Asthma - Cold Wheezing Pattern

Dr. Li Wei, DACM

Asthma · Cold Wheezing Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Chest

Pattern Overview

Cold Wheezing is a common pattern in acute asthma exacerbation, characterized by cold air/allergen-induced bronchospasm, wheezing, chest tightness, white thin sputum, and aggravation by cold. The core pathogenesis is cold phlegm hiding in the Lung, triggered by external Cold, causing Qi obstruction, bronchospasm, and wheezing.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Dyspnea, wheezing, chest tightness, white thin sputum |

| Associated Symptoms | Chills, no sweating, cold extremities, pale complexion |

| Tongue and Pulse | Pale tongue with white slippery coating, tense or floating tense pulse |

| Pathogenesis | Cold phlegm hiding in the Lung, triggered by external Cold |

| Etiology | Cold air exposure, cold food intake, cold-phlegm constitution |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Lieque (LU7) | Above the wrist, on the radial side, in the depression between the tendons | Luo-Connecting point of Lung meridian; disperses Wind-Cold and diffuses the Lung |

| Fengmen (BL12) | On the upper back, 1.5 cun lateral to T2 | Disperses Wind and releases the exterior |

| Feishu (BL13) | On the upper back, 1.5 cun lateral to T3 | Back-Shu point of Lung meridian; regulates Lung Qi |

| Dingchuan (EX-B1) | 0.5 cun lateral to GV14 (below C7) | Extra point specifically for asthma; stops wheezing |

| Gaohuang (BL43) | On the upper back, 3 cun lateral to T4 | Nourishes deficiency and supports Lung Qi |

Clinical Recommendation: Filiform needle, reducing or even method; moxibustion may be added to warm and disperse Cold. Ear bleeding may be used during acute attacks.

Herbal Formula

Base Formula: She Gan Ma Huang Tang (射干麻黄汤)

Composition:

Belamcanda (She Gan), Ephedra (Ma Huang), Asarum (Xi Xin), Schisandra (Wu Wei Zi), Pinellia (Ban Xia), Tussilago (Kuan Dong Hua), Ginger (Sheng Jiang), Jujube (Da Zao)

Action: Warms the Lung, disperses Cold, transforms Phlegm, and stops wheezing.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe wheezing | Add Di Long, Bai Guo to descend Qi and stop wheezing |

| Copious thin sputum | Add Gan Jiang, Rou Gui to warm the Lung and transform fluids |

| Severe chills | Add Gui Zhi, Fu Zi to warm Yang and disperse Cold |

| Nasal congestion | Add Cang Er Zi, Xin Yi to open the nasal passages |

Western Mechanism Reference

Cold air/allergen-induced mast cell degranulation, histamine release, bronchospasm, and Th1/Th2 imbalance. Cold Wheezing corresponds to cold-induced asthma, where cold air activates TRPA1/TRPM8 channels inducing mast cell degranulation and bronchospasm.

References

  1. Internal Medicine of TCM - Asthma with Cold Wheezing.

  2. DB-XJB: She Gan Ma Huang Tang.

  3. WHO. (2023). Asthma fact sheet. World Health Organization.

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