Traditional Chinese medicine composition and traditional Chinese medicine preparation for treating cough and expectoration

Abstract

The invention provides a traditional Chinese medicine composition for treating cough and expectoration. The traditional Chinese medicine composition is prepared from the following components in parts by weight: 6-15 parts of radix scutellariae, 5-10 parts of rhizoma pinellinae praeparata, 10-20 parts of herba houttuyniae, 5-15 parts of bulbus fritillariae cirrhosae, 10-20 parts of rhizoma phragmitis, 6-10 parts of radix platycodonis, 6-10 parts of liquorice root, 10-20 parts of radix astragali, 10-20 parts of radix codonopsis and 10-20 parts of semen coicis. The traditional Chinese medicine composition for treating cough and expectoration provided by the invention is simple in medicine flavor and has a relatively good treatment effect on cough and expectoration caused by phlegm-heat obstructing lung. Based on the traditional Chinese medicine composition, the invention also provides a traditional Chinese medicine preparation taking the traditional Chinese medicine composition as a medicinal active component.

Description

Technical Field

[0001] The present invention relates to the technical field of traditional Chinese medicine, and particularly relates to a traditional Chinese medicine composition and a traditional Chinese medicine preparation for treating cough and expectoration. Background Art

[0002] Cough is a protective respiratory reflex action of the human body. Expectoration is an action in which the pathological secretions in the respiratory tract are expelled from the oral cavity by means of the ciliary movement of the bronchial mucosal epithelial cells, the contraction of the bronchial smooth muscle, and the airflow impulse during coughing. Cough and expectoration are common clinical manifestations of respiratory diseases, and the two often occur together. Various physical (including foreign bodies), chemical, and allergic factors that stimulate the trachea and bronchi, as well as infections by bacteria, tuberculosis bacteria, fungi, viruses, mycoplasmas, parasites, and lung tumors, can all cause cough and expectoration. And respiratory tract infection is the most common cause of cough and expectoration. Although cough and expectoration are a protective reflex action, they can also spread the tracheal lesions to the adjacent small bronchi, aggravating the condition. In addition, persistent and severe cough will affect the patient's rest, consume physical strength, and cause damage to the elastic tissue of the alveolar wall, and even induce emphysema, etc. At present, Western medicine uses symptomatic treatments such as anti-infection, cough suppression, expectoration reduction, and anti-asthma, which have problems such as drug resistance, easy recurrence of symptoms, and poor long-term curative effects.

[0003] Traditional Chinese medicine believes that cough is a disease syndrome caused by external or internal injury and other factors, resulting in the failure of the lung to disperse and descend, and the upward reversal of the lung qi, with the clinical feature of emitting a cough sound or accompanied by expectoration. In past dynasties, a cough without phlegm was called "ke", expectoration without a cough sound was called "sou", and a cough with phlegm and a cough sound was called "kesou". Clinically, the sound of phlegm and cough are often seen together and are difficult to be clearly separated, so they are collectively called "cough". Cough is not only one of the main syndromes of lung diseases but also an independent disease. The research on cough in traditional Chinese medicine has a long history and has formed a relatively complete syndrome differentiation and treatment system in the development process of past dynasties. The treatment of cough has significant advantages, definite curative effects, and can greatly reduce the disadvantages such as drug resistance and side effects of Western medicine treatment.

[0004] However, there are problems such as complex drug flavors, poor pertinence, and uncertain curative effects in the current numerous proprietary Chinese medicines and traditional Chinese medicine compound prescriptions.

[0005] In view of this, the purpose of the present invention is to provide a traditional Chinese medicine composition that has a good therapeutic effect on cough and expectoration caused by phlegm-heat blocking the lung. Summary of the Invention

[0006] The technical problem to be solved by the present invention is to provide a traditional Chinese medicine formula for treating cough and expectoration, with concise drug ingredients and having a good therapeutic effect on cough and expectoration caused by phlegm-heat blocking the lung.

[0007] The first aspect of the present invention is to provide a traditional Chinese medicine composition for treating cough and expectoration, comprising the following components in parts by weight:

[0008] Scutellaria baicalensis Georgi 6 - 15 parts, Pinellia ternata (Thunb.) Breit. var. cirrhosa (Schott) Hsiao & K. C. Hsia 5 - 10 parts, Houttuynia cordata Thunb. 10 - 20 parts, Fritillaria cirrhosa D. Don 5 - 15 parts, Phragmites communis Trin. 10 - 20 parts, Platycodon grandiflorus (Jacq.) A. DC. 6 - 10 parts, Glycyrrhiza uralensis Fisch. 6 - 10 parts, Astragalus membranaceus (Fisch.) Bunge 10 - 20 parts, Codonopsis pilosula (Franch.) Nannf. 10 - 20 parts, Coix lacryma-jobi L. var. ma-yuen (Roman.) Stapf 10 - 20 parts.

[0009] Furthermore, the traditional Chinese medicine composition for treating cough with expectoration includes the following components in parts by weight:

[0010] Scutellaria baicalensis Georgi 10 parts, Pinellia ternata (Thunb.) Breit. var. cirrhosa (Schott) Hsiao & K. C. Hsia 10 parts, Houttuynia cordata Thunb. 15 parts, Fritillaria cirrhosa D. Don 6 parts, Phragmites communis Trin. 20 parts, Platycodon grandiflorus (Jacq.) A. DC. 10 parts, Glycyrrhiza uralensis Fisch. 10 parts, Astragalus membranaceus (Fisch.) Bunge 15 parts, Codonopsis pilosula (Franch.) Nannf. 10 parts, Coix lacryma-jobi L. var. ma-yuen (Roman.) Stapf 20 parts.

[0011] Furthermore, the traditional Chinese medicine composition is used for treating cough with expectoration caused by phlegm - heat obstructing the lung.

[0012] Furthermore, the cough with expectoration caused by phlegm - heat obstructing the lung is caused by cold, acute or chronic tracheo - bronchitis, pneumonia, chronic obstructive pulmonary disease, bronchiectasis, lung abscess, lung nodule, lung cancer, or novel coronavirus infection.

[0013] The second aspect of the present invention is to provide a traditional Chinese medicine preparation for treating cough with expectoration, which contains a pharmaceutically active ingredient and a pharmaceutically acceptable excipient, wherein the pharmaceutically active ingredient is the powder of the traditional Chinese medicine composition described in the first aspect, or the aqueous or organic solvent extract of the traditional Chinese medicine composition.

[0014] Furthermore, the traditional Chinese medicine preparation is an oral preparation, and the oral preparation is a solution, granule, pill, tablet or ointment.

[0015] Furthermore, the traditional Chinese medicine composition is used for treating cough with expectoration caused by phlegm - heat obstructing the lung.

[0016] Furthermore, the cough with expectoration caused by phlegm - heat obstructing the lung is caused by cold, acute or chronic tracheo - bronchitis, pneumonia, chronic obstructive pulmonary disease, bronchiectasis, lung abscess, lung nodule, lung cancer, or novel coronavirus infection.

[0017] The traditional Chinese medicine composition for treating cough and expectoration of the present invention is mainly aimed at cough and expectoration caused by phlegm-heat obstructing the lung. Exogenous or endogenous factors can lead to the failure of the lung to disperse and descend properly, resulting in the upward reversal of lung qi and causing cough. The main organ involved in the pathological changes of cough is the lung, and the pathological factors are mainly phlegm, heat, and deficiency clinically. Insufficient vital qi and weak external defense make the six exogenous pathogenic factors invade the lung system from the outside, leading to cough. As the saying goes, "where pathogenic factors gather, the qi must be deficient." The normal exercise of the function of the defensive qi in resisting pathogenic factors depends on the lungs and spleen. The defensive qi is derived from food and water. When the spleen and stomach function healthily and transport the essence of food and water, the defensive qi can be generated smoothly. When the lung qi disperses, the defensive qi can be distributed to the body surface, skin, and pores. Therefore, patients with cough often have deficiency of both lung and spleen qi. The spleen is the mother of the lung and the source of phlegm production. Improper diet and internal injury to the spleen can lead to the failure of the spleen to transport and transform, resulting in the endogenous production of phlegm turbidity, which accumulates in the lung and can cause the failure of the lung to disperse and descend and reverse upward, leading to cough. The lung is the upper source of water and is responsible for regulating waterways. When the lung fails to disperse and descend, the water fluid cannot be regulated properly, resulting in abnormal metabolism of body fluids, endogenous production of phlegm turbidity, and its transformation into heat, with the combination of phlegm and heat. Phlegm and fire can cause each other. Prolonged stagnation of phlegm can transform into fire, and fire can refine body fluids and consume body fluids to form phlegm. Prolonged accumulation of phlegm and heat that cannot be resolved can lead to repeated and protracted symptoms. The treatment should focus on clearing heat and resolving phlegm, dispersing the lung qi and relieving cough, and tonifying qi and strengthening the spleen. The traditional Chinese medicine composition of the present invention is formulated based on the etiology and pathogenesis of this disease. Among them, Fritillaria cirrhosa is bitter, sweet, and slightly cold in nature, and belongs to the lung and heart meridians. It is moistening, dispersing, descending, and slightly ascending. It is good at resolving phlegm and relieving cough to restore the function of the lung in dispersing and descending. Astragalus membranaceus is sweet and warm, and belongs to the spleen and lung meridians. It can tonify the qi of the lung and spleen, and can also assist the vital qi to expel pathogenic factors. It can expel pathogenic factors without harming the healthy qi and prevent the recurrence of pathogenic factors. The two herbs are combined as the monarch drugs. Scutellaria baicalensis is bitter and cold, and enters the lung, stomach, gallbladder, and large intestine meridians. It is good at clearing away lung heat, drying dampness, and detoxifying. Pinellia ternata is pungent and warm, and belongs to the lung, spleen, and stomach meridians. It is good at resolving phlegm and dissipating nodules. "Compendium of Materia Medica" states: "Pinellia ternata can mainly treat phlegm retention... When dampness is removed, the earth becomes dry, and phlegm and saliva will not be produced." Prepared Pinellia ternata has a milder drying property. When combined with Scutellaria baicalensis, it can resolve phlegm and dissipate nodules without the drawback of promoting heat due to its warm nature. The two herbs are combined as the minister drugs. Houttuynia cordata is pungent and cold, and belongs to the lung meridian. It is a product that can be used both as medicine and food. It can clear heat without causing cold stagnation. Reed rhizome is sweet, cold, and enters the lung and stomach meridians. It is sweet, cold, and floating. It is good at clearing lung heat. Its stem is hollow and is specialized in promoting diuresis. It is good at treating lung abscess with foul-smelling and purulent sputum. Platycodon grandiflorum is pungent, dispersing, bitter, and discharging. It can disperse the lung qi and benefit the chest diaphragm, throat, and can also resolve phlegm and expel pus. Codonopsis pilosula is sweet and flat, and belongs to the spleen and lung meridians. It can tonify qi and strengthen the spleen. Coix seed is sweet, cool, and belongs to the spleen, stomach, and lung meridians. It can strengthen the spleen and promote diuresis to eliminate dampness, targeting the source of phlegm production. The five herbs are combined as the assistant drugs. Licorice is used as the envoy to harmonize all the herbs, and together with Platycodon grandiflorum, it forms the Platycodon Decoction, which is a good prescription for treating lung abscess by Zhang Zhongjing. The compatibility of each herb is precise, and they work together to clear heat and resolve phlegm, disperse the lung qi and relieve cough, and tonify qi and strengthen the spleen.

[0018] Compared with the prior art, the beneficial effects of the traditional Chinese medicine composition for treating cough and expectoration provided by the present invention are as follows:

[0019] The traditional Chinese medicine composition for treating cough and expectoration provided by the present invention has concise ingredients, precise compatibility of each herb, and together they achieve the effects of clearing heat and resolving phlegm, dispersing the lung qi and relieving cough, and tonifying qi and strengthening the spleen, and has a significant effect on cough caused by phlegm-heat obstructing the lung. BRIEF DESCRIPTION OF THE DRAWINGS

[0020] To more clearly illustrate the technical solutions in the embodiments of the present invention, the following will briefly introduce the accompanying drawings required for the description of the embodiments. Obviously, the accompanying drawings in the following description are only some embodiments of the present invention. For those of ordinary skill in the art, without creative efforts, other accompanying drawings can be obtained based on these drawings.

[0021] Figure 1 It is a bar chart of the expression level of rat NF-κBp65 protein in the present invention;

[0022] Figure 2 It is a strip chart of the expression of rat NF-κBp65 protein in the present invention;

[0023] Figure 3 It is a bar chart of the expression level of rat NF-κBp65 mRNA in the present invention. Detailed implementation manners

[0024] In order to enable those skilled in the art to better understand the technical solutions in the embodiments of the present invention and make the above-mentioned objects, features, and advantages of the present invention more obvious and understandable, the following further describes the detailed implementation manners of the present invention.

[0025] In the ranges disclosed herein, the endpoints and any values are not limited to the exact ranges or values. These ranges or values should be understood to include values close to these ranges or values. For numerical ranges, between the endpoint values of each range, between the endpoint values of each range and individual point values, and between individual point values, they can be combined with each other to obtain one or more new numerical ranges, and these numerical ranges should be regarded as specifically disclosed herein.

[0026] The traditional Chinese medicine composition for treating cough and expectoration of the present invention, the nature, flavor, meridian tropism, and pharmacological effects of each drug are as follows:

[0027] Scutellaria baicalensis: Bitter, cold. It belongs to the lung, gallbladder, spleen, large intestine, and small intestine meridians. It clears heat and dries dampness, purges fire and detoxifies, and stops bleeding. It is used for treating diseases such as cough due to lung heat, high fever and restlessness, damp-warm summer heat, chest distress and nausea. Its main chemical components include flavonoids, terpenoids, volatile oils, phenolic acids, polysaccharides, and trace elements. Baicalein, wogonin, baicalin, and wogonoside are the main active components of flavonoids. Modern pharmacological research shows that Scutellaria baicalensis has anti-inflammatory, antitussive and antiasthmatic, diuretic, antimicrobial, antitumor, antioxidant, antifibrotic, and cardiovascular and nervous system protection effects. Its active ingredients can treat respiratory diseases by inhibiting airway or lung inflammation, improving oxidative stress, and reducing pulmonary fibrosis.

[0028] Pinellia ternata: pungent, warm. It acts on the spleen, stomach and lung meridians. It dries dampness and resolves phlegm, and reduces adverse qi and stops vomiting. It is used for cough with profuse phlegm, dizziness due to phlegm retention, wind-phlegm dizziness, headache due to phlegm syncope, vomiting and nausea, stuffiness and discomfort in the chest and epigastrium, etc. Its main chemical components include alkaloids, amino acids, flavonoids, volatile oils, organic acids, pinellin and various trace elements, etc. Modern pharmacological studies have found that Pinellia ternata has antibacterial, anti-inflammatory, antitussive and expectorant, antioxidant, anti-tumor and other effects.

[0029] Houttuynia cordata: pungent, slightly cold. It acts on the lung meridian. It clears heat and detoxifies, and eliminates carbuncles and discharges pus. It is used for lung abscess with expectoration of pus, cough with phlegm and heat, etc. Its main chemical components include volatile oils, flavonoids, alkaloids, phenylpropanoids and steroids and other compounds. Modern pharmacological studies have found that Houttuynia cordata has significant anti-inflammatory, antibacterial, antiviral activities and other pharmacological effects.

[0030] Fritillaria cirrhosa: bitter, sweet, slightly cold. It acts on the lung and heart meridians. It clears heat and moistens the lung, reduces phlegm and relieves cough, and disperses nodules and eliminates carbuncles. It is used for dry cough due to lung heat, dry cough with little phlegm, consumptive cough due to yin deficiency, blood streaks in sputum, etc. Its chemical components are mainly alkaloids. Modern pharmacological studies have found that Fritillaria cirrhosa has antitussive, antiasthmatic, expectorant and anti-inflammatory effects, and it has an obvious relaxing effect on bronchial smooth muscle.

[0031] Phragmites communis rhizome: sweet, cold. It acts on the lung and stomach meridians. It clears heat and purges fire, promotes the production of body fluid and quenches thirst, eliminates vexation, and stops vomiting. It is used for febrile disease with vexatious thirst, cough due to lung heat, vomiting due to stomach heat, etc. Its main chemical components include inorganic elements, proteins, fats, carbohydrates, crude fiber, organic acids, vitamins, sterols, etc. Modern pharmacological studies have found that it has antibacterial, antiviral, anti-inflammatory and immunomodulatory effects. It has good antibacterial activity against Staphylococcus aureus, Bacillus subtilis and Escherichia coli.

[0032] Platycodon grandiflorum: bitter, pungent, flat. It acts on the lung meridian. It disperses the lung qi, reduces phlegm, soothes the throat, and discharges pus. It is used for cough with profuse phlegm, difficult expectoration, chest distress, sore throat with hoarse voice, lung abscess with expectoration of pus, etc. Its main chemical components include triterpenoid saponins, flavonoids, phenolic acids, phytosterols and polysaccharides, etc., among which triterpenoid saponins are its main active components. Modern pharmacological studies have found that it has antitussive, antioxidant, anti-tumor, anti-inflammatory activities, immunomodulatory, cardiovascular protection and liver protection effects.

[0033] Glycyrrhiza uralensis: sweet, flat. It acts on the heart, lung, spleen and stomach meridians. It invigorates the spleen and replenishes qi, clears heat and detoxifies, reduces phlegm and relieves cough, alleviates spasm and pain, and harmonizes various medicinal herbs. It is used for cough with profuse phlegm, weakness of the spleen and stomach, lassitude and weakness, sore throat, etc. Its main active ingredients mainly include flavonoids, triterpenoid saponins, coumarins, polysaccharides, organic acids and alkaloids, etc. Modern pharmacological studies have found that it has antitussive and antiasthmatic, antiviral, anti-tumor, anti-inflammatory, immunopotentiating and other effects.

[0034] Astragalus: Sweet and slightly warm. It enters the spleen and lung meridians. It tonifies qi and raises yang, strengthens the exterior defense, promotes diuresis and reduces swelling, and promotes fluid production and blood nourishment. It is used for conditions such as lung qi deficiency, cough, shortness of breath, spontaneous sweating due to superficial deficiency, fatigue due to qi deficiency, poor appetite and loose stools, and sallow complexion due to blood deficiency. Its main chemical components, including astragalus polysaccharides and astragaloside IV, have multiple pharmacological effects, including antioxidant, anti-inflammatory, anti-fibrotic, antiviral, blood sugar-lowering, blood pressure regulation, anti-cancer, and immunomodulatory.

[0035] Codonopsis pilosula: Sweet, neutral. It enters the spleen and lung meridians. It tonifies the spleen and lungs, nourishes the blood and promotes fluid production. It is used for conditions such as spleen and lung qi deficiency, poor appetite, fatigue, cough and shortness of breath, qi and blood deficiency, sallow complexion, dizziness, and fatigue. Its main chemical components include codonopsis polysaccharides, codonopsis pilosula glycosides, phytosterols, codonopsis lactones, flavonoids, phenolic acids, and alkaloids. It has pharmacological effects such as anti-tumor, anti-aging, intelligence-enhancing, analgesic, expectorant, antitussive, and improvement of microcirculatory disorders.

[0036] Coix seed: Sweet, mild, and cooling. It enters the spleen, stomach, and lung meridians. It promotes diuresis and eliminates dampness, strengthens the spleen and stops diarrhea, eliminates numbness, drains pus, and detoxifies and resolves stagnation. It is used for lung abscesses, edema, spleen deficiency diarrhea, and cancer. Its main components include esters and fatty acids, polysaccharides, and proteins, and have pharmacological effects such as anti-cancer, blood sugar reduction, lipid metabolism regulation, antiviral, anti-inflammatory, immunity enhancement, and regulation of the intestinal microbiome.

[0037] The Chinese medicine composition for treating cough and sputum of the present invention comprises the following ingredients in parts by weight:

[0038] 6-15 parts of Scutellaria baicalensis, 5-10 parts of Pinellia ternata, 10-20 parts of Houttuynia cordata, 5-15 parts of Fritillaria cirrhosa, 10-20 parts of Phragmites australis, 6-10 parts of Platycodon grandiflorum, 6-10 parts of Licorice root, 10-20 parts of Astragalus membranaceus, 10-20 parts of Codonopsis pilosula, and 10-20 parts of Coix seed.

[0039] The Chinese medicine preparation for treating cough and sputum of the present invention comprises a pharmaceutically active ingredient and a pharmaceutically acceptable excipient. The pharmaceutically active ingredient comprises the following components in parts by weight:

[0040] 6-15 parts of Scutellaria baicalensis, 5-10 parts of Pinellia ternata, 10-20 parts of Houttuynia cordata, 5-15 parts of Fritillaria cirrhosa, 10-20 parts of Phragmites australis, 6-10 parts of Platycodon grandiflorum, 6-10 parts of Licorice root, 10-20 parts of Astragalus membranaceus, 10-20 parts of Codonopsis pilosula, and 10-20 parts of Coix seed.

[0041] The active ingredient is the powder of the above-mentioned traditional Chinese medicine composition, or the water or organic solvent extract of the traditional Chinese medicine composition, and the organic solvent is an alcoholic organic solvent, such as ethanol. Pharmaceutically acceptable excipients include starch, dextrin, lactose, etc.

[0042] The Chinese medicine preparation is an oral preparation, such as a solution, granules, pills, tablets or ointment.

[0043] The following describes in detail the Chinese medicine composition and Chinese medicine preparation for treating cough and sputum of the present invention through specific examples.

[0044] Example 1

[0045] A traditional Chinese medicine composition for treating cough and sputum, comprising the following ingredients in parts by weight:

[0046] 10 grams of Scutellaria baicalensis, 10 grams of Pinellia ternata, 15 grams of Houttuynia cordata, 6 grams of Fritillaria cirrhosa, 20 grams of Phragmites australis, 10 grams of Platycodon grandiflorum, 10 grams of Licorice root, 15 grams of Astragalus membranaceus, 10 grams of Codonopsis pilosula, and 20 grams of Coix seed.

[0047] Example 2

[0048] A traditional Chinese medicine composition for treating cough and sputum, comprising the following ingredients in parts by weight:

[0049] 10 grams of Scutellaria baicalensis, 10 grams of Pinellia ternata, 15 grams of Houttuynia cordata, 6 grams of Fritillaria cirrhosa, 20 grams of Phragmites australis, 10 grams of Platycodon grandiflorum, 10 grams of Licorice root, 10 grams of Astragalus membranaceus, 10 grams of Codonopsis pilosula, and 20 grams of Coix seed.

[0050] Example 3

[0051] A traditional Chinese medicine composition for treating cough and sputum, comprising the following ingredients in parts by weight:

[0052] 15 grams of Scutellaria baicalensis, 10 grams of Pinellia ternata, 20 grams of Houttuynia cordata, 10 grams of Fritillaria cirrhosa, 20 grams of Phragmites australis, 10 grams of Platycodon grandiflorum, 10 grams of Licorice root, 20 grams of Astragalus membranaceus, 15 grams of Codonopsis pilosula, and 20 grams of Coix seed.

[0053] Example 4

[0054] A traditional Chinese medicine preparation for treating cough and sputum, wherein the active ingredients thereof include the following raw materials:

[0055] 10 grams of Scutellaria baicalensis, 10 grams of Pinellia ternata, 15 grams of Houttuynia cordata, 6 grams of Fritillaria cirrhosa, 20 grams of Phragmites australis, 10 grams of Platycodon grandiflorum, 10 grams of Licorice root, 15 grams of Astragalus membranaceus, 10 grams of Codonopsis pilosula, and 20 grams of Coix seed.

[0056] The Chinese medicine preparation of this embodiment is prepared as follows:

[0057] Weigh the above raw materials according to the ratio, add 10 times the volume of water to soak for 30 minutes, heat to boiling, and then decoct for 20 to 30 minutes, filter and extract the medicinal liquid; add 10 times the volume of water to the residue, repeat the decoction and filtration extraction once, combine the two filtrates, heat at normal pressure and concentrate to 400 ml.

[0058] Example 5

[0059] A traditional Chinese medicine preparation for treating cough and sputum, wherein the active ingredients thereof include the following raw materials:

[0060] 10 g of Scutellaria baicalensis, 10 g of Pinellia ternata (processed), 15 g of Houttuynia cordata, 6 g of Fritillaria cirrhosa, 20 g of Phragmites communis rhizome, 10 g of Platycodon grandiflorum, 10 g of Glycyrrhiza uralensis, 10 g of Astragalus membranaceus, 10 g of Codonopsis pilosula, 20 g of Coix lacryma-jobi.

[0061] The traditional Chinese medicine preparation of this example is prepared as follows:

[0062] Weigh the above raw materials according to the ratio, soak them in 20 times the amount of water for 30 min, then decoct for 1 h, filter, add 20 times the amount of water to the medicinal residues, repeat decocting and filtering once, combine the two filtrates, concentrate them under normal pressure to 400 ml by heating, and add the commonly used excipients in medicines to make tablets.

[0063] Example 6

[0064] A traditional Chinese medicine preparation for treating cough with expectoration, and its pharmaceutically active ingredients include the following raw materials:

[0065] 15 g of Scutellaria baicalensis, 10 g of Pinellia ternata (processed), 20 g of Houttuynia cordata, 10 g of Fritillaria cirrhosa, 20 g of Phragmites communis rhizome, 10 g of Platycodon grandiflorum, 10 g of Glycyrrhiza uralensis, 20 g of Astragalus membranaceus, 15 g of Codonopsis pilosula, 20 g of Coix lacryma-jobi.

[0066] The traditional Chinese medicine preparation of this example is prepared as follows:

[0067] Weigh the above raw materials according to the ratio, soak them in 8 times the amount of water for 30 min, then decoct for 1 h, filter, add 8 times the amount of water to the medicinal residues, repeat decocting and filtering once, combine the two filtrates, concentrate them under normal pressure to 400 ml by heating, and add the commonly used excipients in medicines to make granules.

[0068] Carry out animal experiments and clinical studies on the traditional Chinese medicine water extract corresponding to the traditional Chinese medicine composition of Example 1 to illustrate its effect in treating cough with expectoration.

[0069] 1. Animal experiments

[0070] 1.1 Experimental purpose

[0071] Explore the effects of Zhikeyin (the traditional Chinese medicine composition of the present invention) on IL-8, TNF-α, IL-β, and NF-κB in the lung tissues of rats with post-infection cough.

[0072] 1.2 Drug preparation

[0073] Weigh a total of 126 g of the traditional Chinese medicine pieces in Example 1, wrap them tightly with sterile gauze, put them into a sterile beaker, add Class III laboratory water, add 500 ml of water and soak for 30 min. Then place the beaker on an experimental electric stove for heating. After boiling over high heat, change to low heat and simmer for about 30 min. After cooling, filter and place the juice separately; add an appropriate amount of distilled water (level with the medicinal residues) to the residues and continue to decoct. After boiling, cool, and combine the two decoctions and concentrate them to 121 ml over low heat. The concentration of the concentrated medicine is 1 g / ml. After filtering the above-mentioned medicinal liquid with sterile gauze, store it in a refrigerator at -4°C for later use.

[0074] 1.3 Animal experiment design and methods

[0075] Forty SPF-grade male SD rats were randomly divided into a blank group, a model group, a traditional Chinese medicine group, and a western medicine group, with 10 rats in each group. Except for the blank group, the other groups were continuously intervened for 20 days by smoking + intranasal administration of lipopolysaccharide + atomization of capsaicin to establish a cough model after infection. The success of the model establishment was judged by observing the behavioral changes of the rats after the last atomization of capsaicin. After the model was successfully established, each group was given the corresponding drug by gavage. The blank group and the model group were given normal saline, the traditional Chinese medicine group was given the decoction of the cough-relieving drink at a dose of 10.9 g / kg / d, and the western medicine group was given dexamethasone solution at a dose of 0.2 mg / kg / d. After continuous gavage for 15 days, the rats were sacrificed. The contents of IL-8, TNF-α, and IL-β in the rat serum were detected by the Elisa method, and the expression level of NF-κB in the lung tissue was detected by Western Blot and real-time fluorescence quantitative PCR.

[0076] 1.4 Experimental results

[0077] 1.4.1 Results of detecting the contents of IL-8, TNF-α, and IL-β by the Elisa method

[0078] The detection results of the contents of IL-8, TNF-α, and IL-β in the serum of rats in each group are shown in Table 1.

[0079] Table 1 Detection results of the contents of IL-8, TNF-α, and IL-β in rats in each group

[0080]

[0081]

[0082] Note: * indicates P < 0.01 compared with the blank group; @ indicates P < 0.01 compared with the model group; # indicates P < 0.01 compared with the western medicine group.

[0083] As shown in the data of Table 1, compared with the blank group, the contents of IL-8, TNF-α, and IL-β in the lung tissues of rats in the model group increased significantly (P < 0.01). Compared with the model group, the contents of IL-8, TNF-α, and IL-β in the lung tissues of rats in the traditional Chinese medicine group and the western medicine group decreased significantly (P < 0.01); compared with the western medicine group, the contents of IL-8, TNF-α, and IL-β in the traditional Chinese medicine group decreased significantly (P < 0.01).

[0084] 1.4.2 Results of detecting the expression of NF-κBp65 protein by Western Blot method

[0085] Please refer to Figure 1 and Figure 2 where Figure 1 is the bar graph of the expression level of NF-κBp65 protein in rats in the present invention, Figure 2 is the strip graph of the expression of NF-κBp65 protein in rats in the present invention. It can be seen from Figure 1 and Figure 2 that: compared with the blank group, the expression of NF-κBp65 protein in the model group increased (P < 0.01); compared with the model group, the protein expression of NF-κBp65 in the traditional Chinese medicine group and the western medicine group decreased significantly (P < 0.01); compared with the western medicine group, there was no significant difference in the protein expression of NF-κBp65 in the traditional Chinese medicine group (P > 0.05).

[0086] 1.4.3 Results of detecting the expression of NF-κBp65mRNA by real-time fluorescence quantitative PCR

[0087] Please refer to Figure 3 which is the bar graph of the expression level of NF-κBp65mRNA in rats in the present invention. It can be seen from Figure 3 that: compared with the blank group, the expression of NF-κBp65mRNA in the model group increased (P < 0.01); compared with the model group, the expression of NF-κBp65mRNA in the traditional Chinese medicine group and the western medicine group decreased significantly (P < 0.01); compared with the western medicine group, the expression of NF-κBp65 mRNA in the traditional Chinese medicine group decreased relatively, and there was no significant difference (P > 0.05).

[0088] In summary, the traditional Chinese medicine preparation of the present invention can effectively reduce the expression levels of inflammatory factors IL-8, TNF-α, and IL-β in the lung tissues of rats with post-infection cough, thereby improving airway inflammation, and its mechanism may be related to inhibiting the expression of NF-κB.

[0089] 2. Clinical research

[0090] 2.1 Data and methods

[0091] 2.1.1 Research purpose and methods

[0092] A total of 80 patients who met the inclusion criteria for cough and sputum due to phlegm-heat obstructing the lung syndrome within the past year were selected as research subjects and randomly divided into a treatment group and a control group, with 40 patients in each group. The treatment group was treated with the pharmaceutical composition of the present invention, and the symptom improvement, clinical efficacy, and adverse reactions were observed.

[0093] 2.1.2 Research subjects

[0094] The study included 80 patients with cough and sputum in Changsha, Hunan Province. The treatment group included 23 males and 17 females, aged 18 to 70 years (mean, 43.7 ± 15.7 years), with a cough duration of 5 to 21 days (mean, 10.5 ± 4.2 days). The control group included 22 males and 18 females, aged 21 to 72 years (mean, 44.3 ± 16.2 years), with a cough duration of 3 to 20 days (mean, 10.6 ± 4.1 days). There was no significant difference in general information between the two groups (P > 0.05), indicating that the two groups were comparable.

[0095] 2.1.3 Diagnostic criteria

[0096] Inclusion criteria: ① Patients met the TCM symptom diagnostic criteria: primary symptoms included cough, expectoration, yellow or white sputum; secondary symptoms included chest tightness, wheezing, gurgling phlegm, restlessness, fever, thirst, dry throat, sore throat, constipation, and short, dark urine. The tongue tip and edges were red, the tongue coating was thin, yellow or greasy, and the pulse was slippery and rapid. Patients were diagnosed with phlegm-heat obstructing the lungs. ② Patients were between 18 and 80 years old, regardless of gender. ③ Patients provided informed consent for participation.

[0097] Exclusion criteria: ① Patients with serious primary diseases of the heart, liver, kidney, or hematopoietic system, as well as psychiatric conditions. ② Pregnant women. ③ Psychiatric conditions. ④ Allergies to the study drugs. ⑤ Patients who do not meet the inclusion criteria, who do not take the prescribed medication, whose efficacy cannot be determined, or whose data are incomplete, which may affect the efficacy or safety assessment.

[0098] 2.1.4 Treatment options

[0099] Test drug: The water extract of the Chinese medicine composition was obtained by the preparation method of the Chinese medicine preparation in Example 4, wherein the formula of the Chinese medicine composition was appropriately adjusted within the formula range of the present invention according to the patient's condition.

[0100] Dosage: Administer the Chinese medicine preparation of the present invention, 200 ml each time, twice a day, warm and take in the morning and evening.

[0101] Control group medication: Qingfei Huatan Pills. Specifications: 6g / bag, 1 bag per dose, 3 times daily, taken with boiled water. Manufactured by Kunming Traditional Chinese Medicine Factory Co., Ltd. Approval number: National Medicine Standard Z53020763.

[0102] 2.1.5 Observation indicators

[0103] After 7 days of treatment, a traditional Chinese medicine syndrome score scale was used to comprehensively evaluate the improvement of the main and secondary symptoms of traditional Chinese medicine in the two groups of patients. The higher the score, the more severe the symptoms. After 7 days of treatment, 2 ml of peripheral venous blood was collected from the patients, and a fully automatic biochemical analyzer was used to detect the levels of inflammatory factor indicators such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), and total serum immunoglobulin E (TIgE).

[0104] 2.1.6 Overall efficacy judgment criteria

[0105] The efficacy scoring criteria for traditional Chinese medicine syndromes refer to the "Guiding Principles for Clinical Research of New Chinese Medicines".

[0106] (1) Clinical cure: The syndromes of phlegm-heat obstructing the lung disappear or basically disappear, cough and expectoration disappear, N≥95%;

[0107] (2) Marked effect: The syndromes of phlegm-heat accumulating in the lung are significantly improved, cough and expectoration are reduced, 95%>N≥70%;

[0108] (3) Effective: The syndromes of phlegm-heat accumulating in the lung are all improved, cough and expectoration are reduced, 70%>N≥30%;

[0109] (4) Ineffective: The syndromes of phlegm-heat accumulating in the lung show no obvious improvement or even aggravation, cough and expectoration are not improved, N<30%.

[0110] The efficacy was judged using the Nimodipine method: Efficacy index (N)=[(total score before treatment - total score after treatment) / total score before treatment]*100%.

[0111] Total effective rate=(clinical cure + marked effect + effective) / total number of cases×100%

[0112] 2.1.7 Statistical methods

[0113] Measurement data were analyzed by t-test, expressed as ; Count data were analyzed by chi-square test; Ranked data were analyzed by Wilcoxon rank sum test. P>0.05 was considered as no significant difference, and P<0.05 was considered as significant difference. SPSS 26.0 statistical software was used for statistical analysis.

[0114] 2.2 Results

[0115] 2.2.1 Comparison of traditional Chinese medicine syndrome scores

[0116] After the intervention, the scores of the main and secondary symptoms of traditional Chinese medicine in the treatment group were lower than those in the control group, and the difference was statistically significant (P<0.05). See Table 2.

[0117] Table 2 Comparison of traditional Chinese medicine syndrome scores between the two groups of patients

[0118]

[0119] 2.2.2 Comparison of inflammatory factor levels

[0120] After the intervention, the levels of inflammatory factor indicators such as TNF-α, IL-6, CRP, and TIgE in the treatment group were lower than those in the control group, and the difference was statistically significant (P < 0.05). See Table 3.

[0121] Table 3 Comparison of inflammatory factor levels between the two groups of patients

[0122]

[0123]

[0124] 2.2.3 Comparison of clinical efficacy

[0125] Among the 40 patients with cough and expectoration in the treatment group, 7 cases (17.5%) were clinically cured, 17 cases (42.5%) showed marked improvement, 14 cases (35.0%) were effective, and 2 cases (5.0%) were ineffective, with a total effective rate of 95.0%. Among the 40 patients with cough and expectoration in the control group, 1 case (2.5%) was clinically cured, 15 cases (37.5%) showed marked improvement, 13 cases (32.5%) were effective, and 11 cases (27.5%) were ineffective, with a total effective rate of 72.5%. The results showed that the clinical efficacy of the treatment group was better than that of the control group (P < 0.05). See Table 4.

[0126] Table 4 Comparison of clinical efficacy between the two groups

[0127]

[0128] 2.3 Adverse reactions

[0129] No serious adverse reactions occurred during the treatment in both groups.

[0130] 2.4 Conclusion

[0131] According to the above efficacy results, the traditional Chinese medicine composition of the present invention can significantly improve the symptoms of cough and expectoration in patients with phlegm-heat obstructing the lung.

[0132] 3. Typical cases

[0133] Case 1

[0134] Patient Xiao, female, 30 years old, visited the hospital on June 15, 2024. Chief complaint: cough for 5 days. The patient developed fever, nasal congestion, and runny nose due to cold 5 days ago. She took ibuprofen sustained-release tablets on her own. After the fever subsided, she developed cough and sputum. Taking antibiotics and Chinese patent medicines for cough and phlegm did not provide obvious relief. Current symptoms: cough, yellow sputum, nasal congestion, runny nose, poor diet, normal bowel movements, yellow urine, and normal sleep. The tip of the tongue is red, the tongue coating is yellow, and the pulse is thin. After syndrome differentiation, the patient was diagnosed with cough due to phlegm-heat blocking the lungs. After one week of treatment with the Chinese medicine preparation of the present invention (the preparation method of Example 1), the patient was clinically cured.

[0135] Case 2

[0136] The patient, Liu, female, 6 years old, was admitted to the hospital on April 23, 2024. Chief complaint: cough for half a month. The patient's family reported that the child had a cough due to a cold half a month ago. The local clinic gave antibiotics, cough suppressants and expectorants, but the cough was not relieved significantly. Three days ago, the child was diagnosed with Mycoplasma pneumonia at the People's Hospital. Current symptoms: cough, phlegm in the throat, nasal congestion and runny nose, good diet, and dry stool. The tip of the tongue is red, the tongue coating is thin and yellow, and the fingerprints are purple. After syndrome differentiation, it was found that the cough was caused by phlegm-heat blocking the lungs. After 2 weeks of treatment with the Chinese medicine preparation of the present invention (the preparation method of Example 1), the child was clinically cured.

[0137] Case 3

[0138] Patient Zhou, female, 57 years old, visited the hospital on June 23, 2024. Chief complaint: intermittent cough for 8 years, aggravated for 10 days. The patient has had intermittent cough and sputum in the past 8 years, with repeated attacks. Western medicine diagnosed her with bronchiectasis. Ten days ago, her symptoms worsened due to her greed for coolness. Current symptoms: cough, little sputum, chest tightness, palpitations, dry mouth, poor diet, yellow and red urine, dry stool, and general sleep. The tip of the tongue is red, the tongue coating is yellow and greasy, and the pulse is stringy and rapid. The patient was diagnosed with cough due to phlegm-heat blocking the lungs. After 4 weeks of treatment with the Chinese medicine preparation of the present invention (the preparation method of Example 1), the patient was clinically cured.

[0139] Case 4

[0140] Patient Hou, male, 45 years old, visited the hospital on March 28, 2024. Chief complaint: cough for 1 month. The patient developed nasal congestion, runny nose, and fever after catching a cold 1 month ago. The fever subsided after taking the granules, but cough, sputum, and itchy throat soon appeared. Taking cough and expectorant Chinese patent medicines and antibiotics was ineffective. Taking Jinshengzi throat treasure sublingually relieved the symptoms slightly, but they recurred soon. Current symptoms: cough, yellow sputum that is difficult to cough up, itchy throat, dry mouth, normal diet, normal sleep, yellow urine, loose and sticky stools. The tip of the tongue is red, the tongue coating is yellow and slightly greasy, and the pulse is stringy and rapid. Chest X-ray shows: thickened and disordered texture of both lungs. After syndrome differentiation, it is a cough caused by phlegm-heat blocking the lungs. After 2 weeks of treatment with the Chinese medicine preparation of the present invention (the preparation method of Example 1), the patient achieved clinical cure.

[0141] Case 5

[0142] Patient Zhang, female, 29 years old, visited the hospital on October 12, 2023. Chief complaint: cough for 10 days. 10 days ago, the patient developed cough, nasal congestion, runny nose, sore throat, and fever due to greed for cold drinks. The highest body temperature was 38.8℃. She was treated with intravenous antibiotics at the community hospital. After 2 days, the fever subsided, but the cough, sputum and sore throat were not significantly relieved. She took Chinese patent medicine for cough and phlegm but it was ineffective. She came to the hospital for treatment with traditional Chinese medicine. Current symptoms: cough, thick yellow sputum, sore throat, dry mouth, upset, normal diet, normal sleep, yellow urine, and normal bowel movements. The tip of the tongue is red, the tongue coating is yellow, and the pulse is thin and rapid. History of chronic pharyngitis. The syndrome differentiation is that the cough is caused by phlegm-heat blocking the lungs. After 2 weeks of treatment with the Chinese medicine preparation of the present invention (the preparation method of Example 1), the patient was clinically cured.

[0143] Case 6

[0144] Patient Zhang, male, 72 years old, visited the hospital on December 9, 2023. Chief complaint: cough and sputum for more than a month. The patient caught a cold a month ago and had cough and fever. After comprehensive treatment in a certain hospital, his body temperature dropped to normal, but he still had cough and asthma. Current symptoms: cough, sticky sputum that is difficult to cough, chest tightness, fatigue, loss of appetite, poor sleep, normal urination, constipation, and bowel movements 3-4 days / times. The tip of the tongue is red, the tongue coating is yellow and greasy at the root, and the pulse is deep and slippery. The history of chronic bronchitis is more than 10 years. The syndrome differentiation is that the cough is caused by phlegm-heat blocking the lungs. After 6 weeks of treatment with the Chinese medicine preparation of the present invention (the preparation method of Example 1), the patient was clinically cured.

[0145] Case 7

[0146] Xie, female, 35 years old, visited the hospital on April 16, 2023. Chief complaint: repeated cough and sputum for more than 3 months. The patient developed cough and sputum after being infected with the new coronavirus more than 3 months ago. The sputum was thick and yellow, small in quantity, difficult to cough up, occasionally with blood streaks, and accompanied by chest tightness and shortness of breath. She went to the local hospital for treatment. The symptoms were slightly relieved after taking oral cough and expectorant drugs, and recurred after stopping the drugs. Current symptoms: cough with little sputum, mainly dry cough, aggravated by talking or being affected by wind, itchy throat, foreign body sensation in the throat, dry mouth, and chest tightness. The diet is okay, but the sleep at night is poor, it is difficult to fall asleep, the tongue is red, the fur is thin and yellow, and the pulse is stringy. Routine blood tests and chest CT were normal. Pulmonary function tests showed a positive bronchial provocation test. The syndrome is characterized by cough due to phlegm-heat blocking the lungs. After 3 weeks of treatment with the Chinese medicine preparation of the present invention (the preparation method of Example 1), the patient achieved clinical cure.

[0147] The above cases are only some of the cases treated clinically. In actual clinical use, the dosage of the specific drugs in the pharmaceutical composition can be selected within the scope of the present invention according to the different clinical symptoms of the patients. At the same time, in clinical practice, the prescription can be adjusted for different patients, as follows:

[0148] (1) When affected by pathogenic factors of the four seasons, modifications can be made according to syndrome differentiation. For those with cough and expectoration due to wind-warm pathogen, 6 - 10 grams of Saposhnikovia divaricata and 10 grams of Schizonepeta tenuifolia, and 6 grams of Mentha haplocalyx can be added; for those affected by summer heat pathogen, 6 - 15 grams of Lonicera japonica, 6 - 15 grams of Forsythia suspensa, and 6 grams of Mentha haplocalyx can be added; for those affected by autumn dryness pathogen, 6 - 15 grams of Morus alba leaf and 6 - 15 grams of Chrysanthemum morifolium can be added; for those affected by cold pathogen, 3 - 10 grams of Ephedra sinica and 6 - 10 grams of Cinnamomum cassia can be added.

[0149] (2) If there are symptoms of yin injury such as scanty tongue coating in addition to cough and expectoration, 10 - 20 grams of Rehmannia glutinosa, 10 - 20 grams of Ophiopogon japonicus, 10 - 20 grams of Lilium brownii, and 10 - 15 grams of Glehnia littoralis can be added to nourish yin and moisten the lungs.

[0150] (3) If chronic cough damages qi and blood, with symptoms such as fatigue and shortness of breath, 6 - 20 grams of Panax ginseng and 10 - 20 grams of Angelica sinensis can be added to tonify qi and nourish blood.

[0151] (4) If there is severe sore throat like a saw in addition to cough and expectoration, 10 - 15 grams of Belamcanda chinensis, 6 grams of Cryptotympana pustulata, and 10 - 15 grams of Scrophularia ningpoensis can be added to clear heat and soothe the throat.

[0152] (5) If there is blood streaks in the sputum in addition to cough and expectoration, 10 - 15 grams of Prunus persica, 10 - 20 grams of Benincasa hispida seed, and 10 - 20 grams of Imperata cylindrica can be added to cool the blood for hemostasis, activate blood circulation and expel pus.

[0153] In summary, the traditional Chinese medicine composition and traditional Chinese medicine preparation of the present invention have concise ingredients and definite curative effects, and can be used as a basic formula for cough and expectoration caused by diseases such as cold, acute and chronic tracheo - bronchitis, pneumonia, chronic obstructive pulmonary disease, bronchiectasis, lung abscess, lung nodule, lung cancer, and novel coronavirus infection.

[0154] The above has made a detailed description of the embodiments of the present invention, but the present invention is not limited to the described embodiments. For those skilled in the art, various changes, modifications, substitutions, and variations made to these embodiments without departing from the principle and spirit of the present invention still fall within the protection scope of the present invention.

Claims

1. A traditional Chinese medicine composition for treating cough and expectoration, characterized in that, It comprises the following components by weight parts: Scutellaria baicalensis Georgi 6 - 15 parts, Pinellia ternata (Thunb.) Breit. var. chekiangensis Hsiao et K. M. Feng 5 - 10 parts, Houttuynia cordata Thunb. 10 - 20 parts, Fritillaria cirrhosa D. Don 5 - 15 parts, Phragmites communis Trin. 10 - 20 parts, Platycodon grandiflorus (Jacq.) A. DC. 6 - 10 parts, Glycyrrhiza uralensis Fisch. 6 - 10 parts, Astragalus membranaceus (Fisch.) Bunge 10 - 20 parts, Codonopsis pilosula (Franch.) Nannf. 10 - 20 parts, Coix lacryma-jobi L. var. ma-yuen (Roman.) Stapf 10 - 20 parts.

2. The traditional Chinese medicine composition for treating cough and expectoration according to claim 1, wherein It comprises the following components by weight parts: Scutellaria baicalensis Georgi 10 parts, Pinellia ternata (Thunb.) Breit. var. chekiangensis Hsiao et K. M. Feng 10 parts, Houttuynia cordata Thunb. 15 parts, Fritillaria cirrhosa D. Don 6 parts, Phragmites communis Trin. 20 parts, Platycodon grandiflorus (Jacq.) A. DC. 10 parts, Glycyrrhiza uralensis Fisch. 10 parts, Astragalus membranaceus (Fisch.) Bunge 15 parts, Codonopsis pilosula (Franch.) Nannf. 10 parts, Coix lacryma-jobi L. var. ma-yuen (Roman.) Stapf 20 parts.

3. The traditional Chinese medicine composition for treating cough and expectoration according to claim 1 or 2, wherein The traditional Chinese medicine composition is used for treating cough and expectoration caused by phlegm-heat obstructing the lung.

4. The traditional Chinese medicine composition for treating cough and expectoration according to claim 3, characterized in that, The cough and expectoration caused by phlegm-heat obstructing the lung are caused by cold, acute and chronic tracheo-bronchitis, pneumonia, chronic obstructive pulmonary disease, bronchiectasis, lung abscess, lung nodule, lung cancer, or novel coronavirus infection.

5. A Chinese medicine preparation for treating cough and sputum, characterized in that: It contains a pharmaceutically active ingredient and a pharmaceutically acceptable excipient, wherein the pharmaceutically active ingredient is the powder of the traditional Chinese medicine composition described in claim 1, or the water or organic solvent extract of the traditional Chinese medicine composition.

6. The traditional Chinese medicine preparation for treating cough and expectoration according to claim 5, characterized in that, The traditional Chinese medicine preparation is an oral preparation, and the oral preparation is a solution, granule, pill, tablet or ointment.

7. The traditional Chinese medicine preparation for treating cough and expectoration according to claim 5 or 6, characterized in that, The traditional Chinese medicine composition is used for treating cough and expectoration caused by phlegm-heat obstructing the lung.

8. The traditional Chinese medicine preparation for treating cough and expectoration according to claim 7, characterized in that, The cough and expectoration caused by phlegm-heat obstructing the lung are caused by cold, acute and chronic tracheo-bronchitis, pneumonia, chronic obstructive pulmonary disease, bronchiectasis, lung abscess, lung nodule, lung cancer, or novel coronavirus infection.

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