Many children always cough a few times from time to time, and parents do not take it seriously. Children who often have symptoms of coughing must pay attention, because frequent coughing in children may be a reflection of disease, so when When children have frequent coughs, they need to be checked and treated. So, what is the reason why children have a persistent cough? What should I do if my child has a long-term cough that won’t heal?
1. Causes of chronic cough in children
The top three most common causes of chronic cough in Chinese children are cough variant asthma, upper airway cough syndrome, and respiratory tract disease. Infection and post-infection cough; others include gastroesophageal reflux cough, eosinophilic bronchitis, congenital respiratory diseases, psychogenic cough, foreign body aspiration, etc. A situation like Qianqian's is a common case of chronic cough in children. Clinical diagnosis requires careful systematic evaluation, thorough history, and physical examination. Such children need to undergo chest X-ray examination, and those of appropriate age should undergo pulmonary ventilation function examination.
1. Cough variant asthma (CVA) is one of the common causes of chronic cough in children, especially preschool and school-age children. Its symptoms are:
(1) Cough that lasts for 4 weeks, often attacks at night and/or early in the morning, and worsens after exercise or exposure to cold air. There are no clinical signs of infection or after a long period of antibiotics. Treatment is ineffective;
(2) Diagnostic treatment with bronchodilators (such as ?2 receptor agonists: Bricanil, Meprolin, etc.) can significantly relieve cough symptoms;
(3) The pulmonary ventilation function is normal, and the bronchial provocation test shows airway hyperresponsiveness;
(4) There is a history of allergic diseases, including a history of drug allergy, and a positive family history of allergic diseases. A positive allergen test can assist in diagnosis;
(5) Exclude chronic cough caused by other diseases.
2. Upper airway cough syndrome (UACS): various rhinitis (allergic and non-allergic), sinusitis, chronic pharyngitis, chronic tonsillitis, nasal polyps, adenoid hypertrophy, etc. Airway diseases can cause chronic cough. It was previously diagnosed as postnasal drip syndrome, which is a cough caused by the backflow of nasal secretions into the pharynx through the back of the nose. Coughing is most obvious in the early morning or when body position changes, and is often accompanied by nasal congestion, runny nose, dry throat with foreign body sensation, repeated throat clearing, and a feeling of mucus adhering to the posterior pharyngeal wall.
3. Respiratory tract infection and post-infectious cough: Respiratory tract infections caused by many pathogenic microorganisms such as Bacillus pertussis, Mycobacterium tuberculosis, Mycoplasma pneumoniae, Chlamydia, etc. are common causes of chronic cough in children, and are more common in preschoolers aged 5 years. child. For acute respiratory tract infections, post-infectious cough may be considered if cough symptoms persist for more than 4 weeks.
4. Others: Gastroesophageal reflux (GRE) is a physiological phenomenon in infancy. The incidence of GRE in healthy infants is 40%-65%. It usually occurs at night, mostly after eating, and there are feeding difficulties. Inhalation of foreign bodies is an important cause of chronic cough in children, especially those aged 1-3 years. It usually manifests as paroxysmal severe choking cough, which can cause atelectasis or obstructive emphysema on one side of the lung. Parents should pay special attention to nuts such as peanuts and melon seeds, and try not to eat them among young children.
For the cause of chronic cough in older children, we should also pay attention to psychogenic cough, which is mainly daytime cough and disappears when focusing on something or resting at night. Children are generally anxious, and some introverted children appear this way to attract the attention of their families. Of course, when diagnosing this cause, other causes of chronic cough must be ruled out.
2. Treatment of chronic cough in children
The treatment of chronic cough mainly focuses on the cause of the disease. If the cause is unknown, empiric symptomatic treatment can be performed in order to achieve effective control; if the cough symptoms are not relieved after treatment, the diagnosis of the cause should be reconsidered. In chronic cough, the use of antitussive drugs, such as codeine, is not recommended until the cause is unknown. If the cough is accompanied by phlegm, the principle should be to eliminate phlegm. Instead of simply relieving the cough, you can use ambroxol hydrochloride, myrtle oil and traditional Chinese medicine to eliminate phlegm. Antibiotics can be considered for infections that are clearly caused by bacteria or mycoplasma. Abuse of antibiotics should be avoided. Reasonable and standardized use of antibiotics has always been encouraged and advocated. Antihistamines such as cetirizine, loratadine, and leukotriene receptor antagonists can be used for cough variant asthma or upper airway cough syndrome. For children with rhinitis, glucocorticoids can be used for nasal inhalation. Children with allergic constitution should also take environmental precautions and avoid exposure to allergens.
3. Cough prevention
Parents with chronic coughs that are clearly caused by allergies should also take preventive measures. If a child is allergic to dust mites, he or she should pay attention to the clean environment at home, washing and drying bedding, cleaning the air conditioner, cleaning toys, cleaning the room, air circulation, etc. Children with food allergies should avoid allergic foods, such as milk, egg albumen, etc. In addition to taking some oral anti-acid drugs, children with gastroesophageal reflux should also pay attention not to eat liquids 1-2 hours before going to bed, and appropriately elevate their body position to 30 degrees before going to bed.
Children can also exercise properly to enhance their physical fitness, bask in the sun more, and go to places with few people and fresh air. The time for outdoor activities can be increased from 1 to 2 times a day for 10 to 15 minutes each time, and gradually extended to 1~2 hours; only expose your face and hands during outdoor activities in winter, and pay attention to keeping your body warm.
However, do not keep warm too much as it will not be conducive to children's activities. In addition, it is easy for children to catch cold again after sweating too much, which increases the chance of colds and coughs.
Qianqian mentioned in the case came to the hospital again accompanied by her mother. After detailed questioning and careful physical examination, the doctor found that Qianqian had eczema, and checked for allergens and found dust mites. Allergy level 6, extremely positive. In the past month, because of the hot weather, my mother turned on the air conditioner every night, causing coughing due to repeated cold stimulation. Qianqian was finally diagnosed with cough variant asthma. On the day after the diagnosis was confirmed, she started taking leukotriene receptor antagonists. After 5 days, the cough gradually disappeared. Only then did the stone in their family's hearts completely fall to the ground, and Qianqian also resumed a good sleep. At the same time, my mother also tried every means to avoid contact with allergens dust mites and reduce triggering factors. Now Qianqian is happy again.
Finally, I would like to remind all parents that due to the complexity of the causes of cough, you should not blindly use medication when treating children's cough, especially for children with long-term cough; we hope that the child can undergo a comprehensive and systematic examination in the hospital to clarify the cause. Then use targeted treatment.
4. How to prevent babies from coughing
1. Keep the air in the room fresh
Dirty air will cause adverse irritation to the respiratory mucosa and can cause Congestion, edema, and increased secretions aggravate coughing. Therefore, it is necessary to keep indoor air fresh and kitchen fumes to be exhausted. Parents should not smoke at home to indulge in smoke addiction and should regularly open windows for ventilation. Director Zhao said that fresh indoor air can also disinfect, and it should be turned on once in the morning and afternoon for about 20 minutes each time.
2. Adjust the room temperature and add or remove clothes and quilts in time
The appropriate temperature is 25°C to 28°C, which is called the neutral temperature. It is difficult to maintain this temperature under normal conditions, but the room temperature can be kept from being too high or too low. Open and close doors and windows appropriately to avoid crowding indoors. Many parents believe that children are definitely more afraid of the cold than adults. They often cover their children too thickly and tightly regardless of the season, indoors or outdoors, so as not to let the children suffer any cold. As a result, the body's ability to regulate is poor. Low resistance.
3. Maintain appropriate humidity in the room
If the environment is too dry, the air humidity will decrease, the mucous membrane will become dry and brittle, small blood vessels may rupture and bleed, ciliary movement is limited, and phlegm is difficult to cough out. When there is inflammation in the respiratory organs, the impact is more obvious. Maintaining a certain humidity indoors is not difficult. When the climate is dry, you can mop the floor with a wet mop or sprinkle some water on the ground.
4. Pay attention to regulating your diet
As the saying goes, "Fish makes fire, meat makes phlegm, vegetables and tofu keep you safe." Traditional Chinese medicine believes that fish, crab, shrimp, fatty meat and other fishy and greasy foods may help dampness and phlegm production, and some may even cause allergic reactions and aggravate the condition. Spicy products such as chili, pepper, and ginger can irritate the respiratory tract and aggravate coughs, so be careful to avoid them. Fresh vegetables such as vegetables, carrots, tomatoes, etc. can provide a variety of vitamins and inorganic salts, which are beneficial to the recovery of the body's metabolic function.
5. Ensure adequate sleep
During sleep, the muscles of the whole body relax, the response to external stimuli is reduced, and activities such as heartbeat, breathing, and excretion are reduced, which is conducive to the functional recovery of various organs and disease prevention. Rehabilitation.
6. Drink plenty of water, pay attention to personal hygiene, and wash hands frequently
Take your children to crowded places as little as possible to avoid cross-infection.
Allow children to exercise appropriately. Enhance children's physical fitness and adapt to the cold environment in winter.