Causes of chronic bronchitis
Chronic bronchitis in children is a difficult disease with a long course, and children are easily stimulated to get sick, so it is difficult to treat it. Chronic bronchitis in children is generally caused by disease, infection or stimulation.
1, Disease: Chronic bronchitis is generally accompanied by chronic sinusitis, proliferative inflammation, primary or secondary respiratory ciliary dysfunction. Chronic bronchitis in children can be secondary to severe adenovirus pneumonia, measles pneumonia, bronchiolitis and mycoplasma pneumoniae infection.
2. Infection: It is an important factor in the occurrence and development of chronic bronchitis. Children's body resistance is poor, and they are vulnerable to virus attacks, so they often damage the respiratory tract, causing secondary bacterial infections, which are aggravated repeatedly. Viral and bacterial infections, rhinovirus, myxovirus and adenovirus are common bacterial viruses that cause chronic bronchitis. Bacterial infection can be secondary to airway mucosal damage caused by virus or mixed infection of virus and mycoplasma. From the results of sputum culture, it was found that Haemophilus influenzae, pneumococcus, Streptococcus A and Zongzi were the most common.
3, physical and chemical stimulation: long-term inhalation of irritating smoke, passive smoking, dust and air pollution (chlorine, nitrogen dioxide, ozone, etc.). ) damage the respiratory mucosal defense function and cause inflammation. Climate also has an effect on chronic bronchitis. Cold air stimulates children's respiratory tract, which not only weakens the defense function of upper respiratory mucosa, but also causes bronchial smooth muscle contraction, mucosal blood circulation disorder and secretion discharge difficulty through reflection, which is beneficial to secondary infection.
4, allergies: dust, dust mites, bacteria, fungi, parasites, pollen and chemical gases. , can become an allergic factor and cause disease. These allergens enter children to produce allergic reactions, causing bronchial contraction or spasm, tissue damage and inflammatory reactions, and then chronic bronchitis occurs.
5, nutrition: nutrition also has a certain impact on bronchitis, such as vitamin C deficiency in children, the body's resistance to infection is reduced, and vascular permeability is increased; Vitamin A deficiency can weaken the repair function of columnar epithelial cells and mucosa of bronchial mucosa, decrease the activity of lysozyme, and make it easy to suffer from chronic bronchitis.
6. Heredity: Whether genetic factors are related to the pathogenesis of chronic bronchitis has not been confirmed yet. Severe deficiency of α 1- antitrypsin can cause emphysema, but it has no symptoms of airway disease, suggesting that it is not directly related to chronic bronchitis.
Parents need to know the cause of children suffering from chronic bronchitis, and at the same time of active treatment, avoid exposing children to such pathogens again, so as not to lead to repeated illness and increase the difficulty of treatment.
Symptoms of chronic bronchitis
Chronic bronchitis in children has a slow onset and a long course of disease, and seasonal factors have a great influence on the condition. Children with chronic bronchitis have the following symptoms:
1, persistent cough often occurs after a cold, which persists for many days, or is accompanied by mild to moderate wheezing. Generally, cough mainly occurs in the morning and evening. The amount of sputum is more or less, and it is comfortable after coughing. Generally white mucus or serosity, foamy, and occasionally bloodshot. When accompanied by bacterial infection, it is mostly purulent sputum, and more sputum is discharged in the morning. After getting up or changing posture can stimulate expectoration.
2. Children with chronic bronchitis are almost always accompanied by frequent runny nose, stuffy nose and night breathing, except for repeated cough and persistent expectoration. Destruction of bronchi or interstitial lung may be complicated with atelectasis, emphysema and bronchiectasis.
About half of the children are behind their peers in growth and development, and their physical strength is poor. Children often feel chest pain. If not actively treated, it will be aggravated frequently, the course of disease will be prolonged, and the physique will be weaker, even in summer. Eventually, atelectasis, emphysema and bronchiectasis may occur due to the destruction of bronchi or interstitial lungs.
Children with chronic bronchitis are clinically divided into three stages, and children in different stages will have different symptoms:
Acute attack: the condition is aggravated, and the course of disease is within 1 month, which is called acute attack of chronic bronchitis. The child's cough is aggravated, with a lot of mucus and phlegm, accompanied by wheezing. Dry and wet rales can be heard in the lungs;
Chronic protracted period: the patient's condition worsened after acute attack, and there was no obvious remission after prolonged for more than 1 month.
Remission period: the onset season of chronic bronchitis, the remission period when the condition is temporarily stable, is a relatively stable period in which patients have no obvious cough and asthma symptoms in the rare season of chronic bronchitis.
If parents find that their children have the above symptoms, they should consider suffering from chronic bronchitis and go to the hospital for treatment in time.
Treatment of chronic bronchitis
If the condition of chronic bronchitis is not controlled, it will lead to the decline of children's physique and affect normal growth and development. After clarifying the cause of children's chronic bronchitis, parents need to cooperate with doctors to actively treat and remove the cause. Most children's conditions can be cured. The treatment of chronic bronchitis in children is as follows:
1, general measures. Pay attention to children's nutrition supply and strengthen outdoor activities and physical exercise. Related causes, such as sinusitis and proliferative inflammation, should be cured in time. Pay attention to seasonal changes, increase or decrease clothes for children in time, avoid possible allergens and reduce the number of attacks. Nonspecific triple vaccine injection can improve the phagocytic function of serum interferon and white blood cells. Parents can consult a doctor and decide whether to inject their children.
2. Chinese medicine therapy. Traditional Chinese medicine believes that chronic bronchitis is an internal cough, which is mostly caused by visceral dysfunction caused by chronic cough. According to clinical manifestations, it can be divided into phlegm cough and lung dryness cough. The main therapeutic methods are invigorating spleen and eliminating dampness, resolving phlegm and relieving cough, nourishing yin and moistening lung, which can be treated according to clinical manifestations.
Cough due to lung dryness: long cough time, dry cough with little phlegm, hot flashes due to yin deficiency, thirst and dry throat, emaciation and night sweats, fever in hands and feet, reddish tongue with no coating and little coating, and rapid pulse. Nourishing yin and moistening lung to treat cough. Shashen Maimendong Decoction is often used for addition and subtraction. Examples of prescriptions: 9 grams of Radix Adenophorae, 9 grams of Radix Ophiopogonis, 9 grams of Rhizoma Cynanchi Stauntonii, 9 grams of Radix Stemonae, 9 grams of Radix Asteris, 6 grams of almond, 3 grams of indigo naturalis and 9 grams of ebony. The method of addition and subtraction is as follows: less dry expectoration, not easy to cough up, Fritillaria 9 g. If the cough lasts for a long time (no exterior syndrome), add 9g of Schisandra chinensis or 9g of Ginkgo biloba leaves.
Cough due to phlegm retention: cough is mainly caused by excessive phlegm, white and thin, easy to cough, fullness in the chest, loss of appetite, normal tongue quality, white and greasy fur, slippery pulse or damp, and the treatment is to strengthen the spleen and eliminate dampness, resolve phlegm and relieve cough. Commonly used Erchen decoction is modified. Examples of prescriptions: Poria cocos 9g, Fructus Aurantii 9g, Pinellia tuber 6g, almond 6g, perilla 6g, white mustard seed 1.5g can be added or subtracted: loose stool, white greasy tongue coating, fried Coicis Semen 9g, Codonopsis pilosula 9g, almond and perilla can be removed. Asari 1.5g and ginger 3g can be added during acoustic filtration of phlegm.
Parents can choose the appropriate treatment according to their children's symptoms. In addition, some studies believe that chronic bronchitis is mostly caused by bacterial infection. Parents may wish to consult a doctor and choose the corresponding antibacterial drugs for treatment, which can have a good effect.
What is good for chronic bronchitis?
Chronic bronchitis in children is a long-term disease, and diet conditioning plays an important role in the rehabilitation of this disease. Children with chronic bronchitis should follow the following dietary principles:
1, food should be light: give children more fresh vegetables, such as cabbage, spinach, rape, radish, carrot, tomato, cucumber, wax gourd, etc. These vegetables can not only supplement the supply of vitamins and inorganic salts for children, but also have the effects of resolving phlegm, removing fire and relaxing bowels. Give children more soy products. Soybeans and bean products contain high-quality protein needed by human body, which can supplement the nutrient loss caused by chronic tracheitis, without the disadvantages of phlegm accumulating fire.
2, strengthen the usual diet: children with chronic cough, healthy qi consumption, lung and spleen weakness. Therefore, foods with the functions of invigorating spleen and lung, kidney, regulating qi and resolving phlegm, such as pig, cattle, sheep, lung, loquat, orange, pear, lily, jujube, lotus seed, almond, walnut, honey, etc., are usually selected, which is helpful to strengthen physical fitness and improve symptoms.
3, do not eat oily jellyfish: Chinese medicine believes that "fish makes a fire, meat produces phlegm", oily jellyfish food is not conducive to the rehabilitation of chronic bronchitis, so children with chronic bronchitis should eat less yellow croaker, hairtail, shrimp, crab, fat and so on. , so as not to help the fire produce phlegm.
4, do not eat irritating food: spicy things such as pepper, pepper, garlic, onions, leeks and so on. , will stimulate the respiratory tract, aggravating symptoms. Parents should also pay attention to the seasoning of dishes, not too salty or too sweet, and the heat and cold should be moderate.
5, chewing dried ginger can alleviate chronic symptoms: Chinese medicine believes that dried ginger is an important drug for treating colds and resolving phlegm. Dried ginger is warm in nature and pungent in taste, which has the functions of dispelling cold, warming middle warmer, eliminating phlegm and promoting fluid production, and stopping vomiting, and has a good curative effect on chronic bronchitis with cold syndrome. Moreover, when a cold coughs, it contains dried ginger 1 tablet before going to bed, and the cough at night will also be reduced. According to modern pharmacological analysis, dried ginger mainly contains gingerol, borneol, gingerol, citric acid and other components, and these volatile oil components have the functions of expelling wind, dispelling cold and eliminating evil. There is a folk custom of boiling ginger and brown sugar water after catching a cold, which can prevent colds. Dried ginger can also stimulate the sympathetic nerve in the vascular motor center, enhance the ciliary movement of tracheal mucosal cells, and facilitate the upward transportation and discharge of sputum and saliva.
In addition to paying attention to the above dietary principles, parents should also pay attention to let their children develop good eating habits, not picky eaters and anorexia, absorb nutrients in a balanced way, strengthen their physique and resist virus attacks.
Examination of chronic bronchitis
When parents find that their children have symptoms of chronic bronchitis, they need to take their children to the hospital for relevant examinations to clarify the cause and confirm the condition. Clinically, children are generally examined as follows:
1. General examination: During bacterial infection, the total number of white blood cells, neutrophils and asthmatic eosinophils may increase.
2. Etiological examination: bacteria or a large number of destroyed white blood cells and goblet cells can be seen in sputum smear, and pathogenic bacteria can be seen in sputum culture.
White blood cell classification count: The total number and classification count of white blood cells in patients with remission are normal, the total number of white blood cells and neutrophils in patients with acute attack complicated with bacterial infection can be increased, and the blood eosinophils in patients with asthma can be increased.
Sputum examination: during acute attack, the appearance of sputum is mostly purulent, and a large number of neutrophils can be seen in smear examination. There are many eosinophils in asthma patients, and Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis can be seen in sputum culture.
3. Pulmonary function examination: forced expiratory volume in one second and forced expiratory volume/forced vital capacity ratio in one second. There is no obvious change in the early stage. When the airflow is blocked, the ratio of forced expiratory volume and FEV 1 sec to vital capacity or forced vital capacity decreases. When the small airway is blocked, the maximum expiratory flow-volume curve can obviously reduce the flow at 75% and 50% lung volume, and the closed volume can be increased.
4.x-ray examination: there is no abnormality in the early stage, and the lung texture can be thickened and disordered, with reticular, striped or variegated shadows, especially in the lower lung field. This is due to the thickening of bronchial wall, infiltration or fibrosis of inflammatory cells in bronchioles or alveolar interstitium.
5. Other examinations: spiral CT examination and bronchial lipiodol angiography are performed when necessary.
Parents are advised to take their children to a regular hospital for examination of chronic bronchitis. After the disease is diagnosed, it is necessary to consult a doctor in combination with the child's physical condition and choose the most appropriate treatment and nursing method.
Prevention of chronic bronchitis
Once the child has symptoms of chronic bronchitis, parents should take the child to the corresponding department of a regular hospital for examination and treatment as soon as possible, and take effective treatment and nursing methods. In daily life, parents should also do a good job in preventing chronic bronchitis:
1, children with chronic bronchitis, because of the disease, are mostly in poor health, so we must strengthen nutrition, actively participate in various sports activities, exercise and prevent colds.
2. Avoid contact with allergens. Suspected to be allergic to fish, shrimp, egg white, etc. Eating should be reduced or prohibited. Chronic bronchitis mostly occurs in cold winter, but less in summer, so the method of treating winter disease in summer can be adopted. Passive smoking should be avoided, and the effects of smoke, dust and irritating gases on the respiratory tract should be avoided, so as not to induce chronic bronchitis.
3, give children proper cold-resistant exercise, you can try to let children wash their faces with cold water, insist on washing their faces with cold water or wiping their limbs in the morning and evening. After washing your face, you can rub your head and face for 5-6 minutes at a time, which can enhance the cold resistance and personal physique of the upper respiratory tract.
4, pay attention to cold and warmth, don't let children catch a cold. Cold-resistant, but also cold and warm. When the climate changes suddenly, you should add clothes in time to prevent catching a cold. When the cold wave comes, it is best not to take the children out to avoid catching a cold. Children in remission can be regularly injected with influenza vaccine and pneumonia vaccine to reduce the occurrence of colds and the number of acute attacks.
5, regularly open the window to indoor ventilation, keep indoor air moist. Regular indoor ventilation is an important measure to prevent the recurrence of chronic bronchitis in children. When the indoor air humidity is relatively low, it is necessary to appropriately increase the indoor air humidity (measures include sprinkling water, drying wet towels indoors or using humidifiers, etc.). ) make the air humidity reach about 60%.
As long as parents do these nursing work well in daily life and actively treat their children's respiratory diseases, the chances of children suffering from chronic bronchitis will be greatly reduced.