Study On The Characteristics Of TCM Syndromes Of Gastroesophageal Reflux Cough

Gastroesophageal reflux cough is one of the common causes of chronic cough which has been widely studied in modern medicine in terms of its pathogenesis,diagnosis and treatment.Traditional Chinese medicine has a profound understanding and good curative effect of cough and reflux,but its etiology,pathogenesis and syndrome characteristics are little studied.Our team has carried out research on chronic cough for many years,and has a systematic knowledge of chronic cough.On the basis of previous research,this study with the combination of disease differentiation and syndrome differentiation was to deeply study the syndrome characteristics of gastroesophageal reflux cough,and summarize the rules of syndrome and prescription medication,so as to better guide clinical practice.Objective:Through retrospective case study on gastroesophageal reflux cough,this study observed the general information,cough attack characteristics and four diagnostic information of patients,summarized the syndrome characteristics,discussed the etiology,pathogenesis and medication characteristics,to provide the reference for the clinical application of traditional Chinese medicine.Methods:A retrospective study was conducted to collect chronic cough cases from the respiratory department of Oriental hospital from 2009 to 2020,and further selected and included gastroesophageal reflux cough cases,established a database with Microsoft Excel,and then input general information,previous medical history,symptoms,tongue images and pulse.The data were checked and cleaned.Statistical analysis of the data was using SPSS25.0 statistical software.Results:1.This study collected 796 patients with chronic cough,among whom 128(16.08%)patients were eligible for the diagnostic criteria for gastroesophageal reflux cough.2.General information:Among the 128 cases of gastroesophageal reflux cough,females were more than males,and the sex ratio was 3:1.The middle age group(45-59 years old)was the majority in proportion as 41.41%of the total.The ratio of male to female was 1:1.36 in the youth group(aged 18-44),compared 1:5 in the elderly group(aged 60 and above)(?2=7.408,P<0.05).3.Characteristics of coughing onset time:38.28%of the patients had the longest course of disease from 1 to 5 years.About the season and circadian rhythm of this type of cough,65.63%had no obvious seasonal characteristics,and 71.88%had no apparent circadian rhythm.4.Predisposing factors and mitigating factors:odor and cold wind were dominant,accounting for 54.69%and 52.34%respectively.About 41%were related to dietary factors,and 5.47%were relieved by adjusting diet or drinking water.5.Disease location:57 cases were located in lung,spleen and stomach,accounting for 44.53%of the total.There were 39 cases of lung and stomach involvement,accounting for 30.47%.14 patients whose location were in lung,liver and stomach were accounted for 10.94%.6.Clinical manifestations:The first 10 symptoms were dry mouth,itchy throat or trachea,cough,sputum,acid reflux,bitter mouth,white sputum,little sputum,cough causing by itchy throat,paroxysmal cough,back or neck or chest cold.Tongue images and pulse:red tongue(42.97%)was the dominant tongue,while yellow tongue was the dominant tongue(57.03%).The main pulse was the slide vein,accounting for 81.25%.7.Distribution of syndrome types:62.50%of them showed the characteristics of wind evil lurking in lung.In the distribution of syndromes,the common syndromes were dampness-heat stagnation of lung syndrome(40.63%),phlegm-dampness obstruction of lung syndrome(19.53%),adverse syndrome of stomach qi(17.97%),cold drink lurking in lung syndrome(15.63%),and yang-deficiency syndrome of lung and spleen(14.84%).No difference was found among all types of syndrome in age,sex,and course of this disease(P>0.05).8.The commonly herbs in the treatment of gastroesophageal reflux cough were grouped as dispelling wind and lung,warming and dispersing cold,dispelling phlegm and relieving cough,clearing phlegm and heat,removing dampness and clearing heat,regulating qi,strengthening spleen and nourishing stomach,nourishing yin and increasing fluid.Conclusion:1.The disease of gastroesophageal reflux cough is located in the lungs,the spleen,the stomach and the liver.Among them,the spleen and stomach are especially critical,which embody the correction of lung and spleen or lung and stomach.2.As the basic pathogenesis of chronic cough,the pathogenesis of wind evil lurking in lung is still important,which is proved by the result that there are many cases of gastroesophageal reflux cough triggered by odor and cold wind.But this pathogenesis often appears with other pathogenesis and ultimately causes cough.3.The pathologic factors of gastroesophageal reflux cough were mainly fu wind,dampness-heat,phlegm-dampness,and cold drink,which all caused a disorder in the lungs that leads to coughing.4.The characteristics of the total syndrome of gastroesophageal reflux cough include cough with phlegm,acid reflux,itching in the pharynx or trachea,itching in the pharynx,hawk cough,abdominal distension,heartburn,reddish or red tongue,thin yellow or yellow greasy moss,smooth pulse.5.The common syndromes of gastroesophageal reflux cough are dampness-heat stagnation of lung syndrome,phlegm-dampness obstruction of lung syndrome,adverse syndromes of stomach qi,cold drink lurking in lung syndrome,yang deficiency of lung and spleen,etc.Combined with the clinical situation,syndrome differentiation and treatment can often be effective,highlighting the advantages of traditional Chinese medicine.