Diffuse interstitial lung fibrosis is an inflammatory disease of the interstitial lung caused by a variety of causes. The lesions mainly involve the interstitial lung, but can also involve alveolar epithelial cells and pulmonary vessels. The etiology is either clear or unknown. Clear causes include inorganic dusts such as asbestos and coal, organic dusts such as mold and grass dust, cotton dust, gases such as soot and sulfur dioxide, viral, bacterial, fungal, and parasitic infections, drug effects, and radiation damage. This disease belongs to the category of “cough”, “wheezing” and “lung fistula” in Chinese medicine.
Clinical manifestations
The onset of the disease is insidious, with progressive exacerbation. It is characterized by progressive shortness of breath, dry cough with little sputum or a small amount of white mucous sputum, and respiratory failure with mainly hypoxemia in the late stage. On examination, the thoracic respiratory motion is reduced, and fine wet rales or twanging sounds can be heard in both lungs. There are varying degrees of cyanosis and pestle-like fingers. Signs of right heart failure may be present in the late stage.
Diagnosis
1.Progressive shortness of breath, coughing, wet rales or twisted sounds in the lungs.
2, X-ray examination: early hairy glassy, typical changes diffuse linear, nodular, cloudy, reticulated shadows, lung volume reduction.
3, laboratory tests: ESR and LDH are seen to be increased, generally without special significance.
4, pulmonary function tests: reduced lung volume, reduced diffusion function and hypoxemia are seen.
5, lung tissue biopsy provides pathological basis. This disease should be distinguished from asthmatic bronchitis.
Treatment
Treatment of interstitial lung fibrosis is also a project like the treatment of other difficult diseases. The aim of treatment: to obtain a reversible part and time to control the progression of the disease, improve symptoms and enhance the quality of survival. The most common clinical conditions are alveolitis and interstitial fibrosis associated with autoimmune diseases. They can precede the onset of autoimmune disease or appear several years after the onset of autoimmune disease. Early stages are often treated as pulmonary infections.
Notably, when interstitial pulmonary fibrosis is diagnosed, its reversibility is suspected and treatment efforts are often abandoned. In fact, most of the early stages are coexisting with alveolitis and partial fibrosis, whose alveolitis is completely reversible. The repair process of alveoli attacked by inflammation is the process of resorption and fibrosis, and its restoration to normal lung tissue or fibrosis depends on whether the necrotic tissue fragments can be completely absorbed. If it cannot, it will be replaced by fibrotic tissue. Therefore, when damage occurs in the lung it should be treated as early as possible to avoid more irreversible fibrotic tissue that can cause impairment of lung function. This is equally important for both physicians and patients.
Western medicine treatment
1, hormone therapy: prednisone 30 – 40 mg in 2-3 oral doses, gradually reduced to maintenance dose of 5-lO mg once a day.
2.Treatment of complications: anti-infection treatment, select antibiotics according to the pathogenic bacteria.
3.Bronchodilators: aminophylline, albuterol, etc.
4.Oxygen therapy: applicable to patients with advanced stage.
Chinese medicine treatment
1.Lung Qi deficiency: low cough and wheezing, easy fatigue, sweating and fear of wind, easy to catch cold, pale tongue with white coating and weak pulse.
Treatment: Tonify lung qi, stop coughing and stabilize asthma.
Herbs: 30 grams of raw Astragalus membranaceus, 10 grams of raw Atractylodes macrocephala, 10 grams of almonds, 10 grams of asters, 10 grams of dried flowers, 6 grams of windproof, 15 grams of prunus ginseng, 6 grams of roasted ephedra, 6 grams of licorice.
Chinese patent medicine: Yu Ping Feng granules.
2, deficiency of both qi and yin, phlegm blocking lung: dry cough without or with little phlegm, shortness of breath, increased by movement, fatigue, dry mouth and throat, five heartburn, lumbar soreness and knee weakness, light red tongue, thin white first or little moss, smooth or weak pulse.
Treatment: Tonifying the lung and nourishing the kidney, resolving phlegm and activating blood.
Herbs: 15 grams each of prunus ginseng, rehmannia, dogwood, yam, poria, 30 grams of maitake, 10 grams of schisandra, 10 grams of tannin, 10 grams of zedoary, 30 grams of raw astragalus, 30 grams of lily, 15 grams of pecan, 30 grams of salvia, 10 grams of aster, 6 grams of Chuanbei powder (for dosing).
Chinese patent medicine: raw pulse drink oral liquid, Liu Wei Di Huang Wan.
3.Spleen and kidney yang deficiency, internal blockage of blood: cough and asthma are weak, and it is worse when moving, more breathing and less inhalation, swelling of lower limbs, cold form and cold limbs, gray face and purple lips, light fat tongue, thin white fur, sunken and weak pulse.
Treatment: Strengthening the spleen, warming the kidney, resolving phlegm and activating blood circulation.
Herbs: 10 grams of cooked sapodilla, 5 grams of cinnamon, 15 grams of rehmannia, 15 grams of dogwood, 15 grams of yam, 15 grams of poria, 10 grams of dandruff, 0 grams of zedoary, 30 grams of raw astragalus, 30 grams of danshen, 10 grams of aster, 10 grams of almond, 10 grams of dilong, 10 grams of Xianling spleen.
Prepared Chinese medicine: Ginseng and Spleen Pill, Jin Kui Kidney Qi Pill.
Prevention and recuperation
1. Pay attention to avoid cold and keep warm to prevent catching cold and flu.
2.Avoid contact with foreign substances with clear etiology.
3.Pay attention to diet and nutrition.
4.Ginseng, mealybug, Chuanbei powder, safflower, cordyceps in appropriate amount, powder human capsules, take in appropriate amount, or consume 2-3 walnuts daily. The body can be seen with reduced thoracic respiratory movement, and fine wet rales or twang sounds can be heard in both lungs. There are varying degrees of cyanosis and pestle-like fingers. Signs of right heart failure may appear in the late stage.
Etiology
Diffuse pulmonary interstitial fibrosis is an inflammatory disease of the interstitial lung caused by a variety of factors, mainly involving the interstitial lung, but also the alveolar epithelium and pulmonary vasculature. Some of the causes are clear, some are not.
1, environmental factors: inhalation of inorganic dusts such as asbestos, coal; organic dusts such as mold dust, cotton dust; and inhalation of toxic gases such as soot, sulfur dioxide.
2, viruses, bacteria, fungi, parasites and other recurrent infections caused by the disease is often the cause of acute attacks, but also the conditions of the aggravation of the disease.
3.Drug influence and radioactive damage.
4.Subsequent to autoimmune diseases such as lupus erythematosus.