The goals for treating asthma are:

	Underlying conditions such as rhinitis, sinusitis and gastroesophageal reflux should be treated as they can exacerbate asthma symptoms.
	People with aspirin or NSAID sensitivities should avoid taking these drugs and check all medications for these ingredients. People with severe asthma or nasal polyps should also be aware of the potential of these drugs to cause an asthma attack.
	Some people are allergic to sulfites, which are used to preserve foods and beverages. Sulfites can trigger an asthma attack and foods such as processed potatoes, wine, beer, dried fruit, and others containing sulfites should be avoided.
	Nonselective beta-blockers are used as heart medications and are also used in certain eye solutions. People with asthma should be aware these medications might cause asthma attacks and avoid using them. Discuss alternatives with your healthcare provider.
	Allergen immunotherapy (allergy shots) may be effective for some people. This may be needed when a person has repeated exposure to an allergen they cannot avoid, has asthma symptoms for a major portion of the year, or has symptoms that are difficult to control.
	Yearly flu shots are recommended for people with asthma because viral infections can worsen asthma symptoms, especially in young children.

In this age group it can be difficult to diagnose asthma due to challenges in obtaining reliable lung function testing. Underdiagnosis of asthma still remains a significant problem in this age group. Children are often labeled as having frequent viral infections, chronic bronchitis, wheezy bronchitis, or gastro-oesophageal reflux. When this happens these children often do not receive adequate therapy to relieve their symptoms. It has been estimated between 50-80% of children who have asthma will experience symptoms before the age of five. Most commonly asthma symptoms will present with a viral infection in this age group. Your healthcare provider may prescribe a trial of asthma medications to see if symptoms improve and use a stepwise approach to either escalate or decrease therapy.

	Adolescents and younger children, when mature enough, should be included in developing a plan to manage their asthma. Adolescents, especially, may not understand the significant health risks they are taking when their asthma is poorly controlled. In addition, it may be difficult to accept asthma as a chronic illness at a time when they are developing independence from their family. Fostering a positive self-image and encouraging personal responsibility for managing asthma are necessary.
	The healthcare provider and parents should provide the school with an asthma plan that explains the medications the student is taking and what to do in case of an asthma attack.
	Children with asthma should not be discouraged from physical exercise and sports. The child may need to take medication before and/or during a physical activity. Limiting physical activity should only be used as a last resort.

	Older adults may have other conditions such as chronic bronchitis or emphysema that cause asthma symptoms. In this case, the symptoms may not be reversible . Therefore, it is important to assess whether medications really can help relieve asthma symptoms.
	Asthma medications can be absorbed and metabolized differently in elderly people causing an increase in unwanted side effects. The healthcare provider should monitor these people carefully for side effects or reactions to other medications and make adjustments where appropriate.

People with asthma undergoing surgery should see the healthcare provider managing their asthma before going ahead with the operation. Every attempt should be made to have the best possible lung function before going ahead with a procedure. The healthcare provider may need to increase or change medications before or after the surgery.

	The overall goal is to maintain adequate lung function so that the fetus can get an adequate oxygen supply. If asthma is not treated sufficiently during pregnancy it can increase the baby's risk of perinatal mortality, prematurity or a low birth weight.
	Most of the common asthma medications will not put the fetus at increased risk.
	Medications that do pose a risk to the fetus include: epinephrine, brompheniramine, and alpha-adrenergic medications. Medications that have potential risks to the fetus include decongestants, antibiotics, live virus vaccines, immunotherapy (allergy shots), and iodides.
	People with asthma should discuss all their medications with their healthcare provider and eliminate or change those likely to pose a risk to the baby.

The TCM treatment strategy for asthma is based on the diagnosed disharmony patterns.

Cold type asthma
This type of asthma is caused by the cold evils, the therapeutic aim is to remove the cold evils by warming the lungs. In addition, this decoction helps remove the phlegm and relieve the wheezing.

Decoction examples:
Shegan mahuang decoction

In this decoction, She gan and ma huang are responsible for relieving the cough and wheeze, easing the throat and removing the phlegm. Gan jiang, xi xin and ban xia warm the cold phlegm in the lung and reverse the movement of qi. Zi wan, kwuan dong hua and gan cao relieve the cough and remove the phlegm. Wu wei zi stops the lung qi from traveling in the wrong direction and relieves the cough. Da zao helps support the normal qi in the body.

Other related patterns
Wind-Cold tightens the lungs
Wind-cold is an exterior syndrome because it is a pernicious evil which attacks the body from the outside first. The therapeutic goal is to relieve this exterior syndrome with herbs, which are pungent in flavor and warm in property. This helps the lungs to resume their dissemination of qi and provides relief of the asthma symptoms.

Decoction Example
Modified powder of huagai

Heat type asthma
Because this type of asthma is caused by heat evils, the therapeutic goal is to clear away the heat and resume the dissemination of lung qi. Treatment will also remove phlegm and relieve coughing.

Decoction Example
Ding chuan decoction

In this decoction, ma huang restores the lungs' ability to disseminate qi. Huang qin and san bai pi clear away the heat in the lung and restore the liquefying function of the lungs. Xin ren, ban xia, kuan dong and su zi remove the phlegm and redirect qi's movement to descend. Bai guo arrests lung qi. Gan cao keeps the other herbs in balance and supports the body's normal qi.

Other related patterns
Heat retention in lungs
The therapeutic aim is to clear away lung heat and remove phlegm.

Decoction Examples
Maxing shigan decoction with modification

Stagnation of phlegm dampness in middle warmer (spleen and stomach)
The therapeutic goal to expel the phlegm and support the qi descending function of the lungs. This decoction also helps relieve wheezing.

Example decoction
Daotan decoction combined with sanzi yangqin decoction

Lung Deficiency
The lungs are responsible for governing the health of protective qi, which is part of our immunity. When lung disharmony occurs the aim is to restore normal lung function and consolidate the exterior and protective qi in the body so illness can be avoided

Decoction examples
Yu ping feng powder

In this decoction, huang qi and bai zhu support qi and consolidate the exterior. Fang feng also helps support exterior consolidation and in addition removes wind evils. Wind evils usually attack the lungs when the exterior of the body is weak.

Shengmai decoction and erchen decoction with modifications

This is another example of a decoction used to restore lung function.

Spleen Deficiency
The spleen is responsible for transforming fluids into substances that are essential to maintain health. Therefore, in order to restore the healthy balance of the spleen, it is necessary to support the spleen's transformation function and remove the excess unhealthy fluids known as phlegm.

Decoction example
Liu junzi decoction

In this decoction, dang shen, bai zhu, fu lin and gan zao are excellent combination herbs for strengthening the spleen and replenishing qi. Chen pi and ban xia are good for removing phlegm and regulating qi. All the herbs in this combination work together to support the spleen's transformation function.

Kidney Deficiency
The kidneys also play an important role in regulating healthy breathing. Therefore, the treatment goal is to replenish the kidneys and support their qi grasping function so healthy breathing can be resumed.

Decoction example
Jingui shengqi pill

This is a famous decoction for supporting kidney yang. Di huang is good herb for nourishing the kidney yin. It is usually supported by sha zhu yu and shan yao which enhance the spleen's functions. As di huang has certain wet properties, ze xie is added to remove the excessive fluids and regulate the fluid channels. Fu lin helps support the spleen and transform fluids. Dan pi releases and clears away liver fire resulting from deficient heat. After this, fu zi and gui zhi are added to support the kidney yang. Fu zi helps replenish the yang and dispels the cold while gui zhi warms the meridian so there can be smooth movement of fluids inside the blood vessels.

Other related patterns
Yin difficiency of lungs and kidneys
The therapeutic aim is to nourish the yin and keep the yang in its original place without overwhelming other organs.

Decoction example
Liuwei dihuang decoction combined with shengmai decoction