Cough syndrome differentiation to explore

LiYaoHui Shaanxi province respiratory medicine hospital of traditional Chinese medicine

China's traditional Chinese medicine to

        Cough is a common respiratory disease symptoms, the clinical syndrome differentiation in are accumulated relatively mature experience, and formed a "cough of TCM experts consensus opinion," which the clinical guidance has a very positive meaning. However, the author thinks that, cough syndrome differentiation process there are still some problems to be further discussed.

        Pathogenic and internal injury

        Pathogenic and internal injury is the eternal topic of respiratory diseases, external contraction of the six excesses are often cough with incentive, internal injury seven emotions lead to human vital qi deficiency, and thus more likely to feel the six evils, pathogenic and internal injury is cough syndrome differentiation process of a pair of principal contradiction, both in the course of illness often has occurred or existing at the same time. We clinically the cough artificially divided into exogenous and internal injury, in view of the exogenous cough often divided into cold, rheumatism, wind heat, air drying, hot and humid and so on syndrome differentiation; According to the internal injury cough is divided into phlegmy wet, phlegm heat, irascibility make lung, lung spleen qi deficiency, lung renal two virtual of parting treatment, the internal medicine of traditional Chinese medicine mentioned in cough stressed first distinguishes the pathogenic, internal injury, so that the sense that gives a person is exogenous cough and internal injury cough is two completely different cough, thus ignore the pathogenic factors and internal injury factors including necessary contact: exogenous cough exist in the process of the internal injury factors such as cold cough has a WeiYang, lung qi damage, repeatedly pathogenic wind chill of the evil will aggravate the human body the sun be the spirit damage; Internal injury cough feelings six corrupt gas symptoms often aggravate, such as pulmonary spleen qi deficiency of chronic cough patients are more likely to feel the six evils of the evil, and in the pathogenic symptoms after rapid increase. Chronic obstructive pulmonary disease exacerbations issue of the patients, doctors if not considering the pathogenic factors and internal injury factors, and of the degrees earned in grasping the principal contradiction, and pay attention to the secondary contradictions, but only from pure exogenous cough or simple from internal injury cough on syndrome differentiation with one-sided sex, will also affect the treatment effect.

        Cold and hot

        The cough cold problem at least includes three aspects:

        1. Six corrupt air chills and fever and chills and fever patients constitution relationship. Chill of the evil invasion cold sex constitution, there is no doubt that this is cold cough, even can appear Yang cough; Cold evil invasion thermal physical person, cold depression muscle table, by contain internal, may appear cold pack fire cough;

        2. The living environment and season chills and fever relationship to the influence of human body. The comparatively typical is winter in the cold environment and heating plenty of indoor small environment happened cough, and a hot summer environment and cool and refreshing and even cold air conditioning environment happen cough, these two kinds of cough syndrome differentiation must pay attention to not only the analysis of cough chills and fever property, also must take care of patients in environment and living small environment frequent environmental conversion to disease and pharmacodynamic influence;

        3. Lung characteristics and the relationship between the disease. The characteristics of the lung is "lung for charming dirty, not cold hot", not cold heat also easy cold heat easily. So in syndrome differentiation in the process of cough, both must analysis disease chills and fever, also want to pay attention to lung for charming dirty, be not too cold, overheat problem.

        Syndrome differentiation and combination of disease

        Cough is the common symptoms of respiratory medicine, many diseases can cause cough. Different disease pathogenesis is the need of differentiation of symptoms and signs, but this is not to ignore the reason of differentiation of disease. The same is phlegmy wet cough, copd cause cough and lung cancer cause cough its prognosis is completely different, attaches great importance to the diagnosis of disease, as far as possible, in disease diagnosis clear case the syndrome differentiation and treatment, it is time for the new requirements of traditional Chinese medicine.

        The relationship between syndrome differentiation viscera

        The cough zang-fu syndrome differentiation, we are used to from lung, spleen, kidney for syndrome differentiation, but this is not cough syndrome differentiation of all content. Clinically, from other zang-fu syndrome differentiation cough should also attention:

        (1) from the liver syndrome differentiation. Liver, lung is phase grams, phase without relations, lung qi deficiency, liver wood often take the threat of lung gold, thus can aggravate the cough, so cause in the process of treating cough attention liver factor is very important. Small radix bupleuri soup is hydrophobic the courage of qi classical prescription, the original "typhoid five to six days stroke, current chills and fever, chest threat bitter full, hey hey you would not diet, upset xi oh, or in the chest vexed and not oh, or thirsty,... or cough person, small radix bupleuri soup of the Lord." Four inverse bulk is harmonic qi of the square, the original "shaoyin disease, four inverse, the person or cough,... four inverse scattered the Lord." Two sides mentioned treatment "cough", clinical we can in the differentiation of symptoms and signs based on form the two one of prescriptions, believe to be able to increase the curative effect.

        2. From the bowel syndrome differentiation. Cough if accompanied by constipation, wu JuTong there is a famous prescription "XuanBaiCheng gas soup" (plaster stone, almond, trichosanthes kirilowii maxim, rhubarb) is specialized in lung intestinal disease with this situation, clinical can draw lessons from this kind of thought.

        3. From the deficiency syndrome differentiation. Cough day long, break out repeatedly, upright increasingly attenuation, then can be in accordance with the "consumptive idea syndrome differentiation, YeTianShi useful astragalus membranaceus chienchung soup syndrome differentiation" fatigue due to "the medical record.

        Pay attention to the ancient new use

        For bronchiectasis (pulmonary abscess) belong to phlegm heat whooper clinical general like gold with clear phlegm soup (almond and trichosanthes kirilowii maxim, tuckahoe, immature bitter orange, radix scutellariae, bravery south star, dried tangerine or orange peel, pinellia tuber, ginger), then treat intestinal carbuncle of job's tears monkshood defeated sauce powder (coix seed, radix aconiti lateralis preparata and patrinia) and may not be used to treat lung abscess? Obviously in the reasonable after add and subtract is ok. For lung renal two virtual cough, we get used to wheat flavour dihuang pill, but when someone USES Yang and soup (antler glue, cinnamon, ephedra, ginger carbon, prepared rhizome of rehmannia, white mustard, roasted liquorice) treatment virtual cold cough, we can't help feeling that find everything new and fresh.

        Turtle shell Fried pill is on the treatment of cirrhosis of liver fibrosis, the effective prescription, it can be used to treat lung fibrosis? See the composition: turtle shell glue, glue, hives, pill bug insect, ground beetle, dung beetle, saltpeter, radix bupleuri, radix scutellariae, pinellia tuber, dangshen, dry ginger, cortex magnoliae officinalis, cassia twig, radix paeoniae alba, rhizoma belamcandae, peach kernel, cortex moutan, rhubarb, trumpet creeper, semen lepidii, pyrrosia leaf, pink herb. Among them, the turtle shell soft firm, real ground beetle, mantis [removing, can be used for pulmonary fibrosis; Small radix bupleuri soup Lord medicine (radix bupleuri, radix scutellariae, dangshen, pinellia tuber), cassia twig soup Lord medicine (cassia twig, radix paeoniae alba), cortex magnoliae officinalis, semen lepidii are lung disease commonly used medicines; Especially the honeycomb, and for the treatment of pulmonary interstitial fibrosis in the image is often "honeycomb lung", the effect is good. So, the whole turtle shell Fried pill from formula point of view, used for pulmonary interstitial fibrosis is reasonable. Turtle shell Fried pill treatment of pulmonary fibrosis effect still need to clinical verification, but the real soft firm, insect class pick out the train of thought of removing is certainly to traditional Chinese medicine syndrome differentiation pulmonary interstitial fibrosis useful exploration.