Chinese medicine master Li Shimao: experience in treating cough
Li Shimao, the second Master of Traditional Chinese Medicine, served as a professor and doctoral tutor of Hebei University of Traditional Chinese Medicine, as well as the tutor of the second, third, fourth and fifth groups of national senior TCM experts in academic experience inheritance.Chinese medicine master Li Shimao practiced medicine for more than 50 years, adhere to pulse diagnosis as the center, the four diagnosis combined with the treatment of syndrome differentiation, especially good at the treatment of internal diseases, chronic diseases, stubborn diseases.Cough is one of the most common symptoms of respiratory diseases, seen in upper respiratory tract infection, cough variant asthma, chronic pharyngitis, gastroesophageal reflux disease, pneumonia, bronchitis, lung cancer, bronchiectasis, pulmonary interstitial fibrosis and other diseases.Cough has many causes and complicated conditions. Since ancient times, it has been said that “all diseases are easy to cure, but cough is difficult to cure”.Li Shimao’s general idea of cough differentiation and treatment is guided by the theory of traditional Chinese medicine, with pulse diagnosis as the center, strict and flexible syndrome differentiation, no fixed method, no fixed party, now li Lao cough diagnosis and treatment experience is summarized as follows, for colleagues.Li Shimao is good at distinguishing cough from deficiency and reality.He believes that the actual cough is mostly caused by evil obstructions in the lung and the inverse of lung qi.Such as abrupt climate change or careless living, external sensory six sexual invasion from the mouth and nose or fur, so that lung qi bundles;Or improper diet, fat sweet taste or addicted to tobacco good wine, damage the spleen and stomach, damp heat, phlegm turbidness endogenous, dry in the lung;Or emotional stimulation, liver disorders, qi yu fire, or liver Yang wind, qi fire, wind Yang on the lung, can cause lung xuansu and make cough demonstration.Deficiency cough due to chronic disease body deficiency, congenital deficiency and so on lead to qi deficiency and failure, unable to promote and cough, mainly involving lung, spleen, kidney three organs.As Shen Jinao pointed out in the source of Miscellaneous diseases, xi Candle: “Cover lung does not hurt cough, spleen does not hurt soon cough, kidney does not hurt fire does not burn, cough is not very”, indicating the important role of lung, spleen and kidney in empty cough.Deficiency of lung qi and Yin or deficiency of kidney and lung, gold water can not be born or deficiency of spleen and soil, soil is not born of gold, can cause lung deficiency can not be normal xuan fall and cough.In the clinical process, if dry cough, lower limbs heavy, thin ulnar veins and lung pulse, it is caused by kidney water deficit in the lower, deficiency Yang floating on the upper;If repeated cough with poor appetite, complexion is not bright, slow pulse, is a deficiency of temper, soil is not gold caused by.Most cough, especially for a long time, is often mixed with the deficiency and the cold and heat syndrome. Attention should be paid to distinguish the specimen from the deficiency and the fact.● Pay attention to distinguish the nature of evil causes of exogenous cough, including wind, cold, heat, dampness, dryness, fire, especially wind cold, wind heat, wind dryness.For cough with internal injury, the common pathogenic pathogens include phlegm, fire, cold and heat. In addition, Li Shimao believes that there are also dampness, water drinking, blood stasis and internal wind, among which dampness, water drinking and blood stasis can block the qi mechanism of the lung and cause the qi mechanism to promote the disorder and cough.For example, cough accompanied by phlegm, pharyngeal obstruction, chest distress, wan PI, fatigue, pulse and string of moisture-affected lung;Cough prone to wheeze, tender rib pain, dark red tongue, hard and smooth pulse string, or combined with modern medical examination found pleural effusion, phlegm drink on the chest and lung.Cough from the blood stasis theory is less, Li Shimao thought that lung qi, also the main node, help the heart flow blood, lung qi is not smooth, blood stasis is also astringent, so lung blood stasis cough is not rare.Old age patient coughs little phlegm or sputum is taken in phlegm dark violet, pulse astringency sluggish, or accompany the person with the basic disease such as cerebral infarction, myocardial ischemia, belong to yu blood is damaged.In addition, deficiency of liver Yin, fengyang on lung gold can also cause cough, clinical can be accompanied by less sputum, dizziness tinnitus, tongue tender red, pulse string sheng and flood.In the process of clinical syndrome, the syndrome machine is more complicated, and two or more kinds of evil spirits are seen simultaneously as diseases, which requires the doctor to be careful, careful and patient in syndrome differentiation.Li Shimao believed that the diseases of the viscera and six fu organs spread to the lung, which can cause the loss of lung qi in xuandescent, and the upper reverse cough.Clinical, if you have any diseases with ease, something the liver by the hot and humid, or liver Yin deficiency and kidney qi Yang deficiency and kidney Yin deficiency, inverse, spleen stomach gas on earth is insufficient, or pixu (spleen deficient) intrinsic, lack of a better mousetrap, blood stasis phlegm dampness or heart KangSheng, evil indicates bowel or bladder visceral lesions, regardless of the actual situation of can be announced in the lungs and as well, so four diagnostic parameter, is paid attention to when the treatment right from zang-fu organs.● Take pulse diagnosis as the center, flexible syndrome differentiation “Treatise on Febrile Diseases · Distinguish the Pulse syndrome of Sun Disease and Treat it” says: “Observe its pulse syndrome, know what is wrong, and treat it according to the syndrome.”The importance of pulse detection in diagnosis and treatment of disease was pointed out.Li Shimao is well versed in the classics and has a lot of experience in the study of pulse diagnosis and syndrome differentiation in TRADITIONAL Chinese medicine. He knows that syndrome differentiation is the core concept of the basic theory of Traditional Chinese medicine, and the pulse is the core of the syndrome, and the ability to distinguish the pulse directly affects the result of syndrome differentiation, and then affects the therapeutic effect, so he repeatedly emphasizes the important role of pulse diagnosis.When Li Shimao diagnosed diseases, pulse diagnosis accounted for 50%~80% of the weight, which was an important basis for his prescription.If bronchiectasis patient cough, cough up a large number of yellow thick phlegm, red tongue, but the pulse sink string, syndrome differentiation, when from the disease from the tongue to distinguish heat syndrome?Or cold syndrome from pulse diagnosis?Li Shimao believed that yellow phlegm and red tongue should not be identified as heat. When examined from the pulse, the chord pulse is caused by poor Yang transport and astringent blood, so red tongue and yellow phlegm can also be seen.Coughing spasms to play a card, disease see pharynx urticant cough, sudden sudden stop, cough lasts for 5 minutes or so every time a spasmodic, some scholars think that the symptoms and “shing twin acute wind” itchy “” the wind sheng is the wind of the pathogenic features extremely similar, proposed” the wind cough “, but part of the healer, on the basis of every encounter painful pharynx urticant, cough are for the wind cough syndrome,And with schizonepeta, cicada, silkworm, mint, burdock seeds and other wind dispelling and pharyngeal products cast, the result is difficult to play its effect.▲ Jinghua Li Shimao pulse diagnosis found that if the frequency of spasmodic cough, less sputum, pharyngeal itching, pulse slip number of partial sheng, for the fire reverse qi caused;If the pulse is not enough, it is caused by the deficiency of lung qi and Yin, the order of descending su is not good, and the inverse of lung qi;If pulse string and fine number, two guan string and flourishing, is insufficient liver Yin, wood burning gold and cough.If the external symptoms have been in addition to pharyngeal itching, cough, cough sputum, pulse and string tight, and when the cold fu in the lung, lung xuanxuan drop caused by;If the pulse sink string tight number is identified as cold bundle heat depression.It can be seen that When Diagnosing and treating diseases, Li Shimao insisted on taking pulse diagnosis as the center, and determined syndrome by pulse rather than syndrome or tongue, which often achieved miraculous results.Li Shimao often emphasizes that if the lung is not involved, the cough is not involved in the lung, and the treatment also emphasizes the importance of restoring the function of lung qi xuanqi recovery, qi smooth, evil.In addition, Li Shimao used ephedra to relieve cough by promoting lung qi. He believed that the dosage of ephedra was slightly larger and the effect of relieving cough was better. The dosage was usually about 10g.In the application of Maxing Shigan Decoction for the treatment of cough and asthma, Li Shimao believed that the compatibility ratio of ephedra and gypsum in treatises on febrile diseases should be strictly observed, that is, the ratio of ephedra and gypsum is 1∶2. If the ratio of ephedra to gypsum is too low, it will cause cold and cold gypsum to restrain gas machine, stagnation heat can not reach, and cough is more severe.Li Shimao has a deep foundation of the basic theory of Traditional Chinese medicine, thick accumulation, in the treatment of the medication is very accurate.● The concept of dynamic therapy is one of the important academic thoughts in Huangdi Neijing and an important feature of Traditional Chinese medicine.Li Shimao has dynamic treatment ideas when treating patients, and can better grasp the law of disease and syndrome development, timely adjust the treatment plan according to the different stages of disease and syndrome, and develop dynamic treatment strategies.If the cough of wood burning gold, the symptoms of dry cough less sputum, pharyngeal itching and hypochal pain, irritable temperament, pulse string, Li Shimao first to gentian, Chinese neem seeds, peony bark, etc., to relieve the liver, and then to black plum, schisandra fruit, paeonia root and other acid collected products tonifying the liver, to consolidate.● Medical Case 1: The patient, male, aged 36, was diagnosed for the first time on May 3, 2008.Complain of cough for more than 3 months, symptoms see cough, phlegm less difficult, pharyngeal itching pharyngeal pain, food can, mei can, er can, red tongue less moss, pulse string fine number, two obvious.Diagnosis :(wood burn gold type) cough.Treatment: Clear liver, reduce inverse and nourish Yin.Recipe: Rotating generation ochre soup and consistent decoction add and subtract.Composition: Ophiopogon 35g, spiralflower 12g, Daiocher 15g, sea clams shell 15g, Shengdi 12g, Danpi 10g, gentian 8g, daiqing leaf 8g, Azedadim seed 8g, fritillaria fritillariae 6g, 1 dose a day, water decocted juice 300ml, morning and evening after meal to take, a total of 14 doses.▲ Maidong May 18: cough has stopped, but the tongue is still red, less moss, pulse is fine, guan pulse string wang.Although the cough was gone, but the liver pulse was not flat, sanjia Fumai Decoction was given to consolidate the liver with acid jianbu: raw oyster 18g, turtle jia 18g, turtle plate 18g, Maidong 18g, Paeony 12g, Shengdi 12g, danpi 8g, schisandra fruit 6g, wumei 6g. The usage was as above. A total of 6 doses were taken, guan Pulse ping.Press: pulse string fine number, two obvious, for the deficiency of liver Yin, wood burn gold pulse.Prime man, work trouble, life trivia, easy to give birth to irascibility and punishment lung gold to cough.After 14 days of treatment, the cough symptoms were eliminated, but the liver veins were still vigorous. Therefore, sanjia Fu Mai decoction was added and reduced to nourish Yin and nourish Yin.● Medical case 2: The patient, female, aged 30, was diagnosed for the first time on February 12, 2002.She complained of cough for more than 20 days.The patient caught a cold more than 20 days ago, and the nasal congestion and runny nose were relieved, with lingering cough. Cefuroxime axetil tablets and azithromycin were taken orally successively, but the symptoms were not improved. The cough was paroxysmal, phlegm was not good, pharynx was itching, the urine was not good, the stool was dry, the tongue was light red, the moss was white, and the pulse was tight.Diagnosis: cough due to cold fluid accumulation in lung.Treatment: Xuanfei cold.Recipe: Small qinglong decoction plus or minus: cassia twig 10g, ephedra 8g, almonds 10g, pinellia 8g, asarum 3G, dried ginger 8g, schisandrae 6g, paeony 6g, licorice 6g, 1 agent a day, water decocted juice 300ml, morning and evening meal points, a total of 5 agents.▲ Guizhi on February 18: pharyngeal itching relief, cough relief, sputum more easy to cough up, chest full stuffy, pulse string sliding according to the reduction, syndrome differentiation is phlegm depression chest wan, qi machine adverse.Recipe: Add and subtract Trichosanthes kirilowii macrostemon and Cassia twig soup.Composition: 20g Trichosanthes Kirilothes maxim, 10g allium macrostemon, 8g Cassia twig, 10g Tuckahoe, 8g Pinellia pinellia, 6g Fructus aurantii, 6g Magnolia officinalis, 6 doses, decocted in water, all the above diseases disappeared.According to: the cough left after a cold, the application of a variety of antibiotics is not good, for the surface syndrome has been solved, evil in the lung, resulting in lung xuanxuan drop caused by, should be treated xuanfei dispersing evil.In this case, the patient’s pulse string is tight, which is the main artery of cold and leads to coagulation and astringency. If this pulse is seen during the clinical process, no matter cough, shortness of breath or chest obstruction, xiaoqinglong Decoction can be added and reduced to treat it.■ Solemnly declare: because each person’s constitution and condition is different, the formula and dose in this case only apply to the patient’s condition at that time.The prescription and dosage in this case shall not be copied without diagnosis and treatment based on TCM syndrome differentiation.If necessary, readers should go to a regular hospital for diagnosis and treatment, so as not to delay the illness.