"Simple chronic bronchitis" refers to a productive cough for at least 3 months of the year for 2 consecutive years. It af-fects 10 to 25 per cent of the adult population. Cough with sputum production is more common in men than in women and more common in persons over the age of 40 than in younger in-dividuals. All forms of chronic bronchitis are strongly linked to cigarette smoking. Thus, a large proportion of cigarette smok-ers, particularly those over age 45, fit the diagnostic criteria for simple chronic bronchitis. Some occupations (e. g., those involving dust, handling grain, and mining) are associated with an abnormally high incidence of chronic bronchitis, even after statistics are corrected for smoking habits. Few individu-als with simple chronic bronchits consult a physician, and then the visit is usually prompted by acute or recurrent respiratory tract infections or wheezing in addition to chronic cough. Chronic asthmatic bronchitis tends to develop in elderly indi-viduals, most commonly, they are smokers.
Three direct effects of inhaling bronchial irritants cause chronic bronchitis:1. stimulation of mucus secretion in the air-ways, 2. impaired mucus clearance due in part to interference with ciliary activity, and 3. lowered resistance to bronchopul-monary infection because of disturbed alveolar macrophage function. Cough develops owing to accumulation of secretions. As a result of bacterial colonization by organisms usually found in the nasopharynx, normally sterile bronchi now harbor or-ganisms.
Although cigarette smoking is the most important of the identifiable causal factors, not all smokers experience mucus hypersecretion, and no more than 15 to 20 per cent develop airflow obstruction. Little is known about the reasons for the variable susceptibility to hypersecretion and airflow obstruction in smokers or why reversible airways obstruction develops in many patients with chronic bronchitis. Retention of secretions may be a major factor in some instances. Immunologic factors and other mediators of bronchoconstriction may play a role, since some patients have subacute or chronic bronchospasm re-sembling classic asthma.
Differentiation and Treatment of Common Syndromes in Traditional Chinese Medicine
1. Interior Retension of Phlegm with Exopathic Cold:
Clinical manifestations: Cough with whitish thin sputum, dyspnea, or accompanied with chills and headache, whitish and moist fur of the tongue, string-like and tight or floating and tight pulse.
Therapeutic method: Relieving exterior syndrom and warming the interior organs, ventilating the lung to resolve phlegm retention.
Recipe: Xiao Qing Long Tang, modified
Ingredients:
Herba Ephedrae 6g
Ramulus Cinnamomi 6g
Fructus Schisandrae 10g
Radix Paeoniae Alba 3g
Herba Asari 10g
Rhizoma Pinelliae 6g
Rhizoma Zingiberis 12g
Flos Farfarae 6g
Radix Glycyrrhizae 6g
Administration: All the above drugs are to be decocted in water for oral administration.
Modification: In case of cough with profuse sputum which is whitish and mucous, feeling of fullness and distress in the chest, anorexia, abdominal distension, all these suggest that the accumula-tion of phlegm-dampness is in the lung, add
Exocarpium Cirri Reticulatae 15g
Poria 10g
Fmctus Perillae 10g
Cortex Magnoliae Officinalis 10g
Rhizoma Atractylodis 12g
