Cough Variant Asthma, Syndromes And Efficacy Of Traditional Chinese Medicine Interventions

Background: Cough Variant Asthma (CVA) is a special type of asthma. Western diagnosis of CVA depends on lung function,also ruling out other reasons caused in chronic cough. Due to high rate of misdiagnosis and delayed treatment, some patients developed into typical asthma. Corticosteroids, bronchodilators and leukotriene receptor antagonists are the based western medicine treatment, which are disadvantages of side effects, easy to relapse after treatment, higher medical costs due to long-term clinical application. The unique advantages of traditional Chinese medicine in syndrome differentiation, prescription and drug use,special treatment of CVA are simple, convenient, effective and cheap. Currently,huge complicated view and lack of a unified understanding in the disease name, etiology and pathogenesis, syndrome differentiation, clinical applications of CVA by scholars in TCM, are not conducive to the promotion of traditional Chinese medicine treatment in CVA.Objective: Through clinical studies of82patients with CVA, to optimize the basis of clinical classification, to reveal the objective laws of syndrome differentiation, and to provide reference and methods of standardization of Chinese medicine syndrome differentiation of CVA. Through clinical studies of42patients with CVA (the syndrome of pathogenic wind attacking lung), to observe the clinical efficacy of decoction of Shufengxuanfei and to explore the theoretical basis of formula in TCM at the same time.Methods:First, according to the references, formulated the table for CVA to observe the symptom, signs, tongue and pulse,and the result of the relevant laboratory examinations. Second, according to the general symptoms of infection situation,characteristics of symptoms, syndrome type of patients, extracted the traditional Chinese medicine syndrome characteristics of CVA. Third, on the basis of traditional Chinese medicine syndrome characteristics of CVA, combining with the tutor’s clinical experience in the treatment of CVA, formulated the based prescription-decoction of Shufengxuanfei to treat CVA (the syndrome of pathogenic wind attacking lung) and addition and subtraction of it. The treatment group and the control group were established.Both groups took the same basic treatment for2weeks to assess clinical efficacy, the treatment group also with decoction of Shufengxuanfei at the same time. Four weeks after the end of treatment,followed up by telephone to assess the disease control.Results: Symptoms survey part:Completed symptom investigation82cases of CVA patients. Age distribution: male35cases, accounted for42.68%, female47cases, accounted for57.32%, the male to female ratio is about1to1.34. Age distribution: the minimum age18years old,the maximum age77years old, the average age (42.20±16.100) years old. Professional distribution: workers in13cases(15.85%),farmers in6cases (7.32%),staff in49cases(59.76%), the other14cases(17.07%). Incentive distribution: Because of upper respiratory tract infection induced by the38cases, accounting for46.34%. Because of excitant odour, dust,soot induced29cases, accounted for35.37%. Due to encounter cold air induced10cases, accounting for12.20%. The rest of the rare. Course of distribution: The shortest1month, the longest7.5years, average duration of10.56months. Smoking is31cases (37.80%). Who has more than one kind of allergy or more than one allergic disease is50cases (60.98%). Irritating cough with28cases (34.14%), choking cough with20cases (24.39%), cough with phlegm with54cases(65.85%), Paroxysmal cough with46cases (56.10%), Cough at night is aggravating with31cases (37.80%). With pharyngeal itching in79cases (96.34%), With sore throat in49cases (59.76%),With a stuffy nose, nasal itching, sneezing are27cases (32.93%), Wi th runny nose in30cases (36.59%); With dry mouth thirsty in28cases (34.15%);28cases with dry throat (34.15%)33cases with shortness of breath,(40.24%). Tongue reddish,20cases (24.39%); Tongue light dark,13cases (15.85%); Dark red tongue,21cases (25.61%),Red tongue,22cases (26.83%); Dark purple tongue and (or) have petechial petechiae,6cases (7.32%). Tongue body slants thin,43cases,(52.44%).Crack tongue,6cases (7.32%). Tongue body fat soft, side with teeth marks,13cases (15.85%).Thin tongue coating,62cases(75.61%). Thick tongue coating,7cases,(8.54%).Greasy coating,17cases (20.73%).82cases of CVA patients enrolled in the study on syndrome differentiation type, the wind evil committed lung syndrome,42cases,(51.22%), significantly higher than other types of symptoms. Second, lung qi deficiency syndrome,9cases (10.98%). Liver-fire attacking lung syndrome7cases (8.54%). Blood stasis resistance lung collaterals syndrome,6cases (7.32%).In addition, lung Yin deficiency syndrome, phlegm heat indicates pulmonary syndrome,hot wind make lung syndrome, kidney Yin deficiency syndrome, spleen deficiency syndrome, kidney Yang deficiency syndrome, cold attack lung syndrome, phlegm turbidity resistance pulmonary syndrome are visible in the investigation of the symptoms, but less than5.00%.Clinical curative effect observation:Finished curative effect observation of42cases. Treatment group21cases, male8of cases,13cases of female, aged21to77years, an average of (45.52±16.893) years, average duration(10.52±13.489)months. Control group21cases,9cases of male,12cases of female, ages19to65years, an average of (44.38±13.987)years, average duration of (6.81±5.582) months. Two groups in terms of gender composition ratio, age, course of comparative differences have no statistical significance (P>0.05),data comparable. The treatment group total effective rate was80.95%The control group total effective rate42.86%Comparing the two groups P=0.011<0.05, the difference was statistically significant. Comparison of the efficacy of TCM syndrome, the treatment group, the total efficiency of90.48%; the control group, the total efficiency of57.14%, by chi-square test, x2=6.035, P=0.014<0.05, the difference was statistically significant. In reducing the frequency, extent of cough and expectoration volume, the degree of itchy throat, both the treatment group and the control group were having significant effect, P<0.05, and the treatment group was significantly better than the control group, P<0.05. In the degree of sore throat and nasal congestion areas, the treatment group had significant effect, P<0.05; the control group had insignificant effect, P>0.05. In patients with lower lung condition urgent degree, the treatment group and control group all can reduce symptoms integral, but P>0.05, no significant curative effect. Comparison of the efficacy of the main symptoms, the total efficiency was95.24%in the treatment group, and the total efficiency was85.71%in the control group. By fisher’s exact test, the difference was not statistically significant, P=0.606>0.05. Treatment group and control group can obviously reduce the peripheral eosinophil count, the difference between two groups was not statistically significant, P=0.610>0.05. Comparison of safety, no adverse effects were found during treatment and during follow-up in the two groups.Conclusion: Symptoms survey part:Recurrent paroxysmal and irritating cough is the characteristic of CVA, always see the pharyngeal itching, sore throat, nasal itching, nasal congestion, sneezing, runny nose, etc. Its etiology and pathogenesis is that natural endowment is not resistance, pulmonary qi deficiency, external pathogens invaded (mainly wind evil), cause lung qi on inverse, pulmonary vein spasm suddenly. Time can cause fluid loss injury, liver depression and qi stagnation,blood stasis resistance lung collaterals, lung and kidney Yin deficiency, lung, and spleen qi deficiency, spleen kidney Yang deficiencyr, etc. Disease in the lungs, cosely associated with liver, involved in spleen and kidney. Strong pathogens is the surface phenomenon, weakness of the vital qi is its essence. The disease is easy to break out repeatedly, difficult to completely heal, has a certain influence on the patient’s mood. Clinical syndrome differentiation main syndrome type for the wind made the lung, lung qi deficiency syndrome, something make lung syndrome, blood stasis resistance lung collaterals, but often a variety of card type doped with each other.In summary,decoct ion of Shufengxuanfei is safe and effective in treating CVA (the syndrome of pathogenic wind attacking lung) and suitable for promotion.