According to reports, there are 30 families and dozens of plant species in China that grow, bloom, and release pollen in rotation throughout the different seasons, causing allergic conditions to flare up in succession. For people with pollen allergies, the period from mid- to late April through May, or September and October, is truly a disastrous time.
The most common and widespread allergic conditions include allergic rhinitis, allergic dermatitis, and allergic asthma. When these conditions are triggered by pollen allergies, they typically occur in April and May, as well as in September and October. Because pollen levels are extremely high during these periods—with a very high concentration of pollen in the air—patients’ symptoms are particularly severe. Once the peak pollen season passes, their symptoms subside or disappear. This is a classic case of pollen allergy. But why are there still patients with pollen allergies during the cold season? This is because, although the north is cold, some regions in the south are as warm as spring, with lush flora, allowing large amounts of pollen to be carried by the wind across provinces and regions, spreading as far as the north. Pollen is extremely tiny and invisible to the naked eye; it can only be seen under an electron scanning microscope. Pollen grains are typically only 30 to 50 micrometers in diameter, making them highly susceptible to being carried by the wind through the air. Pollen is robust, with a hard outer shell that is resistant to wind, rain, extreme heat, and cold. When the concentration of allergenic pollen in the air reaches a certain threshold, it can trigger symptoms. This is why there are patients with pollen allergies even in February.
I. Causes of Pollen Allergies
As is well known, certain types of pollen can trigger allergic diseases. When individuals with an allergic constitution are exposed to the pollen to which they are sensitive, their bodies produce large amounts of immunoglobulin E (IgE) “antibodies.” While a small portion of these antibodies is used to combat the antigen, the vast majority accumulates over time on mast cells in the respiratory tract, skin, and conjunctiva of the eyes. During this accumulation phase, many people experience no noticeable symptoms. However, once these antibodies accumulate to a certain level, exposure to an allergen triggers the mast cells to release large amounts of substances such as histamine. This causes spasms in the smooth muscles of the trachea and dilation of the capillaries in the skin, nasal mucosa, and conjunctiva, leading to various clinical symptoms such as asthma, rhinitis, dermatitis, and conjunctival hyperemia.
Allergic diseases are also known as allergic reaction disorders. Allergic rhinitis, also known as allergic rhinitis, corresponds to what Traditional Chinese Medicine (TCM) refers to as “nasal congestion or sneezing.” Allergic dermatitis, on the other hand, corresponds to conditions in TCM such as “damp-toxin,” “damp sores,” or “percolating sores”; Allergic asthma is classified in TCM according to the patient’s yin-yang and deficiency-excess patterns as cold asthma, heat asthma, phlegm asthma, and kidney asthma, among others. TCM attributes the pathogenesis of allergic diseases to external factors caused by “wind”—the foremost of the Six Excesses—and internal factors resulting from “insufficient vital energy, allowing pathogenic factors to take hold”; “where pathogenic factors gather, vital energy must be deficient.” In other words, individuals with weakened constitutions are more susceptible to allergic diseases when exposed to allergens. “When vital energy is strong within, pathogenic factors cannot invade.”
II. The Complexity of Allergens
Pollen allergies are a common cause of allergic reactions, but many allergy sufferers are not only allergic to various types of pollen but also to numerous unidentified substances. Even doctors are often unable to determine exactly how many substances a patient is allergic to, as there are simply too many potential allergens. In addition to the dozens of types of pollen that commonly trigger allergies, the fur of certain animals (such as cats and dogs), many synthetic fibers, pesticides, dust, paint, medications, dust mites, mold, seafood such as fish and shrimp, and so on, are all substances that can easily cause allergic reactions. Some people are allergic to common foods, while others are allergic to nearly every substance in the world and can only live in specially designed environments. Because allergic diseases involve so many allergens, some are extremely difficult to treat, and symptoms can only be alleviated through symptomatic medications and passive measures.
III. Prevention and Control of Allergic Diseases
Patients with a predisposition to allergies, or those who have been diagnosed with allergies to specific types of pollen or substances, should minimize or completely avoid contact with allergens. They should wear a helmet that covers the eyes, mouth, and ears to prevent contact with pollen, or wear goggles, and avoid strenuous exercise to reduce the inhalation of additional pollen (since during strenuous exercise, breathing becomes deeper and faster, leading to increased inhalation of pollen).
Consult a doctor to identify the allergen (specifically, which type of pollen) and have a vaccine prepared from that pollen. This vaccine is then administered to the patient in advance to stimulate the body’s immune response.
Desensitization therapy: This involves preparing a solution of the allergen as an antigen and injecting it into the patient’s subcutaneous tissue until complete desensitization is achieved. While this method is theoretically very effective and has indeed cured some patients, allergic diseases are highly complex, and treatment outcomes may not be ideal for all patients.
Traditional Chinese Medicine (TCM) treatment: Based on TCM pattern differentiation, herbal formulas that strengthen the spleen, lung, and kidney functions are used to regulate the body’s immune system. This approach has been shown to have clear efficacy against allergic diseases and helps prevent recurrence.
The following section briefly describes several common allergic diseases.
IV. Allergic Rhinitis
Patients allergic to pollen experience sudden and recurrent episodes of nasal itching during the flowering season of the allergenic plants. These episodes are accompanied by itchy eyes and throat, frequent sneezing (sometimes dozens of times in a row), a profuse, clear, frothy nasal discharge, and nasal congestion. The onset is acute, the symptoms subside quickly, and the course of the disease is generally prolonged. In addition to pollen, other substances—such as inhaled dust and fungi; consumption of milk, fish, shrimp, or eggs; and contact with certain cosmetics, animal fur, or medications—can also trigger allergies and cause rhinitis. During an examination in the acute phase, the nasal cavity shows copious watery secretions, and the nasal mucosa appears edematous, pale, or purplish-gray; systemic symptoms such as headache, tinnitus, and hearing impairment may also occur.
Treatment of Allergic Rhinitis:
Western medical treatment involves the use of antiallergic and antihistamine medications.
Traditional Chinese Medicine (TCM) treatment is based on pattern differentiation and treatment according to concomitant conditions of lung qi deficiency, spleen qi deficiency, or kidney yang deficiency.
(1) For cases primarily characterized by cold-type lung qi deficiency, it is appropriate to warm and tonify the lungs, dispel wind, and disperse cold. Modified Wenfei Zhiliu Dan may be used, or a combination of Yuping San and Cang’erzi San.
(2) For cases primarily characterized by spleen qi deficiency, it is appropriate to strengthen the spleen, tonify qi, raise the pure, and transform dampness. Use Modified Bu Zhong Yi Qi Tang, Modified Shen Ling Bai Zhu San, or Bi Yu Tang.
(3) For cases primarily characterized by kidney yang deficiency, it is appropriate to warm and strengthen kidney yang, consolidate the kidneys, and anchor qi. Use Modified Jin Gui Shen Qi Wan.
Traditional Chinese Medicine Topical Formulas
(1) Apply Biyun Powder intranasally 3–4 times daily.
(2) Insert a tablet of Yunaoshi Ointment into the nose once daily.
Acupuncture and massage therapy are both effective for allergic rhinitis.
Ear Acupoint Pressure Therapy: Applying pressure to the allergy zone on the ear yields good results.
V. Allergic Contact Dermatitis
Allergic contact dermatitis is an acute inflammatory reaction on the skin or mucous membranes caused by contact with a specific substance. Depending on the substance involved, it is known by various names, such as “lacquer dermatitis,” “pollen dermatitis,” or “toilet seat dermatitis.”
Clinical Manifestations: In the acute phase, mild cases often present with localized hyperemia, erythema, or papules. In severe cases, blisters, edema, large vesicles, erosion, and exudation may develop on top of the erythema and papules. The affected skin areas are accompanied by itching and pain. A small number of patients experience systemic reactions, such as fever, headache, and nausea. If the acute phase is not managed properly, if the underlying cause cannot be eliminated over the long term, or if there is repeated exposure to certain allergens, the dermatitis may recur or progress to a subacute or chronic stage. In such cases, the affected skin gradually undergoes changes such as infiltration, thickening, roughness, fissuring, and lichenification.
Treatment: For treatment with traditional Chinese medicine, in the early stages, it is advisable to clear heat, eliminate toxins, cool the blood, and dispel wind, using formulas such as Pu Ji Dishao Decoction or Liang Xue Jie Du Decoction. In the late stage, it is advisable to promote blood circulation, nourish the blood, moisten dryness, and dispel wind; the Danggui Yinzi formula is used for treatment.
VI. Bronchial Asthma
Bronchial asthma is most common in adolescents and is a paroxysmal pulmonary allergic disease. It is often caused by inhalation of or contact with allergens. Common allergens include plant pollen, dust, dust mites, and pathogens.
Clinical Manifestations: The onset of this disease is often sudden, with nighttime attacks being more common. Patients frequently experience a sudden sensation of chest tightness and shortness of breath, leading to orthopnea (sitting upright to breathe). This is due to bronchial smooth muscle spasm, mucosal edema, and increased secretions during an attack, which cause airway obstruction and severe dyspnea. Each episode lasts from a few minutes to several hours. During an attack, wheezing may be heard in the lungs; if an infection is present, wet rales may also be heard. As the episode subsides, the patient may cough up large amounts of mucus-like sputum.
If asthma does not improve with treatment and persists for more than 24 hours, the patient may experience profuse sweating, pallor, cyanosis, tachycardia, and cold extremities; in severe cases, respiratory failure may occur, posing a life-threatening risk.
Differential Diagnosis and Treatment in Traditional Chinese Medicine
(1) Cold-Type Asthma: Most commonly occurs during cold seasons or is triggered by exposure to cold. Treatment should focus on dispersing cold from the lungs, resolving phlegm, and relieving wheezing. The modified Shegan-Ma Huang Decoction is recommended.
(2) Heat-Type Asthma: Most commonly occurs during hot seasons or is triggered by exposure to heat. Treatment should focus on clearing heat, resolving phlegm, dispersing cold from the lungs, and relieving wheezing. The Ma-Xing-Shi-Gan Decoction combined with the San-Zi-Yang-Qin Decoction, with appropriate modifications, is recommended.
(3) Deficiency-Type Asthma: Characterized by long-term, recurrent episodes, often accompanied by mild, persistent wheezing, a weak cough, palpitations, shortness of breath, spontaneous sweating, and aversion to wind. Treatment should focus on tonifying the lungs, strengthening the spleen, anchoring the qi, and alleviating wheezing. The modified Ren Shen Ge Ge San formula yields good results.
In summary, treating this type of allergic disease is relatively difficult. It is challenging to eliminate allergens, particularly plant pollen, which drifts in the wind and cannot be completely isolated. Some have suggested that individuals allergic to pollen should wear a specially designed helmet during peak pollen seasons—one that covers the eyes, mouth, and ears to prevent the inhalation of pollen particles.