Volume 2,Issue 1
Research on Clinical Efficacy and Immunomodulatory Mechanisms of an Integrated Traditional Chinese and Western Medicine Approach for Treating Chronic Cough Based on the “Concurrent Treatment of Lung and Spleen” Theory
Objective: This study aims to explore the clinical efficacy of an integrated traditional Chinese and Western medicine approach for treating chronic cough based on the “concurrent treatment of lung and spleen” theory and to conduct an in-depth analysis of its immunomodulatory mechanisms, including the balance of T lymphocyte subsets, regulation of immunoglobulin levels, and associated molecular pathways. This research seeks to provide new insights and evidence-based foundations for the clinical treatment of chronic cough. Methods: A total of 120 patients with chronic cough who were treated in the hospital from January 2023 to June 2024 were selected and randomly divided into an observation group and a control group using a random number table method, with 60 patients in each group. The control group received standardized Western medical treatment (budesonide/formoterol powder inhaler combined with montelukast sodium tablets), while the observation group received traditional Chinese medicine syndrome differentiation treatment based on the “concurrent treatment of lung and spleen” theory (self-formulated Yiqi Jianpi Runfei Decoction with modifications) in addition to the control group’s treatment. Both groups were treated continuously for 8 weeks. The cough symptom scores, cough visual analog scale (VAS) scores, and quality of life scores (LCQ) were compared between the two groups before and after treatment. Peripheral blood immune indicators [CD3+, CD4+, CD8+, CD4+/CD8+, immunoglobulin G (IgG), immunoglobulin A (IgA), immunoglobulin M (IgM)] and levels of related cytokines (IL-4, IFN-γ, TNF-α) were measured before and after treatment. The clinical efficacy and incidence of adverse reactions were statistically analyzed, and subgroup analyses were conducted based on age and disease duration. Results: After 8 weeks of treatment, the overall effective rate in the observation group was 93.33% (56/60), significantly higher than that in the control group, which was 76.67% (46/60), with a statistically significant difference (P < 0.05). Subgroup analysis revealed that the observation group demonstrated superior therapeutic effects compared to the control group across different age and disease duration subgroups (P < 0.05). Both groups showed a significant reduction in cough symptom scores and cough VAS scores, along with a significant increase in LCQ scores compared to pre-treatment levels. Moreover, the magnitude of improvement in the observation group was superior to that in the control group, with statistically significant differences (P < 0.05). Peripheral blood levels of CD3+, CD4+, CD4+/CD8+, IgG, and IgA significantly increased in both groups, while CD8+ levels significantly decreased post-treatment. The observation group exhibited a greater degree of improvement in immune indicators compared to the control group, with statistically significant differences (P < 0.05). Additionally, the observation group showed a significant reduction in IL-4 and TNF-α levels and a significant increase in IFN-γ levels compared to pre-treatment, with statistically significant differences compared to the control group (P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion: The integrated traditional Chinese and Western medicine approach based on the “simultaneous treatment of lung and spleen” theory demonstrates definite clinical efficacy in treating chronic cough. It significantly improves cough symptoms and quality of life in patients across different subgroups. Its mechanism of action may be related to regulating immune function, balancing T lymphocyte subsets, modulating immunoglobulin levels, and regulating relevant cytokine pathways. With good safety, this approach is worthy of clinical promotion and application.
[1] Asthma Group of Respiratory Disease Branch, Chinese Medical Association, 2022, Guidelines for the Diagnosis and Treatment of Cough (2021). Chinese Journal of Tuberculosis and Respiratory Diseases, 45(1): 13–46.
[2] Zhao J, Li N, 2020, Changes in T-lymphocyte Subsets and Immunoglobulin Level in Patients with Chronic Cough. Journal of Clinical Pulmonary Medicine, 25(9): 1365–1368.
[3] Chen M, Liu Y, 2022, Research on the Role and Intervention of Immune Dysfunction in the Pathogenesis of Chronic Cough. Chinese Journal of Immunology, 38(10): 1235–1238.
[4] Li Y, Zhang QX, 2022, Research on the Correlation between Changes in Immune Function and Inflammatory Factor Levels and Traditional Chinese Medicine Syndromes in Patients with Chronic Cough. Journal of Emergency in Traditional Chinese Medicine, 31(8): 1405–1408.
[5] Li J, Wang Q, 2021, Advances in Western Medicine Treatment of Chronic Cough. Journal of Clinical Pulmonary Medicine, 26(8): 1276–1280.
[6] Wang H, Zhang M, 2022, Adverse Reactions and Countermeasures of Long-term Use of Glucocorticoids in the Treatment of Chronic Cough. Journal of Clinical Rational Drug Use, 15(12): 172–174.
[7] Respiratory Disease Branch of the Chinese Medical Association, 2024, Guidelines for the Diagnosis and Treatment of Chronic Cough in China (2025 Version Draft for Comments). Chinese Journal of Tuberculosis and Respiratory Diseases, 47(5): 385–413.
[8] Zhang JY, 2007, Complete Works of Jingyue. People’s Medical Publishing House, Beijing.
[9] Zhou ZY, 2021, Internal Medicine of Traditional Chinese Medicine. China Press of Traditional Chinese Medicine, Beijing.
[10] Wu LL, Li ZG, 2020, Exploration of the Modern Immunological Mechanism of the Theory of “Lung-Spleen Correlation” in Traditional Chinese Medicine. Chinese Journal of Traditional Chinese Medicine, 35(11): 5568–5571.
[11] Liu M, Zhao J, 2022, Discussion on the Efficacy and Mechanism of Traditional Chinese Medicine Decoction Based on the Theory of “Simultaneous Treatment of Lung and Spleen” in the Treatment of Chronic Cough. Journal of Traditional Chinese Medicine, 50(3): 67–70.
[12] Zhang L, Wang P, 2021, Meta-analysis of Clinical Efficacy of Integrated Traditional Chinese and Western Medicine in the Treatment of Chronic Cough. Chinese General Practice, 24(S1): 12–16.
[13] Wang YL, Zhang HX, 2021, Clinical Observation of Yiqi Jianpi Runfei Decoction in the Treatment of Chronic Cough (Deficiency of Both Lung and Spleen Syndrome). Journal of Emergency in Traditional Chinese Medicine, 30(5): 876–878.
[14] Wang HY, Liu QQ, 2023, Current Research Status and Reflections on the Integrated Traditional Chinese and Western Medicine Treatment of Chronic Cough. Chinese Journal of Integrated Traditional Chinese and Western Medicine in Emergency, 30(2): 247–249.
[15] Asthma Group of Respiratory Disease Branch, Chinese Medical Association, 2022, Guidelines for the Diagnosis and Treatment of Cough (2021). Chinese Journal of Tuberculosis and Respiratory Diseases, 45(1): 13–46.
[16] State Administration of Traditional Chinese Medicine, 1994, Diagnostic Efficacy Criteria for Traditional Chinese Medicine Diseases. Nanjing University Press, Nanjing.
[17] Sun YC, 2023, Western Medicine Treatment Strategies and Controversies for Chronic Cough. Chinese Journal of Tuberculosis and Respiratory Diseases, 46(3): 221–224.
[18] Zhang Y, Li J, Wang Y, et al., 2022, Clinical Efficacy and Immune Regulation Mechanism of Yiqi Jianpi Runfei Decoction Combined with Western Medicine in the Treatment of Chronic Cough. Journal of Ethnopharmacology, 2022(298): 115089.
[19] Chen ZQ, Yang GL, 2021, Effects of the Method of Replenishing Qi and Invigorating the Spleen on Immune Function and Intestinal Flora in Rats with Spleen Deficiency Model. Chinese Journal of Integrated Traditional and Western Medicine, 41(9): 1105–1110.
[20] Writing Group of the Guidelines for the Diagnosis and Treatment of Cough (2021), 2022, Expert Consensus on the Application of Cough Symptom Score in the Evaluation of Therapeutic Effect of Chronic Cough. Chinese Journal of Tuberculosis and Respiratory Diseases, 45(8): 673–676.
[21] Li M, Chen P, 2020, Application Value of Visual Analogue Scale in the Assessment of Chronic Cough Symptoms. Journal of Clinical Military Medicine, 48(7): 826–827.
[22] Liu CT, Wang CZ, Wang C, et al., 2008, Reliability and Validity Evaluation of the Chinese Version of the Leicester Cough Questionnaire. Chinese Journal of Tuberculosis and Respiratory Diseases, 31(11): 807–810.
[23] Wang C, Zhan QY, 2022, Interpretation of Guidelines for the Diagnosis and Treatment of Respiratory Diseases. People’s Medical Publishing House, Beijing.
[24] Cao XM, He QY, 2023, Selection and Application of Evaluation Indicators for Immune Function in Patients with Chronic Cough. Chinese Journal of Lung Diseases (Electronic Edition), 16(1): 112–115.
[25] National Medical Products Administration, 2020, Guiding Principles for Clinical Research of New Traditional Chinese Medicine Drugs (2020 Edition). China Medical Science and Technology Press, Beijing.
[26] Liu J, Zhang H, Wang L, et al., 2023, Safety and Efficacy of Integrated Traditional Chinese and Western Medicine for Treating Chronic Cough: A Systematic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine, 2023: 7896432.
[27] Chen Y, Li JS, 2020, Research Progress on the Pathogenesis of Chronic Cough. Chinese Journal of Integrated Traditional and Western Medicine, 40(7): 886–890.
[28] Li MH, Yin KS, Cai YY, 2018, Diagnosis and Treatment of Chronic Cough. People’s Medical Publishing House.
[29] Huang XS, Hu YM, 2019, Research on the Correlation between the Theory of “Lung-Spleen Correlation” in Traditional Chinese Medicine and Immune Function. Chinese Journal of Basic Medicine in Traditional Chinese Medicine, 25(7): 921–923.
[30] Wang L, Zhang NZ, 2021, Study on the Mechanism of Regulating Immune Function in Patients with Chronic Cough by the Method of Replenishing Qi and Invigorating the Spleen. Journal of Information on Traditional Chinese Medicine, 38(4): 56–59.
[31] Zhao D, Li JS, 2022, Effects of Yiqi Jianpi Huatan Prescription on Airway Inflammation and TLR4/NF-κB Signaling Pathway in Rats with Chronic Cough Model. Chinese Journal of Experimental Traditional Medical Formulae, 28(12): 56–62.
[32] Wang J, Liu ZD, 2021, Clinical Characteristics and Therapeutic Effect of Integrated Traditional Chinese and Western Medicine in Elderly Patients with Chronic Cough. Chinese Journal of Gerontology, 41(19): 4235–4238.
[33] Huang W, Zhang Y, 2023, Mechanism Study of Astragalus Polysaccharide in Regulating the Balance of T Lymphocyte Subsets in Patients with Chronic Cough through the JAK/STAT Pathway. Chinese Pharmacological Bulletin, 39(7): 1324–1329.
[34] Li J, Chen M, 2024, Research Progress on Target and Mechanism of Active Components of Traditional Chinese Medicine in Treating Chronic Cough. Chinese Traditional and Herbal Drugs, 55(3): 897–905.