Maimendong-Tang Treatment for Subacute and Chronic Cough in a Primary Care Korean Medicine Clinic

Background: Despite guideline-based evaluation of identifiable causes, many patients still have refractory or unexplained chronic cough, highlighting the need for adjunctive therapies. Real-world clinical evidence for Maimendong-Tang (MMDT) in primary Korean medicine is scarce.Methods: Medical records from 1 primary Korean medicine clinic were retrospectively reviewed. Adults with subacute or chronic cough who received MMDT for ≥ 2 weeks were included in the study. Outcomes were improvement in severity for cough and sputum. The data were summarized descriptively, cumulative proportions achieving ≥ 50% and ≥ 3-point cough-NRS reductions were calculated by visit and cough type, and exploratory k-means clustering (Jaccard distance) was performed, and herb-symptom bipartite networks were assessed.Results: Thirty-one patients were included (mean age 53.6 ± 14.8; 90% female; 14 subacute, 17 chronic). Inter-visit medians (IQR) were 35.5 (32.0-49.5), 34.5 (33.2-43.5), and 34.0 (34.0-42.0) days for Visits 1-2, 2-3, and 3-4. Cough NRS scores decreased from 7.95 ± 1.04 at Visit 1 to 3.14 ± 1.87 at Visit 2 (subacute 8.21 ± 0.97 → 2.58 ± 1.46; chronic 7.74 ± 1.06 → 3.63 ± 2.09), and sputum NRS scores from 3.18 ± 2.51 to 1.68 ± 1.72. By Visit 2, 67.7% achieved ≥ 50% cough reduction (subacute 85.7%; chronic 52.9%). No adverse events were observed. Clustering and herb-symptom networks showed no meaningful prescription-pattern differences by co-occurring symptoms; subacute- and chronicstratified networks resembled the overall network.Conclusion: MMDT prescription may be associated with a decrease in cough and sputum severity. Due to risk of bias, generalizability is limited; however, demographics, clinical characteristics, and treatment patterns, may provide foundational data for large-scale prospective studies.