A 65-year-old woman with a one-year history of recurrent, trigger-induced cough was managed with a modified Fu He Tang decoction targeting wind and phlegm-dampness.

Case ID: CHC-0004

Case Summary

This case describes a 65-year-old woman who presented with a chronic, refractory cough lasting one year. The original report documented a Western medical diagnosis of cough variant asthma and upper airway syndrome, along with a TCM assessment of Wind pathogen invading the lungs complicated by internal phlegm-dampness. The patient was managed through a customized herbal approach focusing on dispersing wind and resolving dampness.

Patient Presentation

• Patient: 65-year-old female.
• Main Complaint: Recurrent, paroxysmal choking cough lasting for one year.
• History: The patient experienced sudden, dry coughing bouts triggered by a tickle in the throat and environmental irritants like cooking fumes or strong odors. The coughing was markedly worse at night when lying down, frequently waking her up. She reported mild aversion to wind and occasional headaches, but had normal sweating, appetite, and digestion. Previous conventional treatments, including prescription medications for asthma, failed to provide lasting relief.

Examination and Diagnosis

• Conventional Diagnosis: A pulmonary function provocation test was positive, while a chest CT showed no obvious abnormalities. She was diagnosed with cough variant asthma and upper airway syndrome secondary to sinusitis.
• TCM Tongue and Pulse: The tongue was pale and enlarged with teeth marks, covered by a thick, white, greasy coating. The pulse was fine (脉细).

TCM Assessment

The original practitioner interpreted the presentation as Wind pathogen invading the lungs with internal Phlegm-Dampness (风邪犯肺，痰湿内伏).

In TCM theory, “Wind” is considered a pathogenic factor that moves swiftly, changes rapidly, and often attacks the upper respiratory tract. The patient’s extreme sensitivity to drafts, sudden throat tickles, and nighttime worsening are hallmark signs of this dynamic. According to the core principles of yin and yang Chinese Medicine, when the exterior defensive layer of the body is breached by Wind, it disrupts the Lung’s natural descending function. Furthermore, her enlarged tongue and greasy coating indicated underlying Phlegm-Dampness. This internal dampness acted as a chronic anchor (or “root”) for her illness, while the external Wind served as the acute trigger, collectively creating a highly reactive and spastic airway.

Treatment Approach

Within the TCM framework reported in the case, the primary treatment principle was to disperse wind, ventilate the lungs, and relieve airway spasms, while simultaneously strengthening the Spleen to resolve the underlying phlegm-dampness.

Herbal Formulas and Modifications

• Core Formula (Initial Visit): The practitioner prescribed a modified version of Fu He Tang (敷和汤加减).
• Action: This prescription was designed to address both the acute symptoms and the underlying constitution. It included wind-dispersing herbs to calm the hyper-reactive airways and stop the ticklish, choking cough. This was paired with Spleen-fortifying and damp-resolving herbs to clear the internal phlegm, preventing the wind and dampness from binding together and causing relapses.

Follow-Up

• One Week Later: After one week of the herbal decoction, the source reported a significant improvement in the patient’s symptoms. Her nighttime choking cough had largely disappeared, and she was no longer waking up at night. Her sensitivity to environmental irritants was markedly reduced. She experienced only occasional, mild coughing during the day, with all other bodily functions remaining stable. The practitioner subsequently adjusted the formula to consolidate lung function and prevent further relapses.

Why This Case Is Interesting (Clinical Reasoning)

The notable feature of this case is the diagnostic focus on “Wind” rather than just “Phlegm” or “Heat” in treating a chronic cough. While chronic coughs are frequently treated with standard lung-moistening or heavy expectorant formulas, the original practitioner recognized the specific pattern of a Wind-driven condition: a sudden onset (a ticklish throat leading immediately to a coughing fit) and extreme sensitivity to environmental triggers. By utilizing a strategy that prioritized dispersing Wind from the airways alongside resolving internal Dampness, the treatment effectively addressed the airway hyperresponsiveness that characterizes cough variant asthma in Western medicine.

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What This Case Can — and Cannot — Tell Us

This is an individual case report, not a controlled clinical trial. It documents the reasoning, treatment, and outcome reported for one patient and should not be interpreted as evidence that the same approach will produce the same result in another person.

Source

• Original source: Guangdong Provincial Hospital of Chinese Medicine (广东省中医院) / Guangdong Provincial Administration of Traditional Chinese Medicine
• Original title: 以案说医丨风邪犯肺引发反复咳嗽，预防方法与茶饮推荐
• Practitioner: Professor Lin Lin (林琳教授)
• Publication date: May 2, 2026
• Original language: Chinese
• Source link: View original page
• ChineseHerb.org version: English translation and editorial adaptation