How can TCM support children with allergic rhinitis?

In Traditional Chinese Medicine, allergic rhinitis is commonly classified under 鼻鼽 (Bi Qiu), a condition characterised by recurrent sneezing, nasal itching, watery discharge and nasal obstruction.

TCM considers allergic rhinitis through two important aspects: the immediate nasal symptoms and the child’s underlying constitution.

Rather than assuming every child with a runny nose has weak immunity, we look at the relationship between the Lung, Spleen and Kidney systems, together with environmental influences.

肺开窍于鼻: The Lung Opens Into the Nose

In TCM, the Lung is closely associated with the nose and respiratory function.

The classical principle 肺开窍于鼻 describes how the nose is traditionally regarded as the external opening of the Lung system.

Another important concept is 肺主宣发肃降, meaning that the Lung governs the dispersing and descending movement of Qi.

• 宣发 (Dispersing): The outward distribution of Lung Qi and Body Fluids, traditionally associated with nourishing the skin and supporting defensive Qi (卫气).

• 肃降 (Descending): The downward movement of Lung Qi and regulation of fluids, traditionally associated with maintaining smooth respiratory function.

When these functions become disrupted, TCM describes the condition as 肺失宣降.

This may manifest as recurrent sneezing, nasal obstruction or excessive discharge.

From a modern medical perspective, allergic rhinitis results from immune-mediated inflammation. The TCM explanation is a traditional framework for understanding symptom patterns, rather than an equivalent description of the biological mechanism.

Why Are the Lung, Spleen and Kidney Important?

Lung (肺): Supporting Nasal and Defensive Functions

The Lung governs Qi, opens into the nose and regulates defensive Qi (卫气).

When Lung Qi is deficient, TCM considers the body’s protective functions to be weakened.

Children with this pattern may experience recurrent sneezing, clear watery discharge, spontaneous sweating, fatigue and sensitivity to cold air.

Spleen (脾): Supporting Digestion and Qi Production

The Spleen governs the transformation and transportation of food and fluids.

In TCM, it is considered the foundation of acquired Qi (后天之本), meaning that nourishment from food supports the body’s functional vitality.

The Spleen and Lung are closely related through the Five Element principle of Earth generating Metal (土生金).

When Spleen Qi is deficient, the production of Qi may be affected, while impaired fluid transformation may contribute to Dampness and Phlegm accumulation.

Children may present with nasal congestion alongside poor appetite, abdominal bloating, loose stools or fatigue.

This is why I often ask parents about their child’s digestion and bowel movements, even when their main concern is nasal allergy.

Kidney (肾): Supporting Constitutional Development

The Kidney is traditionally regarded as the foundation of innate constitution (先天之本).

It is associated with growth, development and the body’s fundamental Yin and Yang balance.

TCM also describes the Kidney as supporting the Lung’s ability to receive Qi (肾主纳气).

Kidney deficiency may be considered in certain longstanding or recurrent presentations when additional constitutional signs are present.

However, frequent allergic rhinitis alone does not indicate Kidney deficiency.