate your patients to reduce their chance of developing chronic sinusitis (or chronic coughs, asthma, or lingering pathogenic influences, for that matter). Rather than just letting the cold “run its course” or suppress the symptoms only with pharmaceuticals, it’s important to treat colds and flus appropriately, using one of the many classic formulas available, including Gan Mao Ling, Yin Qiao San, Gui Zhi Tang, and Ma Huang Tang, each with their own diagnostic cues.

Internal Causes of Chronic Sinusitis

Qi deficiency, internal Heat, and Dampness are some factors TCM attributes to the development of chronic sinusitis from internal factors.

Lung Qi deficiency can be associated with a weak immune system, shortness of breath, weak voice, weak cough, spontaneous sweating, and fatigue. It might be constitutional or could result from overexertion or a sedentary lifestyle, frequent or significant infections, aging, or prolonged or intense sadness and grief. Because the Lungs circulate the energy that helps defend the body against intruders (Wei Qi), Lung Qi deficiency can impede the body’s ability to oust a pathogen. The Lungs are also connected to the pathways of respiration, including the nasal passages and the sinuses. In addition to using formulas or herbs to address the sinusitis symptoms, Bu Fei Tang is a classic TCM formula to boost Lung Qi.

Internal Heat in the body may stem from too much caffeine, fatty and fried foods, processed foods, and alcohol. It can also be constitutional or built up by stress, smoking, and ongoing exposure to environmental heat, toxins, and irritants. Heat often contributes to inflammation in the body, so Heat that affects the Lungs in particular may result in chronic sinusitis. In this case, herbs like shi gao, zhi mu, and lu gen may be included in a formula.

Because inflammation of the sinuses results in an inability of them to properly drain, there is nasal congestion, mucus discharge, and postnasal drainage. It can also seem like the nose is continuously producing an excess of mucus, filling up again quickly after every time the nasal passages are drained either through lavage or simply blowing the nose. This excess of mucus is called excess Dampness or Phlegm in TCM, and they can be either hot or cold. Damp-Heat and Phlegm-Heat can be treated with herbs like huang qin and chuan bei mu. Herbs to address Phlegm-Cold include jie geng and ban xia.

Symptomatic Treatment

Of course, patients also want their symptoms to be resolved quickly, and TCM uses formulas such as Cang Er Zi San, Bi Yan Pian, Qing Bi Tang with herbs like bai zhi, cang er zi, xi xin, and xin yi hua to open the nasal passages and sinuses.

Acupuncture or acupressure at the points LI20, LI4, UB2 (BL2), ST2, ST3, yintang, and bitong can also be helpful for relief of symptoms.

Case Study

Jane, age 43, had been struggling with chronic sinusitis since she had a bad cold 3 years ago.  She was unable to breathe through her nose at all, had no ability to smell, felt short of breath, was often sick, perspired easily, and was tired all the time. Blood tests, allergy tests, and an ENT exam all showed nothing.

At the time of onset, she was in the midst of a divorce, moving to another city, and looking for work. She was very anxious about the losses in her life and she was not eating well, subsisting on too much sugar, caffeine, and fast food.

When she was able to blow her nose or when the postnasal drip caused her to cough, the mucus was thick and yellow.

I diagnosed her with Phlegm-Heat in the Lungs and Lung Qi deficiency and prescribed a combination of Cang Er Zi San, bai zhi, chuan bei mu, zhi mu, ren shen, huang qi, ling zhi, and zhi gan cao. I also did acupuncture and guided her to choose easily digested foods, avoid processed foods, limit caffeine, and speak to a counsellor. After three months of treatment she was able to breathe normally again.