First, tracheitis refers to chronic nonspecific inflammation of trachea, bronchial mucosa and its surrounding tissues. The main cause of bronchitis is chronic nonspecific inflammation of bronchus caused by repeated infection of virus and bacteria. When the temperature drops, the small blood vessels in the respiratory tract are spasmodic and ischemic, and the defense function declines, it is beneficial to cause disease; Chronic stimuli such as smoke and dust, air pollution, etc. can also occur; Smoking makes bronchospasm, mucosal variation, ciliary movement decrease and mucus secretion increase, which is beneficial to infection; Allergic factors also have a certain relationship. At the initial stage of acute bronchitis, the symptoms are usually upper respiratory tract infection, and patients usually have clinical manifestations such as nasal congestion, runny nose, sore throat and hoarseness. However, the general symptoms are mild, but there may be low fever, chills, general fatigue, itchy throat, irritating cough and retrosternal pain. There is not much sputum in the early stage, but the sputum is not easy to cough up. After 2 ~ 3 days, the sputum can change from mucus to mucus purulent. Patients who catch cold or inhale cold air or irritating gas can aggravate or induce cough. Patients often cough significantly in the morning or at night. Cough can also be paroxysmal and sometimes persistent. Severe cough is often accompanied by nausea, vomiting and muscle pain in the chest and abdomen. If accompanied by bronchospasm, there may be wheezing and shortness of breath. Generally speaking, the course of acute bronchitis is self-limited, and the systemic symptoms can subside within 4 ~ 5 days, but sometimes the cough can be extended for several weeks.
Second, differential diagnosis of bronchitis Many acute infectious diseases such as tuberculosis, lung abscess, mycoplasma pneumonia, measles, whooping cough and acute tonsillitis, as well as postnasal drip syndrome, cough variant asthma, gastroesophageal reflux disease, interstitial lung disease, acute pulmonary embolism and lung cancer often cough, which is similar to the cough symptoms of acute bronchitis. Therefore, it should be thoroughly examined and clinically differentiated. The symptoms of influenza are quite similar to acute bronchitis, but it is not difficult to distinguish from the widespread epidemic, sudden onset, obvious poisoning symptoms, high fever and muscle pain all over the body, and the diagnosis can be made by virus isolation and complement fixation test.
Treatment of acute exacerbation of sexual bronchitis
(1). Control infection depends on the main pathogenic bacteria and severity of infection or choose antibacterial drugs according to the drug sensitivity results of pathogenic bacteria. If the patient has purulent sputum, it is an indication of the use of antibacterial drugs. Mild cases can be taken orally, and patients with severe cases can be given antibiotics by intramuscular injection or intravenous drip. Commonly used are penicillin G, erythromycin, aminoglycosides, quinolones and cephalosporins.
(2) expectorant and antitussive. In addition to anti-infection treatment, expectorant and antitussive drugs are used to improve symptoms in patients with acute attack. Commonly used drugs include ammonium chloride mixture, bromohexine, ambroxol, carboxymethyl cysteine and strong thinning mucin. Chinese patent medicine also has a certain effect on relieving cough. For the elderly who are weak and unable to expectorate or have a large amount of sputum, they should assist in expectoration and unblock the respiratory tract. The application of antitussives should be avoided, so as not to inhibit the central nervous system, aggravate respiratory obstruction and produce complications.
(3) Antispasmodic and antiasthmatic drugs are often taken orally with aminophylline and terbutaline, or inhaled with short-acting bronchodilators such as salbutamol. If airflow restriction persists, lung function examination is needed. If the diagnosis of COPD is confirmed, long-acting bronchodilator inhalation or glucocorticoid plus long-acting bronchodilator inhalation should be used if necessary.
(4) Atomization therapy Atomization inhalation can dilute the secretions in the trachea and is beneficial to expectoration. If the sputum is sticky and difficult to cough up, atomized inhalation is helpful.