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. Its incidence has been gradually increasing in recent years. The etiology is either clear or unknown.
The more definite ones are as follows.
1, environmental factors: inhalation of inorganic dust such as asbestos, coal; organic dust such as mold grass dust, cotton dust; and smoke, sulfur dioxide and other toxic gas inhalation.
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 aggravation.
3.The influence of drugs (such as amiodarone and some chemotherapy drugs, etc.) and radiation damage.
4. Secondary to autoimmune diseases such as lupus erythematosus and rheumatoid arthritis. This disease belongs to the category of “cough”, “asthma” and “lung fistula” in Chinese medicine.
The disease starts insidiously and worsens progressively. 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. In the late stage, right heart failure may occur, manifested by bilateral lower limb edema, abdominal distension, and loss of appetite. Once interstitial pulmonary fibrosis is suspected, chest CT and pulmonary function tests may be performed to further confirm the diagnosis.
Treatment of interstitial pulmonary fibrosis is a systemic project, as is the treatment of other difficult diseases. The goal of treatment is to achieve 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. It can precede the autoimmune disease or appear several years after the onset of the autoimmune disease. Early stages are often treated as pulmonary infections.
Notably, when interstitial fibrosis is diagnosed, its reversibility is often suspected and treatment is 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. Whether normal lung tissue is restored or fibrosis is restored depends on whether the necrotic tissue fragments can be completely absorbed.
If it cannot, it will be replaced by fibrotic tissue. Therefore, when damage to the lung occurs it should be treated as early as possible to avoid the development of more irreversible fibrotic tissue that can cause damage to lung function. This is equally important for both doctors and patients. Currently, treatment is mainly based on a combination of Western and Chinese medicine.
Western medicine treatment.
1, hormone therapy: generally give methylprednisolone or prednisone 30 to 40 mg per day, gradually reduce the amount to the maintenance amount of 5 to lO mg per day. The total course of treatment is six months to one year. Pay attention to calcium and potassium supplementation, observe blood pressure and blood sugar, and prevent side effects of hormones.
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.
To go to the regular hospital doctor according to the diagnosis and treatment, there are mainly the following types of evidence.
1, deficiency of lung qi: cough and wheeze low, easy fatigue, sweating and fear of wind, easy to catch a cold, light tongue with white coating, weak pulse. Treatment: Tonify lung qi, stop coughing and stabilize asthma. Prescription: Radix Astragali, Rhizoma Atractylodis Macrocephalae, Almonds, Aster, Flos Daturae, Di Long, Fructus Anemarrhenae, Radix prunus ginseng, roasted Ephedra, Radix Glycyrrhiza Uralensis, etc. Chinese patent medicine: Yu Ping Feng granules.
2, deficiency of both qi and yin, phlegm blocking the 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 or little moss, smooth or weak pulse. Treatment: Tonifying the lung and nourishing the kidney, resolving phlegm and activating blood. Remedy: Radix et Rhizoma prince ginseng, Radix rehmanniae, Cornu Cervi Pantotrichum, Cornu Cervi Pantotrichum, Poria, Mai Dong, Wu Wei Zi, Dan Pi, Ze Xie, Radix Astragali, Lily, Walnut, Danshen, Aster, Chuan Bei Powder (punch), etc. 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, increased by movement, 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. Prescription: Shuan Yu, Cinnamon, Shu Di, Cornu Cervi Pantotrichum, Yam, Poria, Dampi, Ze Di, Raw Astragalus, Danshen, Aster, Almond, Di Long, Xian Ling Spleen, etc. plus or minus.
Prepared Chinese medicines: Ginseng and Spleen Pill, Jin Kui Kidney Qi Pill.