| Objectives:Professor Xi Zhaoqing has been involved in clinical treatment for acute respiratory disorder for the past 49 years.This thesis is to evaluate the effectiveness of treating acute cough by dispelling wind and phlegm pathogen through examining the treatment methods and medications used by Professor Xi as well as to examine the rules in the usage of herbal medications in treating acute cough.This is to provide objective statistical evidence in evaluating Professor Xi's treatment methods.Method:Through literature research in the root cause of acute cough,analyzing the etiology and pathogenesis of this illness as well as evaluating the clinical treatment experience of Professor Xi,a total of 120 clinical cases were collected from Jiangsu Provisional Hospital for evaluation from March 2013 to December 2015.Among them,67 cases were cough related to wind pathogen while 53 related to phlegm.Clinical symptoms of these cases such as the course of the disease,texture of the phlegm,colour of the phlegm,age and gender were evaluated.7 days form one full course of treatment,observe for 2 treatment courses.The prescriptions for the treatment of acute cough from the outpatient medical records of Professor Xi were examined using the Traditional Chinese Medicine Inheritance Assistant platform software(V25).The prescription was analyzed from three aspects-single drug use,drug pairing and a core combination of the commonly used drugs.The frequency of TCM herbs usage,the type of TCM herbs used,Four Qi(??),Five Flavors(??),meridian attribution and relationship among the use of these drugs were examined in totality.In addition,clinical cases were analyze for the main signs and symptoms before and after treatment using SPSS 22.0 software.Variance analysis is used to analyze successive data acquisition.Chi-square test is used to analyze classifying variable.Ordered categorical data is evaluated using Wilcoxon sign test.Mean Difference and Standard Deviation were used to analyze successive data with P smaller or equal to 0.05 deem as significant.Results:Acute cough is classified under the generic "cough" category in Traditional Chinese Medicine(TCM).The six external pathogens are main cause of acute cough affecting the respiratory system.Degeneration in the lungs is also the cause of acute cough.Wind pathogen is recognized as the main pathogen causing this illness,this view is also supported by other experienced TCM physicians.Treatment methods for this illness include medication,acupuncture,using spray medication as well as point application.Of the 120 clinical cases that were diagnose with acute cough from Jiangsu Provisional Hospital(48.47±15.79 in age),male 41 cases(34.17%),female 79 cases(65.83%).average course of disease 5.13±3.93 days,cough due to phlegm pathogen average course of disease 4.87±3.52 days,cough due to wind pathogen average course of disease5.33±4.23 days.Cases during summer and autumn scored 30%,cases during spring scored the lowest percentage of 17.5%.The scores for signs and symptoms before and after treatment 5.92±2.52,this score as a significant drop of 1.01±1.19,signs and symptoms dissolve rate is 84.34±17.58(P<0.01).Of the 120 cases,full recovery 54 cases(45.00%),44 cases(36.67%)have most of the signs and symptoms resolved,22 cases(18.33%)showed some improvements.All cases showed some form of improvement.Recovery rate for cough due to wing pathogen 49.25%,recovery rate for cough due to phlegm pathogen 39.62%,showing no significant difference between the 2 groups.Using Wilcoxon test,for the 120 clinical cases,comparing the improvement in the signs and symptoms during the day and night,the results showed a significant drop,with an average drop of 4.29 for the day and night score.In term of the volume of phlegm,94.03%of the patients shows a significant reduction in phlegm with 77.6%showed a completed resolved in phlegm.The course of the disease is between 4-13 days with cough due to wind pathogen mostly around 9 days.Professor Xi opined that the six external pathogens as well as emotional well being that resulted in the malfunctions of the major internal organs are the main causes for cough.The main disease location for cough is at the lungs and is closely related to the other organs such as the heart,liver,spleen and kidney,internal deficiency is also a factor resulted in cough.Professor Xi classified cough into cough related to wind pathogen that affects the upper part of the respiratory system and cough related to phlegm pathogen that affects the middle and lower parts of the respiratory system.The main principle for treatment is to treat the root cause if it is a long time cough and to treat the immediate signs and symptoms if it is an acute cough.In term of using TCM herbs in treating acute cough,126 decoctions were used for the 120 cases.Herbs that are used to resolve phlegm and relieving cough and asthma form the main portion of the decoction and were used 702 times,decoctions that were used to strengthen deficiency is used 508 times,decoctions used to expel external pathogens 271 times,decoction used to relieve heatiness 166 times,decoctions to regulated qi 102 times.The top 20 most frequency used herbs are ganchao,huangqi,huangqin,ziwan,baisu,fangfeng,jugen,baibu,baishao.In terms of meridian tropism,herbs that belong to the lungs ranked first,followed by spleen,heart,stomach and liver.Herbs that are"warmth"in natural forms the main part of the decoction,followed by herbs that are neutral,cool,cold and heaty in nature.Herbs that are used as a pair to increase efficacy such as ganchao with huangqi,ganchao with huangqin,ganchao with ziwan,and ganchao with jugen,were used extensively.Other herbs such as wuweizi,pibaye,dry ginger,xixin,jinjie,zisuzi,taizishen,renshen,guizhi,lugen,dongguazi,fuling and niubangzi were also used.Of the 126 decoctions,28 herbs were most frequently used by Professor Xi to resolve phlegm and relieving cough and asthma as the main function,followed by strengthen deficiency and relieve external pathogens.The main decoctions used were Yupingfeng powder,Zhisu powder,Shensu decoction,Qianjinweijin decoction,Guizhi decoction,Lianqiao powder,Huangqijianzhong decoction,Liujunzi powder,Sanbaipi decoction and Bufei decoction.Through 4 clinical cases related to respiratory disorder,such as nasal sinusitis,cough due to lung deficiency with wind pathogen,cough due to qi deficiency with internal wind,cough due to lung deficiency with phlegm pathogen and cough due to both deficiency in the lung and kidney,these clinical cases further amplified the unique way in which Professor Xi used Chinese medications to relieve these illnesses.Conclusion:Based on clinical cases as well as medical research,acute cough should preferably be treated by targeting the wind and phlegm pathogen as advocated by Professor Xi Zhaoqing.Professor Xi classified cough into cough related to wind pathogen that affects the upper part of the respiratory system and cough related to phlegm pathogen that affects the middle and lower parts of the respiratory system.The main principle for treatment is to treat the root cause if it is a long-time cough and to treat the immediate signs and symptoms if it is an acute cough.Herbs that are"warmth"in natural forms the main part of the decoction,followed by herbs that are neutral,cool,cold and heaty in nature.Herbs that are used as a pair to increase efficacy such as ganchao with huangqi were used extensively.Other herbs such as wuweizi,pibaye,dry ginger,and xixin were also used.Yupingfeng powder and Zhisu powder are most effective for cough related to wind pathogen.While Sanbaipi decoction,Shensu decoction and Qianjinweijin decoction were best used for cough related to phlegm pathogen.From the clinical case studies,Professor Xi's unique way of using traditional chinese herbs expediate the recovery of the illnesses. |
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