| The famous Chinese ENT (ear, nose and throat) specialist Professor Gan Zu-wang(干祖望)has pointed out that laryngeal cough is caused by prolonged throat irritation due to itchiness and dryness. This is a year-round illness clinically and it could attack male and female, young or old. To-date, no effective treatment to cure this type of illness has been found in the modern medicine. Hence, finding an effective and efficient treatment for laryngeal cough, with less toxic side effect has become a hot medical research topic. Currently, significant results have been achieved in using TCM to treat laryngeal cough. Clinically, a number of effective TCM prescriptions for this illness have been found. However, until today, we can hardly find any report on the systematic study of how such an illness is being treated, not to mention the compatibility rules of prescriptions for treating this illness. Therefore, this paper seeks to collate clinical literatures concerning laryngeal cough and to study the compatibility rules of those prescriptions that are effective in treating the illness. These will help in the understanding of the expected outcomes of compatibility rules and the characteristics of the drugs which are to be used so as to provide beneficial references for the clinical treatment of the illness.This paper includes three main components. In the first part, research on the relevant discussions amongst the ancient Chinese physicians is presented, together with a study and conclusion of the general outlook of how laryngeal cough is being treated with respect to the modern clinical research. In the second part, a statistical study on the common TCM syndromes of laryngeal cough as well as how the prescriptions and herbs are being used to treat the illness is presented. The method for this statistical study is to collate the relevant clinical literature, a total of 258 articles with 21053 cases, which are found in the China Academic Journal Full-text Database (CNKI) published in between 1991-2012. Afterwhich, Microsoft Excel is used for the data entry and to sort these prescriptions out systematically in terms of statistical analysis. Then, the syndromes of high-frequency, the pathogenic factors, the affected organs, the characteristics of Zheng Qi and deficiency, the types of drugs used and its classification are derived. In the third part, the results from the statistical analysis are analysed and discussed under the guidance of the TCM theory.The findings from the study are as follows:(A) Statistically, from more than 1% of the total number of cases of laryngeal cough syndromes, it shows that ①there are 17 types of common syndromes, of which the most common ones are wind evil attack of lungs, the deficiency in ’Yin’ causing dryness of lung, wind and dryness attack of lung, wind and heat evil attack of lung, the liver-fire invading lung etc.② the pathogenic factors and pathogenesis of laryngeal cough is very complicated and comes with many permutations. The most important factor is wind evil attack, followed by heat evil, dryness etc. When the illness cannot be treated over a prolonged period of time, or is depressed, the heat evil may injure the "Zheng Qi", i.e. weakening the immune system of the body; or the patient who is weak and is attacked by the evil,_this deficiency in the ’Zheng Qi’ will show up. The most common type is deficiency in ’Yin’ that causes lacking in fluid. Besides this, there are also cases where deficiency in ’Qi’ or ’blood’ is prevalent. ③secondary risk factors that cause the illness include phlegm, blood stasis infestation.④Although lesion of the illness is in the throat which is controlled by the lung, it is also closely linked with other organs such as the liver, kidneys, spleen etc.(B) The prescriptions in term of composition compatibility:’Jiegeng Tang’ from "The book of Exogenous Febrile diseases", which consists of Gancao and Jiegeng mainly, is quite commonly used. The use of herbs, raw Gancao (17577 cases,83.49% of the total number) and Jiegeng (16,796 cases,79.78% of the total number) rank at the top. This indicates that these type of prescriptions focus on soothing the lung and eliminating cough.The prescription basically consists of herbs that can eliminate cough and deprive wind. In terms of the classification, the top ranking herbs are those can relieve the exterior syndrome with the capability to eliminate phlegm, cough and for asthma as well as able to dispel the wind-evil. Amongst which, the most important ones are those which can eliminate cough and are used for treating asthma. The herbs with characteristics of warmness, moisturising and gentleness are commonly used, such as Xingren (9732 cases,28.69%), Baibu (6354 cases,18.73%), Ziwan (6241 cases,18.40%), etc.In terms of herbs that can dispel the pathogenic wind, the main types are those can dispel the wind and clear the heat or antipyretic (29003,65.4%) and those can subdue internal wind and relieve muscular spasm (11894,97.64%). The commonly used herbs are Chantui (11170 cases, 38.51%), Niubangzi (6641 cases,22.90%), Bohe (6345 cases,21.88%), Jiangcan (9238 cases, 77.67%), etc. In cases of cough, with itchy throat as the main symptom, the basic principle is that as the wind is dispelled, the itchiness will be eliminated. Therefore, it is necessary to emphasis to eliminate the cough and dispel the wind. As it is quite often for wind-evil to combine with dryness and heat-evil attack, the herbs used should therefore, not only be able to dispel wind-evil, but also to clear the heat-evil.In terms of herbs that are able to clear the heat, i.e.antipyretic, and also of tonic nature. This is the combination ranked as No.2 (16055 cases,6.97%), following after those that can eliminate phlegm, cough and for asthma (50167 cases,21.79%). For antipyretic herbs, commonly used herbs are those which have the effect of detoxification and of smoothing the throat, such as Xuanshen (8136 cases,71.80%), Shegan (5403 cases,18.78%), Jinyinhua (4807 cases,16.71%), Lianqiao (4745 cases,16.49%) etc. Herbs of tonic nature used are those that can supplement the yin (11104 cases,69.16%). The most commonly used herbs are radix, including Maidong (5678 cases,51.13%), and Shashen (3236 cases,29.14%), etc. As laryngeal cough is always combined with heat evil attack, dryness and the common syndromes shown are deficiency in ’yin’ and lacking of fluid. Therefore, the drugs used for its treatment, mostly, are combined herbs that are antipyretic and of tonic nature, particularly in supplementing the yin.Where situations arise, one may add in herbs for astringence (6011 cases,2.61%), smoothing the qi (5973 cases,2.59%), diuretic and removing dampness (2067 cases,0.90%), improving the blood circulation (1903 cases,0.83%) etc. The commonly used herb for convergence cough is Hezi, for smoothing the qi and removing dampness and phlegm, Chenpi and Fuling, and for improving blood circulation, Danshen etc.It is necessary to note the particular features in the treatment of laryngeal cough as throat or pharynx is the gateway to the airway belonging to the lung, which prefers temperature moisture but not extreme dryness. Therefore, herbs that help to soothe the lung are widely used. Herbs of pungent taste can help to disperse the qi and also the evil attacking the lung. Herbs that taste bitter can help to depress the qi that is erratically moving upward. Those herbs used should be of light and clear nature. This is to reflect the principles of using light stuff to rise up the qi. There is also a need to take care of the yin and fluid. Therefore only herbs that are cooling and moisturizing, tonic but not greasy will be used. Herbs that have characteristics of heat and dryness, heavy and turbid should only be used discretely. |
PDF Full Text Request