【Chinese medicine for smoking cessation】Chinese medicine for smoking cessation has its origins and evidence

Editor's note: Studies have shown that there are more than 300 million smokers in my country, and the number of deaths caused by smoking in the country is as high as 1 million each year. Quitting smoking is an important means to reduce or eliminate the harm of smoking. Anyone can benefit from quitting smoking at any age, and the earlier you quit smoking and the longer you quit, the greater the health benefits. However, once tobacco addicts stop smoking, they will experience withdrawal syndrome symptoms such as cravings, headaches, and decreased appetite, resulting in a low success rate of quitting smoking. How to quit smoking safely and effectively? This edition recommends three effective methods of quitting smoking in traditional Chinese medicine: acupuncture, Chinese medicine, and qigong.

【Acupuncture】Wang Yingying Acupuncture Hospital, China Academy of Chinese Medical Sciences

Quitting smoking can cause withdrawal syndrome, the severity of which varies from person to person. Acupuncture can help improve these symptoms.

Three effects help people quit smoking. First, acupuncture can regulate the positive reinforcement of the brain's reward system by regulating dopamine in the brain, reducing the euphoria, relaxation, and excitement when smoking, thereby blocking smokers' dependence on cigarettes and achieving the effect of inhibiting smoking addiction behavior.

Secondly, the anxiety after quitting smoking is mostly related to the abnormal changes in the functions of multiple central nervous systems. Acupuncture can regulate the emotional state by regulating 5-HT in the brain, relieve the anxiety and depression of addicts, and help smokers to quit smoking more "easily".

In addition, acupuncture can change the patient's taste of tobacco. It can regulate the smoker's bitter taste sensitivity through nerves, restore the smoker's oral environment to normal levels, and produce a bad smell for tobacco. When smoking again, the patient will experience symptoms such as bitter mouth, tongue numbness, dizziness, and choking, thereby achieving the goal of quitting smoking.

Treatment plan Conventional treatment Conventional acupuncture smoking cessation plans mostly use Baihui, Lieque, Zusanli, Hegu, Sanyinjiao, and Taichong points. All acupoints use the method of equal supplementation and equal drainage to achieve the purpose of getting qi. It is recommended that acupuncture treatment start 1 to 2 weeks before quitting smoking to improve the quitting effect. Acupuncture treatment lasts 20 to 30 minutes each time, and it is recommended to be treated 3 to 5 times a week for a total of 12 weeks. The number of acupuncture treatments in the first month is proportional to the success rate of quitting. Studies have shown that completing more than 6 treatments can significantly improve the quitting effect. For smokers with a higher degree of nicotine dependence, it is recommended to increase the intensity, frequency, and duration of acupuncture treatment.

Acupuncture points selection for syndrome differentiation Smoking for a long time can damage body fluids, resulting in symptoms such as excessive phlegm, dry mouth, and tasteless mouth. The spleen is the source of phlegm and the foundation of acquired constitution, so acupoints with the effect of strengthening the spleen and stomach are often selected in acupuncture for smoking cessation, such as Zusanli, Sanyinjiao, Zhongwan, etc., in combination with regulating qi, blood, body fluids, and strengthening the spleen and stomach; cigarettes are inhaled through the mouth and enter the lungs and exit the nose. The lungs and large intestine are the exterior and interior of each other, so acupuncture points often select the lung meridian point Lieque and cooperate with the large intestine meridian Hegu to clear lung heat and benefit the throat; the most common manifestations of withdrawal syndrome are mental symptoms such as restlessness, mental depression, irritability, and difficulty concentrating, so acupoints with calming and tranquilizing effects are often selected, such as Baihui and Shenmen; Tianmei point is an empirical effective point used for smoking cessation. Acupuncture can change the taste of cigarettes, thereby reducing the effect of smokers smoking.

In addition, smokers are often accompanied by symptoms such as yin deficiency and blood stasis, yin deficiency and hyperactivity of fire, and taking Sanyinjiao can nourish yin and activate blood circulation; smoking can cause heat to burn body fluids, refining the fluid into phlegm, phlegm heat blocking the airway, and the lungs failing to descend. Smokers often have symptoms such as coughing and excessive sputum, so Yingxiang and Yintang are used to open the nose and lungs; after quitting smoking, there may be symptoms such as nicotine addiction, irritability, fatigue, etc., and you can also cooperate with the ear points of the lungs, mouth, inner nose, Shenmen, and cortex to ventilate the lungs, calm the mind, and relieve the discomfort caused by stopping smoking, thereby obtaining a satisfactory smoking cessation effect.

【Medicinal Tea】Liu Yang Beijing University of Chinese Medicine Oriental Hospital

Traditional Chinese medicine can give full play to its advantages in syndrome differentiation and treatment, and use medicinal tea to improve the withdrawal symptoms of smokers with different syndromes.

Symptoms of dryness and toxicity damaging the lungs: dry throat, dry mouth and nose, hoarseness, dry cough without phlegm or little and sticky phlegm that is difficult to cough up, emaciation, red tongue with little fluid, and a thin and rapid pulse.

Medicinal tea: Choose mulberry leaf and ophiopogon tea. 3g mulberry leaf, 3g mint, 6g ophiopogon, brew with boiling water and drink as tea. Mulberry leaf in the recipe has the effect of clearing dryness and expelling evil due to its cold nature and light quality. Ophiopogon nourishes yin and moistens the lungs, clearing and moistening without hurting the lungs; mint clears and removes tobacco poison and turbidity. All the medicines are used together to achieve the effect of clearing dryness, moistening the lungs and detoxifying.

Symptoms of Liver Depression and Qi Stagnation: Depressed mood, low spirits, forgetfulness and insomnia, phlegm obstruction in the throat, difficulty in coughing up and vomiting, loss of appetite, white tongue coating, and stringy pulse.

Medicinal tea: Citron and tangerine peel tea. Add 6g of citron and 6g of tangerine peel to an appropriate amount of water and boil for 10 minutes. Take one dose a day and drink it instead of tea. Citron can soothe the liver and relieve depression, invigorate the spleen and invigorate the lungs; tangerine peel can regulate qi and harmonize the stomach, dry dampness and resolve phlegm. The two medicines are used together to soothe the liver, regulate qi and relieve depression.

Symptoms of dampness and toxic accumulation: chest fullness and stuffiness, itchy throat, cough with excessive white and sticky sputum, difficulty in coughing up sputum, or accompanied by feeling heavy and lazy, loss of appetite, nausea, heartburn, fullness, white and greasy tongue coating, and slippery pulse.

Medicinal tea: Almond, calamus, and poria tea. Add 6g of almond, 6g of calamus, and 6g of poria to appropriate amount of water and boil for 10 minutes. Take one dose per day and drink it instead of tea. Almond moistens the lungs and eliminates phlegm, calamus is aromatic and eliminates dampness and harmonizes the stomach, and poria strengthens the spleen and eliminates dampness. The combination of these medicines is a good remedy for eliminating phlegm, eliminating dampness, and detoxifying.

Symptoms of phlegm and blood stasis syndrome: dull complexion, cyanotic lips, chest tightness and pain, dizziness and headache, insomnia and forgetfulness, excessive phlegm, dark purple tongue with ecchymosis and petechiae, and thready and wiry pulse.

Medicinal tea: Lily, Chuanxiong and Polygala tea. Add 6g lily, 6g Chuanxiong and 6g Polygala to appropriate amount of water and boil for 10 minutes. Remove the residue and take the juice. Take one dose a day and drink it instead of tea. Lily moistens the lungs and resolves phlegm. Chuanxiong is a "blood qi medicine" with the effects of promoting qi and blood circulation, relieving depression and relieving pain. Polygala calms the mind and soothes the nerves. The three medicines can improve the symptoms of dark complexion, chest tightness and phlegm, insomnia and forgetfulness.

Symptoms of Qi and Yin deficiency syndrome: fatigue, spontaneous sweating and night sweats, sputum that is difficult to cough up, fever in the five parts of the body, weight loss, pale red tongue, little coating, and a rapid and deep pulse.

Medicinal tea: Polygonatum odoratum tea. 6g Polygonatum odoratum, 6g Polygonatum odoratum, add appropriate amount of water and boil for 10 minutes, one dose per day, drink instead of tea. Polygonatum odoratum nourishes the lungs, strengthens the spleen, and benefits the kidneys, while Polygonatum odoratum has the effects of nourishing yin, moistening dryness, promoting body fluid and quenching thirst. The two medicines are used together to nourish the qi and yin of the lungs and kidneys.

【Daoyin】Yan Shiqing Shanghai Institute of Traditional Daoyin Medicine

This recipe is from the "Weituo Presenting the Pestle First Posture" of the "Chinese Medicine Diagnosis and Treatment Method - Ancient Yijinjing Twelve Postures Daoyin Method", a national intangible cultural heritage. According to Chinese medicine, the lungs are delicate organs that like moisture and hate dryness. Long-term smokers are prone to dry lungs. Daoyin can dredge the hand Taiyin lung meridian, help to dredge the lung qi, relieve lung dryness, and enhance lung function.

Action essentials

Stand in a relaxed position, clench your teeth, press your tongue against the upper palate, look straight ahead, and breathe evenly through your nose. Stand with your feet shoulder-width apart. Turn your palms forward, slowly raise them in front of your body, and put your palms together in front of your chest. Point your fingertips forward and push them straight out, with strength penetrating through your fingertips. Open your arms to the left and right, while straightening your chest and lower abdomen. Bring your arms to a horizontal position, turn your palms downward, curl your fingers and make fists. When you lower your arms, relax your shoulders, elbows, wrists, and fingers in turn. The above movements count as one time. Repeat the guidance 7 times, and then return to a relaxed position.

Precautions

1. The lung opens up to the nose, and to guide this posture, it is best to inhale and exhale through the nose.

2. Beginners can use the two-stage breathing method, that is, inhale when holding up the palms, exhale when closing the palms, inhale when opening the arms, and exhale when lowering the arms.

3. When to perform the Qigong Exercises: Perform the Qigong Exercises 2 sets a total of 14 times in fresh air every morning to help clear the lung qi and relieve lung dryness.

This recipe is from the "Red Dragon Stirring the Well" of the "Sitting Eight-Section Brocade Daoyin Method", an intangible cultural heritage of Shanghai. Tobacco is pungent and warm in nature, and its qi is hot. Long-term smoking can easily cause dryness and heat to damage body fluids, leading to dry mouth, phlegm and other symptoms. Practicing this method can produce body fluids, nourish yin and reduce heart fire.

Action essentials

Sit upright (you can cross your legs, cross your legs, or sit with your legs hanging down). Breathe evenly through your nose, place your tongue against the upper palate, close your eyes and concentrate. Use the root of your tongue as the axis to stir in your mouth. When saliva is produced, gargle 36 times. When the saliva in your mouth is full, swallow it in three times. After swallowing, keep sitting upright with your eyes closed, regulate your breathing and concentrate before getting up.

Precautions

1. When producing saliva, stir it thoroughly and slowly.

2. When gargling saliva, gargle 9 times each time as one set, and gargle saliva 4 sets in total.

3. When swallowing saliva, swallow the saliva in your mouth in three times. There should be a gurgling sound when swallowing.

4. If you have dry mouth, you can take a sip of lemon water before practicing this posture to induce salivation.

[Expert opinion: Traditional Chinese medicine has a history and evidence for smoking cessation] Yang Jinsheng, chief expert of the Traditional Chinese Medicine Acupuncture Smoking Cessation Project of the Hong Kong Department of Health and director of the Institute of Basic Theory of Traditional Chinese Medicine of the China Academy of Chinese Medical Sciences

The core of TCM smoking cessation is syndrome differentiation and treatment, that is, using acupuncture, ear acupuncture, Chinese herbal decoctions, acupoint plasters and other methods based on the smoker's physical constitution, living habits, and clinical manifestations to reduce withdrawal symptoms, enhance confidence in quitting smoking, and increase the success rate of quitting smoking.

"Continuation of Famous Doctors' Cases" mentioned that chewing Houttuynia cordata can cure smoking addiction. Traditional Chinese medicine believes that tobacco poison attacks the lungs and affects the lung's function of descending and dispersing. Houttuynia cordata belongs to the lung meridian. Chewing Houttuynia cordata can promote lung qi, clear away heat and detoxify, eliminate carbuncle and discharge pus, restore lung function, and help quit smoking. "Medical Emergencies" records a smoking cessation prescription: 1 liter of raw early rice, 1 liang of peach blossom, 4 liang of licorice, 1 liang of Taurus grass, grind into powder and make pills with brown sugar. Take the medicine every day and reduce the amount of smoking. You can quit after half a month. It also promotes smoking cessation by resolving phlegm and relieving cough, and improving the lung's function of descending and dispersing. Recent studies have summarized that the most frequently used internal medicines are mint, licorice, Houttuynia cordata, Polygala tenuifolia, Platycodon grandiflorum, earthworm, Patchouli, etc., and the most commonly used external medicines are cloves, mint, cinnamon, ginseng, fennel, etc.

The clinical and research work on acupuncture for smoking cessation was reported in foreign countries in the 1970s. In 1975, Sacks from the United States and Requena from France reported the effect of ear acupuncture for smoking cessation in the American Journal of Acupuncture in 1976. In the mid-1980s, Huashan Hospital affiliated to Shanghai Medical University, Shanghai Branch of Chinese Medical Association and other institutions jointly conducted a study on the clinical efficacy and mechanism of ear acupuncture for smoking cessation, which was an early report of in-depth research on ear acupuncture for smoking cessation in China.

Since then, scholars have continued to explore acupuncture for smoking cessation. In particular, since 2010, the State Administration of Traditional Chinese Medicine has included the "TCM Acupuncture for Smoking Cessation" project in the TCM Exchange and Cooperation Project for Hong Kong. The study proposed a clinical program for smoking cessation with acupuncture based on Baihui and Lieque points, with more than 10,000 cases as research subjects, providing definite evidence-based evidence for acupuncture smoking cessation, and preliminarily clarified the mechanism of acupuncture smoking cessation - regulating the cerebellum and visual cortex neural activity through the "insula-anterior cingulate gyrus" pathway, thereby alleviating the craving for smoking.

[Expert opinion: The harm of smoking is not only lung cancer] Li Guangxi, Director of the Respiratory Department of Guang'anmen Hospital, China Academy of Chinese Medical Sciences

It is generally believed that smoking is the most harmful to the lungs. A 50-year cohort study conducted by British scholar Doll et al. showed that smoking can indeed cause lung cancer, especially small cell lung cancer, 98% of the causes of which can be attributed to smoking. However, the harm of smoking is very extensive and not limited to lung cancer.

The "China Smoking Health Hazards Report 2020", which was led by the National Health Commission and revised by Wang Chen, an academician of the Chinese Academy of Engineering, as the leader of the expert group, mentioned that tobacco smoke contains at least 69 carcinogens, which can cause permanent mutations in key genes in the body and gradually accumulate, leading to malignant tumors. Laryngeal cancer, bladder cancer, gastric cancer, cervical cancer, ovarian cancer, pancreatic cancer, liver cancer, esophageal cancer, kidney cancer, etc. are all highly prevalent caused by smoking. In addition, smoking can damage vascular endothelial function, cause atherosclerotic changes, and induce a variety of cardiovascular and cerebrovascular diseases; smoking can increase the secretion of hormones that antagonize insulin, inhibit the production of insulin by affecting the synthesis of cellular insulin signal transduction proteins, and then lead to type 2 diabetes... It can be said that smoking is closely related to the "four major chronic diseases" of respiratory diseases, malignant tumors, cardiovascular and cerebrovascular diseases, and diabetes.

It is worth mentioning that secondhand smoke is also harmful, and there is no so-called "safe level" of exposure. There is evidence that even short-term exposure to secondhand smoke can harm the human body, and ventilation devices such as exhaust fans and air conditioners cannot completely prevent non-smokers from inhaling secondhand smoke. At present, there are more than 300 million smokers in my country, and the number of deaths caused by smoking in the country is as high as 1 million each year, so quitting smoking is a major social issue.

[Expert opinion: Nicotine is the culprit of smoking addiction] Liu Chao, assistant researcher of the Department of Smoking Control and Respiratory Disease Prevention and Control of China-Japan Friendship Hospital

Smoking addiction is medically known as tobacco dependence. When nicotine in tobacco is inhaled into the lungs, it can quickly penetrate the alveolar membrane into the pulmonary capillaries and reach the central nervous system within seconds, acting on the nicotine receptors in the brain, thereby activating brain dopamine neurons to release dopamine, giving smokers a sense of "pleasure" and other rewarding feelings. If this happens repeatedly, people can easily become tobacco dependent. Generally, the more you smoke, the longer you have smoked, and the younger you start smoking, the higher the risk of tobacco dependence.

How to judge whether a smoker is tobacco dependent? According to the "Chinese Clinical Smoking Cessation Guidelines (2105 Edition)", if you have experienced or shown at least 3 of the following 6 items in the past year, you are suffering from tobacco dependence: ① Strong desire for smoking; ② Difficulty in controlling smoking behavior; ③ When you stop smoking or reduce the amount of smoking, you experience withdrawal symptoms such as anxiety, restlessness, irritability, irritability or fatigue, decreased concentration, fever, sweating, and palpitations; ④ Tobacco tolerance occurs, that is, you need to increase the amount of smoking to get the smoking experience that you could get with less smoking in the past; ⑤ Give up or reduce other activities and hobbies for smoking; ⑥ Insist on smoking regardless of the harm of smoking.

In fact, as early as the Ming and Qing Dynasties, doctors had already paid attention to the problem of smoking addiction. For example, "Jue Yi Chu Yan" records: "Smoking addiction is also a disease", and describes the precursor symptoms of smoking addiction as "similar to disease but not disease, between the heart and lungs. Itching is like insects crawling, just like the itching of wind addiction, which is difficult to scratch." "Pu Ji Liang Fang" describes its symptoms as "tears or sweating, back swelling, yawning, vomiting, or panic." "Yi Shuo Jian Lue" mentions "snot and tears come out, and the face changes immediately." These records are very similar to the physical symptoms of tobacco dependence in modern medicine, indicating that the ancients have long realized that smoking addiction is a disease.

Note: Please follow your doctor’s advice on specific treatment and medication!

Copyright Notice:

• This article is transferred from: China Traditional Chinese Medicine News
• The copyright belongs to the relevant rights holders. If there is any improper use, please feel free to contact us.
• The articles and videos shared on this public account are only for learning, communication and reference. Non-TCM professionals are not allowed to try the medicine at will.