Traditional Chinese medicine believes that this disease falls under the categories of "cough," "phlegm-fluid retention," and "wheezing syndrome." It is closely related to the repeated invasion of external pathogens and the dysfunction of the lungs, spleen, and kidneys. In the acute stage of attack, it is mostly caused by external pathogens invading the lungs and the failure of lung qi to purify, leading to cough. Chronic cough disease damages the lungs, resulting in lung qi deficiency, which further impairs the functions of the spleen, kidneys, and heart. Spleen deficiency leads to the inability to transport and transform water-dampness, causing dampness to condense into phlegm, which then affects the lungs. The failure of lung qi to disperse results in coughing, while phlegm obstructing the lungs or the failure of the kidneys to receive qi leads to wheezing. Therefore, the chronic and lingering stage is often characterized by insufficient healthy qi or a complex syndrome of deficiency and excess.

bubble_chart Modern Research

Chronic bronchitis is a chronic non-specific inflammation of the tracheal and bronchial membranes caused by reduced local defense and immune function of the respiratory tract, and stimulation by factors such as infection, physical and chemical agents, and climate. Clinically, it is characterized by cough, sputum production, or accompanied by wheezing, and a chronic process of recurrent episodes. Based on the condition, it can be divided into the acute stage of attack, chronic protracted stage, and clinical stage of remission

Modern medicine believes that this disease is caused by the interaction of multiple factors. External factors include viral or bacterial infections, air pollution, smoking, climate changes, and sensitizing factors; internal factors include reduced immune function, allergic reactions, autonomic nervous system dysfunction, and genetic factors. The pathological changes involve early glandular hyperplasia in the trachea and bronchi, hyperactive secretion, congestion, edema, and exudation of the membrane, eventually leading to thickening of the bronchial walls, narrowing and obstruction of the lumen, and tissue fibrosis, which in turn leads to lung qi swelling.

Medical history: Patients often have a long history of recurrent cough.

Symptoms: Mainly characterized by cough, sputum, wheezing, and inflammation. Acute attacks or exacerbations are often triggered by sudden climate changes or upper respiratory infections during autumn and winter. Purulent yellow sputum may appear, accompanied by fear of cold, fever, and wheezing. Patients with chronic obstructive lung qi swelling may experience difficulty breathing and cyanosis.

Signs: Long-term sufferers may exhibit barrel chest, generally weakened breath sounds on auscultation, and distant heart sounds. In cases of infection, wet rales and wheezing sounds may be heard at the base of the lungs. Severe patients may have clubbing of the fingers.

X-ray examination: May show thickening, disorganization, or deformation of lung markings. In cases complicated by lung qi swelling, the translucency of both lungs increases, and the diaphragms are low and flat.

bubble_chart Pattern Analysis

1. Wind-cold Invading the Lung︰Severe cough, fear of cold with cold limbs, or pale complexion, even inability to lie flat due to coughing and wheezing, affecting sleep. Profuse white and thin sputum, no thirst, preference for hot drinks, clear and abundant urine. Pale red tongue with white greasy coating, slippery or wiry and slow pulse. Disperse wind and dissipate cold, resolve phlegm and relieve cough. Modified Belamcanda and Ephedra Decoction combined with Sun Euphorbia Decoction. Belamcanda 12g, roasted Aster 12g, Platycodon Root 10g, roasted Ephedra 10g, Sun Euphorbia 10g, Pro Formula Pinellia 10g, Peucedanum 10g, Dried Tangerine Peel 12g, roasted Cultivated Purple Perilla Fruit 10g, Liquorice Root 5g. For exterior cold excess pattern, replace with raw Ephedra 10g; if no sweating, add Cinnamon Twig 10g; for loose stool, remove roasted Cultivated Purple Perilla Fruit and add Fresh Ginger Rhizome 2–3 slices; if accompanied by thirst, yellow tongue coating, or red tongue tip, add Skullcap Root 10g; for those with stomach issues, remove Sun Euphorbia.
2. Wind-heat Invading the Lung︰The phlegm is yellow and turbid or white and sticky, difficult to expectorate. There is a slight fever with wind-cold, or soreness in the limbs, sore throat, thirst with a preference for cold drinks, dark and scanty urine, and constipation. The tongue is red with a yellow, greasy coating, and the pulse is floating and rapid or slippery and rapid. The treatment involves dispersing wind and releasing the exterior, clearing heat, and resolving phlegm. Modified Lonicera and Forsythia Powder is used, consisting of Lonicera 15g, Forsythia 12g, Skullcap Root 12g, Bamboo Juice 10g, Peucedanum 10g, Pro Formula Pinellia 10g, Submature Bitter Orange 12g, fresh Reed Rhizome 15g, Lophatherum Herb 6g, Platycodon Root 10g, Schizonepeta 5g, and raw Liquorice Root 5g. If phlegm-heat is severe or alternating chills and fever are present, add Bupleurum 12g, increase Skullcap Root to 15g, Lonicera to 15g, and Forsythia to 15g. For wheezing and inability to lie flat, add roasted Ephedra 10g and Earthworm 15g. For constipation, remove Submature Bitter Orange and add raw Rhubarb Rhizome 15g and Immature Orange Fruit 12g.
3. Dryness-heat Damaging Lung︰Dry cough with little or sticky sputum that is difficult to expectorate, dry nose and throat, severe cough may cause chest pain, blood-streaked sputum, or accompanied by aversion to cold, fever, and other exterior patterns. The tongue is dry and red with scant moisture, thin yellow coating, and floating rough or thin rapid pulse. Treatment involves clearing lung heat with cool herbs, moistening dryness, and resolving phlegm. Modified Mulberry Leaf and Apricot Kernel Decoction is used: Mulberry Leaf 10g, Cape Jasmine Fruit 10g, Coastal Glehnia Root 10g, Bitter Apricot Seed 10g, Thunberg Fritillary Bulb 10g, Fermented Soybean 6g, fresh pear peel 10g, Skullcap Root 10g, Trichosanthis Fruit peel 10g. For severe heat and significant fluid depletion, add Raw Gypsum 20–30g (to be decocted first), Ophiopogon Tuber 15g, and Anemarrhena 12g. For severe constipation, add Scrophularia Root 12g and Trichosanthes Seed 10g.
4. Lung Qi Deficiency︰The cough sounds clear, often a single cough or intermittent cough, more severe during the day than at night, with thin and clear sputum, white in color and scanty in amount, or accompanied by chest tightness, breathlessness, susceptibility to sweating and wind, and frequent common cold. The tongue is pale red with thin white coating, and the pulse is wiry, thin, and weak. The treatment involves tonifying the lung and replenishing qi, strengthening the exterior and resolving phlegm. Modified Jade Screen Powder combined with Sun Euphorbia Decoction is used. The prescription includes Astragalus Root 20g, White Atractylodes Rhizome 10g, Saposhnikovia Root 12g, Sun Euphorbia 10g, Peucedanum 12g, Pinellia Rhizome (processed) 10g, Bitter Orange (submature) 10g, Aster Root 12g, Platycodon Root 6g, Dried Tangerine Peel 10g, and Liquorice Root 5g. If there are symptoms of aversion to cold, fever, or other exterior patterns, add roasted Ephedra 10g and Fresh Ginger Rhizome 2–3 slices. For severe cough, add Coltsfoot Flower 12g and Stemona Root 10g.
5. Spleen Deficiency with Phlegm Retention︰The cough is heavy and turbid, often occurring in bouts, with copious white, sticky, or thin and clear phlegm. It worsens at night and is milder during the day, accompanied by chest and abdominal tightness and fullness, a puffy and pale complexion, and loose stools. The tongue texture is pale or swollen and tender with tooth marks on the edges, and the coating is white or white and greasy. The pulse is soggy and slippery. The treatment focuses on tonifying qi, strengthening the spleen, resolving phlegm, and relieving cough. Modified Chenxia Liujunzi Decoction is used, consisting of: Heterophylly Falsestarwort Root 25g, White Atractylodes Rhizome 12g, Poria 15g, Dried Tangerine Peel 12g, Processed Pinellia 10g, Platycodon Root 10g, Bitter Apricot Seed 10g, Bamboo Shavings 10g, Tangerine Pith 6g. For severe phlegm, add Cultivated Purple Perilla Fruit 10g and Inula Flower 10g (wrapped for boiling). For poor appetite, add Villous Amomum Fruit 10g and White Cardamom Seed 10g. For chest tightness, abdominal distension, and fullness, add Submature Bitter Orange 15g and Magnolia Bark 12g.
6. Failure of Kidney to Receive Qi︰Panting upon exertion, shortness of breath, low and paroxysmal cough (especially at night), expectoration of white, thin, or sticky sputum in large amounts, often accompanied by chest tightness, wheezing in the throat, and even nocturnal asthma preventing lying flat, fear of cold, cold back, soreness and weakness in the lower back and knees. The tongue is pale and swollen with tooth marks on the edges, and the pulse is deep, thin, and weak. Treatment involves warming the kidney to improve qi reception, resolving phlegm, and relieving asthma. Modified Golden Chamber Kidney Qi Pill is used: Cassia Bark 15g, Prepared Aconite Root 10g (to be decocted first), Unprocessed Rehmannia Root 15g, Asiatic Cornelian Cherry Fruit 20g, Chinese Yam 20g, Tree Peony Bark 10g, Poria 20g, Alisma 10g, Schisandra Fruit 10g, Psoralea 15g, Walnut Kernel 15g. For severe illness and physical weakness, add Ginseng 10–15g and Tokay Gecko 10g; for phlegm and qi stagnation, add Cultivated Purple Perilla Fruit 12g, Dried Tangerine Peel 10g, and Prepared Pinellia 10g; if accompanied by cyanosis of the lips, tongue, or nails and an irregular pulse, add Salvia 12g, Sichuan Lovage Rhizome 12g, and Red Peony Root 10g.
7. Lung-kidney Yin Deficiency︰Dry cough with little or sticky sputum that is difficult to expectorate, shortness of breath that worsens with activity, dry mouth and throat, vexing heat in the chest, palms, and soles, tidal fever, night sweats, dizziness, blurred vision, sore lower back, and weak legs. The tongue is red with scant coating or peeled and lacking moisture, and the pulse is thin and rough or thin and rapid. The treatment involves nourishing yin and moistening the lungs, relieving cough, and resolving phlegm. Modified Lily Bulb Metal-Securing Decoction is used, consisting of: Unprocessed Rehmannia Root 15g, Prepared Rehmannia Root 15g, Schisandra Fruit 12g, Lily Bulb 20g, Scrophularia Root 10g, Ophiopogon Tuber 30g, Coastal Glehnia Root 30g, Tendrilleaf Fritillary Bulb 10g, Mulberry Leaf 10g, Aster Root 12g, Coltsfoot Flower 10g. For cough with shortness of breath, add Chebulic Fruit 10g and Tokay Gecko 5g (ground and taken orally). For tidal fever, add Leaf of Leatherleaf Mahonia 15g and Neopicrorhiza 6g. For night sweats, add Smoked Plum 12g and Light Wheat 15g. For yellow, sticky sputum, add Clam Shell Powder 10g, Anemarrhena 12g, and Wild Buckwheat Root 10g. For blood-streaked sputum, add Moutan Bark 10g, Gardenia 6g, Hairyvein Agrimonia Herb 20g, and Donkey-hide Gelatin 10g (melted and taken separately).
8. Deficiency of Both Yin and Yang︰Shortness of breath upon exertion, lack of qi, reluctance to speak, cold body and limbs, dizziness, palpitations, spontaneous sweating, night sweats, spermatorrhea and impotence in men, menstrual irregularities or amenorrhea in women. Red tongue with little coating or pale, swollen tongue with tooth marks, faint and rapid pulse, or weak and rootless pulse. Nourish yin and tonify yang, replenish qi, and activate blood. Modified Great Life-Endowing Pill with Human Placenta. Ginseng 10g (stewed separately), White Atractylodes Rhizome 10g, Chinese Angelica 10g, Milkwort Root 6g, Deer Horn 10g, Sour Jujube 15g, Honey-fried Astragalus Root 30g, Peony Root 20g, Chinese Yam 30g, Barbary Wolfberry Fruit 15g, Human Placenta 20g, Euryale Seed 12g, Prepared Rehmannia Root 15g. For those with hemoptysis, tidal fever, and night sweats, remove Deer Horn and Human Placenta, and add Donkey-hide Gelatin 15g (melted and taken separately), Anemarrhena 12g, Phellodendron Bark 10g. For obvious cold limbs and edema, add Cinnamon Twig 12g, Prepared Aconite Lateral Root 10g, Dried Ginger 6g.