Persistent cough due to cough variant asthma following upper respiratory tract infection treated by traditional Chinese medicine: A case report.

Rationale: Cough variant asthma (CVA) is one of the primary causes of chronic cough, significantly impacting quality of life. Although inhaled corticosteroids-long-acting beta agonists are the first-line treatment, their limitations-such as prolonged treatment duration, high relapse rates after discontinuation, and suboptimal efficacy in some patients-highlight the need to explore alternative treatment options. Traditional Chinese medicine (TCM), with its holistic framework, syndrome differentiation-based treatment, and emphasis on preventing relapse, offers a promising strategy for complementary therapy. This case report aims to evaluate the potential efficacy of personalized TCM protocols for CVA patients who have not responded to conventional treatment.

Patient Concerns: A CVA patient with poor medication compliance developed persistent airway inflammation after an upper respiratory tract infection, resulting in worsening of existing cough symptoms and poor response to standard western medical treatment.

Diagnoses: The patient was diagnosed with CVA, and the Chinese medicine diagnosis was cough and wind-heat offending the lung syndrome.

Interventions: The patient received a Chinese medicine decoction. The principle of TCM treatment is to clear heat, dispel wind, relieve the pharynx, and relieve cough.

Outcomes: After 2 weeks of Chinese medicine treatment, the patient's visual analogue scale, cough evaluation test, Leicester cough questionnaire, and traditional Chinese medicine criteria scores improved. All key indicators reflecting small airway function (forced expiratory flow at 50% of vital capacity, forced expiratory flow at 75% of vital capacity, and maximal mid-expiratory flow) showed sustained and clinically significant improvements. Additionally, the treatment process was safe, with no adverse reactions or abnormal changes in liver, kidney, or hematological parameters observed. Overall, this TCM treatment was safe and effective for this CVA patient.

Lessons: This case demonstrates the potential of TCM as a viable option for managing CVA, particularly in cases suboptimally controlled by conventional therapy. The "one person, one prescription" approach, targeting both pathogenic factors and systemic regulation, may address the multifactorial nature of CVA and contribute to sustained remission. Rigorous larger-scale studies are warranted to validate these findings.