bubble_chart Concept

During pregnancy, persistent coughing is referred to as cough during pregnancy, also known as cough during pregnancy.

If this condition persists as a chronic cough disease or the coughing is severe, it can often lead to injury of fetal qi disease, causing late abortion, or developing into a consumptive cough (embracing child consumption).

bubble_chart Pattern Analysis

1. External Contractionwind-cold︰The cough produces white and thin sputum, accompanied by throat itching and a hoarse voice, nasal congestion with runny nose, headache, soreness and pain in the limbs, aversion to cold with fever, absence of sweating, thin white tongue coating, and a floating slippery pulse. It is caused by wind-cold attacking the lung, leading to impaired lung dispersion and descent, hence the cough with white and thin sputum. Additionally, there is severe aversion to cold, mild fever, absence of sweating, headache and body pain, thin white tongue coating, and a floating slippery pulse, indicating an exterior cold pattern. The treatment should focus on dispersing wind and dissipating cold, ventilating the lung, and relieving cough. Commonly used formulas include Apricot Kernel and Perilla Powder or Cough-Stopping Powder with modifications.
2. External Contraction Wind-heat︰The cough is characterized by yellow and sticky phlegm that is difficult to expectorate, accompanied by fever, aversion to wind, or headache, sweating, dry mouth, and sore throat. The tongue coating is thin and yellow, and the pulse is floating and rapid. This condition is caused by wind-heat invading the lungs and pathogenic heat damaging the fluids, hence the yellow and sticky phlegm. The key points for differentiating these two syndromes are the nature of the phlegm and the manifestations of cold or heat. Additional symptoms include fever, slight aversion to wind and cold, sweating, dry mouth, sore throat, a thin yellow tongue coating, and a floating rapid pulse, indicating an exterior heat pattern. The treatment principle is to disperse wind and clear heat, ventilate the lungs, and relieve cough. Commonly used is the Mulberry Leaf and Chrysanthemum Decoction with modifications.
3. Dryness-heat︰Dry cough without phlegm, or cough with scanty phlegm, difficult expectoration, or blood-streaked sputum, accompanied by dry nose and throat, or itchy and sore throat, chills and fever, red tongue tip, thin yellow coating, floating and rapid or slippery and rapid pulse. It commonly occurs in the dry climate of autumn, caused by the invasion of {|###|}autumn dryness{|###|} pathogen damaging the lung, mostly belonging to an excess pattern. Frequently seen in autumn, accompanied by dry nose, dry throat, or itchy and sore throat, chills and fever, red tongue tip, thin yellow coating, floating and rapid or slippery and rapid pulse. Treatment should focus on {|###|}clearing heat and moistening dryness{|###|}, {|###|}resolving phlegm and relieving cough{|###|}. Prescriptions such as {|###|}Mulberry Leaf and Apricot Kernel Decoction{|###|} or Dryness-Clearing Lung-Rescuing Decoction with modifications can be used.
4. Yin Deficiency︰A dry cough without phlegm, persistent over time, or a choking cough with blood, dry throat and mouth, hoarseness, flushed cheeks, and gradual fever in the afternoon. The tongue texture is red with thin, yellow, and dry coating, and the pulse is weak, thin, and rapid. This is caused by a constitution inherently prone to yin deficiency, insufficient lung yin, internal obstruction of phlegm-heat, or after Rebing, the consumption of lung yin and lingering phlegm-heat disrupt the clear descending of qi, belonging to a deficiency pattern. Its symptom and sign characteristics include: a prolonged course, dry cough without phlegm, and obvious symptoms of yin deficiency with internal heat, red tongue texture, thin and rapid pulse, etc. The treatment method should focus on nourishing yin and moistening the lung, relieving cough and calming the fetus. The prescribed formulas are Lily Bulb Metal-Securing Decoction or Lung-Nourishing Donkey-hide Gelatin Decoction with modifications.
5. Damp Phlegm︰Cough with copious sputum, white in color and easy to expectorate, chest and gastric stuffiness, reduced appetite, loose stool, white greasy tongue coating, and soggy slippery pulse. This is a condition of root deficiency and branch excess, often caused by spleen deficiency generating dampness, which accumulates into phlegm, and phlegm-dampness gathering in the lungs, leading to impaired lung qi circulation. The symptoms include copious white sticky sputum, chest and gastric stuffiness, poor appetite, loose stool, and other signs of spleen deficiency with dampness obstruction. The treatment should focus on invigorating the spleen and resolving dampness, regulating the lungs and dispelling phlegm. The recommended formulas are Erchen Pingwei Decoction or Six Gentlemen Decoction with modifications.
6. Deficiency of Both Lung and Kidney︰Cough with shortness of breath, difficulty expectorating phlegm, breathlessness upon exertion, dry throat, tinnitus, dizziness, soreness in the waist, red tongue without coating, and thready rapid pulse. This condition is mostly caused by constitutional weakness, kidney deficiency failing to grasp qi, lung deficiency failing to descend qi, phlegm obstruction internally, and abnormal ascending and descending of qi. Its clinical features include: cough with shortness of breath, difficulty expectorating phlegm, and involuntary urination during coughing. There may also be soreness in the waist, tinnitus, etc. Treatment should focus on tonifying the kidney and nourishing the lung, relieving cough, and calming panting. Prescriptions such as Ginseng-Ophiopogon-Rehmannia Pill or Middle-Tonifying Qi-Replenishing Decoction and Modified Qi-Pill can be used with modifications.

The occurrence of coughing during pregnancy is generally due to a deficiency of lung qi. After conception, the blood gathers to nourish the fetus, leading to yin deficiency and stirring up fire. The fire pathogen then damages the metal element, scorching the lung yin. Alternatively, it may be caused by the stirring of deficient fire in the anus during pregnancy, combined with exposure to wind pathogens, resulting in the lung qi failing in its purifying function. For mild cases, the treatment is not significantly different from that for non-pregnant individuals, except for the cautious use of slippery and descending qi herbs to avoid harming the fetus. For severe cases, it is essential to stabilize the fetal origin while simultaneously treating the cough.

bubble_chart Documentation

1. Zhangshi Yitong．Pregnancy．Cough: "Pregnant women with cough should primarily focus on calming the fetus. If wind evil injures the lung, Xiang Su San should be used; if cold evil injures the lung, Minor Center-Fortifying Decoction should be used; if there is lung and stomach qi deficiency, Extraordinary Efficacy Powder should be used; if there is spleen and lung qi deficiency, Liu Jun Zi Tang with Chinese Angelica should be used. For prolonged cough that does not heal, it is often due to spleen and lung qi deficiency, with the striae and interstices not being dense, leading to repeated external evil invasion, or due to lung deficiency with yin fire flaring upwards. If there is external evil, internally supplement with Angelica Center-Fortifying Decoction plus Asarum; if there is yin fire flaring, use Liu Wei Wan with Ophiopogon Tuber and five flavors."
2. 《Gynecological Classics．Pregnancy Symptoms》: "Quoting Zhu Dan-xi: Cough during pregnancy is caused by the gathering of blood and fluids to nourish the fetus, leading to lung dryness, and is also due to stagnant fire flaring upwards. The method should focus on moistening the lungs, with Asparagus Root Decoction as the main treatment."
3. Jiyin Gangmu．Pregnancy Section．Cough: "A pregnant woman coughed and expectorated phlegm due to anger, with pain in both flanks. This was due to liver fire injuring the lung metal. She was treated with Minor Bupleurum Decoction plus Gardenia, Submature Bitter Orange, White Atractylodes Rhizome, and Poria, and recovered. However, she began to feel nauseous, which was due to the liver insulting the spleen. She was treated with Liu Jun Zi Tang plus Cimicifuga Rhizome and Bupleurum, and recovered."