“Are cough, why can’t he heal for a long time?”
Cough is the most common symptom of respiratory tract infection, but long -term cough does not improve, and most of them have little to do with the infection. About 30 million patients in the United States have coughing each year.In the respiratory clinic, patients who evaluate and treat continuous cough can account for up to 40%of the outpatient volume.Generally less than 3 weeks of cough is an acute cough. The most common cause is acute respiratory infections. It lasts 3-8 weeks for sub-acute cough. It is more than 8 weeks of chronic cough. Women are more common.”Chronic cough ” “cough is not good, what to do ” “cough ” “Beijing headline “
Continuous cough is generally more common in these reasons: 1. Postinfectious cough (PIC); 2. The upper airway cough syndrome (UACS), chronic rhinitis or allergic rhinitis, sinusitis, posterior nasal leakage syndrome(PNDS); 3. Eachotic cytosteritis (EB), this EB is abbreviated, not the meaning of EB virus; 4. Cough mutant asthma (CVA); 5. Cough related cough related (GerC);6. ACEI drug -induced medicinal cough.The following two pictures are about epidemiological surveys of long -term cough. The results will definitely be different, and the causes of the first cough in the previous cough are crossed. Sometimes it is difficult to completely distinguish.Features.
(Tang Zhijun, et al., Chongqing Medicine, 2011, 40: 3399-3400.)
(Lai kf, et al. Respirology 2016, 21: 683-688
After the acute respiratory tract infection, the infection itself disappeared, and the cough still delayed for 3-8 weeks.This infection refers to all pathogenic bacteria, which may be bacteria or viruses.Although PIC is induced by respiratory tract infection, it has no direct relationship with the infectious disease. Generally there is no serious consequences, but sometimes treatment is difficult.The most common cause of patients with acute cough is PIC. Compared with Asian acute cough, the proportion of PIC in chronic cough is not high, only 3 ~ 6%, so most coughs have nothing to do with PIC for more than three months.The specific mechanism after infection is not very clear. It may be related to factors such as posterior nasal leakage, suctional mucosal damage and inflammation, high reaction of airway, and increased cough sensitivity. In fact, the airway becomes sensitive after infection.Treatment can choose oral Asme, Monte, decentralized, etc. There are also inhaled treatment of amopycrite amoprobium bromide atomization. In fact, it is mainly diastolic trachea and anti -allergic drugs.
It may be associated with post -nasal drops. Basic causes include allergic rhinitis, non -allergic rhinitis, vascular motion rhinitis, acute nasopharyngeal and sinusitis, etc., which causes nasal mucosa damage, causes inflammatory response, and the secretions enter the throat backwards into the throat.Stimulate a series of symptoms, including cough, sputum, nasopharyngeal discomfort, changes in the throat wall pebble -like, nose pain, itching and clear water or thick nose, nasal congestion.It is characterized by nasal symptoms such as sneezing, runny nose, and nasal congestion outside the cough. Of course, sometimes the symptoms of the nose are not obvious. You can still think of it and check it.There are considerable secretions, which are specific changes in the leakage syndrome of the nose.Treatment is antihistamine, such as dectorrho, and inhalation hormones, such as Buditanid nasal spray. Of course, if there are more thick -nose, nasal congestion and other bacterial infections, antibiotics are required, and sometimes it may need to be needed.Operation.
Ear and Nose and Throat Anatomy Structure
A non -asthma bronchitis characterized by pneumoritic acid -addicted granulocyte infiltration, which is high -response negative in the airway and has a good response to glucocorticoids.The main symptoms are chronic irritating cough, which is often the only clinical symptom. It can cough or cough with a little white mucus and can cough during the day or night.Some patients are more sensitive to oil fume, dust, odor or cold air, and are often induced by cough.Diagnostic criteria: 1. Chronic cough, manifested as most irritating dry cough, or with a small amount of sticky sputum; 2. The chest CT is normal; 3. The lung ventilation function is normal, the AHR airway is high -response negative, the peak peak flow rate is PEF day dayThe rate of mutation is normal; 4. The proportion of eosinophils in phlegm cytology is ≥3%; 5. Eliminate other acidic diseases in other acidic cells;To put it in vernacular, in addition to the increase in the proportion of eosinophils in phlegm cells, other examinations are normal and hormone therapy is effective.
It is a potential form of asthma. There are diseases all year round, but most of them are in winter and spring.The patient is relatively young, and the cough is generally more severe. It shows spasm dry cough, especially at night, and can also be accompanied by asthma and chest tightness.Check the increase in the proportion of phlegm -enriched cells and high -reactivity.However, conventional lung function tests are normal, while bronchial stimulation tests can show high reactivity of the airway.Conventional anti -cold, infection and ordinary cough treatment are invalid.The treatment is similar to asthma. You can use bronchial extensions (such as amopymoprobarium bromide) and inhaled hormone (such as Pidine), oral white trigane receptor blockers, such as Monruist.
According to reports, gastroesophageal reflux is the second or third cause of sustainable cough, and even the most common cause, which occurs in patients with 30%-40%.However, I personally think that this reason has been exaggerated in recent years, just like Helicobacter pylori. In fact, most of the indigestion symptoms have nothing to do with it. As long as the patient complains about indigestion, it will make Chan Gatem bacteria. This is indeed true.The positive rate is also very high, but I often cannot solve the problem of indigestion after I treatment.
Continue to talk about anti -stream -related cough, it may be accompanied by reflux symptoms, such as anti -acid, heart burning, sternum burning sensation, etc., or there may be no relevant symptoms. If CVA, EB, PNDS and other chronic cough diseases can be excluded.Note that you must exclude other chronic cough diseases. If you can’t see the red throat, you feel that it is caused by reflux.Cough -related cough is more common, because the flat muscle of the elderly’s cardia is easy to relax, throat reflection is reduced, coupled with long -term medication for chronic diseases, such as oral horizontal antihypertensive drugs can also cause relaxation of the lower end of the esophagus. In addition, obesity or pregnancy will meetThe increase in abdominal pressure, etc., may also be incentives.Governance can be taken orally, mocoline, etc., and those who have a significantly reduced cough or disappear can be clearly diagnosed. The treatment time is about 8 weeks.
Dry cough is a common complication of ACEI, with a rate of up to 15%, which may be related to the accumulation of slow peptides to stimulate the passing C fiber in the airway.If you are taking ×× Prubi drugs and coughing, you must think of a drug problem.A few years ago, my mother had always coughing for a while. At first she told me that I didn’t care yet. It wasn’t until I cough for three or four months.Puli, quickly let her stop, and soon became fine.Such coughs do not need to be treated. Cough will usually fade within 1-4 weeks after the ACEI is discontinued, but occasionally it will last up to 3 months.If you still need to use related drugs, you can use ×× Satan, which generally does not produce cough.
In addition, there is a conceptual degenerative cough (AC): As an independent disease, it has not been recognized. In fact, it can be attributed to the upper airway cough syndrome. The antihistamine drugs and glucocorticoids are effective, but it cannot be diagnosed with asthma, Dynamic rhinitis or eosinophils of cytosophils (EB) are actually just to get a name.There are still airway sensitivity factors in these diseases, and the treatment is actually similar.
Here we have talked about the cause of chronic cough. Of course, it is not comprehensive, and it may also be inaccurate, which is to give you a reference.Other other like lung cancer, lung fibrosis, slow branch, and heart failure can also cause chronic cough, but generally can find related lesions through examination, so as to confirm the diagnosis.
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