2. Acute Bronchitis Traditional Chinese medical Therapies-TCM Therapies [TCM Discovery Net]

2. Acute Bronchitis

Case 1

Name: Wang.

Sex: Female.

Age: 63 years.

Occupation: A retired teacher.

Chief Complaint: Constant cough for more than 20 days.

History of Present Illness: More than 20 days ago, the patient got cough due to whiffing some oily-gas from her cooking. At the beginning, it occurred paroxysmally without sputum, but it was accompanied by dryness and itching of the throat. Then she went to the college-clinic and was treated by some common antibiotic and antitussive drugs for 1 week, but there was no curative effect on her. Then she went to a hospital for treatment. Through chest roentgenogram examination, it was showed that " the lung-markings were increased and disorderly," the illness was diagnosed as "Acute Bronchitis, "she was treated by intravenous dripping "Penicillin" and oral taking "Syrup of Loquat Leaf for relieving cough" "Capsule of Cinnamorrfi and Dragon's Bone etc. for relieving cough and asthma. "After half a month's treatment, her symptom could not be relieved yet. Furthermore, her expectorated sputum became white coloured, thick textured and profuse amounted. Her cough occurred constantly all day and night, accompanied with chest oppression, excessive sweat, lassitude and fatigue. Then she came to our hospital for treatment on June 23,1997.

Physical Examination: The patient was conscious with a normal general condition. The pulse was floating and thready, the tongue was red with a thick layer of white fur. The respiratory sounds of both lungs were all harsh, occasional bubbling sounds could be heard, some wheezing sounds could be heard occasionally too. There was not other abnormal sign.

Lab Test: WBC 9.2X10(9)/L, N 0.66, L 0. 34.

Diagnosis: Acute Bronchitis.

Differentiation: This disease, in TCM, belongs to the category of "WanKe"(obstinate cough). It was caused by obstruction of dampness-heat evil in the lungs and retention of phlegm dampness in spleen. It could be directly and protrudently reflected by her pulse and tongue.

Therapeutic Principle: Clearing away heat evil and eliminating pathogenic dampness-phlegm, regulating qi and restraining the excessive consumption of kidney-qi

Recipe:

ShengDiHuang, Dried Rehmannia Root 30g

ZhiMu, Windweed Rhizome 15g

ShengShiGao, Gypsum 25g (to be decocted earlier)

ZhuLiBanXia, Pinellia Tuber 15g (stir-fired with bamboo juice)

HuangLian,Coptis Root 15g

HuangQin,Scutellaria Root 15g

BaiJieZi,White Mustard Seed 15g

WuWeiZi,Schisandra Fruit 25g

SuZi,Perilla Fruit 12g

MaHuang, Ephedra 6g

ZhiKe,Fruit of Citron 12g

ChenPi,Tangerine Peel 12g

QianHu,Peucedanum Root 15g

RouGui,Cinnamon Bark 6g

GanCao,Liquorice Root 10g

All the above drugs were to be decocted in water for oral taking. 3 doses were prescribed.

Effect Observation: After taking the decoction, her cough got better, it occurred paroxysmally and the interval was obviously extended, while there was no change in chest oppression, profuse whitish mucoid sputum, fatigue, lassitude and excessive sweating. The pulse got thready and soggy, the tongue got light red with a thick layer of white fur. All these signs indicated that spleen was too deficient to transport the phlegm-dampness effectively. So that the followed therapeutic principle should be strengthening invigorating spleen-qi, sending turbid factor down and eliminating phlegm evil, sending adverse ascending of lung-qi down and expelling dampness, restraining excessive consumption of lung qi.

Recipe:

DangShen,Pilose Asiabell Root 30g

BaiZhu,Bighead Atractylodes Rhizome 15g

FuLing, Tuckahoe 12g

ZhuLiBanXia, Pinellia Tuber 9g (stir fired with bamboo juice)

ZhiMu,Windweed Rhizome 15g

HuangQin,Scutellaria Root 15g

SangBaiPi,Mulberry Bark 20g

DiGuPi,Wolfberry Bark 20g

ChenPi,Tangerine Peel 12g

BaiQian,Swallowwort Rhizome 20g

ShanYao,Chinese Yam Rhizome 20g

YiYiRen,Coix Seed 20g

HeZi,Chebula Fruit 12g

WuMei,Black Plum 15g

GanCao,Liquorice Root 10g

All the above drugs were to be decocted in water for oral taking. 3 doses were prescribed.
After taking the decoction, there were not chest oppression, profuse whitish mucoid sputum, lassitude and fatigue any more, her cough was stopped completely, she didn't sweat excessively. Result of reexamination of lab test was WBC 6.9 X 109/L, N 0.62, L 0.38. After half a month's follow up, the illness didn't recur, then it's ending.

Case 2

Name: Zhang.

Sex: Male.

Age: 20 years.

Occupation: A college-student.

Chief Complaint: Chest oppression and cough for 2 months.

History of Present Illness: Two months ago, the patient got chest oppression and cough caused by a cold. Chest oppression occurred constantly with difficult breathing; cough occurred intermittently with a discomfort of the throat. Furthermore, he felt that there was profuse sputum in his chest, but he couldn't expectorate it. He himself intermittently took some common antibiotics such as "Acetylspiramycini" for 2 months, but there was no obvious effect on him, moreover, he slowly got fatigue and lassitude. Then he came to me for treatment on May 7,1997.

Physical Examination: The patient was conscious with a normal general condition. The pulse was thready and soggy, the tongue was red with a thick layer of white fur. Some scattered dry rales could be heard in lungs. There was not other abnormal sign.

Examination of Chest Roentgenogram: It showed that the lung-markings were increased and disorderly. There were not other abnormal signs.

Lab test: The result of blood routine examination was: WBC 6.8¡Á10(9)/L, N 0.90, L 0.10.

Diagnosis: Acute Bronchitis.

Differentiation: This disease, in TCM, belongs to the category of "WanKe"(obstinate cough). It was deficiency of spleen Yang, which caused the physiological water-fluid couldn't be transported effectively. So that some part of physiological water fluid accumulated upward in the lungs and then turned into pathogenic dampness-phlegm, the patient then got the chest oppression and felt there was profuse sputum in lungs. In addition, there was excessive consumption of kidney-Yang, it caused there was a failure of kidney to be responsible for reception of air, so his cough occurred constantly. As for the decreasing of leukocyte count and the increasing of neutrophil classification showed his healthy qi was too deficient to resist the attack of evils effectively, then the patient got lassitude and fatigue.

Therapeutic Principle: Invigorating spleen-Yang and eliminating pathogenic dampness, sending turbid pathogenic factor down and removing phlegm-evil, warming kidney-Yang to restrain excessive consumption of kidney-qi, releasing stagnant lung-qi and regulating qi.

Recipe:

DangShen,Pilose Asiabell Root 15g

BaiZhu,Bighead Atractylodes Rhizome 9g

FuLing, Tuckahoe 10g

FaBanXia,Pinellia Tuber 12g

ChenPi,Tangerine Peel 12g

QianHu,Peucedanum Root 12g

SuZi,Perilla Fruit 10g

YiYiRen,Coix Seed 15g

SangBaiPi,Mulberry Bark 12g

BaiJieZi,White Mustard Seed 10g

RouGui,Cinnamon Bark 6g

WuWeiZi,Schisandra Fruit 8g

ZhiGanCao,Prepared Liquorice Root 6g

All the above drugs were to be decocted in water for oral taking. 3 doses were prescribed.

Effect Observation: After taking the decoction, his cough was stopped, chest oppression disappeared, there was not discomfort of the throat any more. Reexmination of chest roentgenogram was normal. Blood routine test showed the result became normal too: WBC 7.5)< 10(9)/L,N 0. 79, L0. 21. All the signs indicated the illness was cured completely. After 2 months' follow up, there was not recurrence of the illness, then it's ending.

Case 3

Name: Cai.

Sex: Female.

Age: 19 years.

0ccupation: A college-student.

Chief Complaint: Bad cough for half a month.

History of Present Illness: About half a month ago, the patient got a bad paroxysmal cough resulting from catching a cold, accompanied with yellowish sticky sputum and discomfort of throat. There were not headache, high fever, and rhinorrhea. She was treated in the collage-clinic for half a month(the used drugs were unknown). The yellowish sticky sputum was slightly reduced and the discomfort of throat disappeared. Meanwhile, the bad paroxysmal cough remained unchanged. Then she came to our hospital for treatment on December 11,1996.

Physical Examination: The' patient was conscious with a normal general condition. The respiratory sounds were harsh, some dry rales could be heard occasionally. The pulse was floating and scattered, the tongue was red with a thin layer, of white fur. There wasn't other abnormal sign.

Diagnosis: Acute Bronchitis.

Differentiation: This disease, in TCM, helongs to the category of "WanKe" (obstinate cough). It was caused by attack of pathogenic wind heat from the exterior to the interior, which was retained in the lungs and prevented the lung qi from taking charge of dispersing, purifying and descending function as normal. Then the bad cough was caused by the upward adverse flow of lung-qi.

Therapeutic Principle: Clearing away pathogenic heat in the lungs and nourishing Yin, releasing stagnated lung qi and regulating qi to stop coughing.

Recipe:

SangBaiPi, Mulberry Bark 15g

HuangQin. Scutellaria Root 6g

HuangLian,Coptis Root 6g

ZheBeiMu,Fritillary Bulb 9g

QuanGuaLou,Trichosanthes Fruit 10g

ChenPi,Tangerine Peel 10g

BaiQian,Swallowwort Rhizome 8g

FaBanXia,Pinellia Tuber 9g

KuanDongHua,Coltsfoot Flower 12g

ZiYuan,Tatarian Aster Root and Rhizome 12g

ShengDiHuang,Dried Rehmannia Root 15g