Observation On Curative Effect Of Treating Subacute Cough Based On Syndrome Differentiation And Correlation Study On TCM Constitution

Objective:Through literature research,this paper analyses the etiology and pathogenesis of subacute cough,clinical diagnosis and treatment,and the theory and research progress of TCM constitution theory,learn and summarize the clinical experience of director Tang Yi in treating subacute cough based on syndrome differentiation.By observing and analyzing the correlation between TCM Constitution,syndrome types of patients with subacute cough and general data such as gender,age and season,this paper discusses the distribution of constitution and syndrome types of patients with subacute cough and their correlation;At the same time,observes the clinical efficacy of TCM syndrome differentiation in the treatment of subacute cough,so as to provide reference for clinical diagnosis and treatment and individualized prevention and treatment of the disease.Methods:By consulting and sorting the relevant literature of subacute cough and TCM Constitution,this paper discusses the physical factors related to the onset of subacute cough,and summarizes Director Tang Yi’s experience in syndrome differentiation and treatment of subacute cough.From March 2019 to December 2020,we selected 168 patients who met the diagnostic criteria of subacute cough in the outpatient department of preventive treatment department of the First Affiliated Hospital of Tianjin University of traditional Chinese medicine.The general information,TCM related information and TCM Constitution identification results of the patients were collected,and the syndrome types of subacute cough were determined according to the TCM syndrome diagnosis criteria formulated in the consensus opinion of TCM diagnosis and treatment experts on cough.We objective to explore the correlation between subacute cough and TCM constitution,and use Excel to build database,use spss25.0 software to statistics and analysis of data.168 patients with subacute cough were intervened with traditional Chinese medicine according to the method of TCM syndrome differentiation.Some time recently treatment,2weeks after treatment and 4 weeks after treatment,the TCM syndrome score,cough visual analogue score and related safety indexes were observed and recorded.The differences before and after treatment were compared.We use Excel to build database,and use spss25.0 software to statistics and analysis of data to objective to explore the clinical effect of TCM syndrome differentiation in the treatment of subacute cough.Result:1.In this study,168 patients with subacute cough were collected,including 63 males(37.5%)and 105 females(62.5%).The average age was 39.45 ± 10.909 years old.The number of patients aged 18-35 years old was the most,followed by 36-50 years old,and 51-65 years old was the least.The seasonal distribution of the disease was winter(31.5%)> spring(26.8%)> autumn(22.6%)> summer(19.0%).2,In 168 cases of subacute cough,mild cough(51.2%)and moderate cough(42.3%)were the main symptoms,while severe cough(6.5%)was less.The proportion of different degrees of cough was different.3.Distribution of syndrome types:The most common syndrome types of 168 patients with subacute cough were wind evil attacking the lung(42.9%),phlegm dampness accumulating in the lung(25.6%)and phlegm heat stagnating in the lung(17.3%).The extent of each syndrome sort was measurably distinctive(P < 0.05).There was no correlation between TCM Syndrome Types and gender,age and season(P > 0.05).4.Distribution of Constitution types:There were 18 cases of mild constitution,accounting for 10.7%,150 cases of biased constitution,accounting for 89.3%.In biased constitution,Qi deficiency constitution(27.4%),Yang deficiency constitution(23.2%)and phlegm dampness constitution(13.1%)were the most common.There are differences in the proportion of each constitution distribution.There is a correlation between constitution and gender in the onset of subacute cough.The male is more than the female in phlegm dampness constitution and damp heat constitution,and the female is more than the male in Yang deficiency constitution.Constitution and age are related to the onset of subacute cough,and yin deficiency constitution is more common in 51-65 years old patients.The seasonal difference of subacute cough patients with different constitution was statistically significant(P < 0.05).Qi deficiency constitution was easy to fall ill in spring,and damp heat constitution was easy to fall ill in summer.There was no correlation between constitution and cough degree(P > 0.05).5.Correlation between constitution and syndrome type:(1)There was a correlation between Qi deficiency constitution,damp heat constitution and syndrome of wind evil attacking lung(P < 0.05).Qi deficiency constitution is more common than damp heat constitution in syndrome of wind evil attacking lung.(2)There was a correlation between phlegm dampness constitution,yin deficiency constitution and Syndrome of phlegm dampness accumulating in lung(P < 0.05).phlegm dampness constitution is more common than yin deficiency constitution in syndrome of wind evil attacking lung.6.Curative effect analysis:(1)In this clinical study,168 cases of subacute cough were treated according to syndrome differentiation.The total score of TCM symptoms was 15(10,20)before treatment,4(2,10)after 2 weeks of treatment,and 2(0,4)after 4 weeks of treatment.Some time recently treatment,2 weeks after treatment and 4 weeks after treatment,the contrasts were measurably noteworthy(P < 0.01).Some time recently treatment,2 weeks after treatment and 4 weeks after treatment,the main symptom score(cough),secondary symptom score(expectoration,pharyngeal itching,etc.)and accompanying symptom score(epigastric discomfort,spontaneous sweating,etc.)of the patients were reduced to varying degrees.There were significant differences in the scores before treatment,2 weeks after treatment and 4 weeks after treatment(P < 0.01).(2)The total effective rate of TCM syndrome and clinical recovery,marked effect,effective,invalid situation: After 4 weeks of treatment,concurring to the most clinical appearances of the patients,by evaluation of curative effect of TCM Syndrome,Results 67 cases(39.9%)were clinically cured,52 cases(30.9%)were markedly effective,40 cases(23.8%)were effective,and 9 cases(5.4%)were ineffective.The total effective rate of syndrome was 94.6%.(3)The total effective rate of single symptom quantitative index:After 4 weeks of treatment,the total effective rate of each symptom index was more than 70% in the group with specific symptoms.Among them,the improvement of the symptoms of oral pain is the best.The full successful rate is 100%.Secondly,cough,stuffy nose,dry stool,headache,shortness of breath,spontaneous sweating,fatigue,evil wind and cold,sore throat and other symptoms improved significantly,the whole successful rate was more than 90%.The improvement of loose stools and abdominal discomfort was relatively poor.The total effective rate was less than 80%.(4)Change of VAS score:The VAS score of 168 patients with subacute cough was 3(3,5)before treatment,2(0,2)after 2 weeks of treatment,and 0(0)after 4 weeks of treatment.During the treatment,VAS score showed a downward trend,and the contrasts were factually noteworthy some time recently treatment,2 weeks before treatment and 4 weeks after treatment(P < 0.05).Conclusion:1.Subacute cough is common in clinic,mostly in female and young patients,but mainly in mild cough.2.Subacute cough constitution is related to the onset of subacute cough,Qi-deficiency quality,Yang deficiency quality,phlegm-dampness quality is susceptible to this disease;Different physique types have certain susceptibility and tendency to gender,age,onset season and syndrome type of patients with subacute cough.82.1% of the patients with Yang deficiency are female,which is significantly more than male.Patients with qi-deficiency and quality were prone to develop in spring and were most likely to show the syndrome of wind evil attacking the lung.Male accounted for 81.8% of the patients with damp and hot matter,which was significantly more than female,and it was easy to develop in summer and not easy to be manifested as the syndrome of wind evil attacking the lung.Among the patients with phlegm and dampness,male accounted for 63.6%,which was significantly more than female,and it was easy to show the syndrome of phlegm and dampness accumulation of lung.Yin deficiency in 51-65 years of age accounted for a relatively high physical distribution,not easy to show phlegm dampness accumulate lung syndrome;3.TCM syndrome differentiation and treatment of subacute cough is effective in relieving cough and other complications,with good safety.4,Summarize experience:Director Tang Yi believes that lung qi deficiency in patients with subacute cough is the leading factor of the disease,and the problems of early loss of treatment,mistreatment and irrational drug use should be paid attention to.Subacute cough is based on unclear lung qi,which is affected by many factors,such as exogenous evil Qi,visceral injury and so on.Qi deficiency,evil substance,phlegm turbid,internal fire and yin deficiency are the common pathological manifestations of subacute cough.Acute cough is mainly characterized by deficiency and excess syndrome.Director Tang Yi identified the degree of pathogenic excess and positive deficiency to analyze the different pathogenesis characteristics of patients by distinguishing the elimination,growth,advance and retreat between the good and evil,and adjust the pathological changes of cold and heat,deficiency and excess by the combination of catharsis,clearing,moistening,reducing,restraining and supplementing,etc.