A Research On The Rule Of Syndromes Of Subacute And Chronic Cough

BackgroundCough is most common chief complaint in respiratory. Patients suffering from subacute and chronic cough endure a long course. And the causes of these two categories of cough are so complex that many patients are misdiagnosised and given wrong treatment. It makes a large waste of medical resources. Both the doctors and the patients are puzzled in subacute and chronic cough because of their high incidence, high relapse rate, complicate causes, refractoriness and high economic input. Now the causes of these two types of cough are gradually understood in-depth of by western medicine. But to some patients,even if the diagnosis is clear, there is a lack of specific effective treatment. Subacute and chronic cough belong to "cough","stubborn cough" "cough with internal injury" or "wuzangliufu cough" in Traditional Chinese Medicine(TCM).There are exceptional advantages of treatments for subacute and chronic cough in TCM. But they are not recognized, and further researches are restricted in TCM because there are lack of recognized, unified standards of syndroms. So it is necessary to study on the rule of syndroms of subacute and chronic cough and each cause of them, combine with western medicine.ObjectiveUsing literature research and clinical epidemiology method to study on the rule of syndroms of subacute and chronic cough and each cause of them. To provide the basis for differentiation of symptoms of these two categories of cough in clinical.MethodCarry out a literature research in TCM on subacute and chronic cough, demonstrate the result by the experts, and then develop the form for collecting information of cases suffering from subacute and chronic cough in clinical. Data analysis is performed in the statistical analysis soft package for SPSS13.0. Descriptive analysis method is adopted to processing data on distribution of clinical information and TCM syndroms of the two categories of cough. The samples cluster analysis is adopted to analyze TCM syndroms sub-type of them. And then the descriptive analysis is used to analyze the four indicators frequency of syndroms sub-types, weight cases by frequency.Result1. Symptom distribution characteristics of subacute and chronic cough from literature research:cough takes the most large constituent ratio, next is sputumless, dry pharynx, itch pharynx, dry mouth, chest tightness. And red tongue, white greasy moss, thin yellow moss, pale tongue, carmoisine tongue, yellow greasy moss, thin white moss are the main tongue. Parvus pulsus, rapid pulsus,slippery pulse, wiry pulse, floating pulse are the main pulse.2. Basic characteristics of cases of subacute and chronic cough from clinical research:these two categories of cough are most likely to take place in young or middle-aged, highly educated people, and most of them are mental laboures. A great part of them have suffered a longer course, got some treatment, and visit doctor in out-patient deparment. The two categories of cough have little relationship with smoking, environmental stimulus and history of allergies. The most common cause is Cough Variant Asthma (CVA) and Cough Post Infectious (CPI).3.The characteristics of four indicators of subacute and chronic cough: dry cough, itch pharynx, well-spirit, cough in daytime or occasionally at night. Stimulated by smoking or bad smell held the most frequence in the symptom. White moss, yellow moss, pale tongue, thin moss, moistening moss, wiry pulse, parvus pulsus are the main tongue and pulse. The common cough grade is midrange. And many of the patients cough sonorously, especially in morning or at night. Some people have accompanied with symptoms such as chest pain, vomiting or enuresis, which is especially in women. Cough in the morning or at night especially evident in CVA.4. The characteristics of patient history:most of the cases are health before, and peaceful in yin and yang.5. The rule of Syndromes of Subacute and Chronic Cough:there are six sub-types according to the result of samples cluster analysis:Qizhitazu, Feipiqixu Fengxielianfei, Fengrefanfei, Qiyinliangxu, Tanshiyunfei, Ganhuofanfei.6. The rule of Syndromes of CVA: there are four sub-types according to the result of samples cluster analysis:Fenghanfanfei, Yinxufeizao, Feipiqixu Fengxielianfei, Ganjingyure.7. The rule of Syndromes of CPI: there are four sub-types according to the result of samples cluster analysis:Qiyinliangxu Tanshiyunfei, Ganhuofanfei, Fenghanfanfei, Feipiqixu Fengxielianfei.Conclusion1. There is a concordance between the result of the literature research and the authority.It shows that the result of literature research can provide a reliable basis for the clinical research.2. The basic characteristics of the cases coincident with the epidemiological research results at home and abroad. It shows that the cases we slected have representation.3. All the rules of Syndromes of Subacute and Chronic Cough, CVA, CPI show that they are mainly caused by Fengxie,always inclusioning Ganqibushu and xushijiaza.