Cough, Chronic

Zhi Sou San
Ingredients: Jie Geng (cooked Platycodon Root), Jing Jie (Schizonepeta), Zi Wan (steamed Aster), Bai Bu (steamed Stemona), Bai Qian (steamed Cynanchum, prepared Licorice), Chen Pi (Citrus)

Clinical Applications:
Cai treated 37 cases of obstinate cough with modified Zhi Sou San. The modified formula consisted of the following single herbs: Jing Jie (Schizonepeta), Zhi Qiao (Aurantium Fruit), Chan Tui (Cicada Slough), Gan Cao (Licorice), Chen Pi (Citrus), Zhi Ma Huang (prepared Ma-Huang), Xin Ren (Apricot Seed), Di Long (Earthworm), Jie Geng (Platycodon Root), Zi Wan (Aster), Bai Qian (Cynanchum), Wu Mei (Mume), and E Jiao (Gelatin). One dose of the formula in decoction was administered daily. A comparison group of 30 cases was treated with curoxim, toclase, etc. The results: of the treatment group, 28 cases were resolved, 7 cases much improved, and the remaining 2 cases did not respond to the treatment, with a total effective rate of 94.6%; of the comparison group, the corresponding numbers were 11, 10, 9, and 70%.(1)

Zhi Sou San and Variations of Zhi Sou San
Yao treated 80 cases of chronic cough with Zhi Sou San. The formula consisted of Zi Wan (Aster), Bai Bu (Stemona), Jie Gen (Platyodon Root), Bai Qian (Cynanchum), Chen Pi (Citrus), Gan Cao (Licorice), and Jing Jie (Schizonepeta). For attack of wind-cold on the lung, Fang Feng (Siler), Xing Ren (Apricot Seed), and Qiang Huo (Notopterygium Root) were added. For attack of wind-heat on the lung, Jing Jie (Schizonepeta) was removed, and Sang Ye (Mulberry Leaf), Xing Ren (Apricot Seed), Bo He (Mentha), Niu Bang Zi (Arctium), and Qian Hu (Peucedanum) were added. For accumulation of phlegm-dampness in the lung, Jing Jie (Platyodon Root) was reduced to the minimum while the following were added: Qian Hu (Peucedanum), Xing Ren (Apricot Seed), Shi Chang Pu (Grassleaved Sweetflag Rhizome), Hua Shi (Talc), and Yi Ren (Coix). For dryness-induced lung impairment, Jing Jie (Schizonepeta), Bai Qian (Cynanchum), and Chen Pi (Citrus) were removed, and the following were added: Sha Shen (Adenophora Root), Mai Dong (Ophiopogon Root), Xuan Shen (Scrophularia), Chan Tui (Cicada Slough), Zhi Mu (Anemarrhena), Zhe Bei Mu (Fritillary Bulb), and Huang Qi (Astragalus Root). For cough due to lung-fire, Jing Jie (Schizonepeta) and Chen Pi (Citrus) were removed, and the following were added: Sang Bai Pi (Morus Park), Di Gu Pi (Lycium Bark), Huang Qi (Astragalus Root), Zhi Mu (Anemarrhena), Gua Lou Pi (Trichosanthes Peel), Pi Ba Ye (Loquat Leaf), and Bai He (Lily). One dose of the formula in decoction was orally taken daily. The results: 24 recovered, 36 cases significantly improved, 12 cases improved, and the remaining 8 cases did not respond to the treatment, with a total effective rate of 90%.(2)

Jue Shui Zhuan Shi Tang
Hui treated 64 cases of lingering cough with self-formulated Jue Shui Zhuan Shi Tang. The formula consisted of Sha Shen (Adenophora Root), Mai Dong (Ophiopogon Root), Zhi Qiao (Bitter Orange), Ju Hong (Red Tangerine Peel), Xing Ren (Apricot Seed), Chuan Bei Mu (Si Chuan Fritillary Bulb), Kuan Dong Hua (Coltsfoot flower), Zi Wan (Tatarian Aster Root), Sang Bai Pi (prepared Mulberry Bark), Huang Qin (Scutellaria Root), Zhi Mu (Anemarrhena Rhizome), and Gan Cao (prepared Licorice Root). It was reported that the treatment had achieved a total effective rate of 93.8%.(3)

Jiu Ke Li Qi Tang
Cun, et al. treated 37 cases of chronic cough due to pulmonary heart disease with self-formulated Jiu Ke Li Qi Tang. The formula consisted of Dang Shen (Codonopsis), Bai Zhu (Atractylodes), Gan Jiang (Dried Ginger), Chen Pi (Citrus), Fu Ling (Hoelen), Huang Qi (Astragalus), Ban Xia (Pinellia), and Ting Li Zi (Lepidium Seed), Zi Wan (Aster), Kuan Dong Hua (Coltsfoot Flower), Xi Xin (Herba Asari), Wu Wei Zi (Fructus Schizandrae), and Gan Cao (Radix Glycyrrhizae). Ma Huang (Ephedra) was added for severe asthma. Ren Shen (Ginseng) was added for palpitation and severe asthma. Fang Ji (Stephania) was added for edema. Fu Pian (prepared Aconite Root) and Rou Gui (Cinnamon Bark) were added for cold limbs. The results: 25 cases recovered, 8 cases significantly improved, 2 cases improved, and the remaining 2 cases did not respond to the treatment.(4)

Bei Lou Zhi Ke Tang
Wang treated 28 cases of chronic bronchitis with Bei Lou Zhi Ke Tang. The formula contained Chuan Bei (Sichuan fritillary bulb), Guo Lou Ren (Trichosanthes Seed), Bai He (Lily Bulb), Xing Ren (Apricot Seed), Yuan Zhi (Polygala Root), Su Zi (Perilla Fruit), Bai Jie Zi (Mustard Seed), Sang Bai Pi (Mulberry Bark), Ting Li Zi (Lepidium Seed), Dong Chong Xia Cao (Cordyceps), Mai Dong (Ophiopogon Root), Lai Fu Zi (Radish Seed), and Hong Zao (Chinese Dates). The decoction was orally taken one dose a day. The results: After 3-12 doses, all 28 cases no longer experienced bronchitis symptoms, and no relapse was found during follow-up visits conducted from 11 months to two and a half years after the treatment.(5)

Gu Ben Chuan Sou Ling
Li, et al. treated 1000 cases of chronic cough with Gu Ben Chuan Sou Ling. The formula consisted of Tai Zi Shen (Pseudotellaria Root), Wu Wei Zi (Schizandra Fruit), Xing Ren (Apricot Seed), Ban Xia (Pinellia Tuber), Fu Ling (Poria), Lai Fu Zi (Radish Seed), Dan Shen (Salvia), Shui Zhi (Leech), Che Qian Cao (Plantain Herb), Yin Yang Huo (Epimedium), Bu Gu Zhi (Psoralea Fruit), Huang Qin (Scutellaria Root), Gan Cao (Licorice Root), etc. One dose of the formula in decoction was orally taken daily, and 30 days constituted one course of treatment. After the condition had been stabilized, the patients were administered the pill form of the formula, 9 grams each time, three times a day. The results: 480 cases (48%) significantly improved (complete disappearance of main symptoms and no relapse in 2 years), 509 cases (50.9%) improved, and the remaining 11 cases (1.1%) did not respond to the treatment.(6)

External Applications
Pan treated 200 cases of lingering cough in children with two self-formulated external applications. Formula No. 1 consisted of Fu Zi (cooked Aconite Root), Nan Xing (prepared Arisaema Tuber), Ban Xia (prepared Pinellia Tuber), Wu Wei Zi (Schisandra), Gan Jiang (Dried Ginger), Xi Xin, (Wild Ginger), and Yang Jin Hua (Datura Flower). Formula No. 2 consisted of Bai Zhi (Dahurian Angelica Root), Wu Wei Zi (Schisandra) and Tian Zhu Huang (Tabasheer). The two formulas were grounded into powder. Formula No. 1 was plastered on acupoint Da Zhui (Du 14), and Formula No. 2 was plastered on Shen Chu (Du12). The results: 92 cases (46%) recovered, 84 cases (42%) improved, and the remaining 24 cases (12%) did not respond to the treatment.(7)

Wang treated 218 cases of chronic cough and asthma with a combination of herbs, acupuncture, and acupoint-ligation therapy. An acupoint selected among Shan Zhong (Ren 17), Fei Shu (UB 13), and Ding Chuan (Extra) was cut open after routine local sterilization, ligated with No. 00 surgical catgut, intensively stimulated and sutured. After the acupoint-ligation therapy, suture, acupuncture, and electrotherapy were applied on Qu Chi (LI 11), Tian Tu (Ren 22), Fen Long (St 40), Yu Ji (Lu 10), Lie Que (Lu 7), Zu San Li (St 36), San Yin Jiao (Sp 6), Shen Shu (UB 23), and Kao Huang Shu (UB 43). Acupuncture was applied on 2-4 points daily, and the needles were retained for 30 minutes (electrotherapy). Seven days constituted one course of treatment. Finally, modified Xiao Qing Long Tang was administered to patients of cold-type cough, and Bai Bu Huang Qin Tang to patients of heat-type cough. The results: 98 cases significantly improved, 95 cases improved, and the remaining 25 cases did not respond to the treatment, with a total effective rate of 89%.(9)