Symptoms of internal injury cough and methods of TCM syndrome differentiation and treatment

Coughs are actually divided into many types clinically, among which internal injury cough is the most common symptom. So, what are the symptoms of internal injury cough? How to treat it?

Symptoms of internal injury cough:

The main clinical manifestations are repeated coughing and sputum production. The course of the disease is long and may also be induced by external factors. Different types of cough have different characteristics: there are morning coughs, which are aggravated by paroxysms, with continuous heavy and turbid coughs, and the cough is relieved by sputum; there are coughs that are aggravated in the afternoon and evening, or there are single coughs at night, with mild and short coughs; there are more severe coughs when lying down at night, which are continuous, with shortness of breath or accompanied by wheezing, and those with long-term cough causing wheezing; there are coughs with low and timid voices, and some with loud and powerful voices; the cough is aggravated by eating fatty and sweet food, raw and cold food; and the cough is aggravated by emotional depression. Secondly, the color, quality, quantity and taste of sputum: some people cough up little sputum; some people cough up a lot of sputum; some people have white and thin sputum; some people have white and sticky sputum; some people have white, clear and thin sputum, transparent and foamy sputum; some people cough up blood in sputum; some people have pus and blood in sputum; some people cough up pink foamy sputum, cough with wheezing, and have difficulty breathing; some people cough up sputum with hot or fishy smell, etc.

If internal injury cough is not treated properly, it may further worsen and develop into asthma and lung distension if the disease recurs for a long time.

TCM syndrome differentiation and treatment method:

1. Phlegm-damp cough

(1) Symptoms: Cough with a lot of sputum, which is white and sticky. The cough is more severe in the morning or after meals, or worsened by eating sweet or greasy food. There is also chest tightness, poor appetite, weakness in the limbs, a greasy white coating on the tongue, and a slippery pulse.

(2) The treatment principle is to dry out dampness and resolve phlegm, regulate qi and relieve cough.

(3) The main prescription is Erchen Pingwei San combined with Sanzi Yangqin Tang with modifications. Commonly used medicines: Amomum villosum, tangerine peel, Poria cocos, Atractylodes lancea, Magnolia officinalis can dry dampness and resolve phlegm; roasted Ephedra, Apricot kernel, Aster tataricus, Coltsfoot flower can nourish the lungs, resolve phlegm and relieve cough.

If the phlegm and dampness are severe, there is a lot of phlegm, and there is obvious abdominal distension, add tangerine peel, coix seed, almond and the like to enhance the power of drying dampness and resolving phlegm; if the syndrome is cold phlegm, add dried ginger and asarum to warm it; if it is wind phlegm, add processed Arisaema and White Aconitum to dispel wind and resolve phlegm; if there is phlegm stagnation and food obstruction, and there is a lot of phlegm in the chest, loss of appetite, greasy tongue coating and slippery pulse, add radish seed and perilla seed to smooth the qi, reduce adverse effects, resolve phlegm and aid digestion.

2. Phlegm-heat cough

(1) Symptoms: Cough, yellow and thick sputum that is difficult to expel, or even blood in the sputum, chest tightness, dry mouth, bitter taste in the mouth, sore throat, yellow and greasy tongue coating or a mixture of yellow and white, and slippery and rapid pulse.

(2) The treatment principle is to clear away heat, soothe the lungs, resolve phlegm and relieve cough.

(3) The main prescription is Qingjin Huatan Decoction with modifications. Commonly used medicines: Morus alba bark, Scutellaria baicalensis, Gardenia jasminoides, Anemarrhena asphodeloides for clearing lung heat; Apricot kernel, Fritillaria thunbergii, Trichosanthes kirilowii, Belamcanda chinensis, and sea clam shells for clearing the lungs, reducing phlegm and relieving cough. If there is excessive phlegm and heat, and the patient coughs up pus and sputum, add golden buckwheat, houttuynia cordata, wax gourd seeds, gypsum, and scutellaria baicalensis to clear away heat, resolve phlegm, and discharge pus. Phlegm-heat damages body fluid and causes dry mouth. Add Adenophora Root, Ophiopogon Japonicus, Radix Trichosanthis, and Rhizoma Phragmites to clear heat, nourish yin and produce body fluid.

3. Liver fire attacks the lungs

(1) Symptoms: Coughing, shortness of breath, continuous coughing, or even coughing up blood, or blood-stained sputum, pain in the chest and ribs, impatience and irritability, fever, bitter taste in the mouth, dry throat, and red face and eyes. The tongue coating is thin, yellow and less moist, and the pulse is stringy and rapid.

(2) Treatment principle: Clear the liver, purge the lungs, lower the qi and relieve cough.

(3) The main formula is Daihesan combined with Xiebaisan with added ingredients. Commonly used medicines: Indigo, sea clam shell, and moutan bark clear liver fire and resolve phlegm, while mulberry bark, scutellaria baicalensis, and rehmannia root clear lung heat. If the heat is severe and the cough is frequent, add Fritillaria thunbergii, loquat leaves, etc. If there is cough, shortness of breath, and chest tightness, add Inula japonica vine and Citrus aurantium to reduce qi and relieve the shortness of breath. If the heat damages the body fluid and there is dryness of mouth, add Adenophora scabra, Ophiopogon japonicus, Radix Trichosanthis, and Phragmites australis to clear away heat, nourish yin and promote body fluid.