ObjectiveTo analyze the correlation between the clinical symptoms， signs， syndrome characteristics and laboratory indicators of cough variant asthma （CVA） and deepen the understanding of the treatment of this disease based on the theory of "Fu Feng". MethodsAn observational study was conducted. A total of 207 CVA patients who visited the respiratory department of the Third Affiliated Hospital of Beijing University of Chinese Medicine from September 2022 to November 2023 were included. The information from the four diagnostic methods and the laboratory test results of patients were collected. Factor analysis was conducted on the information obtained through the four diagnostic methods in TCM， and the nature and location of CVA were extracted. Sample cluster analysis （Q clustering） and the K-means method were used for data clustering analysis to determine the syndrome types of CVA and analyze the syndrome characteristics and differences in laboratory indicators among different syndrome types. ResultsThe main symptom of CVA patients was cough， accompanied by symptoms such as itchy throat， foreign body sensation in the throat， dry throat， shortness of breath， dry mouth， chest tightness， hoarseness， bitter mouth， poor appetite， and skin itching. Factor analysis showed that the disease was located in the lung， involving the liver， spleen， and kidney. The pathological factors involved Yin deficiency， Yang deficiency， wind factor， dampness factor， Yin factor， and Qi stagnation. Cluster analysis revealed four syndrome types： Fengfu Yinshang syndrome， Shixie Neiyun syndrome， Tanyin Zufei syndrome， and Ganhuo Fanfei syndrome. Fengfu Yinshang syndrome accounted for the highest proportion， followed by Tanyin Zufei syndrome. There were no significant differences in eosinophil count and percentage， fractional nasal nitric oxide （FnNO） level， and pulmonary function indexes among the four syndromes. The levels of serum total IgE and fractional exhaled nitric oxide （FeNO） in patients with Fengfu Yinshang syndrome were significantly higher than those in patients with Shixie Neiyun syndrome and Tanyin Zufeisyndrome. ConclusionCough is the main symptom of CVA， accompanied by pharyngeal itching， foreign body sensation in the throat， dry throat， shortness of breath， dry mouth， and allergic manifestations. The disease involves the lung， liver， spleen， and kidneys. The essence of the pathogenesis lies in a latent dormant pathogen and a disorder of the pivot mechanism. The four common syndrome types are Fengfu Yinshang syndrome， Shixie Neiyun syndrome， Tanyin Zufei syndrome， and Ganhuo Fanfei syndrome. The TCM syndrome types are correlated with laboratory indexes. The serum total IgE and FeNO of patients with Fengfu Yinshang syndrome are worse.

ObjectiveTo observe the regulation effect of Sangmei Zhike granules on airway inflammation and cyclic adenosine monophosphate （cAMP）-protein kinase A （PKA）-cAMP response element binding protein （CREB） pathway in cough variant asthma （CVA） rats with Fengfu Yinshang syndrome. MethodsEight-week-old male rats were randomly divided into a blank group， model group， western medicine group， and traditional Chinese medicine （TCM） group. Except for the blank group， Fengfu Yinshang models of CVA were established in the other groups. On the 16th day of the experiment， the western medicine group was treated with budesonide aerosol inhalation （dosage of 0.5 g·L^-1）， and the TCM group was given Sangmei Zhike granules by gavage （dosage of 4.19 g·kg^-1·d^-1）， with each group treated once daily for 14 days. On the 30^th day of the experiment， lung function parameters were determined. Whole blood inflammatory cell detection， hematoxylin-eosin （HE） staining of lung tissue， and immunohistochemistry were used to detect the expression of CREB， phosphorylated CREB （pCREB）， and phosphorylated vasodilator-stimulated phosphoprotein （pVASP） proteins in rat lung tissue， and Reverse transcription quantitative polymerase chain reaction （Real-time PCR） was used to determine the protein expressions of cAMP， CREB， and PKA in rat lung tissue. Western blot （WB） was used to detect the expression of PKA， VASP， p-VASP， CREB， and p-CREB proteins. ResultsCompared with the model group， the average dynamic lung compliance （CDyn_average） in the TCM group increased （P0.05）. Compared with the model group， the TCM group showed a decrease in absolute and percentage values of neutrophils （NEUT%）， absolute values of lymphocytes （LYMPH）， absolute and percentage values of basophils （BASO%）， absolute values of monocytes （MONO）， absolute and percentage values of eosinophils （EOS%）， and white blood cells （WBC） （P0.05）. Compared with the western medicine group， the TCM group showed a decrease in MONO， EOS%， and LYMPH% and an increase in MONO% （P0.05）. ELISA results showed that compared with the model group， the TCM group had increased interferon-gamma （IFN-γ） and decreased interleukins （IL）-4， IL-5， IL-13， and total serum IgE， while the Western medicine group had increased IFN-γ and decreased IL-5， IL-13， and total serum IgE （P0.05）. Compared with the western medicine group， the TCM group had decreased IL-5 （P0.05）. HE staining results of rat lung tissue showed that the ciliated epithelium of the D bronchi in the TCM group recovered well. Mucous edema secretion decreased， and a small number of bronchiolar epithelial cells were shed， with reduced infiltration of inflammatory cells and the degree of epithelial injury. Immunohistochemical （IHC） results showed that compared with the model group， positive expressions of CREB， pCREB， and pVASP （brownish-yellow） were significantly increased in the TCM and western medicine groups. Real-time PCR results showed that compared with the model group， the relative expression levels of cAMP， CREB， and PKA in the TCM group were significantly increased （P0.05）， and compared with the western medicine group， the TCM group also showed significantly increased relative expression levels of cAMP， CREB， and PKA （P0.05）. WB results showed that compared with the model group， the expressions of PKA， VASP， p-VASP， CREB， p-CREB， and p-CREB/CREB proteins were increased in the TCM group， while p-VASP/VASP protein expression decreased （P0.05）. Compared with the western medicine group， the TCM group had increased expressions of PKA， VASP， and p-CREB proteins and decreased p-VASP/VASP expression （P0.05）. ConclusionSangmei Zhike granules have the effect of improving lung function and inhibiting airway inflammation in rats with CVA due to Fengfu Yinshang syndrome， possibly related to the activation of the cAMP/PKA/CREB pathway.