Cough Syndrome Research Literature Characteristics And Chinese Medicine Treatment After Infection

Cough is one of the most common complains of respiratory clinic patients, long-term deferment cough will affect not only the health of patients, but also the patient’s mental health, work, life and even to be reckoned with the impact of the interpersonal communication. Post infectious cough (PIC), refers to a persistent cough following symptoms of an upper respiratory tract infection, it can last for3to8weeks, or even longer. It’s the most common cause of sub-acute cough. Because it often occurs after a common cold, so we called it "post-cold cough".ObjectiveThis article concludes the insufficient to the diagnosis and treatment of PIC in the modern medicine and traditional Chinese medicine, through reviewing the advances to the two different cognitive system of science in nearly five years. Summarize the status of western conventional medication(WCM) and Traditional Chinese Medicine (TCM) for PIC in terms of syndromes diagnosis and treatment, and to provide some new perspectives for clinical therapy of PIC.Methods1A limited search term(1) PIC, post-cold cough, cough caused by exogenous pathogenic factor;(2) PIC/post-cold cough/cough caused by exogenous pathogenic factor&TCM;(3) PIC/post-cold cough/cough caused by exogenous pathogenic factor&Traditional Chinese and western medicine;(4) PIC/post-cold cough/cough caused by exogenous pathogenic factor&syndromes;(5) PIC/post-cold cough/cough caused by exogenous pathogenic factor&TCM&differentiation of symptoms and signs.Retrieval Chinese BioMedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI),"Chinese Scientific Journals Database" of VIP(CQVIP),"China Science periodical Database" of Wanfang (CSPD) nearly5years (2009.01-2014.01) published about the treatment of PIC in Traditional Chinese Medicine or Traditional Chinese and western medicine.2Set the inclusion and exclusion criteria(1) Inclusion criteria1) The disease is named PIC, post-cold cough, cough, post-respiratory tract infection cough, or cough caused by exogenous pathogenic factor;2) The article contains syndrome research of TCM;3) Intervening measures are TCM treatment (including decoction, Chinese patent medicine and interventions of traditional extra-pulmonary therapies) or Traditional Chinese and western medicine;4) Literature type:clinical trials, personal experience reports, theoretical research.(2) Exclusion criteria1) Children cough (age<18years old), acute cough (duration<3weeks), experimental study, review;2) If the content of a pair of articles are similar in medication, syndrome types and number of cases as well as a draft two cast, the article which published earlier is included in statistics.With NoteExpress literature management software standard version (Version:2.9.8.5668, developed by Beijing Aegean-Soft Technology Co. Ltd)and the2007version of Excel worksheet, combined with artificial means, through literature research, summarize the literature types, methods and diagnostic criteria, type features of the syndrome, curative principles and therapeutic methods and the characteristics of prescription, efficacy and other contents.ResultsPost infectious cough refers to the persistent cough after the acute phase of common cold disappearing, in addition to respiratory viruses, other respiratory infection, such as Mycoplasma, Chlamydia infection can cause PIC, of which the most common cough caused by cold, it is also known as "cough after a common cold". Course usually lasts3-8weeks, or longer, and normal chest X-ray, and exclude other lung diseases which will cause cough. In currently modern medicine, the truly pathogenesis of the post infectious cough was poorly understood, believed to be primarily the result of many factors, the persistent cough is mainly due to an airway inflammation, airway hyper-reactivity and cough reflex sensitivity based on respiratory mucosa damage, resulting in airway inflammation with or without transient airway hyper-responsiveness. At present, domestic research focuses on aspects of neurogenic inflammation. The medicine for the treatment of post infectious cough in modern medicine was not currently recognized as effectively. Short-term application of anti-histamine H1receptor antagonists and central antitussive was only symptomatic treatment, and only effective for some patients. It may also be accompanied somnolence, xerostomia, loss of appetite, nausea, constipation and other side effects. Further more, easy to relapse after stopping therapy.Currently, understanding to post infectious cough in the doctor of Chinese Traditional Medicine is gradually deepening. But it is yet to reach a unified consensus in it belonging to exogenous cough or internal injuries cough, as well as its specific etiology and pathogenesis. The clinical doctors believe that PIC is still mainly belong to exogenous cough. Syndrome classification is mainly external evil factors (wind, cold, dryness) attack the lung syndrome. A part of doctors think it belongs to both exogenous and internal injuries cough areas. Syndrome type mainly are external evil attack the lung and lung qi deficiency, lung yin deficiency, accumulation of phlegm dampness in lung, cold fluid-retention suspend in lung, lung qi and spleen qi deficiency, lung-kidney yin deficiency, live-fire invading lung. Only a small part of the doctors think it is caused by a purely internal injuries cough. Syndrome type involve the lung, spleen, liver, kidneys and other organs, also include some pathological factors such as phlegm, phlegm-fluid, blood stasis and so on.Therefore Shu-feng, Xuan-fei is the main therapeutic methods, and accompanied by nourishing yin and moisturizing the lung, tonifying qi and strengthening exterior, expectorant, liyan, regulating the liver function and other therapies. Zhisu San and Xiao Qinglong Tang or self-modified herbal formula by the therapeutic methods of Yangyinqingfei are the mostly prescriptions. The mostly medication are platycodon grandiflorum, aster, stemona, nepeta, citrus, ephedra, semen armeniacae amarum, periostracum cicadae, etc. which have Xuanfei and disperse pathogenic factors function. At the anaphasis of cough duration, the patients will present lung deficiency, even lung qi and spleen qi deficiency, failure of qi transforming fluid, sputum, damp, blood stasis, etc. pathological factors after another. The long-term unhealed cough lead patients to poor emotional, liver-qi depression, even liver-wind stirring, then disturbance lungs, making syndrome differentiation more complex. Complex syndromes occur, then clearing heat, expectorant, promoting the circulation of qi, tonifying law, regulating the liver function and other therapies to join the treatment. Skullcap, pinellia, peucedanum, radix codonopsis, bupleurum and other medicine become the major portion.Efficacy of TCM treatment is basically satisfactory, but RCT study with random method and evaluation by detailed description, strict accordance double-blind, parallel, control and other methods is missing, as well as large sample study.