Chronic Cough: Seeking Effective Traditional Chinese Medicine Solutions

Chronic cough that has not improved (Traditional Chinese Medicine treatment has been ongoing for over 8 months)?

Dear compassionate individuals and esteemed members of the medical community,
[Symptoms]: Persistent cough that has not improved (Traditional Chinese Medicine treatment has lasted over 8 months).
[Basic Information]: 33 years old, male.
Height: 176 cm, Weight: 68 kg.
Blood pressure is normal.
Location: Tainan City.
Unmarried.
Sleep schedule: Early to bed, early to rise.
[Medical History]:
1.
During my school years, I enjoyed eating ice and drinking cold beverages after physical education classes.
2.
In the summer, I used to sleep with the air conditioning on.
3.
My water intake is low; I only drink when taking medication or when thirsty.
4.
I enjoy fried foods but do not consume them frequently.
5.
In winter, my hands and feet tend to feel cold.
[Description]:
1.
I cough whenever I speak, chant, smell certain odors, or ride a motorcycle (even while wearing a mask).
The coughing is more severe when riding a motorcycle and about twenty minutes before entering an air-conditioned room; afterward, the symptoms lessen.
2.
I have phlegm in my throat but cannot expel it.
Drinking hot lemon juice helps me cough up white phlegm.
3.
I do not cough while sleeping at night.
4.
If I refrain from speaking, I can go longer without coughing, but after a while, I will cough once; if I chant using my energy, the coughing frequency increases (notably, upon entering an air-conditioned room, the coughing is loud and frequent; after some time, it diminishes in intensity and frequency).
Sometimes, I cough so much while chanting that I become breathless, sweat, and struggle to catch my breath, necessitating deep breaths.
It is worth mentioning that I always drink warm water to soothe my throat before chanting and have also tried drinking plum vinegar for throat relief.
5.
Occasionally, I cough to the point of feeling nauseous.
6.
I have symptoms of allergic rhinitis; however, I do not sneeze or cough upon waking up, just experience a dry throat and thirst.
7.
Before chanting, I have taken folk remedies or over-the-counter cough medicines, which I hold in my mouth, making my entire respiratory tract feel smooth and clear, but once the effects wear off, I start coughing and feel thirsty!
8.
While chanting, I tend to draw out my initial notes for a long time and sing forcefully, which may contribute to my coughing.
I have since shortened my initial notes and no longer have the strength to sing loudly.
[Traditional Chinese Medicine Treatment]: I have seen three different TCM practitioners and taken herbal medicine for over eight months without improvement.
Below is a list of the TCM doctors I consulted, in order of visits.
<1> First TCM Practitioner: I consulted for nearly six months.
The doctor told me that I had been given the best and most suitable medicine.
He mentioned that if my cough did not improve under his care, it would likely not improve with other doctors either.
He shared that he had previously suffered from asthma with symptoms similar to mine and had healed himself through long-term self-treatment.
He advised that treating this condition correctly requires adherence to ancient methods.
The doctor suggested that my chances of recovery would be greater if I refrained from speaking and chanting.
He emphasized that treating this illness requires both treatment and maintenance!
<>: Chenpi (dried tangerine peel), Jie geng (balloon flower root), Jing jie (schizonepeta), Bai qian (cynanchum), Bai bu (stemona), Gan cao (licorice), Zi yuan (aster).
The doctor said to vary the prescription using these ingredients.
During treatment, the doctor had me use a cough powder before chanting, which initially worked well, but I started coughing again once the effects wore off!
<2> Second TCM Practitioner: I consulted for over a month.
The doctor eventually agreed to let me switch to another practitioner.
<>: A.
Mai men dong decoction 5g, Run sou san 3g, Xiang sha liu jun zi tang 2g, Bai jie zi 1g, Su zi 1g, Lai fu zi 1g, Jie geng 1g, Bei mu 1g.
I was to spray a homemade throat spray before chanting.
B.
Mai men dong decoction 5g, Run sou san 3g, Xiang sha liu jun zi tang 2g, Bai jie zi 1g, Su zi 1g, Lai fu zi 1g, Xing ren 1g, Cough syrup.
I was to spray a homemade throat spray before chanting.
C.
Mai men dong decoction 5g, Run sou san 3g, Xiang sha liu jun zi tang 2g, Bai jie zi 1g, Su zi 1g, Lai fu zi 1g, Sha shen 1g, Bai he 1g, Cough syrup.
I was to spray a homemade throat spray before chanting.
D.
Mai men dong decoction 5g, Run sou san 5g, Xiang sha liu jun zi tang 2g, Bai jie zi 1g, Su zi 1g, Lai fu zi 1g.
I was to spray a homemade throat spray before chanting.
<3> Third TCM Practitioner: I consulted for nearly two months, and the doctor also agreed to let me switch to another practitioner.
The doctor said my condition was a type of cold cough.
<>: A.
Bu zhong yi qi tang (Shun) 4g, Sheng mai yin 4g, Chai hu 1g, Qian hu 1.5g, Chi shao 1g, Bai shao 1g, Bai bu 1.5g.
Warm moxibustion was applied at the Tian tu point.
B.
Bu zhong yi qi tang (Shun) 4g, Sheng mai yin 4g, Chai hu 1g, Qian hu 1.5g, Xing ren 1g, Tao ren 1g, Pi pa ye 1.5g.
Warm moxibustion was applied at the Tian tu point, along with acupuncture.
C.
Ma xing gan shi tang* 3g, Zhi sou san* 3g, Gan mai da zao san 3g, Shu di 1.5g, Fu shen 1.5g, Chuan dong zi 1g, Yan hu suo 1g.
Warm moxibustion was applied at the Tian tu point, along with acupuncture.
The doctor specifically prepared a cough syrup for me to take, which I held in my mouth, making my entire respiratory tract feel cool and smooth, but I started coughing again once the effects wore off! D.
Ma xing gan shi tang* 3g, Zhi sou san* 3g, Gan mai da zao san 3g, Shu di 1.5g, Mai men dong 1g, Chai hu 1.5g, Qian hu 1g.
Warm moxibustion was applied at the Tian tu point, along with acupuncture.
E.
I took four doses of decoction without a prescription.
Warm moxibustion was applied at the Tian tu point, along with acupuncture.
F.
Er chen tang 3g, Zhi sou san* 3g, Ma xing gan shi tang* 3.5g, Dang gui 1.5g, Shu di 1.5g, Fu shen 1.5g.
I also took four doses of decoction.
Warm moxibustion was applied at the Tian tu point, along with acupuncture.

Ps: The doctor suggested that I could take Chuan bei pi pa gao before and after chanting.
Ps: The doctor mentioned that my kidney qi is insufficient.
[Western Medical Examination]:
1.
I have had two chest X-rays, which showed no signs of tuberculosis or other abnormalities.
2.
Pulmonary function tests were normal.
3.
The doctor stated that coughing is a symptom, and X-rays cannot reveal whether there is bronchial inflammation; it can only be inferred from symptoms like coughing.
4.
The doctor suggested that this might be similar to allergic cough.
Other doctors have mentioned it could be chronic bronchitis.
5.
The doctor said there was no need for sputum tests, as it was unnecessary.

Ps: Are there any other relevant tests I could undergo?
[Qigong Treatment]:
1.
The Qigong master said that my qi is stagnant; as long as the qi flows smoothly and is sufficient, I will not cough.
2.
I have been undergoing Qigong treatment for nearly a year.
3.
The Qigong master advised that due to my cold and deficient constitution, and my long-term vegetarian diet, I should eat more nuts and consume sesame oil noodles to improve my constitution, and I should practice Qigong.
[Folk Remedies]: Below is a list of methods I have tried, but none have been effective, and I have spent a considerable amount of money!
1.
Drinking hot water mixed with pomelo jam.
2.
Drinking hot water mixed with orange jam.
3.
XX brand polysaccharide enzyme.
4.
XX brand probiotics.
Some say that a clean digestive system strengthens the immune system, preventing coughs.
5.
XX brand lactic acid bacteria powder.
6.
Lemon juice + a little salt, mixed with hot water, can help expel white phlegm.
I sincerely hope that all compassionate individuals can provide medical advice.
I currently reside in Tainan City, and if there are any good TCM practitioners in Tainan City, I kindly ask you to inform me.
I do not have much money left and only wish to spend it wisely to effectively resolve my cough issue.
If you have any suggestions or opinions regarding this medical case, I would greatly appreciate your valuable time in responding.
I would be immensely grateful for your assistance.
Your kindness is immeasurable.

Xiao Guai, 30~39 year old female. Ask Date: 2006/05/28

Dr. Lin Qingzhong reply Traditional Chinese Medicine

1.
Persistent cough that has not improved after more than 8 months of traditional Chinese medicine treatment.
Based on your complaints, it is advisable to first rule out allergic cough, considering factors in your work and surrounding environment such as dust and lint.

2.
Additionally, allergic rhinitis causing allergic cough should also be considered for treatment and exclusion.

3.
After two X-ray examinations, it is recommended to consult two large hospitals for chest X-rays (both frontal and lateral views) and a CT scan, along with tumor marker CEA tests to rule out any tumor-related factors.

4.
Your symptoms seem to align more with the second physician's prescription of Mai Men Dong Decoction, but adjustments can be made as necessary.
Consideration can also be given to the Sang Ju Yin formula for warm diseases.
Since it is difficult to accurately diagnose cough patterns online, it is recommended that you visit my outpatient clinic at Fengyuan Hospital for a detailed examination and treatment.

Finally, I wish you good health.

Director of Traditional Chinese Medicine, Fengyuan Hospital, Lin Qingzhong.

Reply Date: 2006/05/28

More Info

Chronic cough can be a frustrating and debilitating condition, especially when it persists for months despite various treatments. In your case, you have been undergoing Traditional Chinese Medicine (TCM) treatment for over eight months without significant improvement. This situation calls for a comprehensive approach to identify the underlying causes and explore effective treatment options.

Understanding Your Symptoms
From your description, it appears that your cough is triggered by specific activities such as talking, singing, and exposure to certain environments (like air-conditioned rooms). You also mentioned having phlegm that is difficult to expel, which can indicate underlying issues such as mucus buildup or airway sensitivity. Additionally, your history of allergic rhinitis suggests that your respiratory system may be particularly reactive to environmental triggers.

TCM Perspective
In TCM, chronic cough can be attributed to various patterns, including:
1. Wind-Heat or Wind-Cold Invasion: This is often associated with acute respiratory infections but can linger if not treated properly.

2. Phlegm-Damp Accumulation: This pattern is characterized by a productive cough with phlegm that is difficult to expectorate.

3. Lung Qi Deficiency: This can lead to a weak cough that may worsen with exertion or exposure to cold.

4. Kidney Yin Deficiency: This can manifest as a chronic cough, especially if there is a history of cold exposure.

Recommendations for Treatment
1. Consult a TCM Specialist: Since you have already seen three TCM practitioners without improvement, consider seeking a specialist who focuses on respiratory conditions. A fresh perspective may help identify a different approach or herbal formula that could be more effective.

2. Herbal Formulas: Some commonly used TCM formulas for chronic cough include:
- Sang Ju Yin: For coughs due to wind-heat.

- Er Chen Tang: For phlegm-damp accumulation.

- Sheng Mai San: For lung qi deficiency.

- Bai He Guo: For nourishing lung yin and alleviating cough.

3. Dietary Adjustments:
- Increase your fluid intake to help thin mucus. Warm fluids, such as herbal teas or broths, can be particularly soothing.

- Avoid cold and raw foods, as they can exacerbate cough and phlegm production.

- Incorporate foods that support lung health, such as pears, honey, and walnuts.

4. Lifestyle Modifications:
- Avoid Irritants: Stay away from smoke, strong odors, and allergens that may trigger your cough.

- Humidity Control: Use a humidifier in your living space to keep the air moist, which can help soothe your throat and reduce coughing.

- Breathing Exercises: Techniques such as diaphragmatic breathing can help strengthen your lungs and improve your respiratory function.

5. Consider Western Medicine: If your cough persists despite TCM treatment, it may be beneficial to consult a Western medicine specialist, such as a pulmonologist or an allergist. They can perform tests to rule out conditions like asthma, chronic bronchitis, or other respiratory disorders.

6. Allergy Management: Given your history of allergic rhinitis, consider allergy testing to identify specific triggers. Managing allergies effectively can significantly reduce respiratory symptoms.

Conclusion
Chronic cough can be multifactorial, and addressing it often requires a combination of approaches. While TCM offers valuable insights and treatments, it is essential to remain open to integrating Western medical perspectives, especially if symptoms persist. By working closely with healthcare professionals and making lifestyle adjustments, you can improve your chances of finding relief from your chronic cough. Remember, patience and persistence are key in managing chronic health conditions.

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