Chronic Rhinosinusitis (Sinusitis)
Overview
Chronic rhinosinusitis causes nasal obstruction, mucopurulent discharge, facial pressure or pain, and reduced smell for more than 12 weeks, often from persistent acute infection, allergy, or anatomical factors. Chinese medicine calls it "deep nasal discharge," with patterns of wind-heat in the lung channel, gallbladder heat, spleen–stomach damp-heat, and lung–spleen qi deficiency. Recurrent purulent discharge, fever, facial swelling, or eye/vision problems require medical care; TCM support does not replace antibiotics when indicated or specialist treatment.
Pattern differentiation (clinical patterns)
Wind-Heat in the Lung Channel
Blocked nose with thick yellow discharge, mild fever and slight wind aversion, headache, sore throat, cough, red tongue tip with thin yellow coating, floating rapid pulse.
Disperse wind and clear heat; diffuse the lung and open the orifices.
Gallbladder Heat Depressed
Copious foul-smelling yellow turbid discharge, severe headache, bitter mouth, dry throat, irritability, red tongue yellow coating, wiry rapid pulse.
Clear gallbladder heat; drain dampness and open the orifices.
Lung–Spleen Qi Deficiency
Intermittent blockage with white sticky discharge, recurrent with cold, fatigue, shortness of breath, poor appetite, loose stools, pale tongue white coating, moderate weak pulse.
Tonify lung and spleen; boost qi and open the orifices.
Connections
Daily care & prevention
Irrigate the nose with saline, keep indoor humidity up, and avoid smoke, cold air, and known allergens; hydrate and rest. Allergy sufferers should avoid triggers and use medication as directed. Massage Yingxiang (LI20), Yintang (EX-HN3), Shangxing (GV23), Hegu (LI4), and Fengchi (GB20). Purulent yellow discharge with fever lasting over 10 days, or worsening after initial improvement, warrants evaluation for possible antibiotics.
When to seek medical care
Red painful swelling around the eye, restricted eye movement or vision change, severe headache with fever/vomiting, facial swelling, stiff neck, or altered consciousness is an emergency (orbital/intracranial complications); one-sided bloody discharge or facial numbness should rule out a tumor.