Post-infectious cough of different syndromes treated by traditional Chinese medicines: A review

Abstract

The application of traditional Chinese medicines (TCMs) has a history of more than 2000 years, which have the characteristics of multi-component, multi-target, and high safety. Post-infectious cough (PIC) is a respiratory disease with high incidence. It belongs to subacute cough and accounts for as much as 40%–50%. Cough is the main clinical manifestation of PIC. PIC seriously affects people's life quality because of complex etiology, long-term course of disease, treatment difficulties and other characteristics. Western medicines are based on the principle of symptomatic treatment, so they are often difficult to control PIC fundamentally. These factors could due to that PIC is prolonged and unable to heal repeatedly. TCMs have obvious advantages in treating PIC, with accurate curative effects, less side effects and adverse reactions and are effective in improving PIC-related symptoms and indicators, enhancing patients' life quality and reducing pain. TCMs, guided by holistic concept and syndrome differentiation, advocate determine treatment on the basis of pattern types, and have remarkable clinical treatment effects. As for TCMs etiology, pathogenesis and syndrome types of PIC, TCM scholars have not yet reached a unified standard. However, most of them think that wind pathogen can cause PIC alone, or it can be combined with other evils, which might be the main mechanism of PIC. This paper discusses the advantages and limitations of TCMs in PIC treatment from etiology, pathogenesis, distribution of syndrome types and treatment of TCMs. This article focuses on the treatment methods and pharmacodynamic material basis of wind pathogen, providing ideas in treating PIC of TCMs clinically and innovative drug development.

1. Introduction

Post-infectious cough (PIC) refers to a cough lasting for 3–8 weeks after experiencing the acute symptoms of an upper respiratory tract infection (Mehrabi, 2016, Kwon et al., 2006, Lai and Nie, 2014). The main characteristics of PIC are that cough still persists, which the main manifestation is irritant dry cough or cough with a small amount of white mucus sputum, after the symptoms of the acute phase of respiratory tract infection disappear. In addition, the patients' chests radiographs findings are negative (Braman, 2006, Hu et al., 2016). According to studies of unselected adult patients with a history of upper respiratory tract infection, the proportion of PIC symptoms increased from 11% to 25%, while the incidence of Mycoplasma pneumoniae and Bordetella pertussis outbreaks can increase from 25% to 50% (Braman, 2006). Compared with adults, the incidence of PIC is higher, accounting for 39.4% of children with long-term cough, which is a common cause of chronic cough in children and preschool children (Xiong, Wan, Huang, Lin & Wu, 2019). PIC seriously perplexes people's daily work and reduces patients' life quality because of its complicated etiology, delayed healing and other characteristics.

The pathogenesis of PIC is still unknown in Western medicines, and many scholars generally believe that the incidences of PIC are closely related to airway epithelial mucosal injury, airway inflammation, airway hyperresponsiveness, cough reflex sensitivity, gastroesophageal reflux (Braman, 2006). Up to now, there is no specific treatment for PIC in clinical practice, and symptomatic treatment is mainly used, including antitussive agents, antihistamines and decongestants (Hu, Zhao, & Cui, 2016). However, these drugs often produce inevitable side effects, such as drowsiness, dry mouth, loss of appetite, nausea, constipation, easy recurrence after drug withdrawal (Zhang, Tang, Fang, & Yu, 2017), which bring additional pain to patients.

Although the different planting areas and harvest seasons of traditional Chinese medicines (TCMs) may lead to different components and quality, and then affect efficacy, the effectiveness and relative safety of TCMs have been shown by the long-term use of human beings. TCMs often used to treat some refractory diseases, such as hypertension, diabetes and chronic obstructive pulmonary disease (Zhang et al., 2021, Xia et al., 2018, Zhang et al., 2019). Recently, there have been more reports that TCMs have achieved remarkable results for clinical treatment of PIC. Traditional ancient prescriptions such as Maimendong Decoction, Xiaoqinglong Decoction and their modified prescriptions exhibited potential in treating PIC clinically. Modern Chinese patent medicines represented by Suhuang Zhike Capsule have also been widely used in the clinical treatment of PIC (Ding et al., 2016, Hu et al., 2016, Li et al., 2016, Xue and Zhu, 2016, Zhang et al., 2017).

According to theoretical system, etiology and pathogenesis of TCM, this paper systematically introduces the research progress of treating PIC with TCMs. Based on the guiding ideology of determine treatment on the basis of pattern types, this article analyzes the commonness and characteristics of PIC research in TCMs treatment. Although there is no uniform standard for TCM etiology, pathogenesis and syndrome types distribution of PIC, most physicians believe that wind pathogen is the main pathogenic factor leading to PIC. To provide theoretical references for treating PIC with TCMs, this review further discusses the treatment rules and pharmacodynamic material basis of PIC caused by wind pathogen order. Meanwhile, it supplies ideas for clinical treatment of PIC with TCMs and innovative drug development.

2. TCM etiology and pathogenesis of PIC

There are little disease names corresponding to PIC in ancient Chinese medicine books. According to the symptoms and medical history of PIC, modern Chinese medicine practitioners often classify PIC as “exogenous cough”, “obstinate cough”, “lasted cough” and “wind cough”. Modern Chinese medicine physicians have different understandings of PIC etiology and pathogenesis, and there is no unified standard of TCM pathogenesis at present. Chao proposed the theory of “wind cough” (Yang and Chao, 2014, Feng et al., 2016). Clinically, the cough with “no or less sputum” is the main manifestation, with the characteristics of paroxysmal and irritating cough, which is similar to the symptoms of PIC. He considered that the main pathogenic factor of PIC is wind pathogen, and advocates treating PIC from wind. Shi thought that PIC is often caused by exogenous wind pathogen (Shi, Lin, Ma, Wang, & Ji, 2016). With the development and treatment of the disease, although the exterior syndrome is gradually eliminated, the remaining evil is not extirpated. When stimulated by cold wind and peculiar smell, it can induce cough. In addition, PIC is often accompanied by internal injury pathogenesis, which also causes disease with other evils. Wu found that the incidence of PIC may be related to the early frequent use of antibiotics or excessive use of heat-clearing and detoxification TCMs (Wu et al., 2013). The main pathogenesis is exogenous pathogens attacking the lung, which causes impairment of dispersing and descending function of the lung (difficult to breathe, not smooth). After that, the illness is mistreatment, and the pathogenic Qi remains inside, which leads to the deficiency of vital Qi (decline in resistance) and the disease is prolonged and unhealed. Chen et al believed that the occurrence and development of PIC are related to the patient constitution, and the constitution type is connected with the sensitivity and tolerance of the body to external pathogenic factors (Kan and Chen, 2018, Kan et al., 2018). Qian et al. proposed that PIC is in Shaoyang (It has the meaning of weakening Yang Qi. Its position is half exterior and half interior, that is to say, Shaoyang plays a pivotal role between the two Yang Meridians), and the basic pathogenesis is dysfunction of acting as a pivot (hinder normal physiological function) and lung-Qi being unable to descend (Hong et al., 2020, Zhang, 2020a, Wang and Zhu, 2014). Zhu believed that PIC includes post-cold cough and persistent infectious cough, with different pathogenesis and treatment rules (Dai & Zhu, 2018). In conclusion, most TCM practitioners believe that wind pathogen is the main pathogenic factor of PIC. Although the TCM etiology and pathogenesis of PIC have not been unified, it is explained in two ways: exogenous and internal injuries. One part thinks it is caused by wind pathogen or wind pathogen combined with other evils, and the other part believes that it is too deficient to resist the disease caused by exogenous pathogens.

3. TCM clinical types of PIC

According to the clinical symptoms of PIC and the clinical experience of TCM, PIC is classified dialectically. Jiang studied the clinical symptoms of 200 patients with PIC and summarized the TCM clinical types (Jiang, Liu, & Mao, 2016). The results showed that PIC mainly had four TCM syndrome types, namely wind-cold evil tightening the lung, wind-heat invading the lung, wind pathogen adhering the lung and wind-dryness injuring the lung, among which wind-cold evil tightening the lung is the most common. Li believes that wind pathogen is the main cause of PIC, and summarizes five syndrome types: Wind-cold evil tightening the lung, wind-heat invading the lung, wind-dryness injuring the lung, wind pathogen adhering the lung, and wind-phlegm blocking the lung (Li, Sun, & Gao, 2018). Wu studied the distribution characteristics of TCM clinical syndrome types of PIC in 300 patients (Wu, Cai, & Wang, 2013). The study showed that PIC was mainly characterized by wind-cold attacking the lung, followed by wind-heat invading the lung, wind-dryness injuring the lung and deficiency of both vital energy and Yin. Yan discussed the distribution characteristics of TCM clinical syndrome types of 419 PIC patients by factor analysis method, and summed up 36 TCM syndromes, of which wind pathogen adhering the lung is the most common, followed by the syndromes of lung-Qi deficiency, intense lung heat, phlegm turbidity and obstruction of lung, wind-heat invading the lung, lung-spleen Qi deficiency, deficiency of both lung Qi and Yin, and phlegm-heat accumulation in lung (Yan et al., 2014). It can be seen that wind pathogen plays a key role in the syndrome types distribution of PIC.

4. TCM formulas used to treat PIC in clinic

Based on the characteristics of various and different syndrome types of PIC, modern TCM practitioners mostly adopt the ideas of classification and treatment, and achieve good clinical results. On the basis of reading and analyzing a large number of literatures, the research results of TCMs in treating PIC are summarized, as shown in Table 1.

Table 1.

Syndrome types of TCM prescriptions for clinical treatment of PIC.

No.	TCM prescriptions	Efficacy	TCMs compositions	Syndrome types	Refs.
1	Qingfeng Ganke Granules	Expelling wind and relieving cough	Ephedrae Herba (Mahuang, MH), Sabia japonica Maxim (Qingfengteng, QFT), Stemonae Radix (Baibu, BB), Asteris Radix et Rhizoma (Ziwan, ZW)	Wind pathogen invading the lung	Jiang et al. (2015)
2	Majing Zhike Granules	Ventilating lung and expelling wind, relieving cough and resolving phlegm, nourishing Yin and moistening lung	MH, Schizonepetae Spica (Jingjie, JJ), Farfarae Flos (Kuandonghua, KDH), Inulae Flos (Xuanfuhua, XFH), Cicadae Periostracum (Chantui, CT), Cynanchi Paniculati Radix et Rhizoma (Xuchangqing, XCQ), Arctii Fructus (Niubangzi, NBZ), Glehniae Radix (Beishashen, BSS), Scrophulariae Radix (Xuanshen, XS), Trichosanthis Fructus (Gualou, GL), Paeoniae Radix Rubra (Chishao, CS), Glycyrrhizae Radix et Rhizoma (Gancao, GC)	Wind pathogen invading the lung	Lin (2019)
3	Six Ingredients Decoction and Three Crude Drugs Decoction	Expelling wind and ventilating lung, resolving phlegm and relieving cough	JJ, Saposhnikoviae Radix (Fangfeng, FF), Platycodonis Radix (Jiegeng, JG), Bombyx Batryticatus (Jiangcan, JC), MH, Armeniacae Semen Amarum (Kuxingren, KXR), GC, CT, Pheretima (Dilong, DL), ZW, KDH, Belamcandae Rhizoma (Shegan, SG)	Wind pathogen invading the lung	Jiang (2018)
4	Jinfeicao Powder	Ventilating lung and relieving cough	XFH, Pinelliae Rhizoma (Banxia, BX), BS, Peucedani Radix (Qianhu, QH), JJ, Sinapis Albae Semen (Baijiezi, BJZ), Perillae Folium (Zisuye, ZSY), KXR, JG, GC	Wind pathogen invading the lung	Li & Qin (2013)
5	Chaima Qufeng Tang	Dispelling wind and relieving exterior syndrome, ventilating lung and relieving cough	MH, Bupleuri Radix (Chaihu, CH), FF, Mume Fructus (Wumei, WM), KDH, Perillae Fructus (Zisuzi, ZSZ), SG, ZW, BS, GC	Wind pathogen invading the lung	Gao (2017)
6	Xuansu Zhike Decoction	Dispelling wind, ventilating lung and relieving cough	Mori Folium (Sangye, SY), QH, JG, KXR, ZW, BB, GC	Wind pathogen invading the lung	Zhong, Yang, & Weng (2017)
7	Peony Liquorice Decoction	Relieving urgent state and spasm, soothing liver and relieving pain	BS, GC	Wind pathogen invading the lung	Yang (2016)
8	Qufeng Zhike Decoction	Expelling wind and clearing heat, ventilating lung and relieving cough	FF, CT, Angelicae Dahuricae Radix (Baizhi, Bzhi), Isatidis Radix (Banlangen, BLG), Cyrtomium Fortunei (Guanzhong, Gzhong), Chebulae Fructus Immaturus (Zangqingguo, ZQG), Oroxyli Semen (Muhudie, MHD), WM, KXR, BB, Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle (Zhigancao, ZGC)	Wind pathogen invading the lung	Du (2014)
9	Wind-Dispelling and Cough-Checking Formula	/b	SG, ZW, KDH, JG, CT, JC, powders of Scorpio (Quanxie, QX), Citri Reticulatae Pericarpium (Chenpi, CP), Magnoliae Officinalis Cortex (Houpo, HP), Scutellariae Radix (Huangqin, HQ), Houttuyniae Herba (Yuxingcao, YXC), SY, Taraxaci Herba (Pugongying, PGY), KXR	Wind pathogen invading the lung	Wu, Shen, & Yu. (2015)
10	Xuanfei-Zhisou Decoction-Ea	Dispelling wind and ventilating lung, relieving cough and resolving phlegm	MH, NBZ, KXR, CT, Cynanchi Stauntonii Rhizoma et Radix (Baiqian, BQ), Mori Cortex (Sangbaipi, SBP), KDH, FEC, QX, ZGC	Wind pathogen invading the lung	Zhu, Yang, Wu, Zhang, & Tang (2013)
11	Baichan Zhike Decoction	Dispelling wind pathogen, ventilating lung and relieving cough	Chelidonii Herba (Baiqucai, BQC), CT, ZSY, BB, BQ, Eriobotryae Folium (Pipaye, PPY), KXR, JG, ZGC	Wind pathogen invading the lung	Li (2020a)
12	Shufeng Zhike Recipe	/b	JJ, CT, JG, KXR, BB, ZW, QH, HP, SG, JC, XS, GC	Wind pathogen invading the lung	Li (2019b)
13	Suhuang Zhike Capsule	Dispelling wind and ventilating lung, relieving cough and resolving phlegm	MH, KXR, CT, ZSY, ZSZ, Schisandrae Chinensis Fructus (Wuweizi, WWZ), NBZ, QH, PPY, DL etc.	Wind pathogen invading the lung	Li et al., 2016, Wan, 2017
14	Qufeng Xuanfei Recipe-Aa	Ventilating lung and expelling wind, relieving spasm and cough	BB, ZW, JG, JJ, FF, KDH, CT, JC, BQ, QH, QX, DL, ZGC	Wind pathogen invading the lung	Yan, Zhou, Liang, Luo, & Yang (2020)
15	Qufeng Xuanfei Recipe-Ba	Expelling wind and ventilating lung, depressing Qi and relieving cough	MH, HQ, BB, ZW, Coptidis Rhizoma (Huanglian, HL), QH, HP, Sinomenii Caulis (Qingfengteng, QFteng)	Wind pathogen invading the lung	Ji (2013)
16	Goubo Guoming Decoction	/b	Astragali Radix (Huangqi, Hqi), Uncariae Ramulus Cum Uncis (GouTeng, GT), Menthae Haplocalycis Herba (Bohe, BH), YXC, Polygoni Cuspidati Rhizoma et Radix (Huzhang, HZ), JG, ZW, KDH	Wind pathogen invading the lung	Miao (2019)
17	Zhisou Powder Combined with ChuanXiong Tea	Expelling wind and ventilating lung, removing pathogens out	ZW, BB, JJ, Chuanxiong Rhizoma (Chuanxiong, CX), KXR, FF, BH, PPY, ZSY, Notopterygii Rhizoma et Radix (Qianghuo, Qhuo), Bzhi, JG, CP, GC	Wind pathogen invading the lung	Zhang (2019c)
18	Itching and Cough Relieving Decoction-Aa	Nourishing Yin and clearing lung, relieving cough and resolving phlegm, expelling wind and relieving itching, relieving sore throat and suppress coughing	MHD, GC, CT, QX, KXR, BSS, Fritillariae Thunbergii Bulbus (Zhebeimu, ZBM), CS, DP, XFH, JJ, XCQ, Succus Bambusae (Zhuli, ZL), BX, XS, Salviae Miltiorrhizae Radix et Rhizoma (Danshen, DS), Fagopyri Dibotryis Rhizoma (Jinqiaomai, JQM), BQ, KXR, Dictamni Cortex (Baixianpi, BXP), ZW, SG, ZQG, JG, JC, YXC, Japamese Metaplexis Pericarp (Tianjiangke, TJK), FF, WM	Wind pathogen invading the lung	Zheng (2017)
19	Modified Xuanfei Ningsou Decoction-Ba	Dispelling wind and heat, ventilating lung and relieving cough	GT, SY, Chrysanthemi Flos (Juhua, Jhua), JG, KXR, QH, BQ, SBP, ZW, GC, JJ, FF	Wind pathogen invading the lung	Tao, Yu, Zhai, Zhao, & Wan (2019)
20	Fengke Decoction	Dispelling wind and ventilating lung, relieving urgent state and spasm, relieving sore throat and cough	MH, ZSZ, ZSY, PPY, ZW, KXR, SG, NBZ, CT, DL, WWZ	Wind pathogen invading the lung	Huang, Ling, Chen, & Huang (2014)
21	Jiawei Shengjiang Powder	Dispelling wind and clearing lung, downbearing counterflow to suppress cough	JC, CT, Curcumae Longae Rhizoma (Jianghuang, Jhuang), DH, BB, BQ, GC, JG	Wind pathogen invading the lung	Zhao (2015)
22	Qufeng Runfei Decoction	Expelling wind and moistening lung, downbearing counterflow to suppress cough	JJ, FF, JC, BB, ZW, PPY, JG, CT, QH, GC, etc.	Wind pathogen invading the lung	Li (2010a)
23	Zhike Decoction	Dispelling cold and ventilating lung, resolving phlegm and relieving cough	XFH, BS, QH, JJ, Magnetitum (Cishi, Cshi), ZSY, BQ, JG, ZW, BB, CP, GC, KXR, YXC	Wind pathogen invading the lung	Fang (2016)
24	Chanjiang Zhike Recipe	Dispelling wind and resolving phlegm, warming and moistening to stop cough	CT, JC, BX, CP, Poria (Fuling, FL), BB, ZW, KDH, DS, Curcumae Radix (Yujin, YJ), JG, GC, QH, Aurantii Fructus (Zhiqiao, ZQ)	Wind pathogen invading the lung	Jiang, Li, & Ling (2012)
25	Modified Liuwei Decoction	Expelling wind and resolving phlegm, relieving the qi of lung	CT, JC, JG, KXR, ZW, JJ, FF, BH, ZGC etc.	Wind pathogen invading the lung	Ding & Luo (2015)
26	Chanqin Granules	Expelling wind and ventilating lung, regulating Qi and resolving phlegm, activating blood and dredging collaterals, relieving spasm and cough	CT, JC, CH, HQ, BX, JG, ZQ, SG, KXR, ZW, DS, YJ, QH, BQ, GC	Wind pathogen adhering the lung	Shen, Yu, & He (2017)
27	Jiawei Zhisou Powder-Aa	Cold-dispelling, warming and moistening, dispelling wind and resolving phlegm	ZW, BB, JG, BQ, CT, DL, JJ, FL, CP, Pinelliae Rhizoma Praeparatum (Fabanxia, FBX), PPY, WWZ, GC	Wind pathogen adhering the lung	Qin & Yao (2020)
28	ZhiSou Powder and Jade Screen Powder	Reinforcing healthy Qi and eliminating pathogenic factors	BB, ZW, JG, BQ, JJ, CP, Hqi, Atractylodis Macrocephalae Rhizoma (Baizhu, BZ), FF, GC	Wind pathogen adhering the lung	Zhu (2017)
29	Jiushou Tang	Dispelling wind and ventilating lung, resolving phlegm and relieving cough	MH, ZW, KDH, NBZ, BQ, BB, KXR, CT, GC, HQ, Zingiberis Rhizoma Recens (Shengjiang, SJ), WWZ	Wind pathogen adhering the lung	Yan (2019)
30	Eliminating Wind Cough Soup	Expelling evil without damaging healthy Qi	JJ, FF, ZW, ZSZ, BQ, BB, Fritillariae Cirrhosae Bulbus (Chuanbeimu, CBM), KXR, FBX, CP, JG, GC	Wind pathogen adhering the lung	Zhou (2016)
31	Xuanfei-Zhisou Decoction-Aa	Ventilating lung and expelling wind, relieving cough and resolving phlegm	MH, KXR, NBZ, CT, BQ, SBP, ZW, Herba Laphangium Affinis (Foercao, FEC), QX, ZGC, Xanthii Herb (Cangercao, CEC), JJ	Wind pathogen adhering the lung	Wang (2013b)
32	Chanhu Zhike Oral Liquid	/B	CT, QH, ZW, BB, JG, BQ, CP, JJ, KDH, FL, GC	Wind pathogen adhering the lung	Li & Guo (2014)
33	Zhike Gubiao Soup	Regulating lung and lowering Qi, resolving phlegm and relieving cough, replenishing qi and consolidating exterior	BQ, BB, JG, ZW, CP, JJ, XX, HQi, BZ, Lonicerae Japonicae Flos (Jinyinhua, JYH), Anemarrhenae Rhizoma (Zhimu, ZM), SG, ZSZ, KXR, GC	Wind pathogen adhering the lung	An (2009)
34	Shufeng Zhike Mixture	Dispelling wind and ventilating lung, relieving cough and resolving phlegm	JG, BQ, JC, CT, Citri Exocarpium Rubrum (Juhong, JH), ZW, JJ, BB, Lycii Cortex (Digupi, DGP), GC	Wind pathogen adhering the lung	Feng (2016)
35	Shufeng Xuanrun TCM Decoction	Dispelling wind and moistening	SY, CT, QH, FF, JG, KXR, Glehniae Radix (Nanshashen, NSS), CBM, Polygalae Radix (Yuanzhi, Yzhi), ZW, BB, XFH, NBZ, GC	Wind pathogen adhering the lung	Wei, Shi, & He (2020)
36	Xuanfei Zhisou Decoction-Ba	Dispelling wind and evil, ventilating lung and relieving cough	MH, ZW, BB, JJ, JG, BQ, KXR, CP, CT, DL, WWZ, ZGC	Wind pathogen lurking the lung	Sun (2019)
37	Jiawei Zhisou Decoction	Dispelling wind and evil, ventilating lung and relieving cough	ZW, BB, JJ, FF, JG, QH, CP, FL, BZ, DL, JC, PPY, GC	Wind pathogen lurking the lung	Yan (2020)
38	Qingfei Zhisou Tang	Dispelling wind and ventilating lung, relieving cough and resolving phlegm	Concha Meretricis seu Cyclinae (Haigeqiao, HGQ), ZSY, Adenophora stricta Miq. (Shashen, SS), Ophiopogonis Radix (Maidong, MD), BB, JJ, FF, JC, MH, ZGC	Wind pathogen lurking the lung	Wei (2018)
39	Feiketing Mixture	Dispelling wind and evil, ventilating lung and depressing Qi	JJ, QH, ZW, BB, JG, CP, BX, GC	Wind pathogen lurking the lung	Wang (2017)
40	San-ao Wendan Decoction	Dispelling wind and ventilating lung, relieving cough and resolving phlegm, drying dampness and transporting spleen, compensation existing in elimination	MH, KXR, CP, Pinelliae Rhizoma Praeparatum Cum Alumine (Qingbanxia, QBX), FL, Aurantii Fructus Immaturus (Zhishi, ZS), Bambusae Caulis in Taenias (Zhuru, ZR), GC, SG, FF, CT	Wind pathogen lurking the lung	Yang (2019a)
41	Shufeng Jiangqi Zhike Decoction	Dispelling wind and ventilating lung, depressing Qi and relieving cough	ZSY, CH, QH, ZQ, ZS, HP, XFH, ZW, KDH, GC	Wind pathogen lurking the lung	Ding, Yang, Li, & Wang (2021)
42	Xuanfei Zhisou Decoction-Ca	Expelling wind and ventilating lung, resolving phlegm and relieving cough	ZW, JJ, CT, KXR, MH, JG, FBX, CP, ZQ, FL, GC	Wind pathogen tightening the lung	Wang (2011)
43	Qingfei Yin	Resisting inflammation, preventing cough and relieving spasm	JYH, Sophorae Tonkinensis Radix et Rhizoma (Shandougen, SDG), SG, Physalis Calyx Seu Fructus (Jindenglong, JDL), CT, NBZ, JC, HQ, XX	Wind pathogen tightening the lung	Wu (2013)
44	Mulberry Apricot Decoction	Dispelling wind and ventilating lung, clearing throat and relieving cough	SY, KXR, BB, ZW, ZSZ, ZBM, BSS, JG, JC, GC	Wind pathogen and stagnated heat	Huang (2016)
45	Shufeng Xuanfei Zhike Decoction	Straightening out the lung Qi, ventilating lung and relieving cough, relieving asthma and resolving phlegm	KXR, JG, NBZ, MH, YXC, ZSZ, QH, SBP, JYH etc.	Wind pathogen accumulation in lung	Geng (2018)
46	Keping Decoction	Ventilating lung and expelling wind, relieving sore throat and nourishing fluid production	MH, JJ, CT, XCQ, XFH, GL, NBZ, KDH, SS, XS, CS, GC	Wind pathogen guesting lung and consumption of fluid	Chen, Huang, Lian, & Huang (2010)
47	Xuanfei Zhisou Decoction-Aa	Dispelling wind and cold, ventilating lung and relieving cough	MH, KXR, SJ, JG, KDH, FBX, BB, ZSY, ZGC	Wind-cold adhering the lung	Hu et al. (2016)
48	Guizhi Mahuang Each Half Tang	Relieving exterior syndrome and ventilating lung, harmonizing nutrient and defense	MH, Cinnamomi Ramulus (Guizhi, GZ), KXR, Paeoniae Radix Alba (Baishao, BS), ZGC, SJ, Jujubae Fructus (Dazao, DZ)	Wind-cold adhering the lung	Zhuge et al., 2017, Wang et al., 2019
49	Wind-Cold Formula	Evacuating wind and cold, dispersing and lowering lung Qi, resolving phlegm and relieving cough	MH, KXR, SJ etc.	Wind-cold adhering the lung	Wu et al. (2013)
50	Fangfeng Sanao Decoction	Dispelling wind and cold, ventilating lung and relieving cough	FF, MH, ZSY, KXR, BQ, JG, WWZ, BX, XX, GC	Wind-cold adhering the lung	Zhang (2019b)
51	Jinfei Zhisou Powder	Dispelling wind and ventilating lung, relieving urgent state and spasm, relieving sore throat and cough	XFH, MH, BX, BS, JG, GC, KXR, ZSY, ZW, BB, BQ, CT	Wind-cold adhering the lung	Wang (2016)
52	Itching and Cough Relieving Decoction-Ba	Nourishing Yin and clearing lung, relieving cough and resolving phlegm, expelling wind and relieving itching, relieving sore throat and suppress coughing	MHD, GC, CT, QX, KXR, BSS, ZBM, CS, DP, XFH, JJ, XCQ, ZL, BX, XS, DS, JQM, BQ, KXR, BXQ, ZW, SG, ZQG, JG, JC, YXC, TJK, FF, Zingiberis Rhizoma (Ganjiang, GJ), XX	Wind-cold adhering the lung	Zheng (2017)
53	Shegan Mahuang Decoction	Dispelling cold and relieving exterior syndrome, resolving phlegm and relieving cough, warming lung to reduce watery phlegm, strengthening the body resistance in middle-Jiao	SG, MH, SJ, XX, ZW, KDH, WWZ, BX, DZ	Wind-cold adhering the lung	Wang et al. (2017)
54	Chanyi Jiegeng Erchen Decoction	/b	CT, JC, FBX, CP, FL, GC, JG etc.	Wind-cold adhering the lung	Cheng & Li (2013)
55	Sanju Kechuan Oral Liquid	Expelling wind and dispelling cold, widening chest and resolving phlegm, ventilating lung and relieving cough	MH, KXR, GL, Allii Macrostemonis Bulbus (Xiebai, XB), FBX, JG, GC etc.	Wind-cold adhering the lung	Li et al. (2020)
56	Modified Xuanfei Ningsou Decoction-Ca	Dispelling wind and heat, ventilating lung and relieving cough	GT, Jhua, JG, KXR, QH, BQ, SBP, ZW, GC, MH, ZSY	Wind-cold adhering the lung	Tao, Yu, Zhai, Zhao, & Wan (2019)
57	Zihua Wenfei Zhisou Formula	Warming lung and resolving phlegm, dispelling wind and relieving cough	ZW, KDH, GJ, the kernels of Mangifera indica L. (Mangguohe, MGH), SG, JJ	Wind-cold adhering the lung	Lin, Zhou, Lu, Liu, & Tao (2019)
58	Shufeng Zhike Decoction-Aa	Expelling wind and ventilating lung	JJ, ZSY, KXR, ZQ, DL, CT, HP, JG, BS, GC, WWZ etc.	Wind-cold adhering the lung	Chen (2015)
59	Zhike Prescription-Aa	Expelling wind, ventilating lung and relieving cough	ZSY, FF, Pheretima aspergillum E. Perrier (Guangdilong, GDL), CT, QH, NBZ, ZSZ, XFH, JG, GC, MH, KXR, ZW, KDH	Wind-cold attacking the lung	Gu (2021)
60	Jiawei Zhisou Powder-Ba	/b	Paris polyphylla Smith var. chinensis (Franch.) (Qiyeyizhihua, QYYZH), ZW, BB, QH, BQ, JG, CP, Chebulae Fructus (Kezi, KZ), KXR, Canarii Fructus (Qingguo, QG), ZSZ, GC, JJ	Wind-cold attacking the lung	Pan (2009)
61	Jiawei Zhisou Powder-Ca	Ventilating lung and relieving cough, dispelling wind and evil	MH, KXR, ZW, BB, JG, BQ, JJ, CP, ZGC	Wind-cold attacking the lung	Wu, Yang, & Wang (2017)
62	Chaijin Decoction	Reconciling external evil of exterior and interior, warming cold retained fluid to relieve cough and asthma, using diffusing and dissipating together with convergence and descending, attacking evil without damaging healthy Qi	CH, HQ, FBX, Codonopsis Radix (DangShen, DangS), Rehmanniae Radix Praeparata (Shudi, SD), Angelicae Sinensis Radix (Danggui, DG), FL, CP, Scolopendra (Wugong, WG), DL, GJ, XX, WWZ, GC	Wind-cold attacking the lung	Jin, Liu, & Ye (2019)
63	San'ao Tablet	Divergenting wind and cold, warming lung and relieving cough	MH, KXR, GC, SJ	Wind-cold attacking the lung	Fu (2017)
64	Dongwan Zhike Granules	Expelling wind and dispelling cold, ventilating lung and relieving cough, simultaneous treatment of lung and nose	MH, XX, SJ, ZW, KDH, FBX, the flowers of Magnoliae Flos (Xinyihua, XYH), Xanthii Fructus (Cangerzi, CEZ)	Wind-cold attacking the lung	Wang (2013a)
65	Liuwei Decoction	Expelling wind and ventilating lung, relieving sore throat and resolving phlegm, moistening lung and relieving cough	JJ, FF, HQ, JG, BH, JC, KXR, BB, MHD, WWZ, GC etc.	Wind-cold attacking the lung	Yu (2012)
66	General Xuan Shang	Warmly dredging purgation, ventilating lung and relieving cough	Aconiti Lateralis Radix Praeparaia (Fuzi, FZ), GJ, Ginseng Radix et Rhizoma (Renshen, RS), Rhei Radix et Rhizoma (Dahuang, DH), KXR, ZSY, ZGC	Wind-cold invading the lung	Zhang (2017)
67	Xiaoqinglong Mixture	Relieving exterior syndrome and reducing watery phlegm, relieving cough and asthma	MH, GZ, BS, GJ, XX, BX, WWZ, ZGC	Wind-cold invading the lung	Chinese Pharmacopoeia Commission, 2020, Zhang et al., 2017
68	Kechuan Liuwei Mixture	Warming kidney and tonifying fire, warming lung and dispelling cold, ventilating lung and relieving asthma	MH, FZ, XX, HQ, Saxifraga stolonifera (L.) Meerb. (Huercao, HEC), Persicae Semen (Taoren, TR)	Wind-cold invading the lung	Zhang et al., 2017, Mu et al., 2014
69	Shegan Zhisou Decoction	Regulating lung Qi to relieve cough	SG, Perillae Caulis (Sugeng, Sgeng), ZW, QH, WWZ, ZGC	Wind-cold invading the lung	Li & Zhang (2018)
70	Guizhi Method	Harmonizing nutrient and defense when the disease is on the exterior, harmonizing Yin and Yang when the disease is on the interior.	GZ, Atractylodis Rhizoma (Cangzhu, CZ), CP, FL, ZW, BX, Acori Tatarinowii Rhizoma (Shichangpu, SCP), SJ, ZGC	Wind-cold invading the lung	Huang, Chen, Lu, & Huang (2015)
71	Guizhi Wenfei Huatan Decoction	Preventing cough and resolving phlegm, harmonizing nutrient and defense, eliminating sweat and dispelling evil without damaging healthy Qi	MH, GZ, ZW, FBX, SJ, Asari Radix et Rhizoma (Xixin, XX), KDH, TJK, Ardisiae Japonicae Herba (Aiaicha, ADC)	Wind-cold closing the lung	Xiang, Hu, Sun, & Liu (2021)
72	Xuanfei-Zhisou Decoction-Ca	Ventilating lung and expelling wind, relieving cough and resolving phlegm	MH, KXR, NBZ, CT, BQ, SBP, ZW, FEC, QX, ZGC, BB, XX, Bzhi	Wind-cold tightening the lung	Wang (2013b)
73	Jiawei Shensu Yin	/b	ZSY, BX, CP, QH, ZQ, FL, GC, CX, SJ, Aucklandiae Radix (Muxiang, MX), RS etc.	Wind-cold with dampness	Meng (2015)
74	Kugan Granules	Relieving cough and asthma, ventilating lung and resolving phlegm, dispelling wind and heat	MH, HQ, CT, BH, JG, JYH, KXR, ZBM, GC, etc.	Wind-dryness injuring the lung	Yang, Wang & Wang (2020)
75	Zhisou Powder plus Xing Su Powder	Dispelling wind and heat, moistening lung and relieving cough	ZSY, KXR, JG, JH, GC, ZW, KDH, MD, WWZ, ZBM, SBP, CT, NBZ	Wind-dryness injuring the lung	Du, Zeng, Liu, Huang, & Zeng (2020)
76	Sangxing Decoction-Ba	Clearing and relieving dryness-heat, moistening lung and relieving cough	SY, KXR, NSS, ZBM, DDC, Gardeniae Fructus (Zhizi, ZZ), FF, CT, Luffae Fructus Retinervus (Sigualuo, SGL), MHD	Wind-dryness injuring the lung	Liu & Xie (2016)
77	Mulberry Apricot Soup	Relieving exterior syndrome without damaging healthy Qi, expelling wind without damaging body fluid, removing dryness and restoring fluid	SY, KXR, ZBM, BSS, BB, ZW, JJ, JG, CT, HQ, ZSZ, MH, PPY, GC	Wind-dryness injuring the lung	Qiu (2015)
78	Shufeng Runfei Method	Dispelling wind and moistening lung	KXR, BB, ZW, JG, QH, CBM, KDH, FF, GC, JH, CT	Wind-dryness injuring the lung	Chen (2019)
79	Qingzao Jiufei Decoction	Expelling wind and clearing lung, moistening dryness and relieving cough	SY, KXR, PPY, MD, ZW, BSS, CT, FF, JG, MHD, GC	Wind-dryness injuring the lung	He (2018)
80	Qingfei Runzao Decoction-Aa	Eliminating phlegm and relieving cough	BB, SBP, KDH, HQ, JG, KXR, CBM, NSS, GC	Wind-dryness injuring the lung	Chen (2017)
81	Qingfei Runzao Decoction-Ba	Clearing lung and resolving phlegm, moistening dryness and relieving cough	BB, SBP, KDH, HQ, JG, KXR, CBM, seeds of Zanthoxylum bungeanum Maxim (Jiaomu, JM), SS, GC	Wind-dryness injuring the lung	Wang, Li, & Peng (2013)
82	Jingsang Zhike Mixture	Dispelling wind and clearing lung, moistening dryness and relieving cough, promoting blood circulation and removing blood stasis	JJ, SY, TR, NSS, MD, Trichosanthis Radix (Tianhuafen, THF), BB, Indigo Naturalis (Qingdai, QD), QX, CX, CT, SG, ZQ, GC	Wind-dryness injuring the lung	Gong (2017)
83	Itching and Cough Relieving Decoction-Da	Nourishing Yin and clearing lung, relieving cough and resolving phlegm, expelling wind and relieving itching, relieving sore throat and suppress coughing	MHD, GC, CT, QX, KXR, BSS, ZBM, CS, DP, XFH, JJ, XCQ, ZL, BX, XS, DS, JQM, BQ, KXR, BXQ, ZW, SG, ZQG, JG, JC, YXC, TJK, FF, SS, MD	Wind-dryness injuring the lung	Zheng (2017)
84	Modified Xuanfei Ningsou Decoction-Da	Dispelling wind and heat, ventilating lung and relieving cough	GT, BH, SY, Jhua, JG, KXR, QH, BQ, SBP, ZW, GC, BSS, XS	Wind-dryness injuring the lung	Tao, Yu, Zhai, Zhao, & Wan (2019)
85	Qingfei Runzao Zhisou Decoction	Ventilating lung and relieving cough, moistening lung and resolving phlegm	BB, KDH, SBP, CBM, NSS, HQ, KXR, GC, JG	Wind-dryness injuring the lung	Zhang (2019a)
86	Sangxing Zhisou Yin	Dispelling dryness evil, recovering Qi-Yin and stopping coughing	SY, KXR, ZBM, SS, PPY, BB, ZW	Wind-dryness injuring the lung	Wang, Ju, & Li (2012)
87	Sangxing Decoction-Aa	Dispelling wind, moistening lung and removing dryness	SY, KXR, ZBM, BSS, ZZ, DDC, peel of Pyrus (Lipi, LP)	Wind-dryness invading the lung	Huang (2018a)
88	Varied Sangxing decoction-Ba	Dispelling wind and reducing dryness, nourishing Yin and moistening lung	SY, KXR, ZBM, BSS, ZZ, DDC, MD, ZM, PPY, CX	Wind-dryness invading the lung	Lan (2017)
89	Varied Sangxing decoction-Ca	Dispelling wind and reducing dryness, nourishing Yin and moistening lung；clearing lung and resolving phlegm, lowering lung Qi	SY, KXR, ZBM, BSS, ZZ, DDC, MD, ZM, PPY, CX, HQ, HGQ, SBP	Wind-dryness invading the lung	Lan (2017)
90	Sanye Tang-Aa	Dispelling wind and ventilating lung, moistening lung and relieving cough	Ginseng Folium (Renshenye, RSY), Sauropi Folium (Longliye, LLY), PPY, the shell of Castanea mollissima Bl. (Fenglike, FLK), KXR, ZBM, ZW, JG, MHD, FF	Wind-dryness invading the lung	Xia & Li (2017)
91	Shufeng Xuanfei Zhike	Dispelling wind, ventilating lung and relieving cough	RSY, LLY, PPY, FYK, KXR, ZBM, ZW, JG, MHD, FF, BB, ZGC	Wind-dryness invading the lung	Xia (2018)
92	Qiangli Pipa Lu	Nourishing Yin and restraining lung Qi, preventing cough and eliminating phlegm	Papaveris Pericarpium (Yingsuke, YSK), BB, BQ, SBP, JG, PPY, l-Menthol (Bohenao, BHN) etc.	Wind-dryness invading the lung	Li & An (2014)
93	Zhike Prescription-Ba	Expelling wind, ventilating lung and relieving cough	ZSY, FF, GDL, CT, QH, NBZ, ZSZ, XFH, JG, GC, JYH, Forsythiae Fructus (Lianqiao, LQ), HQ, ZBM	Wind-heat invading the lung	Gu (2021)
94	Xinghuang Zhike Mixture	Clearing lung, relieving cough and resolving phlegm	HQ, KXR, BX, QH, ZSZ, JJ	Wind-heat invading the lung	Li, Guo, Yu, & Ji (2018)
95	Xuanfei-Zhisou Decoction-Ba	Ventilating lung and expelling wind, relieving cough and resolving phlegm	MH, KXR, NBZ, CT, BQ, SBP, ZW, FEC, QX, ZGC, Jhua, BH, LQ	Wind-heat invading the lung	Wang (2013b)
96	Sangju Yin	Clearing heat and dispelling wind, clearing lung and relieving cough	JG, SY, LQ, Jhua, LG, KXR, BH, GC	Wind-heat invading the lung	Yu (2017)
97	Qingfei Zhike Decoction	Dispelling wind and cold, ventilating lung, resolving phlegm and relieving asthma	MH, KXR, Gypsum Fibrosum (Shengshigao, SSG), ZGC, JG, CP, BB, ZW, BQ, CT	Wind-heat invading the lung	Song (2012)
98	Shufeng Zhike Decoction-Ba	Clearing heat and dispelling wind, depressing Qi and relieving cough	SY, HQ, JJ, KXR, JG, CT, BH, BQ, QH, ZW, PPY, ZBM, GC	Wind-heat invading the lung	Han (2016)
99	Sangye Zhike Granules	Dispelling wind and heat, ventilating lung and facilitating Qi, resolving phlegm and relieving cough	SY, KXR, JG, QH, PPY, ZBM, BB, MH, HQ, JYH, GC	Wind-heat invading the lung	Zhu & Liu (2001)
100	Erchong Ningsou Decoction	Dispersing lung Qi and relieving exterior syndrome	SY, Jhua, JG, KXR, JC, CT, LG, BH, LQ, HQ, SBP, DGP, ZW, KDH, GC	Wind-heat invading the lung	Chen & Zhao (2016)
101	Yure Prescription	Dispelling wind and strengthening body resistance, clearing heat and resolving phlegm, ventilating lung and relieving cough	BB, ZW, JG, QH, JJ, Retinervus Citri Fructus (Juluo, JL), HQ, JC, CS, HQi, GC	Wind-heat lying depressed in the lung	Wang & Huang (2015)
102	Itching and Cough Relieving Decoction-Ca	Nourishing Yin and clearing lung, relieving cough and resolving phlegm, expelling wind and relieving itching, relieving sore throat and suppress coughing	MHD, GC, CT, QX, KXR, BSS, ZBM, CS, DP, XFH, JJ, XCQ, ZL, BX, XS, DS, JQM, BQ, KXR, BXQ, ZW, SG, ZQG, JG, JC, YXC, TJK, FF, SBP, Ginkgo Semen (Baiguo, BG)	Wind-heat lying depressed in the lung	Zheng (2017)
103	Modified Xuanfei Ningsou Decoction-Aa	Dispelling wind and heat, ventilating lung and relieving cough	GT, BH, SY, Jhua, JG, KXR, QH, BQ, SBP, ZW, GC	Wind-heat lying depressed in the lung	Tao, Yu, Zhai, Zhao, & Wan (2019)
104	Shufeng Qingfei Zhike Decoction	Expelling wind, clearing and moistening lung	ZW, BB, QH, JG, JJ, FF, CT, KDH, PPY, LG, JQM, ADC, GC	Wind-heat lying depressed in the lung	Kang (2016)
105	Sangju Yin Combined with Xuanjiang Herb Pairs	Dispelling wind and heat, ventilating lung, relieving cough and resolving phlegm	SY, Jhua, LQ, LG, BH, NBZ, KDH, MH, ZSZ, JG, KXR, GC	Wind-heat lying depressed in the lung	Li (2019a)
106	Sangju Shenmai Tang	Dispelling wind and ventilating lung, nourishing Yin and moistening dryness	SY, Jhua, LQ, KXR, Phragmitis Rhizoma (Lugen, LG), JG, BSS, Polygonati Odorati Rhizoma (Yuzhu, YZ), MD, THF, CT, GC	Wind-heat-Yin deficiency	Zeng (2018)
107	Sangmei Zhike Granules	Dispersing wind pathogen that has not been exhausted on the exterior, clearing and moistening endogenous dryness and heat	SBP, WM, SY, Jhua, JG, KXR, BS, PPY, WWZ, JC, CT, ZGC	Wind-heat-Yin deficiency	Li, Qin, Cui, Bi, & Jin (2018)
108	Fengketing	Ventilating lung and dispelling evil, tonifying kidney and relieving cough	MH, KXR, GC, BQ, JG, BB, ZW, CP, JJ, DG, NBZ, LG, CT	Wind-heat adhering the lung	Zhao & Zeng (2013)
109	Chanqin Granules	Expelling wind and ventilating lung, regulating Qi and resolving phlegm, activating blood and dredging collaterals, relieving spasm and cough	CT, JC, CH, HQ, BX, JG, ZQ, SG, KXR, ZW, DS, YJ, QH, BQ, GC	Wind phlegm adhering the lung	Lv (2019)
110	Sanye Tang-Ba	Dispelling wind and ventilating lung, moistening lung and relieving cough	RSY, LLY, PPY, FLK, KXR, ZBM, ZW, JG, MHD, FF	Wind phlegm adhering the lung	Zhang (2015)
111	Qufeng Wenfei Huatan Granules	/b	JJ, JG, QH, ZW, FL, XX, WWZ, Pinelliae Rhizoma Praeparatum Cum Zingibere et Alumine (Jiangbanxia, JBX), GJ, CP, CT, GC	Wind phlegm adhering the lung	Gao & Luo (2021)
112	E Li Soup	Expelling wind and ventilating lung, resolving phlegm and regulating Qi, tonifying lung and strengthening spleen, nourishing blood and promoting blood circulation	Balanophyllia (Eguanshi, EGS), MH, DG, FL, Trichosanthis Semen (Gualouren, GLR), ZSZ, SY, JH, FBX, ZBM, KXR	Wind phlegm adhering the lung	Qin (2011)
113	Modified Jinfeicao Powder	Sour and sweet nourishing Yin, moisturizing and calming, ventilating lung and defense, invarding to stomach and kidney	ZGC, XX, XFH, HQi, BZ, BS, DangS, JG, FF, JJ, WWZ	Wind phlegm and persistent pulmonary	Zhao & Huang (2016)
114	Qufeng Xuanfei Zhike Prescription	Expelling wind, ventilating lung and relieving cough	FF, JJ, KXR, MH, GT, DL, KDH, ZW, GL, ZBM, ZQ, JG, GC	Wind phlegm resistance	Yuan, Li, & Chi (2016)
115	Jiubaowan Pill	Dredging triple energizer, regulating and invigorating ascension and descent, dredging exterior and interior syndrome	CH, HQ, DangS, BX, Rehmanniae Radix (Shengdihuang, SDH), ZW, KDH, QH, CP, ZGC	Wind phlegm accumulation in lung	Yang, Yao, Shi, & Gu (2016)
116	Kaiyu Zhike Granules	Removing stagnation and ventilating lung, resolving phlegm and relieving cough	Clematidis Radix et Rhizoma (Weilingxian, WLX), YJ, SCP, BH	Wind phlegm lying depressed in the lung	Feng, Zhang, Lian, Li, & Wang (2017)
117	Shufeng Lifei Decoction	Dispelling wind and ventilating lung, regulating Qi and relieving cough	MH, CT, ZSY, QH, NBZ, PPY, DL, JG, ZBM, BB, WWZ	Fengsheng clonic acute	Li (2018b)
118	Xuanfei Zhike Tang-Aa	Dispelling wind and ventilating lung, relieving spasm and cough	ZSY, JG, KXR, SBP, JC, CT, ZW, Citri Grandis Exocarpium (Huajuhong, HJH), MH, GC	Fengsheng clonic acute	Li (2018a)
119	Xuanfei Zhike Tang-Ba	Ventilating lung and relieving cough, Strengthening spleen and tonifying lung	ZW, BB, ZBM, MH, KXR, JG, CT, FF, WWZ, WM, FL, BZ, GC etc.	Fengsheng clonic acute	Shan & Chen (2017)
120	Shema Sanchong Decoction	Dispelling wind and ventilating lung, relieving spasm and cough	SG, MH, JG, KXR, ZW, BB, JC, CT, DL, GC, WWZ	Fengsheng clonic acute	Guo & Lei (2016)
121	Zhike Prescription-Ca	Expelling wind, ventilating lung and relieving cough	ZSY, FF, GDL, CT, QH, NBZ, ZSZ, XFH, JG, GC, CBM, XS, MD, BSS	Dryness evil damaging the lung	Gu (2021)
122	Sangxing Zhike Powder	Clearing and relieving dryness-heat, moistening lung and relieving cough, resolving phlegm and preventing asthma	SY, KXR, ZBM, SBP, BSS, ZZ, BQ, BB, JG, LQ, KDH, ZSZ, JC, MHD	Dryness evil damaging the lung	Kong (2020)
123	Runfei Zhike Decoction-Aa	Nourishing Yin, moistening lung and relieving cough	Asparagi Radix (Tiandong, TD), MD, SG, Lilii Bulbus (Baihe, Bhe), JYH, NBZ, YXC, JG, Polygonati Rhizoma (Huangjing, HJ), ZW	Dryness evil damaging the lung	Liao, Li, & Zhu (2014)
124	Xuanfei-Zhisou Decoction-Da	Ventilating lung and expelling wind, relieving cough and resolving phlegm	MH, KXR, NBZ, CT, BQ, SBP, ZW, FEC, QX, ZGC, MD, BHe	Dryness evil damaging the lung	Wang (2013b)
125	Sangpi Dougen Decoction	/b	SBP, DGP, SDG, KXR, JG, ZW, ZBM, ZM, LG, GC	Dryness evil damaging the lung	Liang (2013)
126	Baihe Gujin Decoction	Gradually filling Yin fluid, nourishing lung and kidney, eliminating virtual fire automatically	BHe, SD, SDH, DG, BS, GC, JG, XS, Fritillaria (Beimu, BM), MD, Dioscoreae Rhizoma (Shanyao, Syao), BZ, WWZ	Deficiency of both Qi and Yin	Wang & Huang (2016)
127	Nourishing Yin and Supplementing Qi Method	/b	BSS, HQi, THF, ZBM, XS, LQ, NBZ, Inulae Herba (Jinfeicao, JFC), BS, JG, BH, ZGC	Deficiency of both Qi and Yin	Yu, Fu, Chen, & Lou (2017)
128	Supplementing Qi, Nourishing yin and Moistening lung Method	Replenishing Qi and nourishing Yin, moistening lung and relieving cough	Hqi, Pseudostellariae Radix (Taizishen, TZS), BSS, NSS, MD, BB, KDH, ZW, etc.	Deficiency of both Qi and Yin	Wang (2014)
129	Zhike Pingchuan Recipe Granules	Strengthening spleen and resolving phlegm, ventilating lung regulating Qi, dredging collaterals and quenching wind	TZS, CP, JC, BZ, DL, FBX, FF, GC	Phlegm-dampness accumulation in lung	Guo (2015)
130	Modified Erchen Decoction	Eliminating dampness and resolving phlegm, regulating and depressing Qi, tonification and purgation in combination	CP, FBX, FL, GC, Citri Sarcodactylis Fructus (Foshou, FS), FF, Yzhi, Oryzae Fructus Germinatus (Daoya, DY), Gall1 Gigerii Endothelium Corneum (Jineijin, JNJ), Arecae Semen (Binglang, BL), WWZ, CEZ etc.	Phlegm-dampness accumulation in lung	Xu (2017)
131	Banxia Pipa Syrup	Eliminating dampness and resolving phlegm, ventilating lung and relieving cough	BX, PPY, JG, MH, Yzhi, GC, ZW	Phlegm-dampness accumulation in lung	Li, Wu, & Liu (2020)
132	Xuanbai Chengqi Decoction	Dredging the Fu organs and purging lung	SSG, DH, Trichosanthis Pericarpium (Gualoupi, GLP), KXR, HQ, CBM, GC	Phlegm-heat lying depressed in the lung	Li (2018c)
133	Sangju Zhike Mixture	Clearing heat and resolving phlegm, relieving cough and sore throat	SY, Jhua, KXR, JG, BQ, ZBM, LQ, HQ, LG, BH etc.	Phlegm-heat lying depressed in the lung	Du & Zhang (2021)
134	Influenza No. 3 Formula	Clearing heat and resolving phlegm, ventilating lung and relieving cough	JQM, Trollius Chinensis Bunge (Jinlianhua, JLH), CT, PPY, ZBM, KXR, NBZ, Isatidis Folium (Daqingye, DQY), QH, WWZ, JG, GC	Phlegm-heat lying depressed in the lung	Han & Zhang (2010)
135	Yangyin Runfei Oral Liquid	Nourishing Yin and moistening lung, resolving phlegm and relieving cough, clearing heart and tranquilizing mind	Bhe, BB, MD, BSS, ZBM, SBP, JYH, PPY, HQ, Polygoni MultiflorI Caulis (Shouwuteng, SWT), GC	Heat injuring to lung Yin	Zhang et al. (2011)
136	Ganshangju Granules	Preventing cough and eliminating phlegm	the roots of Saccharum officinarum (Ganzhegen, GZG), SY, JG, KXR, GC	Heat injuring to lung Yin	Miao (2014)
137	Runfei Zhike Decoction-Ba	Nourishing Yin and moistening lung, depressing Qi and resolving phlegm, dispelling wind and heat, ventilating lung and relieving cough	MH, KXR, BB, ZGC, MD, XS, JG, SY, ZSZ	Dryness-heat injuring the lung	Zhang & Li (2020)
138	Xuanshen Ganju Tang Combined with Sanniutang	Promoting fluid production and nourishing Yin, clearing lung and relieving cough, dispelling wind and dryness	MH, KXR, MD, XS, JG, SY, Centellae Herba (Jixuecao, JXC), CT, JC, ZSZ, BB, GC	Dryness-heat injuring the lung	Huang, et al. (2019)
139	Erchen Decoction and Zhisou Powder	Ventilating lung and relieving cough, strengthening spleen and resolving dampness	CP, FBX, FL, GC, JG, ZW, KXR, JJ, BB, BQ, SJ	Spleen deficiency with dampness	Lin (2016)
140	Jiawei Yigong San	Strengthening spleen and resolving dampness, relieving cough and eliminating phlegm, tonification and purgation in combination, mainly basing on supplementation	DangS, FL, BZ, ZGC, CP, Ipomoea cairica (L.) Sweet (Wuzhaolong, WZL), ZSY, HP, LLY, SJ etc.	Spleen deficiency with dampness	Yang & Wei (2011)
141	Yangyin Qingfei Mixture	Nourishing Yin and clearing heat, moistening lung and relieving cough	SDH, XS, Moutan Cortex (Danpi, DP), MD, JYH, BS, JG, Paridis Rhizoma (Chonglou, CL), LQ, DQY	Yin-deficiency and lung-heat	Song, Wang, Guan, Zhang, & Liu (2021)
142	Jiawei Xiebai Powder	Clearing heat and nourishing Yin, moistening lung and relieving cough	DGP, SBP, BB, JC, ADC, MD, NSS, ZBM, Bhe, Hordei Fructus Germinatus (Maiya, MY), Massa Medicata Fermentata (Shenqu, SQ), GC	Yin-deficiency and lung-heat	Li & Shu (2015)
143	Shenmai Injection	Tonifying Qi and preventing exhaustion, nourishing Yin and promoting fluid production, activating pulse	RS, MD	Deficiency of lung Yin	Ren (2018)
144	Qinbai Qingfei Concentrated Pills	Clearing heat and resolving toxins, moistening lung and relieving cough	HQ, BB, ZW, MD etc.	Deficiency of lung Yin	Wang et al. (2018)
145	Jiawei-Yupingfeng-San	Replenishing Qi and consolidating exterior, ventilating lung and relieving cough, clearing heat and relieving sore throat	Hqi, XS, JC, ZW, BZ, SG, QG, JDL, FF, JG, ZGC	Lingering pathogen due to deficient vital Qi	Yu (2016)
146	Fuzheng Zhike Fang	Expelling wind and dispersing evil, treating both symptoms and root causes	Hqi, FF, BZ, DZ, JG, JJ, ZW, BB, QH, CP, GC, MHD	Lingering pathogen due to deficient vital Qi	Dong (2019)
147	Yangyin Qingfei Decoction	Nourishing Yin and moistening dryness	SDH, ZBM, BS, BH, MD, XS, GC, LQ, BB, GT, QH, JYH, ZW	Yin deficiency syndrome	Jia (2020)
148	Long Cough Prescirption	Supporting Yang and relieving exterior syndrome, relieving spasm and cough, expelling wind and resolving phlegm	MH, FZ, XX, JQM, Erodii Herba Geranii Herba (Laoguancao, LGC), Prunellae Spica (Xiakucao, XKC), GZ, GJ, WWZ, WM, CT, DL, JC, SS, MD, GC	Yang deficiency and wind cough	Gulzat (2020)
149	Wumei Pills	/b	NSS, SSG, WM, HQ, ZW, JG, BB, GJ, GZ, Zanthoxyli Pericarpium (Huajiao, Hjiao), XX, HL	Upper heat and lower cold	Ye, Liu, Zeng, & Chen (2017)
150	Xiebai Powder and Shashen Maimendong Decoction	Nourishing Yin and clearing heat, moistening lung, resolving phlegm and relieving cough	SBP, DGP, BSS, MD, THF, GC, SY, PPY, SDH	The lung-dryness syndrome due to Yin deficiency	Sun & Zhang (2015)
151	Sangpi Zhike Decoction	Clearing heat and resolving phlegm, ventilating lung and relieving cough	SBP, DGP, KXR, ZSZ, JG, NBZ, BQ, CT, GC	Stagnated heat of lung	Lv, Bai, & Liu (2016)
152	SuJie Mixture	/b	ZSZ, JG, KDH, GL, QH, FBX, ZBM, Descurainiae Semen Lepidii Semen (Tinglizi, TLZ), YXC, ZW, Raphani Semen (Laifuzi, LFZ), FL, GC	Spleen-deficiency and phlegm-turbid stagnation	Chen (2010)
153	Chaihu Jisang Decoction	Eliminating evil	CH, HQ, TZS, BX, GC, DZ, SJ, QH, SBP, LQ, NBZ, JG	Shaoyang syndrome	Hong et al. (2018)
154	adding or subtracting Chaihuzhijie Decoction	Reconciling and dispelling exterior syndrome, resolving phlegm and relieving cough	CH, HQ, ZQ, JG, LQ, JJ, ZBM, CX, SQ	Shaoyang and wind phlegm	Yang (2020)
155	Zibei Zhike Granules	Promoting lung Qi, relieving cough and resolving phlegm	BB, ZW, BQ, JG, FBX, JH, ZBM, KXR, ADC, BH, GC etc.	Remaining evil adhering the lung	Wan & Fan (2018)
156	Danggui Liuhuang Decoction Combined with Beimu Gualou Powder	Nourishing Yin and reducing fire, moistening lung and resolving phlegm	DG, HL, HQ, PhellodendrI Chinensis Cortex (Huangbai, HB), SDH, SD, Hqi, ZBM, GL, THF, CP, JG, FL	Qi and Yin injury, lung dryness and fluid injury	Wang & Zhao (2012)
157	Qingfei Huatan Granules	Clearing and reducing lung fire, moistening dryness, resolving phlegm and relieving asthma	ZW, KDH, HQ, YXC, KXR, MH, GC	Phlegm-heat congesting the lung	Li (2010b)
158	Qin-xia Qingrequfeng Decoction Granules	Clearing heat and resolving phlegm, expelling wind and relieving cough	HQ, ZBM, YXC, FBX, CP, FL, HP, KDH, CT, XCQ, LG, GC	Phlegm heat with wind	Li (2016)
159	Sijunzi Decoction and Zhisou Powder	/b	DangS, FL, BZ, ZGC, JJ, JG, CP, BQ, ZW, KDH, BB etc.	Lung-spleen Qi deficiency	Ren & Meng (2018)
160	Varied Sangxing decoction-Aa	Moistening dryness and promoting fluid production, clearing lung and resolving phlegm	SY, KXR, ZBM, SS, MD, ZZ, LQ, ZW, KDH, BQ, GL, TZS	Lung Qi being unclear, dryness burning the body fluid	Gong (2014)
161	Sangbai Lishi Decoction	Clearing lung and resolving phlegm, relieving cough and asthma, clearing heat and drying dampness	SBP, HQ, JG, KXR, ZBM, PPY, ZSZ, Coicis Semen (Yiyiren, YYR), ZZ, Amomun kravanh Pierre ex Gagnep (Baikouren, BKR), Artemisiae Scopariae Herba (Yinchen, YC), GC	Lung heat with dampness	Li, Ma, Zheng, & Liu (2018)
162	Qingfei Zhike Tablets	Moistening lung and depressing Qi, relieving cough and eliminating phlegm	JG, Fructus Mori (SangShen, SangS), ZZ, Arnebiae Radix (Zicao, ZC), Pericarpium Citri Reticulatae (Jupi, JP), MH, SGL, WM, PPY, BS, YZ, BX, Cinnamomi Cortex (Rougui, RG), YXC, NBZ, GC	Lung dryness and Yin deficiency	Lao (2015)
163	Daihe Powder Combined with Xiaochaihu Decoction	Clearing liver and relieving depression, clearing throat	QD, HQ, ZGC, SJ, BH, HGQ, CH, JBX, DangS, DZ, JG	Liver fire invading the lung	Luo & Ouyang (2017)
164	Shugan Qingfei Method	Soothing liver and regulating Qi, clearing heat, ventilating lung and relieving cough	CH, ZQ, BS, GC, JJ, BB, JC, ZSZ, HQ, SBP, DGP, FF, CT, JG, KXR	Liver depression and lung heat	Xin (2013)
165	Qingfei Zhike Yangyin Decoction	Strengthening the body resistance to eliminate pathogenic factors, clearing lung and nourishing Yin	SS, MD, Rhodiolae Crenulatae Radix et Rhizoma (Hongjingtian, HJT), CH, HQ, BQC, DGP, ZW, KDH, QH, BQ, DL	Lingering pathogen due to deficient vital Qi, damage and exhaustion of lung-Yin	Zhang (2014)
166	Bainiu Xuanfei Decoction	Outthrusting pathogen and relieving exterior syndrome, dispelling stagnation heat, ascending and descending Qi movement	MH, JC, CT, NBZ, TR, KXR, QH, Schizonepetae Spica (Jingjiesui, JJS), BH, ZW, BB, LG, SBP, GC	Hot and suffocating being inside, exogenous evil being remained	Ma, 2017, Ma et al., 2017a, Ma et al., 2017b
167	Modified Maimendong Decoction	Moistening dryness and clearing lung, depressing Qi and relieving cough, expelling wind and relieving itching	MD, SS, BX, TR, KXR, ZW, FF, ZGC etc.	Dryness evil invading the lung	Chi & Chen (2012)
168	Jiawei Lizhong Tang	Warming middle-jiao and dispelling cold, invigorating Qi and strengthening spleen, warming lung and resolving phlegm	GJ, RS, ZGC, BZ, FL, FBX, CP, XX, WWZ, DZ etc.	Deficiency-cold type	Wu (2013)
169	Chenxia Liujunzi Decoction	Harmonizing lung and spleen, resolving phlegm and relieving cough	CP, FBX, DangS, FL, BZ, ZGC etc.	Deficiency of lung Qi	Zhou & Liao (2012)
170	Xuanbi Decoction and Zhisou Powder	Ventilating lung and relieving cough, clearing heat and draining dampness	JJ, Sojae Semen Praeparatum (Dandouzhi, DDC), ZW, BB, JG, PPY, BQ, YJ, SG, Tetrapanacis Medulla (Tongcao, TC), CP, ZGC	Damp-heat obstructing the lung	Zhang (2020b)
171	Xuanfei Huashi Zhike Decoction	Ventilating lung and clearing heat, eliminating dampness and relieving cough	MH, LQ, Vignae Semen (Chixiaodou, CXD), KXR, JG, PPY, QH, SBP, Amomum kravanh Pierre ex Gagnep (Baidoukou, BDK), HP	Damp-heat lying depressed in the lung	Ding, Wang, & Wan (2015)
172	Jingqiao Zhike Recipe	Regulating both cold and warm syndrome, expelling wind and ventilating lung, resolving phlegm and relieving cough	JJ, FF, Bzhi, XX, HQ, LQ, NBZ, CT, ZW, BS, SJ, GC	Cold-heat complex	Wu (2017)
173	Wenfei Decoction	/b	MH, SJ, XX, ZW, KDH, FBX, ADC, TJK	Cold-evil lurking the lung	Yang (2019b)
174	Linggan Wuwei Jiangxin Decoction	/b	FL, XX, WWZ, GC, GJ, HQ	Cold fluid-retention suspend inside	Sun (2015)
175	Temperature Lung Decoction	Warming lung to reduce watery phlegm, ventilating lung and relieving cough	MH, GZ, XX, GJ, FL, BS, WWZ, JBX, ZGC	Cold fluid-retention lying latent in the lung	Ren (2013)
176	Runfei Zhike Capsule	Resolving phlegm and relieving cough, replenishing Qi and eliminating evil	BB, JJ, JG, CP, PPY, BQ, BH, SBP, KXR, SY, Jhua, GC etc.	Cold evil guesting lung, lung loss of consciousness, cough caused by reversed flow of Qi	Li (2008)
177	Yuping Zhike Decoction	Ventilating lung and relieving cough, lowering lung and resolving phlegm	Hqi, BZ, BB, FF, BQ, JG, ZW, KXR, GJ, GC, WWZ, MH	Asthenic cold of the lung Qi	Huang (2018b)
178	Maxing Shigan Decoction Combined with Xiebai Powder	Cold-pungent catharsis, clearing lung and preventing asthma; clearing lung and relieving heat, stopping cough and asthma	MH, KXR, SSG, ZGC, SBP, DGP, HQ pieces, JG, QH	Accumulation of pathogenic heat in the lung	Li (2020b)

Note: a: The names of the prescriptions are the same, but the compositions of the single TCMs are different. They do not belong to the same prescription, so they are distinguished by A, B, C and D.

b: The traditional efficacy of the compounds has not been reported yet.

As above-mentioned, wind pathogen is the main content in treating PIC by TCMs. It can cause disease alone or together with dryness, cold, heat and phlegm (Fig. 1). Wind pathogen is the first of six evils including wind, cold, heat, humidity, dryness and heat, which is one of the most common and important pathogenic factors. Most modern TCM physicians pay attention to the pathogenic characteristics of wind pathogen, and most of them use TCM prescriptions with the efficacy of dispelling wind or expelling wind, ventilating lung and relieving cough (Table 1). In the selection of single TCMs, Glycyrrhizae Radix et Rhizoma (Gancao), Armeniacae Semen Amarum (Kuxingren), Platycodonis Radix (Jiegeng), Asteris Radix et Rhizoma (Ziwan), Cicadae Periostracum (Chantui), Stemonae Radix (Baibu), Ephedrae Herba (Mahuang) and Schizonepetae Spica (Jingjie) are frequently used (Table 1).

Fig. 1.

Distribution characteristics of syndrome types of PIC treated with TCMs.

4.1. TCM prescriptions for clinical treatment of PIC caused by wind pathogen

Modern research has proven that TCMs with the effects of dispelling wind or expelling wind, ventilating lung and relieving cough is indeed effective in the treatment of PIC caused by most wind pathogens. Du used Qufeng Zhike Decoction (efficacy: expelling wind and clearing heat, ventilating lung and relieving cough) to treat PIC of wind pathogen invading the lung (Du, 2014). Compared with Montelukast Sodium, Qufeng Zhike Decoction has the advantages of faster onset time, shorter course of treatment and more significant treatment effects. Zhong observed the curative effects of TCM syndromes, total scores of cough symptom and visual simulation scores of cough in patients with PIC of wind pathogen invading the lung (Zhong, Yang, & Weng, 2017). They found that taking Xuansu Zhike Decoction (efficacy: dispelling wind, ventilating lung and relieving cough) on the basis of conventional Western medicine treatment can play better therapeutic effects. Yan respectively used Jiushou Tang (efficacy: dispelling wind and ventilating lung, resolving phlegm and relieving cough) and Compound Methoxamine Capsule to treat PIC patients with wind pathogen adhering the lung for 14 d (Yan, 2019). The results showed that the efficacy of Jiushou Tang was superior to Compound Methoxamine Capsule in improving symptoms of PIC patients, with fewer adverse reactions. Sun found that Xuanfei Zhisou Decoction (efficacy: dispelling wind and evil, ventilating lung and relieving cough) can reduce TCM syndrome scores, cough symptom scores, serum interleukin 1-β (IL-1β) level and shorten cough symptom onset time of PIC (wind pathogen lurking the lung), which is safe and effective (Sun, 2019). Weiselected 120 PIC patients with wind pathogen lurking the lung to study the clinical efficacy of Qingfei Zhisou Tang (efficacy: dispelling wind and ventilating lung, relieving cough and resolving phlegm) combined with Compound Methoxyphenamine Capsule in treating this syndrome (Wei, 2018). The results showed that the combination of the two drugs could relieve the cough degree and improve the quality of life more effectively, and the effects were better than that of using Compound Methoxyphenamine Capsule alone. Secretory immunoglobulin A (SIgA) is the main antibody of local anti-infective immunity of body mucosa (Zhu, 2017). Huang used modified Mulberry Apricot Decoction (dispelling wind and ventilating lung, clearing throat and relieving cough) combined with Compound Methoxyphenamine to treat PIC patients with wind pathogen and stagnated heat, found that the combined use of drugs could effectively increase SIgA content in patients' airway mucosa, and the therapeutic effects were better than Compound Methoxyphenamine alone (Huang, 2016).

4.2. Common single TCMs for clinical treatment of PIC caused by wind pathogen

Gancao, entering into the heart, lung, spleen and stomach meridians, has the functions of detoxification, moistening lung, relieving cough, relieving acute symptoms and invigorating spleen (Lv, 2019, Lin, 2019, Wang, 2017). It is sweet in taste, neutral in nature and good in harmony with hundreds of medicines. It can be compatible with most Chinese medicinal materials and harmonize their medicinal properties (Li, 2019b). Modern pharmacological studies have shown that GanCao has the effects of anti-inflammatory, anti-allergic, antitussive, reducing airway hyperresponsiveness (Lv, 2019, Huang, 2016, Wang, 2017).

Kuxingren has the effects of dispelling wind and evil, resolving phlegm, relieving cough and asthma (Yan, 2019). It has been found that amygdalin, the main active ingredient of KuXingRen, can be decomposed into hydrocyanic acid in the body, which can then inhibit the respiratory center, make breathing more gently, and play a part in relieving cough and asthma (Ao, Zhang, Shao, Wang, & Dou, 2021). Many Chinese medicine practitioners use Kuxingren as a medicine for pulmonary diseases in clinic.

Jiegeng is bitter and pungent in taste, neutral in nature, belonging to lung meridian. It has the functions of ventilating lung, relieving sore throat, resolving phlegm and discharging pus (Kong, 2020, Yu, 2016). Studies have shown that the main chemical components of JieGeng include polysaccharides, triterpene saponins, flavonoids, which have pharmacological activities such as antitussive and expectorant, anti-inflammatory, anti-tumor, hypoglycemic and enhancing body immunity (Zuo, Yin, & Hu, 2019).

Ziwan goes into the lung meridian, which has the effects of moistening lung and lowering Qi, resolving phlegm and relieving cough (Zhou, 2016). It is rich in chemical components, mainly including terpenoids and their glycosides, peptides. Modern pharmacological studies have shown that it has the effects of antitussive and expectorant, ventilating lung and relieving asthma, and its antitussive and expectorant effects mainly come from terpenoids (Shen et al., 2017, Yan, 2019, Peng et al., 2015, Fang et al., 2012).

Chantui is an insect medicine, which is sweet in taste and cold in nature. It acts on the lung and liver channels, and has the functions of dispelling wind-heat, ventilating lung and relieving sore throat (Hong et al., 2018, Zeng, 2018). Chantui has complex chemical composition, mainly containing chitin, protein, amino acid (Zhao, Zhou, Wang, Zhang, & Sun, 2017). Modern pharmacological studies have pointed out that ChanTui has antitussive, expectorant, antiasthmatic and spasmolytic effects (Zhang & Yang, 2014).

The main functions of Baibu are to moisten lung and relieve cough. Baibu alkaloid is main active ingredient and also an important component of Baibu in relieving cough (Li, 2019c). Modern pharmacological studies have confirmed that Baibu alkaloids can reduce the excitability of the respiratory center, thus inhibiting the reflex process of cough, playing the role of relieving cough and prolonging the cough incubation period (Fan, Lu, Wang, & Tian, 2017).

Mahuang is slightly bitter, pungent, warm in nature, acts on lung and bladder meridians, and has the functions of ventilating lung, relieving asthma, sweating and relieving exterior, inducing diuresis for removing edema (Huang, Wang, & Wu, 2018). According to modern pharmacological research, Mahuang has the functions of sweating, relieving asthma, relieving cough, anti-inflammatory, anti-allergic, antibacterial, and its effective components are mainly ephedrine, pseudoephedrine and volatile oil (Yang, Xiao, Zhang, & Cheng, 2015).

Jingjie is pungent and slightly bitter. It is slightly warm in nature, belonging to lung and liver meridians, and has the effects of expelling wind and relieving exterior (Jiang, 2018, Dong, 2019). Jingjie has mild medicinal properties, and its main active components are volatile oil and flavonoids. Modern pharmacological studies have shown that Jingjie has antipyretic, anti-inflammatory, analgesic, antibacterial, antiviral, anti-tumor and hemostatic effects (Huang, Liu, Liu, Wang, & Ye, 2017).

5. Pharmacology of TCMs in clinical treatment of PIC

At present, the pharmacodynamic material basis of TCMs in treating PIC is not clear, but the modern pharmacological research shows that PIC pathogenesis is closely related to airway inflammation. Therefore, this paper discusses the possible pharmacodynamic material basis of TCMs in treating wind-induced PIC from the perspective of anti-inflammatory.

Flavonoids from Gancao have excellent anti-inflammatory activity. For example, Guan et al found that licorice flavone can improve lipopolysaccharde (LPS)-induced lung inflammation in mice, and its anti-inflammatory effect may be related to the inhibition of tumor necrosis factor-α (TNF-α) mRNA, IL-1β mRNA and TNF-α protein expression in lung tissues, and the regulation of oxidation/antioxidant response (Guan & Xie, 2009).

Amygdalin not only has antitussive effect, but also has certain anti-inflammatory activity. Hwang et al. treated LPS-induced RAW264.7 cancer cells with amygdalin, and the results showed that serum TNF-α and IL-1β, the molecular markers of inflammation, were inhibited (Hwang, Lee, Kim, Shim, & Hahm, 2008). Yang et al found that amygdalin could inhibit the inflammatory response of LPS-treated mouse BV2 glial cells, and its anti-inflammatory mechanisms might be by down-regulating the mRNA expression of LPS-induced cyclooxygenase-1 (COX-1), cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase (iNOS), so as to inhibit the synthesis of prostaglandin E2 and the production of nitric oxide (NO) (Yang et al., 2007).

Platycodin is the main active component of Jiegeng. Zhang et al. found that platycodin D can significantly inhibit the increase of airway eosinophils induced by ovum albumin (OVA) using mouse asthma model with OVA, and reduce the levels of inflammatory factors interleukin-4 (IL-4), interleukin 5 (IL-5) and interleukin-13 (IL-13) in bronchoalveolar lavage fluid (BALF), which has potential anti-allergic asthma effect (Zhang, Yang, Du, Yao, & Wang, 2015). He et al, established a mouse model of chronic bronchitis by smoking and inhaling concentrated ammonia water, then treated mice with platycodin for 30 d (He et al., 2013). The results showed that the expression of inflammatory cytokines IL-1β and TNF-α in lung tissues of mice in the treatment group was significantly reduced.

Su et al. isolated nine asters saponins from Ziwan and evaluated their anti-inflammatory activities (Su et al., 2019). Among them, aster saponin B has the strongest inhibitory effect on LPS-induced production of NO in mouse macrophages. In RAW 264.7 cells activated by LPS, aster saponin B can down-regulate the levels of iNOS and COX-2 protein in a dose-dependent manner.

Yang et al. obtained two new N-acetyldopamine tetrapolymers, cicadamide A and cicadamide B, from Chantui (Yang, Li, Li, & Wang, 2012). It was found that the above two compounds could inhibit NO release induced by LPS in RAW264.7 cells, indicating that both them possessed anti-inflammatory activities. Xu et al. studied two N-acetyldopamine dimers in Chantui and found that they had antioxidant and anti-inflammatory activities (Xu et al., 2006).

Alkaloids are the main active components of Baibu. Jung et al. found that tuberostemonine has anti-inflammatory effect on mice with acute pneumonia induced by cigarette smoke. Intraperitoneal injection of tuberostemonine in mice improved airway epithelial thickening and significantly inhibited the production of chemokines in lung tissue, indicating its anti-inflammatory activity (Jung et al., 2016a). Jung et al. also found that intraperitoneal injection of tuberostemonine N in mice with chronic obstructive pulmonary disease could significantly reduce the infiltration of inflammatory cells around bronchi and blood vessels, and significantly reduce the levels of inflammatory cytokines and chemokines in BALF, suggesting that tuberostemonine N has an anti-inflammatory effect on airway inflammation (Jung et al., 2016b).

Alkaloids are the main medicinal parts of Mahuang. Meng et al. separated the licorice flavonoids, saponins, and ephedra alkaloids in the experiment of studying the changes of main pharmacodynamic components and anti-inflammatory activities before and after the compatibility of Mahuang and Gancao (Meng, Pi, Song, Liu, & Liu, 2009). The mouse auricle swelling model induced by xylene was used to study the changes of anti-inflammatory activity before and after compatibility. The results showed that the main parts of Mahuang and Gancao had certain anti-inflammatory effect, and the anti-inflammatory effect of co-decoction was better than that of single decoction.

The volatile oil of Jingjie has anti-inflammatory effect on various inflammatory animal models. Xie et al. established a rat model of acute lung injury by tail vein injection of LPS to explore the anti-inflammatory mechanism of Jingjie volatile oil (Xie, Shen, Jin, & Xu, 2007). The results showed that one of the anti-inflammatory mechanisms may be related to inhibiting the degradation of phosphorylation of inhibitor kappa B alpha (IκB-α) and the activity of nuclear factor kappa-B (NF-κB), thereby reducing the synthesis and release of inflammatory cytokines IL1-β and TNF-α.

The above may be the potential pharmacodynamic material basis of common single TCMs in treating PIC based on expelling wind pathogen under the guidance of anti-inflammatory activity, but it still needs further verification. As the molecular mechanism of wind pathogen could not be explained thoroughly at present by modern science, the mechanisms of the TCMs could not be simply ascribed to the anti-inflammatory effects. In the future, we can concentrate our eyes on this aspect and conduct in-depth research.

6. Discussion

6.1. Present situation of PIC

PIC belongs to the category of subacute cough, and its incidence has been high in recent years, which not only brings challenges to clinical treatment, but also brings certain economic burden to patients. In addition to its complicated etiology, difficult diagnosis, long course of disease, and easy recurrence, it is speculated that there is a certain relationship between air pollution and PIC. Although the correlation between air pollution and PIC is unknown at present, some studies have found that air pollution is related to the occurrence and development of residents' upper respiratory tract infection (URTI) (Xia et al., 2017, Li et al., 2018, Tam et al., 2014), and PIC is closely related to URTI, which may be one of the reasons for its high incidence.

6.2. Advantages and challenges of TCMs in treatment of PIC

TCMs have obvious advantages in treating PIC, and they are effective in improving related symptoms and indicators of PIC. Although modern TCM physicians have not reached a consensus on the etiology, pathogenesis and syndrome distribution of PIC, the vast majority of physicians advocate determine treatment on the basis of pattern types, and generally agree that wind pathogen plays a central role in TCM treatment of PIC. It can cause disease alone or with other pathogens. TCMs with the efficacy of dispelling wind or expelling wind, ventilating lung and relieving cough are often used for treatment, and have achieved remarkable therapeutic effects. However, the pharmacological research on treating PIC with TCMs is relatively weak at present. For example, the effective components of prescription therapy for PIC are not known yet, which limits their use to a certain extent. At the same time, there is no unified standard for the diagnosis and treatment of PIC in TCMs, which is also a challenge that cannot be ignored. In the future, we can further explore the material basis and mechanisms of TCMs in treating PIC, so as to better guide the clinical treatment and experimental research of PIC.

TCMs, guided by holistic concept and syndrome differentiation, have certain advantages in treating PIC, with definite curative effect, few side effects and adverse reactions, which can improve PIC patients symptoms and quality of life and reduce their pain. It is believed that with the in-depth study of the material basis and mechanism of pharmacodynamics, TCMs will play a greater role in the treatment of PIC, showing the unique advantages of TCMs.

Authors’ contributions

N.L., W.X. and D.Z. carried out and conceived the project. R.J. searched the literatures, collected the data, analyzed the data and drafted the primary version of manuscript. X.Q. and X.L. were responsible for the initial proofreading of the content. D.Z. and N.L. adjusted the main structure of the manuscript. G.C., D.Z. and N.L. revised the final draft. All authors read and approved the final manuscript. The decision to submit the manuscript for publication was made by all the authors.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.