I. Headache-inducing allergic cough
Many parents and friends have a headache with their baby’s recurrent cough. When they are not careful, their baby will sneeze and runny nose and then develop a cough. “It’s like chiseling my heart with a chisel one by one”. Among the torment, many detours have been taken, including repeated application of antibiotics, long oral administration of herbal tonics, and inhaled hormone therapy, at great cost and with little success. The problem to be solved in this article is to give you a correct understanding of what allergic cough is and to establish a scientific concept of prevention and treatment, which I hope will provide a little help to parents and friends.
II. Diagnostic criteria for allergic cough
Allergic cough, also known as cough variant asthma, is described in textbooks as follows with regard to the diagnostic criteria for allergic cough (regardless of the age of the child).
(1) Persistent or recurrent cough attacks >1 month, often at night and/or early in the morning, aggravated by exercise, with little sputum and no clinical signs of infection, or ineffective with longer-term antibiotic therapy;
(2) Treatment with tracheal diaphoresis can relieve coughing episodes (basic diagnostic condition);
(3) A personal history of allergy or family history of allergy, and a positive allergen test can be used as an auxiliary diagnosis;
(4) Airways are hyperreactive and a positive bronchial excitation test is an aid to diagnosis;
(5) Excluding other causes of chronic cough.
In clinical practice, the following characteristics of allergic cough are summarized: First. The cough lasts for a long time, usually more than a month, and is characterized by: coughing at night (coughing for a while before going to bed at night; waking up in the middle of the night), waking up in the morning, and coughing obviously after activities; second, the application of antibiotic treatment is ineffective; third, it is usually not accompanied by or rarely accompanied by fever; fourth, the cough has little sputum, no sputum or coughing up a little spitted white or gray-white mucous sputum; fifth, most babies have a history of rhinitis, eczema, and other allergies. They usually like to rub their eyes and nose, scratch their scalp, are prone to itchy skin allergy, sweating and restlessness during sleep; sixth, they have a family history of allergic diseases; seventh, there is no obvious abnormality in chest X-ray examination, and some of them may have thickened lung texture; eighth. The cough can be significantly relieved after oral administration or nebulized inhalation of the bronchodilator albuterol.
Children with allergic cough have their special external manifestations. In actual clinical work, a glance combined with the traditional Chinese medicine diagnosis can determine whether the baby is allergic and whether there is an allergic cough.
III. Etiology
Firstly, genetic factors: allergic diseases are genetically related and are a special kind of genetic inheritance. Most children have a past history of eczema, allergic rhinitis, food or drug allergies, and many have a family history.
Secondly, environmental factors: the current serious environmental and dietary pollution has led to a significant increase in the incidence of allergic diseases, and biological, physical and chemical factors can induce allergic diseases.
However, I regret to tell you that there is no such thing as “eliminating the root” in Chinese medicine, not only that, there is no such thing as eliminating the root of any disease in Chinese medicine. In other words, the history of allergy is genetically determined, can traditional medicine change the genes? If it is said that TCM treats diseases to eliminate their roots, it is also the TCM principle of “treating the disease must seek the root”, trying to find the root cause of the disease and then treating it with evidence.
Other common diseases that cause prolonged coughing
1, the whistling tract infection and post-infection cough: many pathogenic microorganisms such as Mycobacterium pertussis, Mycobacterium tuberculosis, viruses (especially whistling syncytial virus, parainfluenza virus, cytomegalovirus), Mycoplasma pneumoniae, Chlamydia, etc. caused by the whistling tract infection is a common cause of chronic cough in children, the mechanism of which may be that the infection causes damage to the integrity of the airway epithelium and/or squamous ciliated epithelial cells. and/or persistent airway inflammation with temporary airway hyperresponsiveness. The clinical features and diagnostic clues for post-infectious cough are.
(1) A recent history of definite whistling infection;
(2) An irritating dry cough or a small amount of white mucous sputum;
(3) No abnormalities on chest radiographs;
(4) normal pulmonary ventilation;
(5) The cough is usually self-limiting;
(6) Other causes of chronic cough are excluded.
If the cough lasts longer than 8 weeks, other diagnoses should be considered. Combined with current tests, it is not difficult to simply distinguish the above diseases. The clinical headache is the combination of allergic cough with the above diseases, which must be analyzed to distinguish the primary and secondary conflicts and treated in an integrated manner.
2. Upper airway cough syndrome (UACS): Various rhinitis (allergic and non-allergic), sinusitis, chronic pharyngitis, chronic tonsillitis, nasal polyps, adenoid hypertrophy and other upper airway diseases can cause chronic cough, which was previously diagnosed as postnasal drip (flow) syndrome, referring to the cough caused by nasal secretions flowing backwards through the postnasal orifice to the pharynx. The name “postnasal drip syndrome” is now usually replaced by “upper airway cough syndrome”.
V. Misconceptions about treatment and daily care
1. Take oral or inhaled adrenal glucocorticosteroids. The most effective medication for allergies is glucocorticoids, so many clinicians recommend oral or nebulized inhaled glucocorticoids to parents in order to pursue the effect, and babies fall into a vicious cycle of coughing – nebulized (oral) – getting better – stopping the medication – coughing repeatedly – nebulized (oral) again.
2. Abuse of antibiotics: It is important to know that antibiotics cannot solve allergic cough. Some babies may get better with antibiotics, but the mechanism that works is the immunosuppression caused by their side effects, which requires the body to pay a big price.
3, forceful wringing of nasal snot: allergic cough is often combined with allergic rhinitis, the baby will have repeated nasal congestion symptoms, the author recommends washing the nose with water, must avoid forceful wringing of nasal snot, which can lead to otitis media and sinusitis.
4, headache treatment, foot pain treatment: the root of allergic cough treatment lies in the adjustment of allergic constitution, rather than the simple application of hormones and bronchodilators nebulized inhalation and the application of anti-allergy drugs simply to control the symptoms, otherwise, the results of excessive pure intervention symptoms may bring greater trouble appear asthma symptoms, or even severe asthma attacks.
5, everyday in the guise of Chinese medicine, in the Chinese medicine added to the western medicine (especially hormone) charlatan ubiquitous, a reminder is that if you choose Chinese medicine treatment, be sure to clarify the composition of the Chinese medicine, try not to choose unknown ingredients of the processed powder, pills and bags of bulk. Remember!!!
VI. Interventions for allergic cough
1. Environmental intervention: Pay attention to the treatment of mites and molds, have the right temperature and moderation in different seasons, avoid decorative pollution, do not disinfect families with “84” and vinegar fumigation, and disinfect families properly with the same score. Families should not keep pets, etc.
2. Dietary control: Many herbalists have very strict dietary control, and even set up strict recipes for dietary contraindications, which are actually very difficult for parents to implement. In addition, the Yellow Emperor’s Classic of Internal Medicine says, “Five grains are nourishing, five fruits are helpful, five animals are beneficial, and five vegetables are filling.” This means that grains (staple food) are the basis of people’s survival, while fruits, vegetables and meat, etc. are used as auxiliary, complementary and supplementary to the staple food. How to manage the diet, the author has a special article on this.
In fact, allergic coughs are characterized by deficiencies in the functions of the lungs, spleen and kidneys, and are essentially a deficiency of positive energy. In terms of clinical evidence, most of the physique is mixed with cold and heat or mixed with deficiency and reality, if this physique characteristic is well grasped in the clinic, the clinical evidence of the use of drugs, there is no ineffective, abandoning the physique, purely to resolve phlegm and stop cough or a single flavor of heat detoxification, or even tonic, often do not see the effect, or even change the evidence, adding more obstacles to the future treatment. Therefore, the author has always stressed that the core of treatment lies in the adjustment of the body, contrary to this principle, whether from the short-term effect or long-term effect, are not ideal.
4. Appropriate symptomatic treatment: e.g. antihistamines, bronchodilators.
5. Inhalation therapy for a short time for persistent and intense cough.
6, reasonable use of fever on the physical: the author often communicates with parents in the clinic, must cherish the fever caused by the common cold. Allergic babies, most of them rarely have fever in daily life. Therefore, when a baby has a fever after a cold, the first thing to do is to clarify whether it is a common cold, if the blood picture is not high, there are no other accompanying symptoms, and the baby’s mental state has not deteriorated significantly, regardless of the application of traditional Chinese medicine and western medicine, must not overly pursue the reduction of fever, control the body temperature below thirty-eight degrees Celsius five, pay attention to rest, and There is no need to pursue fever reduction, even if the application of Chinese medicine simply reduces fever, cold medicine damages the body’s Yang Qi, which is no different from the application of hormones. You will find that after a few fevers, the baby’s body will be significantly stronger and the cough will be significantly reduced.
Summary.
1. “Internal does not cure asthma and external does not cure ringworm”. Allergic cough belongs to asthma, and the clinical treatment process is very tortuous. Parents always hope to solve all the problems overnight, simply by using a few Chinese medicines, which is very wrong. To achieve good results, we must choose the right doctor and then carry out a very good cooperation, so that we will surely get twice the result with half the effort.
2. It is very wrong for parents to put all their hopes on drugs for clinical treatment. The core of the problem lies not in the drugs in the first place, but in the daily diet and care, together with the adjustment of Chinese medicine, especially during the remission period, and in the adjustment of the body constitution, not always relying on drugs.
3. The root cause of allergic cough is immune dysfunction, so the core of clinical care lies in the improvement of the baby’s immune function.
This is the essence of the traditional philosophical dialectic of materialism. Most babies with allergies are more emotionally rich and have a strong learning ability, so the overall IQ of most babies is higher than that of normal children of the same age, which I hope will give parents who worry about their babies coughing all day a little confidence and comfort.