Background: Respiratory sound classification plays a critical role in the clinical identification of pulmonary pathologies. However, its performance is often hindered by the limited size, severe noise, and class imbalance of real-world auscultation datasets. Although conventional audio augmentation techniques are easy to implement, they may inadvertently distort subtle pathological characteristics. Meanwhile, existing Variational Autoencoder (VAE)- or Generative Adversarial Network (GAN)-based generative approaches often suffer from limited sample fidelity and insufficient controllability over class semantics, particularly under conditions of scarce supervision. Methods: To overcome these limitations, we propose C2GA, a class-controllable generative augmentation framework. C2GA first constructs a semantically rich discrete latent space using a conditional Vector-Quantized Variational Autoencoder (VQ-VAE), in which local acoustic tokens are explicitly decoupled from global class prototypes. Subsequently, a Transformer-based autoregressive prior is trained to generate label-consistent token sequences. These generated tokens are then fused with the corresponding class prototypes and decoded into high-fidelity Mel-spectrograms for data augmentation. Conclusion: These results indicate that C2GA provides an effective and semantically reliable augmentation strategy for respiratory sound analysis. By enabling controllable and high-quality data generation, the proposed framework offers a promising solution for improving the robustness and generalization of respiratory sound classification in realistic clinical scenarios.

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