Chinese medicine propagandizes the slogan of nourishing lung

In the face of cough variant asthma, this time, I won't talk about the ineffectiveness of antibiotics in western medicine, the side effects of using hormones and the phenomenon that bronchodilators treat symptoms rather than root causes.

This time, let's talk about a misunderstanding or limitation in the treatment of this disease by Chinese medicine, and analyze it for everyone to see.

This misunderstanding or limitation is manifested in the dialectical treatment of cough variant asthma:

There are many clinical studies on the treatment of cough variant asthma by traditional Chinese medicine. Many Chinese medicine practitioners mainly intervene in the acute attack period, and treat them according to the principles of cough, asthma and asthma syndrome, but less involved in the management of phased treatment.

This disease should be treated from "wind asthma". Because of the different etiology and pathological process, the treatment methods are different, and the emphasis is on staged treatment. In acute attack, it is treated by dispersing wind and dispersing lung, in chronic remission, it is treated by resolving phlegm and dredging collaterals, and in stable period, it is treated by strengthening spleen and consolidating exterior, with remarkable curative effect.

Take the well-known health preservation as a simple analogy. We all know that nourishing yang in spring and summer, nourishing yin in autumn and winter-eat more soup foods with high protein and rich vitamins and minerals in spring, and clear away heat and relieve sore throat in early spring. Summer diet should be light and vegetarian; Autumn diet should be based on the principle of' nourishing yin and moistening lung', and winter diet should pay attention to avoiding cold and warming up, astringing yang and protecting yin.

Doing different things at different stages is in line with heaven, so should seeing a doctor.

Examples are given to provide ideas for clinical staging management of cough variant asthma.

Mr. Zheng, 4 1 year-old, has an intermittent cough for more than 2 years, which is aggravated in 2 weeks.

Two months ago, the patient coughed after catching a cold, which has been delayed for a long time. He was admitted to the hospital.

The absolute value and proportion of eosinophils in peripheral blood were normal, immunoglobulin E(IgE) increased slightly, chest X-ray showed a slight increase in lung texture, and lung function suggested that bronchiectasis test was positive. Previous history of allergic rhinitis.

Combined with symptoms, medical history and laboratory examination, western medicine diagnosed cough variant asthma.

Inhalation of glucocorticoid can relieve symptoms.

Because of the side effects of hormone use on osteoporosis, patients stopped taking glucocorticoid on their own, and cough symptoms broke out intermittently. When necessary, they take glucocorticoid.

Next, the cough gets worse after a cold, especially at night, and I feel chest tightness in the morning. In the past two days, I have often complained that I have coughed because of a cold or a pungent smell. Patients consider using hormones to induce osteoporosis, so they seek Chinese medicine treatment.

20 16 On May 25th, you found me here.

Initial symptoms: frequent cough, aggravated at night, affecting sleep, itchy throat, itchy nose and runny nose, loss of appetite, loose stool, red tongue, thin and white fur and slippery pulse.

Physical examination: The auscultation breath sounds of both lungs are thick, and no obvious dry and wet sounds are found.

I identified the disease as "wind asthma", and the symptoms such as itchy throat, stuffy nose and runny nose were consistent with the characteristics of wind pathogen, such as "changeable behavior", "intellectual fit" and "spasm", which were itching caused by wind pathogen. If wind evil persists for a long time, it will lead to lung qi stagnation, which can not be declared, and airway spasm will lead to frequent cough, which belongs to cough.

The main treatment is "dispersing wind and dispersing lung".

Prescription: honey ephedra and almond, lifting, dispersing lung and relieving asthma are king;

Schizonepeta tenuifolia, cicada slough, dispelling wind and penetrating evil as ministers.

Clearing Pinellia ternate and Pericarpium Citri Reticulatae to eliminate phlegm and regulate qi, Salvia miltiorrhiza and Lumbricus to promote blood circulation and dredge collaterals, which means "treating wind first, promoting blood circulation and self-extinguishing", with * * * as adjuvant and Glycyrrhiza uralensis as harmony medicine.

The second diagnosis: cough and nasopharyngeal itching are removed by half, and a small amount of phlegm is coughed up, with reddish tongue, thin white fur and slippery pulse. Wind evil is sparse, but it is not penetrated. Because of the consolidation of wind and phlegm, it still belongs to the attack period of cough variant asthma. Keep the original prescription, add Fritillaria thunbergii and orange collaterals to resolve phlegm and reduce turbidity, so that wind evil can not attach.

Three diagnoses: itchy nasopharynx, occasional cough, easy sputum and dark color. At this time, cough is mostly caused by phlegm and saliva, because wind evil has been solved, glue phlegm gradually emerges, and lung collaterals become unobstructed, which belongs to the chronic remission period of cough variant asthma. The adjustment method is to clear away heat and phlegm to clear phlegm heat.

Prescriptions: Perilla frutescens, Jiang Qi, Semen Sinapis Albae for resolving phlegm, Raphanus sativus for removing stagnation and resolving phlegm, and * * * as the monarch medicine for resolving phlegm; Pinellia ternata, Poria cocos and Trichosanthes kirilowii can eliminate dampness and eliminate phlegm, gypsum and Scutellaria baicalensis can clear away heat and moisten dryness, which can help lung qi to become a minister, and Salvia miltiorrhiza, Orange Collateral and Glycyrrhiza uralensis can coordinate various drugs.

Four diagnoses: cough, phlegm loss, and all diseases are cured. This shows that phlegm-dampness has cleared, lung collaterals are unobstructed, and cough variant asthma has entered a stable period. According to the theory of asthma, we should legislate to strengthen the spleen, eliminate the source of phlegm, and strengthen the exterior to prevent thief wind. Radix Astragali, Radix Saposhnikoviae, Rhizoma Atractylodis Macrocephalae, Poria, and Radix Ophiopogonis are added to make up for future troubles.

Follow-up visit: after 2 months, the condition did not recur, so I stopped taking medicine and accepted the job.

After 3 months, the condition was stable and there was no attack.

See, from the attack period, chronic remission period to stable period of cough variant asthma, at different stages, due to different etiology and pathogenesis, the law and emphasis of its treatment should also be changed accordingly, and the correct way is to follow the symptoms.

According to the different stages of the case, it can be divided into attack stage and remission stage by "cough and itching" and remission stage and stable stage by "phlegm". Treatment has advanced and retreated to some extent. In the attack period, pathogens should be eliminated first, and phlegm and evil should be eliminated more effectively. In remission stage, phlegm and lung should be removed with the flow, and blood circulation should be promoted to dredge lung collaterals. In the stable period, we should clear the source of phlegm and give consideration to the inducement.

It embodies the general principle of "timely rescue, slow down and cure the root cause", and provides ideas and models for the clinical standardization of TCM treatment and management of cough variant asthma.

I hope it can bring some inspiration to patients, friends or family who are reading this article.

I'm Li Shuxiang, a Chinese doctor. If you have any questions or questions about asthma and chronic obstructive pulmonary disease, please leave a message in the message area or write to me privately on my homepage. I will try my best to answer your questions and wish you a speedy recovery.