Acupuncture can be extremely effective for chronic cough, and one that we as providers have seen more than ever over the last year with a global pandemic going on including the aforementioned symptom. Chronic cough is a health concern that has become top-of-mind, especially with the impact of COVID-19. Many of those who were afflicted with COVID, known in TCM as Wen Yi or Heat Disease, are finding that even if they recover some of the symptoms, namely chronic cough, linger for many months afterwards. Additionally, according to National Institutes of Health in 2020, 10.9% of participants had chronic cough, however this was a poll from the previous two years, and has more than likely skyrocketed due to COVID.
Western Medicine for Chronic Cough
According to western medicine, chronic cough is defined as a cough that persists for more than 8 weeks in adults, and more than 4 weeks for children. The occasional cough is normal as it helps to rid the lungs of irritants, and prevents infection. When the cough persists for too long, however, this is when it is usually resulting from a medical problem.
Chronic Cough Symptoms:
- Stuffy nose
- Hoarse voice
- Incessant throat clearing and/or sore throat
- Shortness of breath
- Sour taste in the mouth
- Heartburn
- Postnasal drip
- In rare examples, spitting up blood or sputum
Once it is determined that chronic cough is the issue, identifying the cause becomes increasingly important.
Causes of Chronic Cough:
- Asthma – this may come and go seasonally, become worse with cold weather, become worse with certain fragrances, or appear after an upper respiratory tract infection.
- Infection – coughing can linger after the majority of other symptoms of a cold, pneumonia, the flu, and more recently, COVID have gone away.
- Gastroesophageal Reflux Disease (GERD) – the persistent irritation from acid flowing back into the esophagus can cause chronic cough which then worsens the GERD.
- Postnasal Drip – when the nose is stuffy, the sinuses are producing extra mucus which drips in the back of the throat causing coughing.
- Chronic Obstructive Pulmonary Disease (COPD) – chronic inflammatory lung disease which causes a blocked airflow from the lungs.
- ACE Inhibitors – blood pressure drugs are known to cause chronic cough in some patients.
Along with these causes are a multitude of other less-common causes such as lung cancer, cystic fibrosis, various forms of bronchitis, and reflux. Having chronic cough can not only come with multiple causes, but also lead to other issues due to the persistent coughing such as sleep problems, headaches, dizziness, fractured ribs, sweating, urinary incontinence, syncope, and vomiting. Fortunately for us, acupuncture can address many issues at the same time.
Acupuncture & Chronic Cough
According to Traditional Chinese Medicine, chronic cough can be caused by both internal and external factors. It is vital to address the root cause of the cough as once this is cleared up the cough will be cleared up as well, but no matter the underlying cause, the lungs must be treated.
Beneficial Acupuncture Points, Herbs, & Patterns for Chronic Cough:
Chronic Coughs from External Factors:
- Wind Heat – acute raspy cough, hoarse throat, headache, sticky yellow mucus, thirst, floating rapid pulse.
- Beneficial herbal formula: Sang Ju Yin with a primary action of treating cough first, then releasing the external factor.
- Beneficial acupuncture points: UB12, LI4, DU14, SJ5, LI11, LU6.
- Beneficial herbal formula: Sang Ju Yin with a primary action of treating cough first, then releasing the external factor.
- Wind Cold – acute heavy cough with frequent loud sound, white phlegm, stuffy nose, achy, headaches, chills, stiff neck, floating tight pulse.
- Beneficial herbal formula: Xing Su Yin with a primary action resolving external factors and deal with the diminished lung Qi function.
- Beneficial acupuncture points: UB12, GB20, LI4, LU7.
- Beneficial herbal formula: Xing Su Yin with a primary action resolving external factors and deal with the diminished lung Qi function.
- Warm Dry – dry cough, incessant tickling in the throat, thirst, headache, minimal phlegm, mild fever, chest pain, dry tongue, floating thin rapid pulse.
- Beneficial herbal formula: Qing Zao Jiu Fei Tang with a primary function of clearing heat and moistening the lung.
- Beneficial acupuncture points: UB12, KI6, LU9, LI4, LU6, SP6.
- Beneficial herbal formula: Qing Zao Jiu Fei Tang with a primary function of clearing heat and moistening the lung.
- Cold Dry – dry cough, dry mouth, dry throat, dry nose, chills, dry tongue, floating tight pulse.
- Beneficial herbal formula: Xing Su Yin with a primary function of nourishing and moistening the lung, dispersing lung qi, and resolving exterior factors.
- Beneficial acupuncture points: LU9, KI6, UB12, LU7, SP6.
- Beneficial herbal formula: Xing Su Yin with a primary function of nourishing and moistening the lung, dispersing lung qi, and resolving exterior factors.
Chronic Coughs from Internal Factors:
- Lung (Kidney) Yin Deficiency – dry chronic short coughs, minimal phlegm potentially with a little blood, thirst, worse in the afternoon or evening, warm hands and soles of the feet, night sweats, dry mouth, low-grade fever, red tongue with no coating, thin pulse.
- Beneficial herbal formula: Bai He Gu Jin Tang with a primary function of moistening the lung, stopping cough, and nourishing yin.
- Beneficial acupuncture points: UB23, LU5, UB13, LU9, KI6, LU9, KI6, KI3.
- Beneficial herbal formula: Bai He Gu Jin Tang with a primary function of moistening the lung, stopping cough, and nourishing yin.
- Lung Phlegm Heat – cough with sticky yellow mucus, phlegmy throat, chest pain, fever, thirst, red tongue with yellow greasy coating, slippery pulse.
- Beneficial herbal formula: Chuan Bei Ban Xia Tang with a primary function of treating the cough from sticky yellow mucus.
- Beneficial acupuncture points: SP6, LU1, LI11, LU5, ST40.
- Beneficial herbal formula: Chuan Bei Ban Xia Tang with a primary function of treating the cough from sticky yellow mucus.
- Phlegm Dampness – chronic cough with a heavy turbid sound, sticky white mucus, cough more in the morning or after eating, wheezing, nausea, pale swollen tongue with a white greasy coating, slippery pulse.
- Beneficial herbal formula: Er Chen Tang or Qing Fei Yin with a primary function of drying damp, reducing phlegm, and regulating the middle burner.
- Beneficial acupuncture points: LU9, LU5, SP6, ST36, SP3, ST40.
- Beneficial herbal formula: Er Chen Tang or Qing Fei Yin with a primary function of drying damp, reducing phlegm, and regulating the middle burner.
- Liver Fire – sudden heavy cough sounding like a barking noise, emotional stress, red face and eyes, dizziness, vertigo, headache, red tongue with yellow coating, wiry rapid pulse.
- Beneficial herbal formula: Long Dan Xie Gan Tang with Chuan Bei Ban Xia Tang or Xie Bai San with a primary function of addressing presenting symptoms of intense cough, and intense emotion.
- Beneficial acupuncture points: LI11, LU1, GB34, LU5, LV3, LV2.
- Beneficial herbal formula: Long Dan Xie Gan Tang with Chuan Bei Ban Xia Tang or Xie Bai San with a primary function of addressing presenting symptoms of intense cough, and intense emotion.
While there are plenty more TCM patterns, especially with internal factors in regards to chronic cough, these are the most common.
In a condition like chronic cough, according to TCM, there is also potentially rebellious Qi, and with the proper acupuncture points, we can redirect the Qi downward in the proper direction. One extremely beneficial acupuncture point that should be used with any combination of points is CV17 or Chest Center. This point allows for Lung Qi to stop rising and reverses the direction of the Qi therefore reducing or even eliminating cough. While acupuncture can be beneficial for cough in its own right, it is suggested to use both herbal formulas and acupuncture to achieve maximum benefits with chronic cough conditions.
Acupuncture Treating Chronic Cough
Along with our TCM treatment, the patient may also benefit from guidance on some changes they can make at home, or even home remedies. Patients should avoid smoking, use a humidifier, implement breathing exercises, and implement a gentle exercise program, such as yoga.
Some home remedies to give patients may be as simple as guidance on Gua Sha therapeutic massage, gargling salt water, honey citrus mixture, or tangerine skin tea. It is important that we treat the patients both in office and give them the tools they need for healing for when they are home. Chronic cough can come with a multitude of factors, and has become more of a concern now more than ever. Being sure to take in all histories, constitutions, and root conditions of the patient, which are vital to overcoming chronic cough and helping them to regain optimal health.
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