The Distribution Of Syndrome Types Of Cough After Infection And Professor Zhang Shunan's Experience In Treating And Treating Cough After Infection

Objective Post-infection cough(PIC)is considered to have persistent cough lasting after experiencing an upper respiratory tract infection,when symptoms in the acute stage has disappeared,with cough as the main clinical manifestation,and the course of the disease usually lasts for 3 to 8 weeks.In recent years,the incidence of PIC has gradually increased,seriously affecting the quality of life of patients.Traditional Chinese medicine(TCM)shows certain advantages in the treatment of PIC due to a significant effect in relieving patients'uncomfortable symptoms and shortening the course of the disease.In this case,it is particularly important to find an effective treatment of TCM.Based on the distribution of syndrome types of PIC,this study explores the syndrome characteristics and related factors of PIC,providing a research basis for the popularization of traditional Chinese medicine in the treatment of PIC.And this study also summarizes Professor Zhang Shunan's clinical experience in the treatment of PIC.Methods 1.The patients with PIC were collected from the Respiratory Department and the Respiratory Department of TCM in China-Japan Friendship Hospital,and the on-the-spot investigation and questionnaire were conducted by the researcher or staffs who had received standardized training,and the general medical history data of the patients were collected.At the same time,the four diagnostic data of TCM were collected by two or more deputy chief physicians to determine the TCM syndrome type.Established case information database of patients with PIC based on above data,and analyzed data by SPSS26.0 software.2.To analyze the clinical experience of Professor Zhang Shunan,the medical records and prescriptions of PIC treated by Professor Zhang Shunan in outpatient clinic were summarized and sorted out.Results 1.(1)A total of 131 patients with post-infection cough were included in the study.With the traditional syndrome differentiation method,paients can be mainly divided into five TCM syndrome types:syndrome of wind evil concealing in the lung(34.4%),syndrome of phlegm-dampness accumulating in the lung(26.0%),syndrome of deficiency of lung qi and pathogenic wind left in the lung(13.7%).syndrome of wind-heat attacking the lung(6.9%)and syndrome of phlegm-heat obstructing the lung(5.3%).(2)Among the patients with PIC in this study,In terms of gender:there are 52 male cases,accounting for 39.7%while 79 female cases,accounting for 61.3%,male:female=1:1.52;age:26 to 35 age group(25.2%)account for the largest proportion;onset season:autumn(40.5%)has the largest number of patients with PIC,followed by winter(27.5%);course of disease:most of the course of disease is 3 to 8 weeks(61.0%);Cough symptom score:the patients with 1 score were the most(41.2%),while the number of people who score one point is least(26.0%).(3)The distribution of syndrome of wind evil concealing in the lung was different in patients with different course of disease and cough symptom score(P<0.05).The longer the course of disease,the higher the score of cough symptoms,the more the proportion of syndrome of wind evil concealing in the lung.But age,sex and onset season has no significant correlation with TCM syndrome distribution(P>0.05).(4)The 35 symptom variables with distribution frequency>5%were analyzed by two-stage clustering.The 131 patients were grouped into 5 groups,and the symptoms with distribution frequency>30%of each type were as follows:type 1 syndrome:cough severe during the day,less phlegm or excessive phlegm,white sticky phlegm,sticky mouth,conscious sputum in throat,easy sweating,normal tongue shape or fat tongue,light red tongue,white greasy fur,slippery pulse;Type 2 syndrome:cough severe at night,less phlegm,white or yellow sticky phlegm.with dry,itching or sore pharynx,dry mouth,drinking more water,yellow urine,dry stool,normal tongue shape,red tongue,thin white or thin yellow coating,rapid pulse or thready and rapid pulse;types 3 syndrome:cough severe at night,can be induced by irritating smell or cold air,choking cough,no phlegm,itching pharynx,chilly,normal tongue shape,light red tongue,thin white fur,string pulse;types 4 syndrome:cough severe at night,can be induced by irritating smell.choking cough,less white sticky phlegm,with dry or itchy pharynx,normal shape of tongue,light red tongue,thin white coating.string pulse;types 5 syndrome:cough severe during the day,less phlegm,white dilute phlegm,itchy pharynx,phlegm in the pharynx,chilly,easy sweating,normal tongue shape,light red tongue,thin white fur,floating pulse.2.Professor Zhang Shunan believes that wind pathogen is the core factor in the pathogenesis of PIC,including internal wind and external wind,so he pays special attention to the combined application of expelling the lung and dispelling wind and relieving the urgency of excessive wind in the treatment of PIC.Accordingly,the basic prescription for treatment is composed of modified Allergic Decoction combined with Zhisou Powder.increasing or decreasing drugs according to accompanying syndrome.Because patients are often accompanied by throat symptoms,Professor Zhang Shunan paid special attention to the treatment of throat symptoms,and thought that the emergence of throat symptoms is most closely related to wind,fire,phlegm and dryness,and paid attention to the daily care of patients at the same time of drug treatment.Conclusion 1.(1)The PIC patients can be divided into 5 main TCM syndromes:syndrome of wind evil concealing in the lung,syndrome of phlegm-dampness accumulating in the lung,syndrome of deficiency of lung qi and pathogenic wind left in the lung,syndrome of wind-heat attacking the lung and syndrome of phlegm-heat obstructing the lung.It means the main pathological factors of PIC are wind,phlegm,heat and deficiency.(2)Women are relatively more susceptible to PIC.The incidence is higher in autumn and winter.Subacute course is more common in PIC and the degree of cough symptom is not severe,so the impact on daily life isn't particularly serious.(3)Syndrome of wind evil concealing in the lung accounted for the largest proportion whatever courses of disease is,and the patients with a course of more than 8 weeks were more common than those with a course of 3 to 8 weeks,showing that wind pathogen is the key factor in the pathogenesis of PIC,and its effect is more significant with the increase of the course of the disease.The higher the score of cough symptom,the higher proportion of the syndrome of wind evil concealing in the lung,suggesting that there is a certain relationship between severe cough and the syndrome of wind evil concealing in the lung.Clinical experience and many other studies have shown that age is related to the distribution of TCM syndrome types of patients with PIC,but in the results of this study,there is no difference in the distribution of TCM syndrome types of patients in different ages,which may be due to the error caused by the small sample size of this study.(4)Clustering results showed that type 1 generally conformed to the syndrome of phlegm-dampness accumulating in the lung(21.4%).Type 2 generally conformed to the syndrome of fluid consumption due to lung heat(17.6%).Type 3 generally conformed to the syndrome of wind evil concealing in the lung(26.0%),and these patients were sensitive to cold air,along with dry cough without phlegm,while type 4 generally conformed to the syndrome of wind evil concealing in the lung(13.7%)with patients that are not sensitive to cold and have a small amount of white sticky sputum and are difficult to cough.Type 5 are basically conformed to the syndrome of deficiency of lung qi and pathogenic wind left in the lung(21.4%).The results of cluster analysis are mostly consistent with the distribution trend of clinical TCM syndrome types,and have a high degree of agreement with the results of traditional syndrome differentiation methods.The above cluster syndrome groups can be considered as the symptom characteristics of each syndrome type of 131 patients included this time.2.Professor Zhang Shunan believes that wind evil is the key pathogenesis of PIC.In the treatment,he often uses the two methods---expelling the lung and dispelling wind and relieving the urgency of excessive wind.Also he pays special attention to the treatment of throat symptoms.The basic prescription is composed of Allergic Decoction combined with Zhisou Powder with pharynx and cough relieving products.