Recurrent Cough - Master Zhu Liangchun’s Three Proven Cough-Treating Formulas
19. Recurrent Cough - Master Zhu Liangchun’s Three Proven Cough-Treating Formulas
Master Zhu Liangchun, a National Master of Traditional Chinese Medicine. The following three formulas respectively target external-sensory and internally-induced coughs of various types, chronic phlegm-heat cough, and phlegm-heat congesting the Lung.
Modified Zhissou San (Cough-Relief Powder)
This formula is adapted from Cheng Zhongling’s Zhissou San. The original formula is warm and mild, neither cold nor hot. Zhu Liangchun added Rapeseed, Lobed Band Leaf, Houttuynia, and Fresh Radish Juice to strengthen the power of descending Qi and transforming phlegm as well as clearing Heat, and changed it to a pill formula for long-term use. It is suitable for various types of external-sensory and internally-induced coughs (excluding coughs due to Yin deficiency with Lung dryness).
Modified Zhissou San (Pill formula)
Platycodon 30g Peucedanum 30g Licorice 30g Delonix 30g Notopterygium 30g
Tangerine Peel 30g Stemonia 30g Raw Rapeseed 60g (pounded) Lobed Band Leaf 60g (hair removed, bag-decocted)
Houttuynia 60g Fresh Radish Juice 60g
All herbs are used raw and powdered. Take Rapeseed, Lobed Band Leaf, and Houttuynia, decoct them in water to obtain the juice. Add Fresh Radish Juice to mix the herb powder, form into pills with honey, each pill approximately 7g. One pill per dose, children’s dose halved, taken once in the morning and once in the evening, dissolved in hot water.
| Herb Group | Herb Dosage | Function |
|---|---|---|
| Sovereign | Delonix 30g, Stemonia 30g | Warm-moistening to stop cough. Delonix is acrid, warm, and moistening for the Lung; it is bitter and warm to descend Qi; Stemonia excels at descending phlegm and stopping cough |
| Minister | Platycodon 30g, Peucedanum 30g, Notopterygium 30g | Diffuse Lung and disperse Wind, descend Qi and transform phlegm. Platycodon opens and diffuses Lung Qi; Peucedanum descends Qi and removes phlegm; Notopterygium disperses Wind and releases the exterior |
| Assistant | Raw Rapeseed 60g, Lobed Band Leaf 60g, Houttuynia 60g, Fresh Radish Juice 60g | Descend Qi, dissolve phlegm, clear Lung, and drain Heat. Rapeseed combined with Lobed Band Leaf counteracts and descends Qi; Houttuynia clears the Lung; Fresh Radish Juice moistens the Lung and transforms phlegm |
| Envoy | Tangerine Peel 30g, Licorice 30g | Regulate Qi and harmonize the middle jiao, transform phlegm and harmonize the middle jiao |
Lung-Clearing and Cough-Suppressing Decoction (Qingfei Dingke Tang)
This is a self-created formula by Zhu Liangchun, targeting phlegm-heat patterns in wind-heat influenza, bronchitis, and chronic pneumonia with prolonged cough. The core concept is to clear Lung Heat, transform phlegm-turbidity, and open the orifices. It is notably quick in effect for chronic phlegm-heat cough with thick, yellow, sticky phlegm, difficult expectoration, slightly yellow tongue coating, rapid pulse, and thirst with desire to drink.
Lung-Clearing and Cough-Suppressing Decoction (Qingfei Dingke Tang)
Gold Filial 20g Houttuynia 15g (add later) Hedyotis 20g Jasminum (Tian Jiang Ke) 12g
Modified Citrus 6g Xanthium 10g Lobed Band Leaf 10g (hair removed, bag-decocted) Raw Licorice 5g
| Herb Group | Herb Dosage | Function |
|---|---|---|
| Sovereign | Gold Filial 20g, Houttuynia 15g (add later) | Clear Lung and drain Heat, resolve Dampness and dispel phlegm. Gold Filial is sweet, cold, bitter, and astringent; it clears and resolves toxins and also invigorates Blood and dispels stasis; Houttuynia is acrid and cold, clears the Lung, and drains pus. The two herbs combined separate and resolve Damp-Heat, cutting off the source of phlegm regeneration |
| Minister | Hedyotis 20g, Jasminum (Tian Jiang Ke) 12g | Hedyotis clears and transforms phlegm-heat and also differentiates and promotes drainage of Damp-Heat; Jasminum (Tian Jiang Ke) is salty and level in nature, softens hardness, transforms phlegm, and stops cough with wheezing |
| Assistant | Lobed Band Leaf 10g, Modified Citrus 6g, Xanthium 10g | Lobed Band Leaf clears the Lung, descends Qi, and transforms phlegm; when Qi descends, Fire descends and phlegm flows smoothly; Modified Citrus regulates Qi and transforms phlegm; Xanthium removes Dampness, raises Yang, and opens the Governing Vessel, also opening nasal orifices |
| Envoy | Raw Licorice 5g | Moistens the Lung and stops cough, harmonizes all the herbs |
Phlegm-Resolving and Cough-Suppressing Decoction (Huanhua Dingke Tang)
Like the Lung-Clearing and Cough-Suppressing Decoction, this formula is also used by Zhu Liangchun for phlegm-heat cough, but the emphasis differs - the Phlegm-Resolving and Cough-Suppressing Decoction has stronger power of clearing Heat and resolving toxins (Hedyotis used up to 30g), biased toward excess patterns with heavy phlegm-heat congestion, sticky phlegm stagnation, and difficult expectoration. It is suitable for acute or chronic bronchitis with prolonged ineffective treatment, still frequent coughing and irritation, thin greasy tongue coating, and slippery pulse.
Phlegm-Resolving and Cough-Suppressing Decoction (Huanhua Dingke Tang)
Gold Filial 20g Hedyotis 30g Vitex Fruit 20g Houttuynia 20g
Nandina Fruit (Tian Zhu Zi) 10g Jasminum (Tian Jiang Ke) 10g Modified Citrus 8g Licorice 8g
| Herb Group | Herb Dosage | Function |
|---|---|---|
| Sovereign | Gold Filial 20g, Hedyotis 30g | Clear Heat and resolve toxins, transform phlegm and promote Dampness drainage. Hedyotis used up to 30g to greatly strengthen clearing and transforming phlegm-heat |
| Minister | Houttuynia 20g, Nandina Fruit (Tian Zhu Zi) 10g, Jasminum (Tian Jiang Ke) 10g | Houttuynia clears the Lung and drains turbidity; Nandina Fruit (Tian Zhu Zi) has a strong cough-suppressing effect (contains Nandina alkaloid; excessive dosing easily causes toxicity, Zhu Liangchun keeps it around 10g), combined with Jasminum (Tian Jiang Ke) to soften hardness, transform phlegm, and stop cough |
| Assistant | Vitex Fruit 20g, Modified Citrus 8g | Vitex Fruit disperses Wind and clears Heat, also clears and opens the head and eyes; Modified Citrus regulates Qi and transforms phlegm |
| Envoy | Licorice 8g | Moistens the Lung and stops cough, harmonizes all the herbs |
Summary
Modified Zhissou San is warm and mild, with the pill formula providing gradual results, suitable for various external-sensory and internally-induced coughs (excluding Yin deficiency with Lung dryness); Lung-Clearing and Cough-Suppressing Decoction clears Lung Heat and drains Fire, transforms phlegm, and opens the orifices, suitable for phlegm-heat chronic cough after wind-heat influenza or pneumonia; Phlegm-Resolving and Cough-Suppressing Decoction has the strongest power of clearing Heat and resolving toxins, suitable for excess patterns with heavy phlegm-heat congestion in acute or chronic bronchitis. All three formulas target phlegm-heat or phlegm-dampness coughs; they are not suitable for cold-Heat binding the Lung or Yang deficiency with phlegm-fluid coughs. Nandina Fruit (Tian Zhu Zi) has a paralytic effect on the respiratory center; the Phlegm-Resolving and Cough-Suppressing Decoction must strictly control the dosage.
References
[1] Qiu Zhiji, Zhu Jianping, Ma Xuanqing. Analysis of Zhu Liangchun’s Experience and Features in Treating Prolonged External-Sensory Cough [J]. Liaoning Journal of TCM, 2002, 29(1): 8-9.
[2] Zhu Liangchun. Zhu Liangchun Medical Collection [M]. Changsha: Central South University Press, 2006.
[3] Zhu Liangchun. Zhu Liangchun’s Herbs and Medications Experience Collection [M]. Changsha: Hunan Science and Technology Press, 2000.
19. 咳嗽反覆—國醫大師朱良春治咳驗方三首
朱良春國醫大師，以下三首方分別針對外感內傷諸咳、痰熱久咳、痰熱壅肺三種咳嗽格局。
止嗽散加減
此方由程鍾齡止嗽散化裁而來。原方溫潤和平、不寒不熱，朱良春加萊菔子、枇杷葉、魚腥草、生蘿蔔汁，增強降氣化痰與清熱之力，並改為丸劑以便久服。適用於外感、內傷諸般咳嗽（陰虛肺燥咳嗽除外）。
止嗽散加減（丸劑）
桔梗 30g 前胡 30g 甘草 30g 紫菀 30g 荊芥 30g
陳皮 30g 百部 30g 生萊菔子 60g（研） 枇杷葉 60g（去毛，包煎）
魚腥草 60g 生蘿蔔汁 60g
諸藥生用研末，取萊菔子、枇杷葉、魚腥草煎湯取汁，加生蘿蔔汁調藥末，蜜泛為丸，每丸約 7g。每服 1 丸，小兒減半，早晚各一次，開水化服。
| 藥組 | 藥物 | 功用 |
|---|---|---|
| 君 | 紫菀 30g、百部 30g | 溫潤止咳，紫菀辛溫潤肺、苦溫下氣，百部長於下痰止嗽 |
| 臣 | 桔梗 30g、前胡 30g、荊芥 30g | 宣肺疏風、降氣化痰。桔梗宣通肺氣，前胡降氣祛痰，荊芥疏風透表 |
| 佐 | 生萊菔子 60g、枇杷葉 60g、魚腥草 60g、生蘿蔔汁 60g | 降氣消痰、清肺洩熱。萊菔子合枇杷葉降逆下氣，魚腥草清肺，生蘿蔔汁潤肺化痰 |
| 使 | 陳皮 30g、甘草 30g | 理氣調中，化痰和中 |
清肺定咳湯
朱良春自擬方，針對風熱流感、支氣管炎、肺炎久咳偏於痰熱者。核心思路是清肺熱、化痰濁、通竅道。對痰熱蘊肺之久咳、痰黏黃稠、咯唾不爽、苔微黃、脈數、口渴欲飲之證，頗有速效。
清肺定咳湯
金蕎麥 20g 魚腥草 15g（後下） 白花蛇舌草 20g 天漿殼 12g
化橘紅 6g 蒼耳子 10g 枇杷葉 10g（去毛，包煎） 生甘草 5g
| 藥組 | 藥物 | 功用 |
|---|---|---|
| 君 | 金蕎麥 20g、魚腥草 15g（後下） | 清肺洩熱、化溼祛痰。金蕎麥甘寒苦澀，清熱解毒兼活血祛瘀；魚腥草辛寒，清肺排膿。二藥相伍，分化溼熱，痰無再生之源 |
| 臣 | 白花蛇舌草 20g、天漿殼 12g | 白花蛇舌草清化痰熱兼分利溼熱；天漿殼咸平，軟堅化痰而止咳平喘 |
| 佐 | 枇杷葉 10g、化橘紅 6g、蒼耳子 10g | 枇杷葉清肺降氣化痰，氣下則火降痰順；化橘紅理氣化痰；蒼耳子祛溼昇陽通督脈，兼通鼻竅 |
| 使 | 生甘草 5g | 潤肺止咳，調和諸藥 |
化痰定咳湯
與清肺定咳湯同屬朱良春治痰熱咳嗽之方，但側重不同——化痰定咳湯清熱解毒力度更大（白花蛇舌草用至30g），偏於痰熱壅盛、黏痰壅滯、咯唾不爽之實證。適用於急慢性支氣管炎久治未愈、咳嗆仍頻、舌苔薄膩、脈滑者。
化痰定咳湯
金蕎麥 20g 白花蛇舌草 30g 蔓荊子 20g 魚腥草 20g
天竺子 10g 天漿殼 10g 化橘紅 8g 甘草 8g
| 藥組 | 藥物 | 功用 |
|---|---|---|
| 君 | 金蕎麥 20g、白花蛇舌草 30g | 清熱解毒、化痰利溼。白花蛇舌草用至30g，加大清化痰熱之力 |
| 臣 | 魚腥草 20g、天竺子 10g、天漿殼 10g | 魚腥草清肺排濁；天竺子鎮咳作用強（含南天竹鹼，過量易中毒，朱良春掌握在10g左右），合天漿殼軟堅化痰止咳 |
| 佐 | 蔓荊子 20g、化橘紅 8g | 蔓荊子疏風散熱，兼清利頭目；化橘紅理氣化痰 |
| 使 | 甘草 8g | 潤肺止咳，調和諸藥 |
小結
止嗽散加減溫潤和平，丸劑緩圖，適用於外感、內傷諸般咳嗽（陰虛肺燥除外）；清肺定咳湯清肺洩熱、化痰通竅，適用於風熱流感、肺炎後痰熱久咳；化痰定咳湯清熱解毒之力最強，適用於急慢性支氣管炎痰熱壅盛之實證。三方均針對痰熱/痰溼咳嗽，寒邪束肺及陽虛痰飲咳嗽不宜。天竺子有麻痺呼吸中樞作用，化痰定咳湯須嚴格控量。
參考文獻
[1] 邱志濟，朱建平，馬旋卿. 朱良春治療外感久咳的經驗和特色選析[J]. 遼寧中醫雜誌，2002，29（1）：8-9.
[2] 朱良春. 朱良春醫集[M]. 長沙：中南大學出版社，2006.
[3] 朱良春. 朱良春用藥經驗集[M]. 長沙：湖南科學技術出版社，2000.