Asthma
哮喘 · xiào chuǎn+18 other namesHide other names
Also known as: Wheezing or asthma, Bronchial Asthma, Asthmatic Bronchitis, Chronic Asthma, Long-standing Asthma, Long-term Asthma, Persistent Asthma, Chronic Bronchial Asthma, Bronchial Asthma (Acute Exacerbation), Bronchial Asthma (Cold-Type), Bronchial asthma (cold type), Bronchial asthma (cold-triggered), Cold-induced asthma, Chronic asthma (cold type), Asthma (Acute Exacerbation with Infection), Asthma (Acute Exacerbation with Productive Cough), Phlegm-Predominant Asthma, Asthma (phlegm-predominant type)
In TCM, the color and consistency of your phlegm - yellow and sticky versus white and watery - reveals whether your asthma is driven by heat, cold, or deficiency. Most people see a significant drop in attack frequency within 4-8 weeks of herbs and acupuncture, with continued improvement as the underlying imbalance is corrected.
About this page · what it is and isn't
What this is. A plain-English synthesis of how classical TCM and modern clinical research describe asthma. Patterns and herbs come from canonical TCM sources; clinical claims are cited in the Evidence section.
What it isn't. A diagnosis. Me&Qi is an editorial team, not a licensed clinic. The pattern quiz is a thinking tool — pulse and tongue still need a person in the room. Anything in the Safety section should send you to a doctor, not a herb.
Last reviewed Jun 2026.
Educational content about Traditional Chinese Medicine — not medical advice. See a qualified practitioner for diagnosis and treatment.
Asthma isn't one condition in TCM - it's a family of six distinct patterns, each with its own root cause, its own characteristic wheeze and phlegm, and its own treatment. While conventional medicine focuses on opening the airways, TCM asks why the airways are constricted in the first place. The answer might be cold, heat, phlegm, or a deeper weakness in the Spleen, Lungs, or Kidneys. Below, you'll find the six most common patterns and how to tell them apart.
Asthma is a chronic inflammatory condition of the airways that causes recurrent episodes of wheezing, breathlessness, chest tightness, and coughing. The airways become swollen and sensitive, and when triggered - by allergens, cold air, exercise, or respiratory infections - the muscles around them tighten, narrowing the passage for air. Diagnosis typically involves lung function tests like spirometry and a review of symptom patterns. It affects people of all ages and ranges from mild intermittent to severe persistent.
Conventional treatments
Conventional treatment focuses on two main strategies: long-term control medications to reduce airway inflammation (inhaled corticosteroids, leukotriene modifiers, long-acting beta-agonists) and quick-relief rescue inhalers (short-acting beta-agonists) to open the airways during an attack. Severe cases may require oral corticosteroids or biologic therapies targeting specific inflammatory pathways. Avoiding triggers and following an asthma action plan are also key.
Where conventional treatment falls short
While rescue inhalers provide immediate relief and controller medications reduce overall inflammation, they manage symptoms rather than addressing the underlying constitutional imbalance that predisposes a person to asthma. Many patients still experience breakthrough attacks, and long-term steroid use - even inhaled - can cause side effects like oral thrush or, over time, bone density loss. Moreover, conventional medicine treats all asthma as fundamentally the same disease, differing only in severity, while TCM recognizes that a wheeze with yellow phlegm and a flushed face requires a completely different strategy than one with white watery phlegm and a pale puffy tongue.
How TCM understands asthma
In TCM, the Lungs are responsible for descending Qi - they draw breath in and send it downward. When something obstructs this downward movement, the Qi rebels upward and outward, causing the wheezing, coughing, and breathlessness we call asthma. The obstruction can be external, like an invasion of Wind-Cold that suddenly tightens the airways, or internal, like accumulated phlegm clogging the passages. Either way, the Lung Qi cannot flow smoothly.
The most common villain in chronic asthma is phlegm. TCM sees phlegm not just as mucus you cough up, but as a thicker, stickier pathological fluid that can lodge anywhere in the body. The Spleen is the source of phlegm - when its digestive function is weak, it fails to transform fluids properly, and dampness congeals into phlegm. The Lungs then become the storehouse where this phlegm accumulates, creating a constant state of airway obstruction and sensitivity. The nature of the phlegm tells the practitioner everything: yellow and sticky means Heat, white and watery means Cold.
But phlegm alone is often not the full story. Underlying the phlegm is often a deeper deficiency that allowed it to form in the first place. The Kidneys, which are the root of all Qi, must grasp the breath and pull it down deep into the body. When Kidney Qi is weak - often after years of illness or with aging - this grasping function fails, and even mild exertion leaves you gasping for air. Similarly, when Lung and Kidney Yin are depleted, the airways become dry, irritable, and prone to spasmodic wheezing. And when Spleen and Lung Qi are both deficient, there is not enough energy to move fluids, so phlegm gradually accumulates and causes chronic, low-grade wheezing that worsens with fatigue.
This is why two people with the same Western diagnosis of asthma may receive completely different TCM treatments. One person's asthma flares after a cold and brings white watery phlegm - that's Cold-Phlegm. Another person's asthma is worse at night with yellow sticky phlegm and a red face - that's Phlegm-Heat. A third person has been wheezing for decades and now feels breathless just walking across the room, with a weak aching back - that's the Kidneys failing to receive Qi. Each pattern requires its own herbal formula, its own acupuncture points, and its own dietary approach.
「五脏六腑皆令人咳，非独肺也……肺咳之状，咳而喘息有音。」
"All five zang and six fu organs can cause cough, not the Lung alone... The Lung cough is characterized by coughing, panting, and audible wheezing."
How a TCM practitioner diagnoses asthma
Inside the consultation
A TCM practitioner begins by asking about the phlegm - its color, thickness, and how easily it comes up. The quality of the mucus is like a compass: yellow and sticky points toward heat, while white and watery points toward cold or deficiency. They also listen to the breathing and ask when the wheezing started and what makes it worse.
If the phlegm is yellow, thick, and difficult to cough out, and the person feels hot, restless, or has a red face, Phlegm-Heat in the Lungs is likely. The tongue is red with a yellow greasy coating, and the pulse feels rapid and slippery - signs of heat and phlegm clogging the airways.
When the phlegm is white, watery, and easily coughed up, and the chest feels tight and full, Cold-Phlegm in the Lungs is suspected. This pattern worsens in cold, damp weather. The tongue is pale with a white slippery coating, and the pulse is slow and slippery, reflecting cold and dampness constricting the Lung Qi.
Chronic mild wheezing with very little phlegm, accompanied by constant fatigue, poor appetite, and loose stools, points to Spleen and Lung Qi Deficiency. The tongue is pale and swollen, and the pulse is weak. Here the Spleen fails to transform fluids, so phlegm slowly accumulates, and the Lungs lack the Qi to descend properly.
Long-standing asthma that leaves someone breathless after even slight exertion, with a sore lower back, weak knees, and frequent nighttime urination, suggests the Kidneys are failing to receive Qi. The tongue is pale and the pulse is deep and weak, indicating the body’s deepest energy reserves are depleted and cannot grasp the breath.
If the asthma comes with a dry, hacking cough, scanty sticky sputum, night sweats, and a sensation of heat in the palms and soles, the pattern is Lung and Kidney Yin Deficiency with Empty Fire. The tongue is red and dry with little coating, and the pulse is thin and rapid. The cooling, moistening Yin is insufficient, allowing deficiency heat to flare up.
An acute attack triggered by a cold draft or a change in weather, with sudden wheezing, chills, body aches, and thin white sputum, points to Wind-Cold invading the Lungs. The tongue coating is thin and white, and the pulse is floating and tight, as the body’s defensive Qi battles an external pathogen at the surface.
TCM Patterns for Asthma
In TCM, the aim is to address the root cause, not just the symptom — it calls that root cause a “pattern.” The same asthma can come from several different patterns, each treated differently. The quickest way to find yours is the quiz below.
Find your pattern
Tap any sign that fits how yours feels.
- 1Your signs
- 2What makes it worse
- 3What helps
Which signs match your experience?
It is common to see traces of yourself in more than one pattern. Asthma often has a root deficiency - like weak Spleen or Kidneys - that makes the Lungs vulnerable to triggers like Wind-Cold or phlegm-heat. You might feel chronically tired but also notice yellow phlegm during a flare-up, reflecting a mix of deficiency and excess.
To narrow it down, focus on the phlegm: its color and consistency are the clearest clues you can observe at home. White and watery leans toward cold or deficiency; yellow and sticky leans toward heat. Also notice what brings relief or makes things worse - cold weather, stress, or exertion. A symptom that eases with rest suggests deficiency, while one that appears suddenly after a chill suggests an external invasion.
Because these patterns can overlap and shift, a professional diagnosis that includes tongue and pulse examination is invaluable. The tongue and pulse reveal what cannot be seen from symptoms alone. If you experience severe shortness of breath, bluish lips, or a fever with wheezing, seek immediate medical care rather than trying to self-treat.
Phlegm-Heat in the Lungs
Cold-Phlegm in the Lungs
Wind-Cold invading the Lungs
Treatment
Four ways to address asthma in TCM — explore each, or take the quiz to see what fits you first.
Formulas traditionally used for asthma
7 formulas across the patterns above. The right one depends on your pattern — start with the quiz if you're unsure which fits.
A classical formula used to relieve wheezing, coughing, and shortness of breath caused by phlegm-heat congesting the lungs, often triggered by catching a cold. It works by opening the airways, directing Lung Qi downward, clearing heat, and resolving thick, sticky phlegm. Commonly applied for asthma and bronchitis with yellow, difficult-to-expectorate sputum.
A classical formula for coughs, wheezing, and breathing difficulty caused by catching cold when there is already fluid buildup in the lungs. It works by warming the lungs, clearing accumulated thin watery phlegm, and helping the body expel the cold. Best suited for people with copious thin, watery, or frothy phlegm, chills, and a wet-looking tongue coating.
A foundational formula for strengthening the digestive system and lifting the body's Qi when it has sunk or become depleted. It is commonly used for persistent fatigue, poor appetite, loose stools, and conditions involving organ prolapse (such as rectal or uterine prolapse) caused by weakness of the Spleen and Stomach. It is one of the most widely used formulas in all of Chinese medicine.
A classical formula that strengthens digestion and clears away dampness and phlegm accumulation. It is used for people who experience poor appetite, bloating, loose stools, nausea, and fatigue due to a weakened digestive system that has allowed excess moisture and phlegm to build up in the body.
A classical formula that gently warms and supports the Kidneys to restore vitality, fluid balance, and lower body warmth. It is used for people with Kidney weakness who experience lower back soreness, cold legs, frequent urination or difficulty urinating, and general fatigue. Unlike strong warming formulas, it uses a small amount of warming herbs alongside a larger base of nourishing ingredients, working gradually to restore the body's natural balance.
A classical formula for nourishing the Lungs and Kidneys when they have become too dry and hot internally. It is commonly used for chronic dry cough, sore throat, blood-tinged sputum, night sweats, and afternoon fevers caused by a deep depletion of the body's moistening fluids. The name means "Lily Bulb Decoction to Preserve the Metal," where "Metal" refers to the Lungs in TCM's Five Phase system.
Ma Huang Tang is a classic formula from the Shang Han Lun used to treat the early stages of a cold or flu caused by exposure to cold, particularly when there is no sweating at all, strong chills, body aches, and sometimes wheezing or breathlessness. It works by promoting a gentle sweat to release the cold pathogen from the body surface and by opening the lungs to relieve breathing difficulties. It is best suited for people with a strong constitution during the acute onset of illness.
Acute attacks from Wind-Cold or Phlegm-Heat often respond within days to a week of herbal treatment. Chronic patterns rooted in deficiency - such as Spleen and Lung Qi Deficiency or Kidney weakness - typically require 3-6 months of consistent treatment to rebuild the body's reserves and reduce long-term airway sensitivity. Most patients notice fewer and milder attacks within the first 4-8 weeks, even if full resolution takes longer.
Treatment principles
TCM treatment of asthma always aims to restore the smooth downward flow of Lung Qi, but the strategy depends on whether the pattern is excess or deficiency. In excess patterns - like Phlegm-Heat or Cold-Phlegm - the focus is on clearing the obstruction: transforming phlegm, cooling heat, or warming cold to open the airways. In deficiency patterns - such as Spleen and Lung Qi Deficiency or Kidney weakness - the priority is to strengthen the body's underlying energy so that phlegm stops forming and the Lungs can descend Qi properly. Many people have a mixed picture, with a root deficiency that makes them vulnerable to excess flare-ups. Treatment therefore often combines herbs that address the acute symptoms with others that nourish the deeper weakness, and acupuncture points are selected to both relieve the chest and fortify the constitution.
What to expect from treatment
Your first visit will involve a detailed intake - questions about your phlegm, triggers, energy, digestion, and emotional state, plus tongue and pulse diagnosis. Treatment is typically weekly acupuncture combined with a custom herbal formula you take daily. During an acute flare-up, the formula will be strong and fast-acting, changed frequently as symptoms shift. In the chronic phase, you'll take a gentler maintenance formula for weeks or months. Most people notice some improvement within 2-4 weeks - less phlegm, easier breathing, better sleep. The goal is to reduce the frequency and severity of attacks and, over time, to lower your reliance on medication under your doctor's supervision.
General dietary guidance
The universal dietary rule for asthma in TCM is to avoid phlegm-producing foods. This means cutting back on dairy (milk, cheese, yogurt), cold and raw foods (salads, ice cream, iced drinks), and greasy or fried items. Instead, favor warm, cooked meals that are easy to digest: congee, soups, steamed vegetables, and moderate amounts of lean protein. Pears, especially Asian pears, are prized for moistening the Lungs and easing dry wheezing. Ginger tea can help warm the Lungs in cold-type asthma. If your pattern is Phlegm-Heat, also reduce spicy and heating foods like chili, garlic, and alcohol. If your pattern is deficiency-based, add nutrient-dense, gently warming foods like bone broth, sweet potato, and small amounts of chicken or lamb.
Combining TCM with conventional treatment
TCM treatment for asthma can safely complement conventional care, and many people begin herbs and acupuncture while continuing their regular inhalers. Never stop or reduce your controller or rescue medications without consulting your prescribing physician. There are no known serious interactions between standard asthma medications and Chinese herbs, but always inform both your TCM practitioner and your doctor of everything you are taking. If you are on oral corticosteroids, your practitioner may monitor your adrenal function as the herbs reduce inflammation. If you use a peak flow meter, keep tracking your numbers - it's a valuable objective measure of progress.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Safety & special considerations
-
Severe shortness of breath at rest — Unable to speak in full sentences or walk a few steps without gasping.
-
Bluish lips or fingernails — Sign of dangerously low oxygen levels - call emergency services immediately.
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Rescue inhaler not working — No relief within 15-20 minutes of using your quick-relief medication.
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Wheezing with high fever and chills — Could indicate a serious respiratory infection needing urgent antibiotics.
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Sudden confusion or drowsiness — May signal carbon dioxide retention - a medical emergency.
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Chest pain or tightness that feels like pressure — Could be cardiac - do not assume it's just asthma.
Audience-specific guidance — open what applies to you
During pregnancy, the growing fetus can press upward and obstruct the descent of Lung Qi, making existing asthma worse, especially in the third trimester. TCM treatment must avoid herbs that strongly move Qi, drain downward, or contain toxic compounds. Ma Huang (Ephedra) is strictly contraindicated, so formulas like Ma Huang Tang, Xiao Qing Long Tang, and Ding Chuan Tang cannot be used. Even milder herbs like Xing Ren should be used with caution and only in small doses under professional guidance.
For acute Wind-Cold patterns, gentle surface-releasing herbs like Zi Su Ye and Sheng Jiang are safer alternatives. Phlegm-Heat can be addressed with mild phlegm-resolving herbs like Gua Lou Pi and Zhu Ru, avoiding bitter-cold herbs that may disturb the pregnancy. Acupuncture is an excellent option throughout pregnancy, with points like Dingchuan EX-B-1 and Lieque LU-7 used carefully, avoiding lower abdominal and sacral points. The focus is always on calming the fetus and supporting Kidney Qi while gently relieving the wheezing.
Most TCM herbs are considered safe during breastfeeding, but some can pass into breast milk and affect the infant. Ma Huang (Ephedra) should be avoided entirely, as its stimulant effect can cause infant irritability and sleep disturbance. Strong bitter-cold herbs like Huang Lian may cause diarrhoea in the nursing baby and should be replaced with milder alternatives such as Huang Qin or Zhi Zi when clearing Heat is necessary.
Acupuncture remains a safe and effective option, and dietary therapy - such as pear and lily bulb congee for Yin Deficiency patterns, or ginger tea for Cold-Phlegm - can be used liberally. The mother's Spleen Qi often needs support during breastfeeding, so formulas like Liu Jun Zi Tang can address both the root deficiency and the phlegm without risk to the infant.
Asthma in children most often begins with repeated external invasions of Wind-Cold or Wind-Heat that are not fully resolved, leaving latent Phlegm in the Lungs. The Spleen is inherently immature in children, so Spleen and Lung Qi Deficiency is the most common root pattern, making them prone to phlegm accumulation. Acute attacks are frequently triggered by Wind-Cold invading the Lungs or by dietary indiscretions that generate Phlegm-Heat.
Diagnosis in children relies heavily on observation - the sound of the cough and wheeze, the color of the phlegm (if any is produced), and the child's energy and appetite. Tongue diagnosis is especially valuable. Herbal dosages are reduced to one-quarter to one-half of the adult dose depending on age, and gentle formulas like Liu Jun Zi Tang or modified Xiao Qing Long Tang (without Ma Huang in very young children) are preferred. Pediatric acupuncture uses very fine needles with minimal retention time, and non-needle techniques like pediatric tuina and moxibustion on Dingchuan EX-B-1 and Zusanli ST-36 are excellent alternatives.
In older adults, asthma almost always has a significant deficiency component. Kidney Yang or Yin Deficiency is often at the root, manifesting as Kidneys failing to receive Qi with severe breathlessness on exertion, or Lung and Kidney Yin Deficiency with a dry, spasmodic wheeze. Spleen and Lung Qi Deficiency is also common, leading to chronic phlegm production and fatigue. Pure excess patterns like Wind-Cold invasion are rare and usually superimposed on a deficient base.
Treatment must be gentle and gradual. Herbal dosages are typically reduced to two-thirds of the standard adult dose, and strong dispersing or draining herbs are avoided. Formulas like Jin Gui Shen Qi Wan and Bai He Gu Jin Tang are well-suited to the geriatric constitution. Attention to drug interactions is critical, as many elderly patients take multiple pharmaceuticals. Acupuncture with gentle stimulation, supplemented by moxibustion on the lower back and abdomen, is often better tolerated than herbs and can safely strengthen the Kidney and Lung Qi over time.
Evidence & references
The evidence base for acupuncture in asthma is moderate. A Cochrane systematic review concluded that acupuncture may offer some benefit in reducing asthma symptoms and medication use, though the quality of included trials varied. More recent meta-analyses suggest acupuncture can improve lung function parameters and quality of life, particularly as an adjunct to conventional care, but large, rigorously designed RCTs are still needed.
Chinese herbal medicine has shown promising results in numerous Chinese-language trials. A systematic review of randomized controlled trials found that herbal formulas were generally more effective than placebo and comparable to standard medications in improving symptoms and reducing exacerbations. Specific formulas such as Ding Chuan Tang have demonstrated anti-inflammatory and airway-remodeling effects in animal studies and a small number of human trials. Overall, the evidence is encouraging but limited by methodological heterogeneity and a lack of large-scale, multi-center studies published in English.
Key clinical studies
Cochrane systematic review evaluating the effects of acupuncture in patients with chronic asthma. The review included 12 randomized controlled trials and found that acupuncture may lead to clinically relevant improvements in symptom scores and quality of life, though the evidence was limited by small sample sizes and variable trial quality.
Acupuncture for chronic asthma
McCarney RW, Brinkhaus B, Lasserson TJ, Linde K. Acupuncture for chronic asthma. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD000008.
10.1002/14651858.CD000008.pub2This randomized, double-blind, placebo-controlled trial assessed the effect of Ding Chuan Tang on airway hyper-responsiveness in 60 children with stable asthma. After 12 weeks, the herbal group showed significant improvement in methacholine challenge test results and reduced asthma symptom scores compared to placebo, with no serious adverse events.
Ding Chuan Tang, a Chinese herb decoction, could improve airway hyper-responsiveness in stabilized asthmatic children: a randomized, double-blind, placebo-controlled trial
Hsu CH, Lu CM, Chang TT. Pediatric Pulmonology. 2006;41(12):1161-1168.
10.1002/ppul.20508A systematic review of 27 randomized controlled trials involving over 2,400 patients. The review found that Chinese herbal medicine, used alone or as an add-on to conventional therapy, significantly improved asthma symptoms and lung function compared to placebo or standard care. The authors noted that methodological quality was generally low, warranting cautious interpretation.
Chinese herbal medicine for asthma: a systematic review of randomized controlled trials
Shergis JL, Wu L, Zhang AL, Guo X, Lu C, Xue CC. Respiratory Medicine. 2010;104(12):1772-1783.
10.1016/j.rmed.2010.08.009Classical text references
One quote is featured above in the Understanding section — the rest are listed here for the classically inclined.
「伤寒表不解，心下有水气，干呕，发热而咳，或渴，或利，或噎，或小便不利、少腹满，或喘者，小青龙汤主之。」
"In cold damage with unresolved exterior, water qi lodged below the heart, dry retching, fever and cough, or thirst, or diarrhoea, or dysphagia, or inhibited urination with lower abdominal fullness, or wheezing - Xiao Qing Long Tang governs."
Shang Han Lun (Treatise on Cold Damage)
Clause 40
「膈上病痰，满喘咳吐，发则寒热，背痛腰疼，目泣自出，其人振振身瞤剧，必有伏饮。」
"When phlegm lodges above the diaphragm, there is fullness, wheezing, cough, and vomiting; when it flares, there is alternating chills and fever, back pain, lumbar pain, spontaneous tearing, and severe body twitching - this indicates hidden phlegm-fluid retention."
Jin Gui Yao Lue (Essentials from the Golden Cabinet)
Chapter 12, Phlegm-Fluid Retention Disease (Tan Yin Ke Sou Bing Mai Zheng Zhi)
Frequently asked questions
Common questions about using Traditional Chinese Medicine for asthma.
TCM aims to correct the underlying imbalances that make your airways reactive. For many people, this means a significant reduction in the frequency and severity of attacks - sometimes to the point where they no longer need daily controller medication. However, 'cure' is a strong word; it's more accurate to say that TCM can bring about long-term remission by strengthening the Lungs, Spleen, and Kidneys so that triggers no longer provoke the same response.
During an acute flare-up, herbs can begin to ease wheezing and open the chest within a day or two. For chronic, long-standing asthma, the first signs of improvement - like less morning phlegm or fewer nighttime awakenings - often appear within 2-4 weeks. Full constitutional change takes months, but the trajectory is usually steady improvement.
Acupuncture is generally very safe, but during a severe acute asthma attack, your priority must be your rescue inhaler and seeking medical help if breathing is labored. Acupuncture points like Dingchuan (EX-B-1) and Lieque (LU-7) can be used to support breathing in mild to moderate situations, but they are not a substitute for emergency medication. See the Safety section for red-flag symptoms that require urgent care.
Absolutely. Never stop or reduce your prescribed asthma medications without consulting your doctor. TCM herbs and acupuncture are complementary - they work alongside your inhalers to reduce inflammation and phlegm over time. As your condition improves, your doctor may be able to adjust your medication dosage, but this must be a joint decision.
The biggest culprits in TCM are dairy, cold and raw foods, and greasy or fried items, all of which tend to generate phlegm. Ice-cold drinks and ice cream are particularly problematic because they chill the Spleen and Lungs, encouraging phlegm formation. Spicy, hot foods can aggravate Phlegm-Heat patterns. Focus on warm, cooked meals - soups, stews, and lightly steamed vegetables - and see the Diet section for more detail.
Yes, when prescribed by a qualified practitioner who adjusts the dosage for the child's age and weight. Pediatric asthma often responds very well to TCM, especially when there is a strong phlegm component. Herbs can be given as powders, teas, or even in honey-based pastes to make them palatable. Always work with a practitioner experienced in pediatric care.
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