When cold and cough, many people will choose cough medicine, the corresponding alternative varieties are also many, and there are many cases of combined use, including the combination of traditional Chinese medicine and Traditional Chinese medicine, and the combination of Traditional Chinese medicine and Western medicine. So, is this combination reasonable? Which varieties are not suitable for use?
Today, we start with 12 representative drugs and talk about this matter in detail.
Among the 12 cough medicines, there are 10 proprietary Chinese medicines and 2 Western medicines. The purpose of this choice is to try to build a platform for the overall consideration of Chinese and Western medicine.
Cough (Source Network)
(i)
First of all, we list the names of these 12 cough suppressants, namely: Lianhua Qing plague granules, Tongxuanli lung pills, SuHuang cough capsules, strong loquat dew, compound licorice tablets, three tablets, hemp cough syrup, lung clearing anti-inflammatory pills, expectorant cough granules, Yangyin Qing lung pills, compound fresh bamboo drainage, compound codeine phosphate oral solution.
The reason for choosing these varieties is that one is common and commonly used, and the other is that it has a certain representativeness.
Some people may say, hey, even flower qing plague granules, three pieces should be cold medicine, how did it become a cough medicine? Well, that's the right idea. Among the 12 medicines, some are full-time cough medicines, and some are part-time cough medicines. Full-time cough medicine is specially designed to suppress cough and phlegm and asthma, and basically has no effect of solving the table; while part-time cough medicine, in addition to coughing up phlegm and asthma, also has a certain anti-table effect.
Maybe some people will say, hey, only the compound codeine phosphate oral solution is a Western medicine, where is the second? Well, the second is a compound licorice tablet. The national medicine of compound licorice tablets begins with H, which is a cough medicine administered according to Western medicine. Why choose these two drugs? Because they contain special components of traditional Chinese medicine, they are equivalent to a bridge, which facilitates the discussion of medicinal properties and efficacy.
In fact, we have always had an idea, that is, through these drugs containing special components of Chinese medicine, we can connect Chinese medicine and Western medicine.
Integrative Medicine (Source Network)
Back to the point, let's first list the ingredients and functions of these 12 cough medicines for subsequent discussion and search.
Lianhua Qing plague granules: Forsythia, honeysuckle, hot ephedra, fried bitter almonds, plaster, plate blue root, cotton horse, houttuynia cordata, patchouli, rhubarb, Rhodiola rosea, menthol, licorice. Detoxify the plague, release heat from the lungs. It is used for the treatment of influenza fever poison lung evidence, symptoms: fever or high fever and cold, muscle soreness, nasal congestion and runny nose, cough, headache, dry throat and sore throat, red tongue, moss or yellow greasy, etc. In the conventional treatment of novel coronavirus pneumonia, it can be used for fever, cough, and fatigue caused by mild and ordinary types.
Tongxuanli lung pills: perilla leaf, anthurium, platycodon, bitter almond, ephedra, licorice, tangerine peel, half summer, poria, fried citrus aurantium shell, skullcap. Dissolve the cold, and stop the coughing of the lungs. It is used for cold and cough caused by wind chills and lung qi, and the symptoms are fever, chills, cough, nasal congestion, headache, no sweating, and limb aches.
Su Huang cough capsules: ephedra, perilla leaf, earth dragon, honey loquat leaf, fried perilla seed, cicada molt, front beard, fried burdock seed, schisandra. Ventilate the lungs, cough and throat. It is used for coughing, itching, itching when coughing, itching, or choking cough caused by the lungs and lung qi losses of wind and evil offenders, sudden or aggravated by factors such as shortness of breath, cold air, odor, etc., or coughing in the morning at night, mostly recurrent attacks, dry cough without sputum or less phlegm, thin white tongue and so on. Clinically used for cough after a cold, recurrent cough and cough variant asthma in accordance with the above symptoms. Cough after a cold and cough variant asthma are seen in the above symptoms.
Strong loquat dew: loquat leaf, poppy husk, hundreds, white front, mulberry white peel, platycodon, menthol. Nourish the yin lungs, suppress cough and expectorant. It is used for long cough, bronchitis, etc.
Compound licorice tablets: Each tablet contains licorice flow extract powder 112.5mg, opioid powder 4mg, camphor 2mg, star anise oil 2mg, sodium benzoate 2mg. Used for antitussive expectorant.
Three pieces: ephedra, bitter almonds, licorice, ginger. Lung digestion table. It is used for wind chill attack lung evidence, which shows that the cough is heavy, the cough sputum is more, and the sputum is white and thin; the above symptoms are seen in the mild case of acute bronchitis.
Hemp cough syrup: ephedra, skullcap, perilla leaf, parsnip, houttuynia cordata, forsythia, platycodon, fabanxia, bitter almond, aster, poppy husk, licorice. Cold spreading lungs, clearing heat and dissolving phlegm, cough and asthma, indications for cough table cold fever, symptoms such as cough, sputum cough, wheezing, phlegm, chills, fever, body pain, thirst, red tongue and moss thin white or yellow; suitable for acute bronchitis and chronic bronchitis acute attack period.
Lung clearing and anti-inflammatory pills: ephedra, plaster, ground dragon, burdock seed, amaranth, artificial bovine yolk, bitter almond (fried), antelope horn. Clears the lungs and dissolves phlegm, relieves cough and asthma. For sputum heat blocking, cough and asthma, chest swelling and pain, spitting yellow thick; upper respiratory tract infections, acute bronchitis, acute exacerbations of chronic bronchitis see the above symptoms.
Expectorant cough granules: ginseng, water half summer, coriander flower, sweet fruit, purple flower rhododendron, alum. Healthy spleen dry and wet, expectorant cough. It is mainly used for chronic bronchitis and bronchitis combined with emphysema, pulmonary heart disease caused by sputum, cough, wheezing and other symptoms.
Yangyin lung pills: ground yellow, wheat dong, xuan ginseng, Sichuan shellfish, white peony, peony skin, mint, licorice. Nourish the yin and moisturize, clear the lungs and throat. It is used for yin deficiency and dry lungs, dry throat, dry cough and less sputum.
Compound fresh bamboo drainage: fresh bamboo drainage, houttuynia cordata, raw half summer, ginger, loquat leaf, bellflower stem, menthol oil. Clears heat and dissolves phlegm, relieves cough. For sputum fever cough, sputum yellow viscous.
Compound codeine phosphate oral solution: This product is a compound preparation, and its components are divided into 1 mg of codeine phosphate per 1ml, ephedrine hydrochloride 0.8 mg, chlorpheniramine maleate 0.2 mg, ammonia chloride 22 mg. For sputum-free dry cough and intense, frequent coughs.
With these basic data, we can now compare and analyze.
Cough syrup (source network)
(ii)
Let's first ask the question, what are the reasons why proprietary Chinese medicines cannot be used together?
If you think about it, there are actually only 2 types.
The first is repeated medication, which has a derivative relationship and contains special components, and it is enough to use one.
The second is a drug conflict, there is a drug conflict that affects the effectiveness or safety, and it is enough to use one.
In fact, the drug conflict is only a symptom, and the more essential reason is still a contraindication. What does that mean? If the applicable population of drug A is the unsuitable population of drug B, then drug A and drug B should not be used together. Taste this sentence carefully.
So, what is the combination of the above 12 cough medicines?
It is reasonable to say that to find out the combination of the above 12 cough medicines, according to statistical principles, there are a total of 66 possibilities, and we should analyze these 66 possibilities one by one. But if you write it this way, this article will not be finished. And, if we want to analyze the 13th drug later, we have to do it again, it is too inefficient. Therefore, we do not intend to use this method of analysis, but directly outline the outline, first classify the drugs, and then analyze the relationship between the categories
Classification of cough medicines (source network)
So, so many cough medicines, can be divided into several categories?
First, it is divided into 4 categories.
Why divide into 4 categories? As we all know, when chinese medicine is dialectically discussed, there is a theoretical method called the Eight Principles of Dialectics. It is to divide the disease into 8 different types according to yin and yang, surface, cold and heat, and virtual reality, and each type takes corresponding treatment methods.
Among these 8 attributes, yin and yang are the general principles, deriving the surface, cold and heat, and virtual reality. When the specific classification, the table, cold and heat and virtual reality represent yin and yang, so yin and yang are not used for specific classification, so there are still 6 left. For cough, the disease position is in the lungs, cold cough is even more so, this position is clear, do not need the classification in the table, so there are still 4 left, that is, cold and heat and virtual reality, which is the reason why we are divided into 4 categories, from the disease type attribute.
Among them, cold and heat refer to the cold and hot properties of cough, hot cough or cold cough, which can be seen from the color of phlegm. Virtual reality refers to the amount of sputum, more phlegm is real, less phlegm is virtual, this can be seen from the amount of phlegm.
Therefore, we say that to cure cough is to cure phlegm.
Eight Principles of Dialectics (Source Network)
It should be noted that the virtual reality we define here is designed by anchoring phlegm, not by anchoring cough. If it is designed for cough, then the cough refers to the cough and wheezing caused by the two deficiencies of the lungs and kidneys, and it is necessary to use tonic drugs for the manifestations of systemic symptoms such as shortness of breath and weakness, waist acid and cold. Please make this clear first.
Why don't we anchor coughs to design it? Because of the false cough of lung and kidney deficiency, it is common in chronic diseases such as chronic bronchitis and chronic obstructive pulmonary disease, and is rarely seen in colds and coughs. This time we are mainly targeting colds and coughs.
(iii)
Well, with the above 4 types of certificates, can we classify them next? Don't worry, we say that the above 4 categories are only theoretical derivations, and the actual situation is more complicated. How complicated is that? Right! It is the combination of cold and heat, that is, the combination of virtual and real, and the corresponding treatment method is to use both cold and heat, that is, to treat phlegm cough and cough.
Therefore, from the perspective of cold and heat, we must add cold and heat inclusion certificates in addition to cold certificates and heat certificates, and increase them to 3 attributes. From the perspective of the virtual and real dimensions, we must also add virtual and real mixed evidence in addition to virtual evidence and empirical evidence, and also increase it to 3 attributes. In this way, 3×3 = 9, there are a total of 9 types of evidence, resembling a nine-square grid. The corresponding treatment methods are: cold is cold, heat is clear, real (phlegm more) is expectorant, deficiency (phlegm less) is antitussive, cold and hot are mixed with cold and hot, and phlegm cough is treated together.
To put it more, Xiaojin Yaoshi believes that this complicated operation is actually the basic connotation of "Dao Sheng One, Life Two, Two Birth Three, And Three Life All Things".
Nine Square Grid (Source Network)
Then, we can do a fill-in-the-blank question and fill in the above 12 drugs.
The basis for answering these fill-in-the-blank questions is mainly derived from the functional indications and components of the instructions. On the one hand, functional indications have a description of the medicinal properties of cold and heat dissipation, and also describe the indications for more sputum and less sputum. On the other hand, through the composition of the formula, it is also possible to know which are antipyretic drugs, which are cold dissipation drugs, which are expectorant wet drugs, and which are lung antitussive drugs. Each drug has a different proportion, and the efficacy characteristics of the whole party are also different. Finally, combining these two aspects, we can get the efficacy positioning characteristics of each of the above drugs.
For example, the efficacy of Lianhua Qing plague granules is "qing plague detoxification, lung heat dissipation", and the formula contains ma xing shi gan soup and silver warp powder. Therefore, Lianhua Qing plague is a fever-clearing medicine, and at the same time, sputum cough is treated at the same time.
For another example, the efficacy of Suhuang cough capsules is "wind and lungs, cough and pharynx", and the indications include "dry cough, less phlegm or no sputum". From the perspective of the group, ephedra temperature, perilla leaf temperature, ground dragon cold, loquat leaf slightly cold, perilla seed temperature, cicada metamorphosis cold, front beard slightly cold, burdock cold, schisandra temperature. Therefore, Su Huang cough capsules are cold and hot and medicinal, and at the same time used for less sputum and no sputum.
For another example, the effect of strong loquat dew is "nourishing the yin lungs, suppressing cough and expectorant", which does not indicate cold and heat, and does not indicate more phlegm and less phlegm. From the perspective of cold and heat medicinal properties, loquat leaves are slightly cold, poppy shell flat, hundred parts of micro-temperature, white front micro-temperature, mulberry white skin cold, platycodon flat, peppermint brain cool, is cold and hot and medicinal. From the perspective of efficacy, this medicine contains both poppy shells for lung suppression, hundreds of lungs and cough, expectorant and cough white front, and expectorant and pus-excretion of orange stems, so it is a phlegm cough and a cure.
For another example, the effect of expectorant and cough suppressor granules is "spleen dryness and wetness, expectorant cough", and the indications include "phlegm more", and also contain coriander, sweet sui, which are rarely used for colds and coughs. Therefore, this is a medicine based on expectorant, and the whole prescription is mainly warm.
As another example, the indication of the codeine phosphate oral solution is "no sputum dry cough". The ingredient, codeine, belongs to the opioid alkaloids, is present in the poppy husk, and is flat in terms of the medicinal properties of the poppy husk. Ephedrine is found in ephedra and is temperate in terms of ephedra medicinal properties. At the same time, the side effects of this drug are "commonly dry mouth, constipation, dizziness, palpitations, etc." Considered comprehensively, the whole prescription is calculated as temperature.
Wait a minute...
Using methods such as this, we can complete these 12 cough medicine fill-in-the-blank questions, and the results are as follows:
Classification table of cold and cough medication (made by Xiaojin Pharmacist)
(iv)
After the fill-in-the-blank questions are done, let's discuss which categories are not suitable for use.
First, drugs with duplicate ingredients in the same square belong to the same subclass of efficacy with high similarity and should not be used together. For example, lianhua qing plague granules and lung clearing anti-inflammatory pills should not be combined.
Second, the medicine in line 1 should not be used in combination with the medicine in line 3. Because in general, patients are either sputum-based (more phlegm) or cough-based (less phlegm). For example, sanjiao tablets and Suhuang cough capsules should not be combined, and compound fresh bamboo drainage and Yangyin Qing lung pills should not be combined.
If there is both phlegm and cough, or no more phlegm, it is also very simple, directly according to the cold and heat properties, choose the second line of medicine on the line.
Third, the drugs in column 1 and the drugs in column 3 should not be used together. Because in general, patients are either mainly fever or cold. For example, the three tablets and the lung clearing anti-inflammatory pills should not be used together, and the Tongxuanli lung pills and compound fresh bamboo drainage should not be combined.
If the patient has both cold and heat, or a mixture of cold and heat, it is also very simple, directly according to the phlegm more phlegm less, choose the drug in column 2.
Fourth, the drugs in line 2 and the drugs in column 2 have the ability to solve the problems of cold and heat inclusion or sputum cough, and are generally not used in combination with other rows or columns of drugs. For example, Lianhua Qing plague granules and Su Huang cough capsules should not be combined, and strong loquat dew and Tongxuanli lung pills should not be combined.
However, if it is necessary to use it in special circumstances, it is recommended that the ingredients are not duplicated and the dosage should be reduced.
This is the discussion about the combination of cough medicines. You can see that according to these rules, many cough medicines are not suitable for combination, and some cough medicines need to be reduced even if they can be used together.
Therefore, please remember that cough medicine is generally used alone, whether it is Chinese medicine or Western medicine. So many cough medicines, even if your condition is complex, you can generally find the right variety.
Need to remind everyone again, here is talking about the cold cough in the lungs. If it is the kind of cough that makes people cough in all parts, it is another problem.
Reducing medication is the greatest rational use of drugs (source network)
Well, at this point, the problems of this issue are basically finished. Add 2 points.
First, if we have a new cough medicine and need to discuss the problem of combining with other cough medicines, then please do a fill-in-the-blank question and fill it in the nine palaces just now. This not only clarifies the problem of joint use, but also clarifies the characteristics of efficacy and the scope of use.
Second, let's take a look at the 2 Western medicines in this table, compound licorice tablets and compound codeine phosphate oral solution. Both drugs are distributed in column 1, one in antitussive cubes and one in sputum cough and cures cubes. In fact, if we include more Western medicine, no matter which variety, it can only be filled in these two squares. This shows that for the treatment of cough, the variety of Western medicine may not be rich enough, the role is relatively single, and the ability to deal with complex problems is lacking. The flexibility brought about by the compatibility of traditional Chinese medicines has enriched the distribution of therapeutic drugs and filled the nine palace grids.
Therefore, cough is an absolute dominant disease of Traditional Chinese medicine, no matter what kind of cough, as long as the right Chinese medicine is selected, the medicine and disease are similar, it will be as effective as a drum.