TCM syndrome differentiation cough is characterized by unclear lung qi, loss of Xuansu, upside down voice and cough. Cough and expectoration are the main symptoms of this syndrome. Because of the difference of etiology and body reactivity, the corresponding symptoms and characteristics appear. The cough and phlegm caused by exogenous infection are mostly accompanied by fever, headache, fever, etc. The onset of the disease is more acute and the course of the disease is shorter. The cough caused by internal injury generally has no exogenous symptoms and has a slow onset and a long course, often accompanied by visceral dysfunction.


Etiology Editor

Cough is related to invasion of exogenous pathogens and dysfunction of viscera. As the Medical Three-Character Classic says, "The lung is the cover of the viscera, the exhalation is empty, the inhalation is full, only the viscera's righteousness can be received, the external politeness can not be tolerated, the politeness is dry and cough; also only the viscera's Qingqi can not be tolerated, the viscera's disease gas can not be suffered, the sickness gas is dry, also cough and cough." The causes of cough are: one is exogenous pathogenic factors of six lewds; the other is the pathogenic Qi of zang-fu organs, which can cause unclear lung qi to be lost in Xuansu and make cough upside down.

1. External pathogenic attack on lung

Six exogenous sensations, from the mouth and nose or fur into, so that the lungs were bundled, lungs were destroyed and dropped, "Hejian Six Books on Cough" said: "Cold, summer, dryness, humidity, wind, fire, six qi, all make people cough" that is the meaning. Because of the difference of four-hour anger, the pathogenic exogenous pathogens felt by the human body are also different. Wind is the first of the six lewds, and other exogenous pathogens invade the human body. Therefore, exogenous cough often takes wind as the guide, or carries cold, or heat, or dryness, especially wind evil carries cold. Zhang Jingyue said: "Six Qis are coughing, mainly wind and cold."

Endogenous pathogenic dry lung

The function of viscera is out of regulation, affecting the lungs. It can be divided into other visceral lesions involving both ends of the lung and the lung. The cough of its viscera and lungs can be caused by emotional stimulation, liver disorder, qi stagnation and fire changing along the meridians; or by improper diet, addiction to tobacco and alcohol, spicy products to help fire, fumigation of the lungs and stomach, burning Jin and generating phlegm; overeating, rich and sweet taste, resulting in unhealthy luck, phlegm turbid endogenous, drying in the lungs, obstructing the airway, all can make the lungs gas inverted. And cough. Because of lung self-disease, it is often delayed by various diseases of the lung system, lung weakness, Yin injury gas consumption, dysfunction of the main Qi of the lung, so that it has no right to purge and cough upstream.

Pathogenesis Editor

On cough caused by exogenous or internal injuries, all involve lung diseases, due to unclear lung Qi lost in Xuansu, so "Jingyue Quanshu Cough" said: "Although there are many cough syndromes, there is no other than lung disease." "Medical Mind Awareness" pointed out: "Lung is metal, for example, Zhong Ran, Zhong Fei does not knock, wind, cold, heat, dampness and dryness, six evil evil, from the outside strikes, the desire to work, the fire of eating from the inside strikes. It is suggested that cough is a pathological reaction of the lung caused by internal and external diseases.

Exogenous cough belongs to pathogenic substance, which is caused by the invasion of lung by exogenous pathogens and the obstruction of lung-qi. If the pathogenic substance can not reach the outside in time, it can further evolve and transform, manifesting wind-cold heat, wind-heat, dryness, or phlegm from lung-heat vapor.

Internal injury cough mostly belongs to the combination of evil and excess and deficiency. Pathological factors are phlegm and fire. But phlegm is different from cold and heat, and fire can be divided into deficiency and reality; phlegm can melt and turn fire into depression, and fire can refine liquid and burn body into phlegm. In other organs and lungs, pathogenic facts often lead to deficiency, such as liver fire invading the lungs and damaging the lung and body by gas fire, and phlegm by liquor refining. Those who suffer from phlegm-dampness invade the lungs are mostly due to spleen dysfunction, and the valley can not be transformed into subtle upper infusion to nourish the lungs. Instead, it accumulates into phlegm-turbidity, which is stored in the lungs, with pulmonary asphyxia and cough. If the disease lasts for a long time, the deficiency of both lung and spleen and the inability of Qi to dissolve Jin, phlegm turbidity is more likely to breed, which is the principle that "the spleen is the source of phlegm, and the lung is the instrument of phlegm storage". Even the disease extends to the kidney, from cough to asthma. If phlegm and dampness accumulate in the lungs, when touched by exogenous sensation and turned from heat, phlegm and heat cough can be manifested; if turned from cold, cold phlegm and cough can be manifested. As for the cough of pulmonary spontaneous disease, it is mostly due to deficiency. If the deficiency of lung yin causes excessive fire due to deficiency of yin, burning Jin for phlegm, moistening lung, coughing due to deficiency of Qi or deficiency of lung qi, it has no right to eliminate the deficiency of Qi without eliminating Jin, gathering Jin into phlegm, and reversing Qi to the top, causing cough.

Exogenous cough and internal injury cough can also affect each other as a disease. If the disease lasts for a long time, the evil and excess will turn into deficiency. Exogenous cough, such as delayed treatment, damaging lung qi, is more prone to repetitive pathogenicity, and causes cough repeated, turning into internal injury cough; the lungs are diseased, the external defense is not solid, vulnerable to external pathogens caused or aggravated, especially in climate change. For a long time, it turned from solid to deficient, the lungs were weak, and the Yin wounded the Qi. From this we can see that although cough can be divided into exogenous and internal injuries, sometimes the two can cause and effect each other.

1. Wind and cold strike the lungs

Symptoms: itchy throat, heavy cough, shortness of breath, thin white phlegm, often accompanied by nasal obstruction, runny nose, headache, sore limbs, chills, fever, no sweat and other symptoms, thin white tongue coating, floating or floating tight.

Therapy: Disperse wind and disperse cold, Xuanfei and relieve cough.

Prescription: Sangao Decoction combined with Zhisousan. In the prescription, ephedra and Schizonepeta were used to disperse wind and cold, and almond was used to propagate lung and reduce qi; Aster, Baiqian, Baipi were used to regulate lung and expectorate phlegm; Platycodon grandiflorum and Licorice were used to relieve cough. If the cough is worse, it will be relieved by dwarf tea and Jinbocao; if the throat is itchy, it will be relieved by Burdock and cicada; if the nose is blocked heavily, Xinyihua and Xanthium sibiricum will clear the nose; if it is damp with phlegm, cough and phlegm sticky, chest tightness and greasy moss, it will be relieved by dryness and dampness of Banxia, Magnolia and Poria cocos; if the surface is cold, there is depression and heat in it, it will be cold stagnation and cough. Souyingga, breathing like asthma, phlegm sticky, thirsty and upset, or the person with body heat plus gypsum, mulberry white skin, Scutellaria baicalensis Jie surface Qingli.

2. Wind and heat invade the lungs

Symptoms: frequent cough, coarseness of breath or hoarseness of cough, dry throat and sore throat, uncomfortable phlegm, viscous or thick yellow phlegm, perspiration during cough, often accompanied by runny nose, thirst, headache, limbs, nausea, body heat and other symptoms, thin yellow tongue coating, floating pulse or slippery.

Therapy: Removing wind and clearing heat, ventilating lung and relieving cough.

Prescription: Sangju Yin. This prescription uses mulberry leaves, chrysanthemum and mint to disperse wind and pathogens, to spread wind and heat, almonds, Platycodon grandiflorum and licorice to lightly disperse lung qi, to dispel phlegm and relieve cough, and Forsythia suspense and reed root to clear heat and generate fluid. Cough is even added Qianhu, loquat leaves, Fritillaria thunbergii Qingxuanfei, phlegm relief cough; Lung heat is filled with Scutellaria baicalensis, Anemarrhena chinensis Qingfei; pharyngalgia, voice ga, plus shoot dry, Shandougen Qingfei throat; If wind-heat injury collaterals, see nosebleeds or phlegm with bloodsilk, add white grass root, raw earth cool blood to stop bleeding; Summer heat with 61 powder, fresh lotus leaf Clear away heat.

3. Wind dryness injures the lung

Symptoms: itchy throat, dry cough, choking, dry throat, dry back nose, no phlegm or less phlegm and adhesion into filaments, not easy to vomit out, or phlegm with blood silk, dry mouth, initial or with nasal congestion, headache, slight cold, body heat and other symptoms, red and dry tongue, less zinc, thin white or thin yellow coating, pulse floating or decimal.

Therapy: Removing wind and clearing lung, moistening dryness and relieving cough.

Prescription: Sangxing Decoction. Fangzhong Mulberry Leaves, Douchi Shufeng Jiebiao, Qingxuan Dry Heat; Almonds, like Fritillaria Fritillaria soothing lung cough; Nansha ginseng, pear peel, mast clear heat and moisten dry Shengjin. If the injury is serious, add Ophiopogon japonicus and Polygonatum odoratum to nourish lung Yin; add gypsum and Anemarrhena asphodeloides to clear lung and relieve fever before the heat is heavy; add blood in phlegm to the place where the blood is added, and cool the blood from the root of White Mao to stop bleeding. There are also cold dryness and lung injury syndrome, which is the combination of dryness syndrome and wind-cold. The symptoms include dry cough, less phlegm or no phlegm, dry pharynx and nose, fever, headache, no sweat, thin white and dry tongue, etc. The principle of medication should be warmth but not dryness, moistening but not cool, and then Xingsu powder should be added or subtracted. The medicinal leaves of perilla, almonds and praeruptorium are dispersed to relieve cough, while purple flowers, tussilago, Baibu and licorice are mild and moist. If the cold is very bad and there is no sweat, it can be matched with Schizonepeta and windbreak to relieve sweating.