Treatment of children with cough variant asthma by adding cough suppressant

  1. Clinical data General data 84 cases of children were outpatients of our hospital from July 2003 to June 2007. Among the patients in this group, 48 were male and 36 were female; 21 were aged 1–3 years, 43 were aged 4–6 years, and 20 were aged 7–12 years; the shortest duration of illness was 2 months and the longest was 28 months. Among them, 52 cases were misdiagnosed as bronchitis, recurrent respiratory infections, chronic pharyngitis, tonsillitis, pertussis, and primary tuberculosis, respectively, during the treatment seeking process.  Diagnostic criteria: The children all met the diagnostic criteria set by the National Children’s Asthma Collaborative Group: (1) the cough was persistent or recurrent for 1 month, often at night or in the early morning, with little sputum and aggravated by exercise; there were no clinical signs of infection, or long-term antibiotic treatment was ineffective. ②Bronchodilators can relieve coughing episodes (basic condition). ③A personal or family history of allergy, a hyperreactive airway, and a positive allergen test can be used as an auxiliary diagnosis.  Among the 84 patients, 67 had paroxysmal cough and 17 had irritating dry cough. The cough occurred throughout the year, but was more frequent in winter, with 54 cases. Upper respiratory tract infections predominated in 45 cases, and the cough worsened after exercise in 34 cases and after inhalation of cold air in 29 cases. There were 12 cases of previous eczema, 9 cases of urticaria, and 7 cases of drug allergy. Some of the children had sneezing, itching of conjunctiva, nose, throat or larynx, and chest tightness. There were 13 cases with a history of allergy in the first and second degree relatives of the children. Lung auscultation breath sounds were clear in 58 cases and coarse in 26 cases. In addition to the routine examination, chest X-ray examination was performed in 57 cases, chest X-ray or chest X-ray was normal in 31 cases, and the lung texture was thickened and disordered in 26 cases.  2.Treatment Method: Treatment with cough suppressant plus flavor. The basic formula: mandarin 6-10g, baiqian 6-10g, Chenpi 4-6g, hempsia 3-6g, aster 6-10g, bupleurum 8-10g, thorny mustard 3-6g, licorice 3-6g. if the cough occurs in the sudden change of climate, manifested as paroxysmal continuous cough, pharyngeal itching, night or morning aggravation, and even can not sleep, the tongue is light, the coating is white, the pulse is floating, identified as wind and fluid injury type, the treatment is appropriate to dredge the wind and ventilate the lung. If repeated cough, aggravated after exertion, sputum is not easy to cough out or sputum more white, weakness and sweating, poor, loose stool, light tongue, white or white coating, pulse sinking weak, identification for the lung and spleen deficiency, treatment is appropriate to nourish the spleen and benefit the lung, phlegm cough, the above combined with Yu Ping Feng San plus reduction; If cough for a long time, sputum sticky white or into a lump, not easy to cough out, dry throat, or even choking cough. Hoarseness, red tongue, thin tongue coating, thin pulse, identification for lung dryness and yin injury type, the treatment is appropriate to clear heat and moisten the lung, lung phlegm, the above combined with Bayberry Guadua San plus or minus. Avoid eating cold, greasy and stimulating food during the medication period, and stop using other cough medicines.  3.Treatment effect Significant effect: cough disappeared, no recurrence for one month; Improvement: cough significantly reduced, still have a small amount of cough in the morning or after activity; Invalid: no significant change in symptoms before and after treatment. Patients were treated with one course of medicine, of which 37 cases (44.05%) were effective, 44 cases (52.39%) were improved, and 3 cases were invalid. The total effective rate was 96.44%.  In recent years, theoretical and clinical research on pediatric cough variant asthma in Chinese medicine has made significant progress, and it is considered a special manifestation or potential manifestation of asthma, i.e., the source is the same but the symptoms are different. The internal cause of the disease is attributed to the deficiency of the three organs of the lungs, spleen and kidneys, which leads to internal phlegm; the external cause is due to sudden climatic changes, heat and cold imbalance, contact with foreign bodies, excessive consumption of cold, salty and sour, etc., which touch the volatile phlegm and block the airway. The Three Character Classic of Medicine. Cough” says: “The Inner Classic says: ‘The five viscera and six internal organs all cause coughing, not just the lungs.’ However, the lung is the master of qi, and when all the qi goes up to the lung, it chokes and coughs, which is not only in the lung but also in the lung.”  The formula includes aster and bupleurum to warm and moisten the cough; orris and baiqian to open and promote the lung qi, dispel phlegm and remove saliva; thorny mustard to promote the lung and relieve symptoms; Chenpi, demerara and licorice not only harmonize the middle and strengthen the stomach, but also help aster and bupleurum to stop the cough and help orris and baiqian to dispel phlegm. This formula is warm, moist and calm, disperses cold without helping the heat, and dredges the surface without hurting the right. When wind and fluid are injured, add Tribulus terrestris, Fangfeng and Cicada molasses to dispel wind and relieve spasm; when it manifests as deficiency of lung and spleen, add Yu Pingfeng San to support righteousness and consolidate the root; if lung is dry and yin is injured, combine with Bayberry Guadua San to moisten lung and clear heat, regulate qi and resolve phlegm. Therefore, the treatment of pediatric cough variant asthma with the addition of cough suppressant powder hits the disease mechanism, and good curative effect is obtained.