Bronchiectasis is a chronic purulent inflammation of the bronchi and their surrounding lung tissue that damages the muscles and elastic tissue of the bronchial walls, resulting in bronchial dilatation and deformation. It occurs mostly in children and young people. Bronchiectasis can be classified as congenital or secondary. Secondary bronchiectasis is mainly caused by recurrent infections of the bronchi and lungs, measles, whooping cough, influenza or severe lung infections, tuberculosis, etc., which are more common in childhood. The course of the disease is mostly chronic and can occur at any age. In some patients, hemoptysis may be the first and only complaint, which is clinically known as “dry bronchiectasis” and is commonly associated with tuberculous bronchiectasis, with lesions mostly in the upper lobe bronchi. Most patients have chronic cough, coughing up purulent sputum, or coughing up blood, which is the most characteristic and common symptom, but in a few cases, patients may also be asymptomatic. The severity and characteristics of bronchiectasis symptoms vary from person to person, and even in the same patient, the manifestations may vary over time, depending largely on the extent of the lesion, as well as whether the infection is co-infected and the extent of the infection. Common symptoms 1. Chronic cough with large amounts of pus sputum is a typical symptom. The daily sputum volume can reach several hundred milliliters, which may have a foul odor and can be divided into three layers after resting: the upper layer is foamy, the middle layer is green and turbid, and the bottom layer is thick pus. Fever may occur in case of infection.2. The patient has a history of repeated hemoptysis, ranging from small hemoptysis to large hemoptysis. Even hemorrhagic shock may occur. 3. Anemia and malnutrition may occur in patients with long disease duration. 4. Fixed wet rales can be heard in the corresponding parts of the lungs on the body surface. Second, how to diagnose bronchiectasis? 1.According to the patient’s typical history of chronic cough, coughing up pus and recurrent episodes, 2.Signs of coughing up blood and fixed wet rales in the lungs, 3.CT is the best means to confirm the diagnosis of the disease. The imaging features and sites of bronchiectasis can be seen directly. 3. What diseases should be differentiated from bronchiectasis? The disease should be distinguished from chronic bronchitis, tuberculosis, lung abscess, lung cancer and other diseases. 1. Chronic bronchitis Patients with chronic cough for more than two years, with obvious sputum symptoms, white mucus foamy sputum and rare hemoptysis, and coarse pulmonary texture or emphysema can be seen on X-ray examination. 2. Tuberculosis Patients with tuberculosis have a mild cough or cough up blood, and sputum examination can detect tuberculosis bacteria. It may be accompanied by weakness, emaciation, low fever in the afternoon, night sweats, etc. The lesions can be seen on X-ray chest X-ray. 3. Lung abscess has rapid onset, chills, high fever, cough, and large amount of yellow pus sputum, and cavities with liquid level can be seen on X-ray. 4. bronchial lung cancer, often with chest pain, cough and hemoptysis. x-ray examination, CT, fiberoptic bronchoscopy and sputum cytology examination can make a clear diagnosis. 5. Congenital pulmonary cyst It is a congenital disease, and there may be no obvious symptoms if there is no co-infection. Multiple elliptical or circular shadows with clear margins and thin walls are seen on lung X-rays without surrounding infiltrative lesions, and bronchography helps to make the diagnosis. (a) Western medical treatment is mainly divided into drug treatment and surgical treatment. 2, those who cough up blood should be treated with hemostasis and anti-inflammatory therapy, and patients with frequent or large coughing up blood can be treated with intervention 3, surgical treatment For those with repeated infections, coughing up blood, and relatively limited lung lesions, surgical treatment of pneumonectomy can be performed. (2) Chinese medicine treatment 1. Chinese medicine’s understanding of the etiology and pathogenesis of bronchiectasis. Bronchiectasis belongs to the categories of ‘cough’, ‘hemoptysis’, ‘pulmonary carbuncle’, ‘coughing’ and ‘lung impotence’ in Chinese medicine, and is mostly seen in children and adolescents. Lung deficiency is the root, and phlegm-heat is the symptom. The lung is the main organ of qi, which is responsible for propagating and regulating the water channels. It was first described in the ancient Chinese medical text “Jin Kui Yao”: Sun Simiao, a medical doctor of the Tang Dynasty, and Wang Kentang, a medical doctor of the Ming Dynasty, discussed it in a way similar to bronchiectasis. For example, the Ming dynasty medical doctor Dai Yuanli in the “key to the treatment of evidence” in the discussion: “labor cough, …… the cough of phlegm, or pus, or sometimes blood fishy odor abnormal.” Also more consistent with the manifestations of this disease. The cause of bronchiectasis is mainly related to physical factors such as spleen deficiency, phlegm and dampness, deficiency of lung health, external aggression, labor injury and addiction to alcohol and tobacco, etc. The pathogenesis can be summarized as follows: fire and heat; due to anger injury to the liver, depression and heat; or because of the habit of smoking, the lungs have phlegm and heat; or external evil offending the lungs and heat or excessive drinking, heat in the stomach, smoked on the lungs. The heat is very hot and generates fire, which burns the lung channels and causes bleeding. Phlegm and dampness; cold evil offends the lung, accumulating cold and dampness, gathering dampness into phlegm, phlegm and dampness blocking the lung, phlegm out and coughing, although the old phlegm is discharged for a while, but the dampness is not removed, new phlegm is born again. The phlegm and turbidity love the lung, depression and heat, the phlegm and heat are congested inside, the poison becomes pus, the pus and phlegm accumulate in the lung, the coughing out is unfavorable, the accumulation of less becomes more, so there is pus and phlegm discharge from time to time. Yin deficiency; Yin deficiency in the body, or long duration of the disease, heat burning Yin injury, resulting in dryness of the lung and depletion of fluid, dry heat increasingly consumes Yin, its Yin is difficult to restore, the lung is not clear and purified, the loss of publicity and descent, fluid is not distributed, and spitting sputum; Yin deficiency and fire, burning the lung complex and bleeding. Lung Yin deficiency may also involve the spleen and kidney organs, causing them to show signs of deficiency. Chinese medicine has a long history of treating bronchial dilatation. The most important thing is to improve the immunity of the body and respiratory tract by tonifying the qi and kidney and strengthening the spleen to reduce the chance of infection, and to treat according to dialectical typing. Based on years of clinical experience, we summarize the following treatment prescriptions. (1) Liver fire offending the lung Treatment: clear the liver and lung, cool the blood and stop bleeding. (2) phlegm-heat injury to the lung Treatment: clearing and draining lung heat to resolve phlegm. (3) Phlegm obstructs the lung. Treatment: Strengthening the spleen, drying dampness and resolving phlegm. Commonly used formulas: Sha Shen Mai Dong Tang, Bai He Gu Jin Tang, etc. If you have bronchial dilatation, you must go to the hospital to choose the right treatment plan to get good results.