In my last article I discussed important simple ways to help patients prevent acquiring cold and flu issues. In this article, I will present my favorite patent medicines for cold/flu presentations and discuss novel methods of administration to improve patient compliance.
One of the most important reasons for clinicians to become aware of effective patent combinations for cold / flu is the issue of compliance. Medicines won't work unless the patient takes them. It is not uncommon for patients to be unwilling to decoct or brew teas when suffering from acute cold/flu symptoms and most often do not have assistance with preparing complex TCM medicinal teas at home. Patients can also be more selective and particular about taste during acute imbalances and are unwilling to drink teas, tinctures or liquid extracts even if provided. Therefore it can be very important for the TCM clinician to have a working knowledge of patent medicines to offer challenging patients treatment options.
One of the most important approaches I always consider when treating cold/flu scenarios is the patient's presenting pattern as well as their unique constitution referred to in Ayurvedic medicine as Vikriti and Prakriti respectively. The presenting pattern may seem common sense to most TCM practitioners, however it is very common to see TCM clinicians to practice "allopathic herbalism" and blindly prescribe anti-viral formulas in cold/flu presentations without consideration of the patient's unique pattern presentation or without even examining the patient. It is important to keep in mind that for TCM medicinals, formulas and patent medicines to be highly effective, they must be administered based upon pattern presentation and not western bio-medical classifications. While biomedical information can be helpful adjunctive information, it is not required in order for the TCM clinician to effectively mitigate and resolve cold/flu scenarios.
The most common presentation, which I see clinically in cold/flu presentations is Wind Heat and Wind Heat with concomitant respiratory complications. I will focus most of my recommendations on these presentations. One final note concerning dosage: patent medicines must be dosed at a higher amount and more frequent dosage than typically listed on bottle particularly in acute cold / flu scenarios. After the acute stage, which typically ranges from 1-3 days, the patient can lower the dose back down to the standard dosage.
Gan Mao Ling + Sang Ju Wan: this combination is excellent for initial stages of Wind Heat particularly if patient has a tendency to respiratory challenges or is current showing early signs of cough.
Yin Qiao Jie Du Wan + Gan Mao Ling: this is a basic yet effective combination and can be very effective if used at the appropriate time. However this is often the most over-prescribed combination and is not effective if patient is past prodromal stages of cold / flu.
Gan Mao Ling + Chuan Xin Lian Wan: this combination is excellent for patients with a robust constitution presenting with Wind Heat symptoms especially with high fever, sore throat, rapid pulse, red tongue body.
Bai Hu Tang + Gan Mao Ling: this combination is also excellent for the patients with a robust constitution presenting with extreme Wind Heat symptoms with the "four bigs:" fever, sweat, thirst and pulse.
Wind Heat with Lung Qi and Yin Vacuity
Gan Mao Ling + Sheng Mai San: this is an important combination for patients experiencing a Wind Heat invasion with concomitant vacuity/weak constitution. This is perhaps one of the most common fallacies perpetuated in TCM in which it is believed to be "dangerous" to give tonics in exterior patterns. If the patient has a weak constitution and has a Qi or Yin vacuity, the clinician must address this in the prescription in order to effectively resolve the pattern of disharmony.
Wind Heat with Lung Yin Vacuity
Gan Mao Ling + Sha Shen Mai Dong Wan: this is a very important combination in winter time as interior heating can dry out the respiratory tract thereby inducing a type of Lung Yin Vacuity. TCM states that the Lung is the "delicate viscus" and in this patent combination effectively protects Lungs while clearing Wind Heat. This combination is also helpful with patients who have a history of upper respiratory tract issues in which the Lung Yin has been depleted. If the patient has Lung Yin vacuity along with Phlegm and Wind Heat invasion, the formulas Bai He Gu Jin Wan can be used along with Gan Mao Ling.
Wind Heat with Lung Yin Vacuity with severe sore throat
Gan Mao Ling + Yang Yin Qing Fei Wan: this is an important combination when severe sore dry throat is a main symptom along with standard Wind Heat and Yin vacuity signs. It can be taken along with a simple tea combo of Ju Hua / Gan cao to increase efficacy.
Wind Heat with Qi Vacuity
Gan Mao Ling +Shen Qi Da Bu Wan: this is addressing the common pattern presentation of Wind Heat Invasion in a patient with a very weak constitution. This patient is the type who has sleep debt and poor dietary habits and "doesn't have time to get sick." If the Qi vacuity is not addressed, the Wind Heat will penetrate deeper and result in complicated lurking/lingering pathogens or fu xie. It is critical for the clinician to stress the importance of rest in these cases. The use of chamomile tea along with patent combo can be very helpful to help patient relax and sleep and can help diffuse the heat from the body especially if combined with a simple Epsom salt bath followed by bed rest.
These simple combinations are just some basic examples of how to more effectively treat acute cold/flu symptoms in patients unwilling or unable to take TCM tea formulas. It is not possible to cover all the possible combinations of patent combinations in this short article, however I hope this examination stimulates TCM clinicians to see the importance of having a working knowledge of important patent medicines in the cold and flu season.
Please note that I have discussed treating cold/flu presentations using TCM medicinals combined with western and Ayurvedic herbs in my past columns. Readers are encouraged to examine these past articles as many of these herbs can be taken along with TCM patent medicines with excellent clinical results at www.acupuncturetoday.com.
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