Bronchitis is inflammation caused by virus or bacterial infection, physical and chemical stimulation or allergic reaction, which often occurs in cold season or when the temperature suddenly changes. Acute bronchitis generally has an acute onset and a short course of disease. Generally, it improves in one to three weeks, and some cases continue to develop into chronic bronchitis. Chronic bronchitis is more common in the elderly, and the prevalence rate over 50 years old is 10- 15%, which is also caused by infectious or non-infectious factors. The clinical manifestations are cough, expectoration or asthma for more than two years and more than three months each year. Early symptoms are mild, mostly in winter, relieved after warm spring, and inflammation is aggravated in the later stage. Symptoms last for many years and are not affected by seasons. Chronic bronchitis can be divided into three stages according to the progress of the disease:
1. Acute attack: refers to purulent or mucinous purulent sputum within one week, with an obvious increase in sputum volume, or accompanied by inflammatory symptoms such as fever, or any of the symptoms such as cough, phlegm and asthma is obviously aggravated.
2. Chronic protracted period: refers to those who have symptoms of "cough, phlegm and wheezing" in different degrees, and delay for more than 1 month.
3. Clinical remission period: After treatment or clinical remission, the symptoms basically disappear or there is occasional slight cough with a small amount of sputum, which lasts for more than two months.
Acute bronchitis is more common in cold season, because catching cold and fatigue will weaken the physiological defense function of respiratory tract and give the infection a chance to develop. Most healthy adults are caused by adenovirus or influenza virus, while respiratory syncytial virus or parainfluenza virus is more common in children. After virus infection, it inhibits the phagocytosis of alveolar macrophages and the vitality of ciliated cells, giving bacteria a chance to invade bronchi and cause acute bronchitis. At the same time, physical and chemical stimuli such as cold air, dust and irritating gases are also easy to cause this disease. Acute bronchitis is mainly congestion, edema, hypertrophy of mucous glands, and increased secretion of tracheal and bronchial mucosa. After rest and drug treatment, the structure and function of trachea and bronchial mucosa can return to normal after inflammation subsides.
The cause of chronic bronchitis is very complicated. According to the investigation of etiology and experimental prevention at home and abroad, it is considered that it is caused by the long-term interaction of many factors, including infection, physical and chemical stimulation, meteorological factors, allergies, decreased immune function and so on.
⑴ Infection: It is a common and important cause of chronic bronchitis. At the beginning, bronchitis was mostly caused by respiratory virus infection. These viruses invade and multiply in bronchial ciliated epithelial cells, destroy mucous membranes and epithelial cells, make them lose their protective function, and make bacteria that originally existed in respiratory tract, such as influenza, Haemophilus and pneumococcus, produce pathogenic effects.
⑵ Physical and chemical stimulation: Long-term smoking and air pollution caused by chemical poisons, dust or harmful industrial waste gas will stimulate respiratory mucosa and damage its normal cleaning and defense functions, thus causing chronic bronchitis. According to the census statistics, the incidence of chronic bronchitis of long-term smokers is 2 .8 times that of non-smokers, and the greater the smoking, the higher the incidence.
⑶ Meteorological factors: Cold is an important inducement of chronic bronchitis. Many elderly patients with chronic bronchitis get sick in winter, mainly because cold stimulation can weaken ciliary movement, tracheal spasm, capillary contraction, affect blood circulation, reduce local resistance and be susceptible to infection. In addition, cold increases secretion of mucous glands, insufficient humidification of inhaled gas, sticky sputum and poor respiratory tract are also inducing factors of chronic bronchitis.
⑷ Allergy: Especially the incidence of asthmatic chronic bronchitis is closely related to allergy. If allergic to dust, dust mites, fungi, parasites, pollen and chemical gases, it can cause respiratory mucosal edema, congestion and bronchospasm, as well as cough and wheezing.
5. Decline of immune function: The incidence of the disease is high in the elderly over 50 years old, which is related to local defense of respiratory tract and low immune function of the elderly. The secretion of adrenal cortical hormone and sex hormone in the elderly is reduced, which makes the respiratory mucosa atrophy, the reserve capacity of lung tissue decrease and the elasticity of lung tissue decrease. These are the reasons that are easy to cause recurrent attacks of chronic bronchitis.
Dietotherapy is effective in treating chronic bronchitis.
1, radish honey juice: hollow out half of the white radish, add appropriate amount of honey, let stand for 3 hours, take the juice, and take it with warm water three times a day, each time 1 spoon; Or use half a catty of radish, a proper amount of rock sugar and honey, and add a small amount of boiled soup to warm the clothes.
2. glutinous rice 15g, almond 10g, licorice 10g, decocted in water and filtered twice a day.
3, honey 50g, bergamot 30g, boiled into tea; Or honey, maltose and onion juice are boiled in equal parts and eaten in moderation.
4, radish tea: take the cream radish and cut it into thin slices, and decoct it in water to make tea.
5, radish stewed tofu: fresh radish pieces 100g, tofu 200g, stew until cooked, add seasoning to eat.
6. Sydney Lily Juice: Sydney 1, Lily 15g. Slice Sydney, cook with 100 contract, and drink soup after cooking. You can also add a proper amount of rock sugar when frying.
7. apocynum tea: Take apocynum venetum leaves 10 ~ 15g for drinking tea, once a day. This prescription has a satisfactory effect in preventing and treating chronic bronchitis.
Treatment of acute attack
(1) Controlling infection depends on the main pathogenic bacteria and severity of infection or selecting antibiotics according to the drug sensitivity of pathogenic bacteria. Mild patients can take orally, and severe patients can use intramuscular injection or intravenous drip of antibiotics. Commonly used penicillin G, erythromycin, aminoglycosides, quinolones and cephalosporins. If narrow-spectrum antibiotics can be used alone, broad-spectrum antibiotics should be avoided as far as possible to avoid double infection or drug-resistant strains.
(2) Patients with acute attack should be treated with expectorant and antitussive drugs to improve their symptoms. In particular, patients in protracted period should insist on taking medicine to eliminate symptoms. Commonly used drugs include ammonium chloride mixture, bromhexine, weijingning and so on. Chinese patent medicine also has a certain effect on relieving cough. For the elderly who are too weak to expectorate or have a large amount of sputum, expectoration should be the main way to help expel phlegm and clear the respiratory tract. Strong antitussive drugs such as codeine should be avoided. So as not to inhibit the center and aggravate airway obstruction and inflammation, leading to the deterioration of the disease.
(3) For spasmolysis and asthma, aminophylline and terbutaline are usually taken orally or inhalants such as salbutamol are used. If the airway is still blocked after using airway relaxants, corticosteroids and prednisone can be used 20-40 mg/d.
(4) Aerosol therapy Aerosol humidification inhalation or compound benzoin tincture can dilute the secretion in trachea, which is beneficial to expectoration. If the sputum is sticky and difficult to cough up, ultrasonic atomization inhalation is helpful at present, and antibiotics and sputum thinner can also be added.
Western medicine
Bronchitis is a mucositis change of trachea and bronchus caused by infection or non-infection factors, and mucus secretion increases. The main clinical manifestations are long-term cough, expectoration or wheezing. The early symptoms of the disease are mild, mostly in winter and relieved after warm spring, and the course of the disease is slow, which is not noticed by people. When the advanced disease progresses and complicated with obstructive emphysema, lung function is impaired, which greatly affects health and labor force. This disease is one of the common and frequently-occurring diseases in China. The onset age is over 40 years old. Smokers are significantly higher than non-smokers. In China, the prevalence rate in the north is higher than that in the south, and the incidence rate in rural areas is slightly higher than that in cities.
diagnostic criteria
(1) Clinically, cough and expectoration are the main symptoms or accompanied by wheezing, which lasts for 3 months every year for more than 2 years.
(2) Exclude other diseases with cough, expectoration and wheezing symptoms (such as tuberculosis, pneumoconiosis, lung abscess, heart disease, cardiac insufficiency, bronchiectasis, chronic nasopharyngeal diseases, etc. ).