The main pathological characters of the development of this disease are phlegm, stasis and deficiency. In the clinical differentiation, the syndromes of phlegm, stasis and deficiency should be focused on.
1. Acute outbreak stage: phlegm should be focused on, which divided into coldness and heat syndromes. The main manifestations are cough, expectoration and asthma, followed with could and heat syndromes. The modification of Xiao Qing Long is applied, viz., Xi Xin, Gan Jiang and Ban Xia are for warming and eliminating phlegm. For the dampness, Ban Xia, Hou Pu and Fu Ling are added to dry dampness and eliminate phlegm. For excess of phlegm and heat in the lung, the modification of Qing Jin Hua Tan Tang is applied, such as Huang Qin, Gua Lou, Bei Mu and Sang Bai Pi to clear away the phlegm. For injury of fluid due to phlegm and heat, Sha Shen, Mai Dong and Tian Hua Fen are added to nourish yin and produce fluid.
2. Chronic prolonged stage: treating both phlegm and stasis, and deficiency as well for the prolonged cough. For the dampness and phlegm, strengthening spleen and drying dampness by modified Er Chen Tang and San Zi Yang Qin Tang; for dryness and phlegm, moistening the lung and eliminating phlegm by modified Sha Shen Mai Dong Tang. Stasis is eliminated by opening lung collaterals, and Tao Ren, Dan Shen, Chuan Xiong and Di Long are applied to clear away stasis and open meridians. For the both lung and spleen deficiency, the modified Yu Ping Feng San combining Liu Jun Zi Tang.
3. Clinical remission stage: tonifying deficiency and consolidating origin, dispelling phlegm as well. The syndromes basically disappeared, slight cough and phlegm left. Tonifying spleen and kidney, strengthening spleen and benefiting qi by modified Liu Juin Zi Tang. Tonifying kidney to receive qi by Qi Wei Dou Qi or Jin Gui Shen Qi Wan. For the unconsolidation of defensive qi due to lung deficiency, or liability to common cold, tonifying the lung, benefiting qi and consolidating surface by modified Yu Ping Feng San. Because in the remission stage, some pathogens still left with dormant phlegm, the herbs for dispelling phlegm and stopping cough, such as Xing Ren, Bai Bu, Bei Mu, Kuan Dong Hua and Zi Wan, etc.
Key words: chronic bronchitis; phlegm, stasis and deficiency, staged treatment
Writer: Gui Liu
Central hospital of railways bureau, Hohhot, Inner Mongolia (010010)
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