| BackgroundCough after infection is a kind of subacute cough,which persists after the disappearance of acute symptoms of respiratory tract.Most of them are irritative dry cough or cough with a small amount of white mucus sputum.The course of disease is 3-8 weeks.There is no abnormal subacute cough in chest X-ray examination.Cough caused by virus cold is the most common,also known as cough after cold.In modern medicine,cough after infection is mainly treated by antitussive,expectorant and antiallergic drugs.The cough symptoms of some patients were stubborn and delayed,which seriously affected the quality of life of the patients.At present,there is no expert consensus on the etiology,pathogenesis and classification of cough after infection.Professor Zhao lancai has studied respiratory febrile diseases for more than 30 years.He has used the method of promoting lung,regulating qi and clearing heat to treat the cough after infection,and established the empirical formula of promoting lung and relieving cough,which has a good effect in clinical application.In order to systematically study the etiology and pathogenesis of cough after infection and the therapeutic mechanism of traditional Chinese medicine,the following studies were carried out:1.Investigation on the etiology of cough after infection;2.Observation on the therapeutic effect of Xuanfei Zhike formula on cough after infection.The project is supported by the green channel special fund of Beijing Municipal Science and Technology Commission.Objective2.1 By investigating the causes of post infection cough,the possible pathogenic factors of post infection cough were analyzed.2.2 Through the observation of the therapeutic effect of Xuanfei Zhike formula on patients with post infection cough,to explore the possible mechanism of Xuanfei Zhike formula in the treatment of post infection cough,and to provide evidence-based medical evidence for clinical treatment of post infection cough.Methods3.1 according to the medical records and life history of the patients with cough after infection,the questionnaire of general situation in 4 weeks before the onset of cough after infection was drawn up for investigation and statistics,and the results were analyzed to summarize the characteristics of the causes of cough after infection.3.2 A randomized,open,non inferiority controlled clinical trial design method was used.The subjects were from the patients in the Department of infectious diseases and expert clinic of Xiyuan Hospital from March 2018 to March 2019.The patients who met the diagnostic criteria were studied as follows:(1)the patients who met the enrollment criteria were informed of the trial content and signed the informed consent,and the case report form was filled in,and the blood routine and C were recorded The patients who did not meet the exclusion criteria were randomly divided into treatment group and control group according to the ratio of 1:1.(2)Before the treatment,the score of cough visual simulation,cough symptom and TCM syndrome were recorded.The treatment group was treated with Xuanfei Zhike formula and the control group was treated with Suhuang Zhike capsule.Both groups were treated for 10 days.(3)On the 4th day,the symptoms and adverse reactions were observed and the case report was recorded.(4)On the 10th day,blood routine,C-reactive protein,liver and kidney function,urine routine were reexamined,case report form was recorded and the study was concluded.Results4.1 90 patients were investigated in this study.From 50 to 70 years old,it is the most common,accounting for 41.1%;from the perspective of gender distribution,the majority of patients with cough after infection are women,accounting for 70%;from the perspective of occupational distribution frequency,from high to low,they are standing for a long time,staying up late,working overtime,contacting with peculiar smell,language work,accounting for 84.5%,indicating that excessive consumption of Qi and Yin is the cause of cough after infection;from the perspective of eating habits,they like spicy food,fried food,meat This kind of food is easy to cause endogenous depression and heat,which blocks the Qi mechanism and reverses the Qi,and is combined with external evils,thus contributing to the occurrence of cough.According to the analysis of the possible causes of cough five days before the onset of the disease,the common causes of cough after infection are feeling the wind chill and contacting the pathogens,accounting for 68.9%,indicating that the common causes of cough are feeling the external pathogens;secondly,the bad lifestyle includes improper diet,staying up late and tiredness,accounting for 26.7%,23.3%and 21.1%respectively,all of which can damage the healthy qi,which is the possible factor to promote the occurrence of cough after infection;lack of exercise and drink Alcohol,smell,emotion and business trip are also possible factors of the disease.The etiology of post infection cough is complex.It is caused by many external causes or internal and external causes,which provides reference for the etiology research of post infection cough.4.2 According to the inclusion criteria,88 cases were included in the treatment group,10 cases were dropped,2 cases were removed,76 cases completed the test,37 cases in the treatment group and 39 cases in the control group.After 10 days of treatment,the visual analogue score and symptom score of cough in the two groups were significantly improved(improvement rate ?70%),and the clinical efficacy evaluation was significant.After continuous correction of chi square test,P>0.05,reflecting that there was no statistical difference between Xuanfei Zhike formula and Suhuang Zhike capsule.After 4 days of treatment,the visual analogue score of cough in the treatment group was lower than that in the control group(P<0.05),indicating that Xuanfei Zhike formula was effective The time was earlier than Suhuang Zhike capsule;there was no statistical difference between the total effective rate of the treatment group and that of the control group according to the score of cough symptoms,which proved that the therapeutic effect of the treatment group was equivalent to that of the control group;there was no statistical difference between Xuanfei Zhike formula and Suhuang Zhike capsule in the improvement of pharyngeal itch(P>0.05).ConclusionThe investigation of etiology shows that the possible cause of cough after infection is to feel exogenous pathogens and bad life style(improper diet,tiredness,staying up late,drinking alcohol,emotional stimulation,etc.).The cough after infection is mostly caused by internal and external factors.The key of pathogenesis of cough after infection is wind movement,Qi inversion and heat dampness caused by various causes.Xuanfei Zhike formula and Suhuang Zhike capsule have the same therapeutic effect on cough after infection,which can significantly improve the symptoms of cough and pharyngeal itch. |
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