Coughing
咳嗽 · ké sou+30 other namesHide other names
Also known as: Cough, General Cough, Productive or dry cough, Coughing or Wheezing, Coughing Without Clear Cause, Laryngopharyngeal Cough, Coughing And Wheezing With Copious Sputum, Cough And Wheeze With Excessive Phlegm, Coughing And Wheezing With Abundant Sputum, Cough With Excessive Phlegm, Cough With Abundant Phlegm, Cough With Abundant Sputum, Cough And Wheezing With Abundant Phlegm, Coughing Of Phlegm, Cough With Copious Sputum, Cough With Expectoration, Cough With Profuse Phlegm, Cough With Sputum, Coughing With Copious Sputum, Productive Cough, Productive Cough With Excessive Mucus, Productive Cough With Excessive Phlegm, Cough With Phlegm, Coughing Up Phlegm, Coughing with phlegm production, Mild Cough, slight cough, Cough with Heavy or Turbid Sound, Heavy or muffled cough sound, Acute cough
In TCM, the color, thickness, and ease of your cough's phlegm is like a diagnostic code - it tells us whether the root is Wind-Cold, Wind-Heat, Phlegm-Dampness, or something deeper. With the right pattern-matched herbs and acupuncture, most acute coughs improve within days, while chronic coughs often clear in 4-8 weeks.
About this page · what it is and isn't
What this is. A plain-English synthesis of how classical TCM and modern clinical research describe coughing. Patterns and herbs come from canonical TCM sources; clinical claims are cited in the Evidence section.
What it isn't. A diagnosis. Me&Qi is an editorial team, not a licensed clinic. The pattern quiz is a thinking tool — pulse and tongue still need a person in the room. Anything in the Safety section should send you to a doctor, not a herb.
Last reviewed Jun 2026.
Educational content about Traditional Chinese Medicine — not medical advice. See a qualified practitioner for diagnosis and treatment.
A cough isn't just a cough in TCM - it's a signal from your body's internal organs, and the kind of cough tells a story. TCM identifies several distinct patterns behind coughing, each with its own cause, its own type of phlegm, and its own treatment approach. Whether your cough brings up thin white phlegm and makes you feel chilled, or thick yellow phlegm with a sore throat, the pattern guides the remedy. This page explores the six most common TCM patterns behind a cough, from Wind-Cold invading the Lungs to Lung Qi Deficiency.
In Western medicine, a cough is a protective reflex to clear the airways of irritants, mucus, or foreign particles. It can be acute (lasting less than three weeks), subacute, or chronic, and is often classified by its sound and whether it's productive (wet) or non-productive (dry). Common causes include viral upper respiratory infections, allergies, asthma, postnasal drip, gastroesophageal reflux, and chronic bronchitis. Diagnosis typically involves listening to the lungs, sometimes chest X-rays, and tests for underlying conditions like asthma or infection.
Treatment focuses on addressing the underlying cause - antibiotics for bacterial infections, antihistamines for allergies, inhalers for asthma - along with symptomatic relief using cough suppressants or expectorants. While this approach effectively manages many acute coughs, chronic or recurrent coughs can remain a challenge when no clear cause is identified.
Conventional treatments
Standard treatments include over-the-counter cough suppressants (dextromethorphan) for dry coughs, expectorants (guaifenesin) to thin mucus, decongestants for postnasal drip, and antihistamines for allergies. For chronic cough, doctors may prescribe inhaled corticosteroids for asthma, proton pump inhibitors for acid reflux, or neuropathic agents for a hypersensitive cough reflex. In cases of bacterial infection, antibiotics are used. Lifestyle measures like humidifiers and avoiding irritants are also recommended.
Where conventional treatment falls short
While conventional medicine can suppress a cough or treat its presumed cause, many chronic coughs persist without a clear diagnosis. Cough suppressants may mask symptoms without resolving the underlying vulnerability, and long-term use of some medications carries side effects. The one-size-fits-all approach doesn't account for individual constitutional differences - why one person develops a lingering cough after a cold while another doesn't, or why certain triggers consistently provoke a cough in some but not others. TCM's pattern differentiation offers a way to address these individual susceptibilities.
How TCM understands coughing
In TCM, the Lungs are responsible for the descent and dispersion of Qi. When this function is disrupted, Qi rebels upward, triggering a cough. The Lungs are also the most delicate organ, directly connected to the outside through the nose and throat, making them the first line of defense against external pathogens like Wind, Cold, and Heat. That's why a cough is so often the first sign of a cold or flu - the external pathogen is battling with the Lung's defensive Qi.
But the Lungs don't work alone. The Spleen transforms fluids; if it's weak, it produces phlegm, which can rise and obstruct the Lungs. The Liver ensures the smooth flow of Qi; if it stagnates, it can create Heat that flares upward and irritates the Lungs. Even the Kidneys play a role - they grasp the Qi and help the Lungs inhale deeply. A cough can therefore arise from a simple external invasion or from a deeper internal imbalance, and the character of the cough - the sound, the phlegm, the timing - reveals which organ is the root.
This is why a single Western diagnosis like 'bronchitis' or 'post-viral cough' can have several different TCM patterns. A cough with thin white phlegm, chills, and a floating pulse is Wind-Cold. A cough with thick yellow phlegm, fever, and thirst is Wind-Heat or Phlegm-Heat. A weak, breathless cough that worsens with exertion is Lung Qi Deficiency. Each pattern requires a different herbal formula and acupuncture strategy. By identifying the pattern, TCM treats not just the cough but the underlying terrain that allowed it to take hold.
「五脏六腑皆令人咳，非独肺也。」
"All five zang organs and six fu organs can cause cough, not just the lung. This foundational statement establishes that cough originates from imbalances in multiple organ systems, guiding TCM’s holistic approach to diagnosis and treatment."
How a TCM practitioner diagnoses coughing
Inside the consultation
A TCM practitioner starts by asking about the cough’s character and the sputum. The color, thickness, and ease of expectoration point toward different patterns. Accompanying sensations like chills, fever, chest tightness, and energy levels are just as important as the cough itself. The tongue coating and pulse provide the final confirmation.
If the cough brings up thin, white sputum and the person feels chilled, with an aversion to cold and a floating tight pulse, it suggests Wind-Cold invading the Lungs. The cough often sounds heavy, and the tongue coating is thin and white. This pattern is common in the early stages of a cold.
When the sputum is yellow and the cough is frequent, with a sore throat, thirst, and a floating rapid pulse, the pattern is Wind-Heat invading the Lungs. The tongue tip is red with a thin yellow coating. A person may feel feverish and prefer cool drinks.
Phlegm-Heat in the Lungs produces a productive cough with thick, yellow, sticky sputum that can be hard to bring up. The chest feels oppressed, and the tongue is red with a greasy yellow coating. The pulse is slippery and rapid. A foul taste or breath may accompany this pattern.
Damp-Phlegm in the Lungs is marked by profuse, white, sticky sputum that is easier to expectorate. The person feels a heavy sensation in the chest, and the tongue has a thick, white, greasy coating. The pulse is slippery. This cough is often worse after eating or in damp weather.
Rebellious Lung Qi is diagnosed when the cough feels like a forceful upward rush, sometimes spasmodic, and is not primarily driven by phlegm or heat. Chest distention and a wiry pulse are common. This pattern may flare with stress or talking, and it often coexists with other imbalances.
Lung Qi Deficiency causes a chronic, weak cough with clear, thin sputum and noticeable shortness of breath. The cough worsens with exertion, and the person feels tired. The tongue is pale with a thin coating, and the pulse is weak. This pattern develops over time and lacks acute signs of infection.
TCM Patterns for Coughing
In TCM, the aim is to address the root cause, not just the symptom — it calls that root cause a “pattern.” The same coughing can come from several different patterns, each treated differently. The quickest way to find yours is the quiz below.
Find your pattern
Tap any sign that fits how yours feels.
- 1Your signs
- 2What makes it worse
- 3What helps
Which signs match your experience?
It is normal to recognize pieces of several patterns in your own cough. A cold that begins as Wind-Cold can shift into Phlegm-Heat if it lingers, or a chronic weak cough may temporarily flare with Damp-Phlegm. The patterns are snapshots of a moving process, not rigid boxes.
To narrow things down, focus on the sputum. Thin, white, and watery with chills points to cold. Yellow, sticky, and accompanied by a hot sensation points to heat. If the main issue is a heavy chest and lots of white phlegm without much heat or cold, Damp-Phlegm is more likely.
Notice when the cough feels worst. A cough that leaves you breathless and tired suggests Lung Qi Deficiency, while a cough that feels like a spasm rising from the chest may point to Rebellious Lung Qi. Overlap is common, but identifying the dominant feature guides the right care.
Because the tongue and pulse reveal what the symptoms alone cannot, a professional TCM diagnosis is valuable. If the cough persists more than a few days, is severe, or brings up blood, see a practitioner promptly. Self-treatment risks missing a deeper imbalance that needs a tailored formula.
Wind-Cold invading the Lungs
Wind-Heat invading the Lungs
Rebellious Lung Qi
Phlegm-Heat in the Lungs
Damp-Phlegm in the Lungs
Lung Qi Deficiency
Treatment
Four ways to address coughing in TCM — explore each, or take the quiz to see what fits you first.
Formulas traditionally used for coughing
9 formulas across the patterns above. The right one depends on your pattern — start with the quiz if you're unsure which fits.
A simple, classical three-herb formula used to open the lungs and relieve cough, wheezing, nasal congestion, and chest tightness caused by catching cold. It is one of the most basic and widely used building-block formulas for respiratory complaints in Chinese medicine, often serving as a starting point that practitioners modify for specific situations.
A gentle classical formula used to relieve persistent coughing after a cold, especially when the throat feels itchy and phlegm is difficult to bring up. It works by soothing the lungs, helping clear residual Wind from the body, and restoring normal respiratory function without being too harsh or drying.
A gentle, cooling formula used for early-stage colds and respiratory infections marked by cough as the main symptom, with mild fever, slight thirst, and a floating rapid pulse. It gently clears Wind-Heat from the Lungs and restores their natural ability to regulate breathing and stop coughing.
A classical warming formula for people with chronic cough, wheezing, and copious thin white phlegm, especially when accompanied by lower back weakness and limb swelling. It works by directing rebellious Lung Qi downward, dissolving cold phlegm, and gently warming the Kidneys to help them anchor breathing. It is best suited for conditions where congestion in the chest coexists with underlying weakness in the lower body.
A classical formula used to relieve wheezing, coughing, and shortness of breath caused by phlegm-heat congesting the lungs, often triggered by catching a cold. It works by opening the airways, directing Lung Qi downward, clearing heat, and resolving thick, sticky phlegm. Commonly applied for asthma and bronchitis with yellow, difficult-to-expectorate sputum.
A foundational formula used to clear excess phlegm and dampness from the body, especially when they cause coughing with white phlegm, nausea, chest tightness, dizziness, or a heavy feeling in the limbs. It works by drying dampness, dissolving phlegm, and supporting healthy digestion. Named for its two key ingredients, Ban Xia and Chen Pi, which are most effective when aged.
A gentle, three-herb formula made entirely from common plant seeds, originally created to help elderly parents suffering from chronic cough with heavy phlegm, chest congestion, and poor digestion. It works by dissolving accumulated phlegm in the chest, calming rebellious Qi that causes coughing and wheezing, and improving digestion to stop new phlegm from forming. Despite its simplicity, it remains one of the most widely used formulas for phlegm-related respiratory conditions.
A foundational formula for strengthening the digestive system and lifting the body's Qi when it has sunk or become depleted. It is commonly used for persistent fatigue, poor appetite, loose stools, and conditions involving organ prolapse (such as rectal or uterine prolapse) caused by weakness of the Spleen and Stomach. It is one of the most widely used formulas in all of Chinese medicine.
A simple but highly valued three-herb formula used to strengthen the body's natural defenses against colds, flu, and allergies. It is especially helpful for people who catch colds easily, sweat spontaneously, or have a generally weak constitution. The name "Jade Windscreen" reflects its role as a precious shield against illness-causing pathogens.
Acute coughs from external pathogens (Wind-Cold, Wind-Heat) often respond within 5-10 days of herbal treatment, sometimes after just a few doses. Chronic coughs rooted in internal imbalances (Phlegm-Dampness, Lung Qi Deficiency) typically require 4-8 weeks of consistent herbs and weekly acupuncture to resolve the underlying pattern and prevent recurrence. Coughs with Rebellious Lung Qi may improve within 2-3 weeks, but deeper Kidney involvement can extend the timeline.
Treatment principles
In TCM, treating a cough is not just about stopping the cough reflex - it's about restoring the Lung's ability to descend and disperse Qi smoothly. The treatment strategy varies by pattern: for external invasions, the focus is on expelling the pathogen and opening the Lungs; for internal phlegm patterns, the priority is to transform phlegm and strengthen the Spleen; for deficiency patterns, the goal is to tonify Lung Qi or nourish Lung Yin. Acupuncture and herbal formulas are chosen to address both the root cause and the symptom, with points like Lieque LU-7 and Feishu BL-13 commonly used to directly regulate Lung function.
Many patients present with mixed patterns - for example, a lingering Wind-Cold cough that has transformed into Phlegm-Heat. TCM practitioners adjust formulas dynamically as the pattern shifts, which is one reason it's effective for coughs that change over time.
What to expect from treatment
Herbal treatment is usually taken 2-3 times daily, and many patients notice a reduction in cough severity and frequency within the first 3-5 days. Acupuncture sessions are typically scheduled 1-2 times per week, with immediate relief of throat irritation and chest tightness often reported after the first session. For acute coughs, a course of 5-10 days may be sufficient. Chronic coughs require a longer commitment - 4-8 weeks of consistent treatment - to fully resolve the underlying pattern and prevent recurrence. Progress is often gradual: first the phlegm becomes easier to expel, then the cough becomes less frequent, and finally the constitutional weakness is rebuilt.
General dietary guidance
Foods that support the Lungs and reduce phlegm are central to managing any cough. Favor warm, cooked foods like soups, congees, and steamed vegetables. Pears, radishes, and ginger tea are particularly helpful. Avoid dairy products, cold and raw foods, and greasy or fried items, as these tend to generate phlegm and dampness. Spicy foods may temporarily thin mucus but can also irritate the throat if there is heat. Keep the throat moist with warm water or herbal teas throughout the day. If your cough is dry, avoid overly drying foods like crackers and toast.
Combining TCM with conventional treatment
TCM herbal formulas and acupuncture can generally be used alongside conventional cough treatments, but it's important to coordinate care. Over-the-counter cough suppressants and expectorants are usually compatible with Chinese herbs, but avoid taking them at the exact same time - space them by at least 1-2 hours. If you're taking prescription medications like corticosteroids, bronchodilators, or proton pump inhibitors, do not stop them abruptly; work with your doctor to adjust as your cough improves. Certain herbs that move Qi or dry phlegm (such as Ma Huang or Ban Xia) may interact with stimulants, blood pressure medications, or anticoagulants, so always inform both your TCM practitioner and your doctor of all medications you're taking. If you have a known allergy to aspirin or are on blood thinners, mention it before starting herbs.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Safety & special considerations
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Coughing up blood or blood-streaked sputum — This could signal a serious lung infection, tuberculosis, or even a pulmonary embolism. Seek immediate medical evaluation.
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Severe shortness of breath or difficulty breathing at rest — If you feel like you can't get enough air or are gasping, go to the emergency room.
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High fever (over 103°F/39.4°C) that doesn't respond to medication — A very high fever with chills and a cough may indicate pneumonia or a serious infection requiring urgent care.
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Chest pain or tightness that feels like pressure or squeezing — Cough with chest pain could be a sign of a heart attack, pulmonary embolism, or pleurisy. Don't wait.
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Bluish lips or face (cyanosis) — This indicates low oxygen levels and is a medical emergency - call 911.
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Cough that persists for more than three weeks without improvement, especially with unexplained weight loss — A chronic cough with weight loss warrants investigation for tuberculosis, lung cancer, or other serious conditions.
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Cough after choking on food or a foreign object — If you suspect something is stuck in your airway, seek immediate help to prevent aspiration pneumonia or suffocation.
Audience-specific guidance — open what applies to you
During pregnancy, a cough should not be ignored, but treatment must be gentle to protect the fetus. Wind-Cold patterns can be treated with mild, warm herbs such as ginger and scallion white, while avoiding strong diaphoretics like Ma Huang (Ephedra), which can stimulate uterine contractions. Sang Ju Yin, a classic formula for Wind-Heat, is generally considered safe in modified doses, but always under professional guidance.
Acupuncture is often preferred over herbs in the first trimester. Points like Lieque LU-7 and Feishu BL-13 can be used with light stimulation, while lower abdominal points are avoided. As pregnancy advances, Blood and Yin deficiency become more common, so a dry cough may indicate Lung Yin Deficiency; nourishing formulas like Sha Shen Mai Dong Tang can be adapted with pregnancy-safe herbs.
Most gentle TCM cough formulas are compatible with breastfeeding, but bitter-cold herbs like Huang Qin (Scutellaria) and Zhi Zi (Gardenia) may pass into breast milk and cause infant diarrhoea or digestive upset. For Phlegm-Heat patterns, milder alternatives such as Zhe Bei Mu (Fritillaria) or Gua Lou (Trichosanthes) are preferred. Acupuncture is an excellent option with no risk to the infant.
If a Wind-Cold cough occurs postpartum, warm pungent herbs like Zi Su Ye (Perilla leaf) can be used safely and may even support milk flow. The key is to avoid any formula that strongly drains Qi or dries fluids, as breastfeeding already consumes Qi and Blood. Always consult a practitioner who can tailor the prescription to your postpartum state.
Children’s Lungs are especially delicate, so they catch external pathogens easily. Wind-Cold and Wind-Heat invading the Lungs are the most common patterns, but food stagnation can also generate Phlegm-Heat, leading to a cough with thick yellow sputum and bad breath. Pediatric coughs often change quickly-a Wind-Cold pattern can transform into Phlegm-Heat within a day if the child has a rich diet.
Herbal dosages are reduced to one-quarter to one-half of the adult dose depending on age and weight. Gentle formulas like Zhi Sou San (for Wind-Cold) or modified Sang Ju Yin (for Wind-Heat) are frequently used. Acupuncture may be replaced by acupressure or pediatric tui na on the back and chest. Because children cannot always describe their symptoms, observing the sputum color, appetite, and sleep posture is essential for diagnosis.
In older adults, cough is more often due to deficiency than to external invasion. Lung Qi Deficiency and Kidney failing to grasp Qi are predominant, leading to a weak, chronic cough that worsens with exertion. The pulse is typically deep and weak, and the tongue is pale with a thin coating. Treatment focuses on tonifying and consolidating rather than expelling pathogens.
Herbal dosages are usually lower-about two-thirds of the standard adult dose-to avoid burdening a weakened digestive system. Formulas like Bu Zhong Yi Qi Tang or Yu Ping Feng San can strengthen Lung Qi and reduce susceptibility to recurrent coughs. Because many elderly patients take multiple medications, careful screening for herb-drug interactions is essential. Acupuncture on points like Zusanli ST-36 and Taiyuan LU-9 is well tolerated and can provide sustained relief.
Evidence & references
Acupuncture for chronic cough has moderate evidence from several randomized controlled trials and a systematic review published in 2021, which found that acupuncture reduced cough severity and improved quality of life compared to sham or medication alone. For acute bronchitis, a Cochrane review of Chinese herbal medicine concluded that some herbal preparations may shorten the duration of cough, though the overall quality of trials was limited.
Chinese herbal formulas for post-infectious cough have been studied extensively in China, with meta-analyses suggesting benefit, but English-language RCTs remain scarce. The evidence base is growing, and the 2021 Chinese expert consensus on cough provides a standardized TCM diagnostic and treatment framework that supports clinical practice, even if more rigorous international trials are needed.
Key clinical studies
A Cochrane systematic review evaluating the efficacy and safety of Chinese herbal medicine for acute bronchitis. It included 17 trials and found that some herbal preparations may improve symptoms and shorten the course of illness, but the evidence was limited by poor methodological quality.
Chinese medicinal herbs for acute bronchitis
Wu T, Yang X, Zeng X, Poole P. Chinese medicinal herbs for acute bronchitis. Cochrane Database of Systematic Reviews 2012, Issue 2. Art. No.: CD004560.
10.1002/14651858.CD004560.pub4This meta-analysis of 16 RCTs concluded that acupuncture significantly reduced cough severity scores and improved quality of life compared to control interventions, with a favorable safety profile. It supports acupuncture as a viable option for chronic cough management.
Acupuncture for chronic cough: a systematic review and meta-analysis of randomized controlled trials
Zhang Y, et al. Acupuncture for chronic cough: a systematic review and meta-analysis of randomized controlled trials. Evidence-Based Complementary and Alternative Medicine. 2021; 2021:6622729.
10.1155/2021/6622729A review of 23 RCTs found that Chinese herbal medicine, often combined with conventional treatment, improved cough resolution rates and reduced symptom scores compared to conventional treatment alone. The study highlighted the need for higher-quality trials.
Chinese herbal medicine for post-infectious cough: a systematic review of randomized controlled trials
Liu W, et al. Chinese herbal medicine for post-infectious cough: a systematic review of randomized controlled trials. Journal of Traditional Chinese Medicine. 2016; 36(5):547-556.
10.1016/S0254-6272(16)30072-1Classical text references
One quote is featured above in the Understanding section — the rest are listed here for the classically inclined.
「伤寒表不解，心下有水气，干呕发热而咳，或渴，或利，或噎，或小便不利，少腹满，或喘者，小青龙汤主之。」
"When the exterior syndrome of cold damage is unresolved and there is water-qi below the heart, with dry retching, fever, and cough, or thirst, or diarrhea, or a choking sensation, or difficult urination, lower abdominal fullness, or panting, Xiao Qing Long Tang (Minor Bluegreen Dragon Decoction) governs. This illustrates the classic treatment for cough arising from external Cold combined with internal Phlegm-Fluid."
Shang Han Lun (Treatise on Cold Damage)
Clause 40
Frequently asked questions
Common questions about using Traditional Chinese Medicine for coughing.
Yes, this is a common situation where TCM excels. A post-viral cough often lingers because the pathogen wasn't fully expelled, leaving behind phlegm or heat that irritates the Lungs. TCM identifies the remaining pattern - often Phlegm-Heat or Damp-Phlegm - and uses herbs and acupuncture to clear it. Many patients find their stubborn cough clears within 1-2 weeks of targeted treatment.
Generally yes, but with precautions. Over-the-counter cough syrups and expectorants are usually compatible if spaced at least 1-2 hours apart from herbal doses. If you're on prescription medications like inhalers or reflux drugs, never stop them abruptly; work with your doctor to adjust as you improve. Always bring a full list of your medications to your TCM consultation so your practitioner can check for interactions.
Acupuncture doesn't just numb the throat; it regulates the Lung's Qi flow and calms the cough reflex by balancing the nervous system. Points like Lieque LU-7 and Feishu BL-13 directly restore the Lung's descending function, while points like Fenglong ST-40 clear phlegm. Many patients feel their throat relax and chest loosen during or right after the first session, with cumulative effects reducing cough frequency over subsequent treatments.
Dairy products, cold and raw foods, and greasy or fried items are the top offenders - they tend to generate phlegm and dampness. Spicy foods may temporarily thin mucus but can also irritate the throat if there's heat. Instead, favor warm, cooked foods like soups, congees, and steamed vegetables. Pears, radishes, and ginger tea are particularly helpful for soothing the Lungs.
A cough that worsens when you lie down often indicates phlegm or fluid accumulation in the Lungs, or a failure of the Kidney to grasp the Qi. It could also be a sign of Rebellious Lung Qi. The specific pattern depends on other symptoms, but TCM can address it with herbs that descend Qi and dry phlegm. Acupuncture and postural advice (like sleeping slightly elevated) can bring immediate relief.
Yes, many chronic coughs respond well to herbs and acupuncture alone, especially when the root is a pattern like Lung Qi Deficiency or Damp-Phlegm that conventional medicine may not target. The goal is to rebuild the body's own ability to keep the airways clear, rather than just suppressing the cough. Some patients are able to reduce or discontinue their conventional medications under medical supervision after a few months of TCM treatment.
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