I. The concept of recurrent respiratory tract infection
The respiratory tract can be divided into upper respiratory tract and lower respiratory tract. The upper respiratory tract refers to the nose, pharynx and larynx, while the trachea, bronchi and alveoli below the larynx are the lower respiratory tract. Respiratory tract infections are infections of the respiratory system, including rhinitis, pharyngitis, tonsillitis, laryngitis, tracheitis, and pneumonia. Recurrent respiratory tract infections in children, as the name implies, refer to recurrent respiratory tract infections, and Chinese medicine refers to such children as recurrent or susceptible children.
Second, the incidence of respiratory infections
Among the respiratory diseases in children, acute respiratory infections (ARI) are the most common. Acute respiratory infections, diarrhea and malnutrition are the leading causes of pediatric morbidity and mortality in the third world. The disease is most common in children aged 6 months to 6 years, and is most common in children aged 2 to 3 years. The tendency of natural remission in the hot summer season. It usually improves significantly around the school age. According to the World Health Organization (WHO) conference in Geneva in April 1979, the incidence of acute respiratory infections among children is 39-65.5%, part of which is recurrent respiratory infections. 1988, our preliminary survey of children in Nanjing, Jiangsu Province and Changshu City, Wushi Township, the prevalence of recurrent infections in preschool children was 29.69%, of which 32.61% in urban areas and 24.19% in rural areas. The prevalence rate in urban areas was 32.61% and in rural areas was 24.19%, which was significantly higher than that in rural areas. From the current clinical observation, this disease has a trend of increasing year by year.
Third, what are the diagnostic criteria for recurrent respiratory tract infection?
The definition, diagnosis, treatment, and observation criteria of pediatric recurrent respiratory tract infections were unified at the National Academic Conference on Pediatric Respiratory Diseases held in Chengdu in 1984, and were officially used as a specific disease name for prevention and treatment research. The nomenclature includes both upper respiratory tract infection (URI) and lower respiratory tract infection (LRI). The diagnostic reference criteria formulated by the National Conference on Pediatric Respiratory Diseases are as follows: 1. Where the age is 0-2 years: URI 7 times per year (with at least 7 d between the two) and LRI 3 times per year; 2. 3-5 years: URI 6 times per year and LRI 2 times per year; 3. 6-12 years: URI 5 times per year and LRI 2 times per year. Compliance with the above can be diagnosed as recurrent respiratory infection (RRI) after 1 year of observation. If the number of URI is not enough, the number of LRI can be added, and vice versa.
Fourth, what are the dangers of respiratory tract infections
Improper treatment of upper respiratory tract infection can easily lead to a variety of diseases, such as downward spread of inflammation, which can develop into tracheitis, bronchitis or pneumonia. Spread to the adjacent area can lead to otitis media, conjunctivitis, cervical lymphadenitis, and even abscesses in the posterior pharyngeal wall. Some purulent infections can cause sepsis and meningitis through blood circulation. AURI caused by streptococcal infections in older children may lead to nephritis and rheumatic fever. Viral infections may cause myocarditis. Repeated infections in allergic children may cause asthma. The growth and development and health of children are seriously affected, therefore, the so-called minor illnesses should not be ignored clinically.
V. Why children are prone to respiratory tract infections
This is due to the anatomical and physiological characteristics of the pediatric period. The nasal cavity of the upper respiratory tract of children is short and small, there are no nasal hairs in the nasal cavity during infancy, the nasal mucosa is soft and vascular, the pharynx is relatively small and vertical, and the nasopharynx is rich in lymphatic tissue. Therefore, the ability to repel and defend against external pathogenic factors is weak and vulnerable to infection. The tonsils gradually increase in size after the age of 1 year, and their development is slow, then fast, and then slows down, with certain defensive functions, but when pathogenic microorganisms are hidden deep in the glandular fossa, they can become foci of chronic infection. The trachea and bronchi of the lower respiratory tract in children are relatively narrow, the cartilage is soft, the lack of elastic tissue and rich in blood vessels, the cilia movement is poor, the mucosa is easily swollen, the elastic tissue in the lungs is poorly developed, the alveoli are less active, and once the infection is inflamed it is easy to generalize, the pathological products are easily retained and blocked, and it is not easy to contour.
Inadequate immune function during the pediatric period, gradual depletion of antibodies obtained from the mother, insufficient production of autoantibodies, or imbalance of essential trace elements, anemia, rickets, vitamin deficiency, etc., lead to immunoglobulin (Ig) and phytohemagglutinin (PHA) significantly lower than healthy children, or sometimes high and sometimes low in a disordered state. Experiments have shown that IgA is the main protective antibody of the respiratory mucosa, and the lack of IgA can lead to recurrent respiratory infections.
1, the parents themselves are weak and sickly, or the baby is premature, twins, low weight babies; artificial feeding, premature weaning; developed a poor diet of paranoia, anorexia, malnutrition; itself suffering from rickets, poor body resistance to disease, very easy to get sick.
2, parents in the care of improper conditioning, such as often to the baby wearing too much, so that the baby a little activity, will be covered in sweat, more than other babies are more likely to catch a cold; winter activities outside less, so that the baby’s ability to adapt to the cold and temperature is poor, as the flowers in the greenhouse as intolerant of wind and cold, a change in temperature, or encounter others with a cold will be a dye that disease, and easy to recur after the disease.
3, baby cold, parents improper medication, too much to take sweating, relieving the table and other drugs, resulting in the baby’s body vitality is depleted, so that resistance is reduced, thus causing recurrent colds.
What are the causes of recurrent respiratory tract infections and how is it recognized by Chinese medicine?
The physiological characteristics of children are that the internal organs are delicate, the shape is not yet full of qi; the vitality is vigorous and the development is rapid. The delicate internal organs of children refer to the deficiencies of the five organs and the six internal organs, but the deficiencies of the lungs, spleen and kidneys are more prominent. This is partly due to the fact that the lungs, spleen and kidneys are all incomplete and not yet strong after birth. This is because children not only need to maintain normal physiological activities as adults, but also are in a stage of vigorous growth and rapid development, the demand for water and grain essence is relatively more urgent than that of adults, and must meet this special demand. Therefore, children have a higher demand for the functions of kidney qi generation, spleen qi transportation and lung qi propagation. Therefore, relative to the growth and developmental needs of children, there is often a deficiency of kidney, spleen and lung qi, which manifests itself in the form of delicate lungs, often deficient spleen and often deficient kidneys.
The lack of Qi in the body is often reflected in the lack of stability and perfection in the functional status of the five viscera and six internal organs. The lung is a delicate organ, and it is combined with the skin and hair, so the lung of children is often insufficient and the fence is not solid, so they are easy to feel external evil. The lung is the main propagator, the main surface of the body, the lung of the child is not yet sound in the function of propagation, the coup open and close, the function of the solid surface to resist evil is weak; the lung is the main respirator, the main body of Qi, the lung of the child is not yet perfect in the function of suction and lowering, “cure” the function of the Qi of the body is not healthy. Therefore, the six evil spirits, whether from the mouth and nose, or from the skin and hair to receive, are first offended by the lungs, so there is “form of cold drinking cold will hurt the lungs”, “warm evil up to receive, first offended by the lungs” said. Therefore, children are prone to lung diseases such as cold, cough, pneumonia and asthma, making lung diseases the most prevalent type of disease in pediatrics.
Wu Jutong, a Qing Dynasty physician, used the theory of yin and yang to summarize the physiological characteristics of children as “infantile yang is not yet full, infantile yin is not yet long”. Yin” here refers to the body’s essence, blood, fluids and tangible substances such as internal organs, tendons and bones, brain and marrow, blood vessels and skin; “yang” refers to the various physiological functions of the internal organs; “infantile” refers to the tender not yet mature. The characteristics of infantile yin and yang include the tender body, the lack of vital energy and blood, the weakness of the spleen and stomach, the lack of kidney energy, the looseness of the couples, the weakness of the spirit, and the lack of firmness of the tendons. Wu Jutong’s theory of infantile yin and infantile yang further clarifies that the body of a child is in a relatively deficient state, both in terms of form and physiological functions, and needs to grow and develop as it grows older in order to gradually become perfect and mature.
Chinese medicine has discussed this a lot, specifically five aspects: 1.
1, congenital deficiencies, stunted: refers to the parents are weak and sickly or often have a history of repeated respiratory infections, or senior parents suffer from various diseases at conception or pregnancy, or premature birth, twin births, multiple births, after birth congenital deficiencies, stunted, tender and timid muscles and bones, loose skin and fur, intolerant of natural viral attacks, a sense that disease.
2, improper feeding, inappropriate care: the prevalence of susceptible children and feeding methods are directly related: artificial > mixed > breast milk. Most of the affected children have partial food, picky food, less food, long-term loss of appetite. Therefore, artificial feeding or premature weaning, malnutrition, the spleen and stomach transport power is weak, the diet is refined, insufficient intake, the function of the internal organs is not healthy, the spleen and lung Qi deficiency, susceptible to external evil attack.
3, see less wind and sun, weak constitution: outdoor activities are too little, the ability to adapt to the cold environment is weak, the table gas is weak, the guard outside is not solid, like the yin ground grass, greenhouse flowers, intolerant of wind and cold, easy to touch.
4, improper medication, damage to the right qi: after the cold, over-served dispersant (Chinese medicine, such as ephedra, cinnamon, Western medicine, such as Anaixin, paracetamol) so that the table deficiency is not solid, Ying and Wei is not, Yin does not guard and sweating, sweating body weakness, Wei Yang can not be outside and repeatedly feel. Improper use of antibiotics, hormones and other drugs can also deplete the vital energy, so that the resistance is reduced, and repeated infections.
5, the evil poison to stay in the ambush, is deficient is made: after the invasion of external evil, due to the weakness of the right qi, the evil poison can not outline, stay in the ambush body, once the cold or after exertion, the body’s resistance decreases, the new sense of susceptibility, stay in the evil hair, or no new sense, the remaining poison reignited, the symptoms again.
In short, children’s internal organs are delicate, the skin is weak, the external function is poor, the resistance to disease is not strong, coupled with the cold and warmth can not be self-regulation, once the regulation of inappropriate, the six evil from the skin and into or from the mouth and nose, the lungs are the first to bear the brunt of the changes, with the positive and the evil of the changes led to recurrent respiratory infections in children.
Seven, susceptible children have what performance
1.Lung and spleen qi deficiency
Symptoms Repeated exposure to external evil, with a yellowish or less florid face, a thin or flabby body, little breath and lazy speech, or delayed coughing and wheezing, sweating, little food and dullness, irregular bowel movements, pale tongue, thin white fur, weak pulse and light fingerprints.
2.Deficiency of both qi and yin
Symptoms Repeated external sensation, yellow face with little color, emaciation, little food and thirst, night sweating, sweating, heat in the heart of hands and feet, dry stool, red tongue with little moss, flaking moss or map tongue, thin pulse, light purple fingerprints.
3.Dysregulation of Ying and Wei
Symptoms Repeated colds, cold and fear of heat, intolerance of cold, sweating, muscle relaxation; or accompanied by low fever, red throat and moths do not disappear; or pneumonia and asthma after a long time to recover; light red tongue, thin white moss, or flower peeling, the pulse is floating and weak, fingerprints purple.
Eight, what are the morbidity characteristics of susceptible children
The onset of recurrent respiratory tract infections is characterized by: old illnesses heal at first, and new ones start again. The course of the disease is long, with each respiratory infection lasting more than 10 days (generally 5-7 days in healthy children) and lower respiratory tract infections lasting more than 3 weeks (generally 2 weeks in healthy children), and in some cases, the next infection follows after an untreated one. In some cases, the initial infection is an upper respiratory tract infection, which soon develops into a lower respiratory tract infection. After treatment, some clinical symptoms improve, but the lung lesions are difficult to disappear.
Nine, what are the advantages of Chinese medicine in the treatment of recurrent respiratory tract infections
Since society entered the 1980s, bacterial infections have been effectively controlled due to the common application of antimicrobials, while viral infections still lack effective methods. However, more than 90% of pediatric respiratory infections are caused by viruses. As far as we know, there are more than 130 types of respiratory infection viruses, and there are many variants, human immunity cannot last, and serum antibodies cannot prevent the occurrence of reinfection, thus bringing difficulties to the prevention and treatment work, while Chinese medicine has certain advantages in improving the physical condition of children, enhancing the ability to resist disease, and helping to dispel evil. We have made great progress. In recent years, we have also developed the anti-sweating agent, which is effective for children with excessive sweating, white face, dry hair, intolerance of wind and cold, and easy to catch cold. Animal experiments have proved that anti-sensory compound and antiperspirant can improve immune function and induce interferon to play an antiviral role. Therefore, we believe that the use of Chinese medicine to prevent and treat recurrent respiratory tract infections has positive significance and broad development prospects.
X. What is the main method of Chinese medicine for treating recurrent respiratory tract infections
The main pathological mechanism of recurrent respiratory infections is deficiency of positive qi, deficiency of both lung and spleen, loss of solidity outside the body, and retention of evil toxins, in which the deficiency of positive qi is the root of the disease, so improving the body is the key to treatment. The clinical evidence can be identified and treated according to the different stages of the disease. During the infection period, the main focus is to dispel the evil, so that the evil toxin from the surface out, from the inside and clear. In the extension period, the main focus is to support the righteousness, and the righteousness is restored and the evil is eliminated. In the recovery period, we should reinforce the root of the disease, either by replenishing the qi and fixing the surface, or by transporting the spleen and the bones.
Respiratory tract susceptible children, usually sweating a lot, often spontaneous sweating, night sweats, nasal grain is not fragrant, low immunity, intolerance of cold and cold. When the external climate changes suddenly cold and hot, easy to catch a cold. These children should be properly regulated in the winter season, one to regulate the lung qi to strengthen the body and improve resistance to disease, and the other to regulate the spleen and stomach to eliminate the source of phlegm production, which is conducive to preventing or reducing recurrence. However, in the specific prescription, it is necessary to take into account individual differences and dialectical treatment.
The best way is for the doctor to prescribe on the basis of evidence based on the different physical characteristics and clinical manifestations of each affected child. Such a herbal prescription can be taken as one decoction per day. However, children with recurrent respiratory infections must insist on taking the medicine for a longer period of time during the non-onset period in order to achieve the goal of supporting the righteousness, strengthening immunity and reducing the incidence of respiratory infections. In order to make it convenient for parents to give their children long-term medication, we often prescribe them according to the child’s condition and then teach parents the method of boiling these medications into a syrup agent, which can be taken for about 1 month after boiling once. Each child should take the medicine for 2 to 3 months. Many children in our provincial Chinese hospital pediatrics department, in accordance with our method of taking, achieved remarkable results.
1, lung spleen qi deficiency evidence: treatment: strengthen the spleen and benefit the qi, nourish the lung and fix the surface. Main formula: Si Jun Zi Tang and Yu Ping Feng San. Commonly used drugs: roasted Astragalus, Radix Codonopsis, Atractylodes, Poria, Pericarpium, Radix et Rhizoma, Glycyrrhiza.
2. Qi and Yin deficiency: treatment: benefit the Qi and nourish Yin, support the correctness and consolidate the surface. Main formula: Shengve San and Yu Pingfeng San. Commonly used drugs: prunus ginseng, maitake, wu wei zi, roasted astragalus, atractylodes, bifeng.
3, Ying and Wei disorders: treatment: harmonize the Ying and Wei, support the positive and consolidate the surface. Main formula: Astragalus and Cinnamomum Wuwu Tang plus or minus. Commonly used drugs: roasted astragalus, cinnamon stick, white peony, atractylodes, licorice, jujube.
Add and subtract: sweating, add wheat, Wu Wei Zi, calcined keel, calcined oyster; anorexia, add chicken naijin, fried grain buds, raw hawthorn; red throat, milk moths have not disappeared, add Xuan Shen, Xia Ku Cao, Zhe Bei Mu.
XI. What are the commonly used traditional Chinese medicines and how to use them?
Chinese medicine emphasizes on the differentiation and treatment, therefore, according to the clinical manifestations of the child, we should identify the deficiency of the lung, spleen and kidney and treat them separately.
1, if the child repeatedly cold, vicious wind, fear of heat, intolerance of cold, usually sweating, muscle relaxation, pneumonia after a long period of time does not recover, this is the Ying and Wei disorder, the treatment is intended to harmonize the Ying and Wei, can be used to prevent the combined agent, stop sweating spirit punch.
2, if the child’s face white light white, sweating, coughing, thin shape, mountain root color clear, this is the lung deficiency is not solid, the treatment is intended to benefit the lung solid surface, can be used Yu Ping Feng Oral Liquid, Astragalus Oral Liquid, Astragalus Raw Pulse Drink, Sophora Qiyi Huang granules.
3.If the child’s face is yellowish, sweaty, the limbs are tired, the food is not fragrant, the shape is thin or fat, the stool is loose or dry, the map tongue, this is the spleen and stomach is weak, the treatment is intended to benefit the spleen and stomach, can use the child Kangning syrup, the spleen eight treasure cake.
4, if the child’s face is less florid, muscle relaxation, sweating, restless at night, tendons and bones are weak, unstable walking, standing, walking, teeth, hair, speech is late, chicken chest and turtle back, dry hair, this is a kidney deficiency bone weakness, treatment is intended to benefit the kidney bone, can be selected to supplement the kidney Dihuang Wan, Jin Shui Bao, Liu Wei Dihuang Wan.
Twelve, how parents care
1, for recurrent respiratory infections of susceptible children, in the treatment of many methods, in the baby was infected stage, should be timely to the regular hospital for symptomatic treatment, taking some common cold drugs. It is worth noting that such a baby has the characteristics of a weak constitution, therefore, the medicine to clear heat and bitter cold should not be taken for a long time, and the amount of western medicine to relieve and reduce fever should not be too large, if the sweating is too much, the baby’s constitution will be even weaker.
2, in the baby’s recovery period, we should pay attention to replenish the qi and strengthen the surface, enhance immunity, so that “the righteousness of the internal, evil can not dry”, in order to achieve the purpose of strengthening the body and reduce recurrent infections.
3, can adopt some simple and feasible treatment methods at home, such as for the baby with runny nose and congestion, can take 15g each of Qiang Zhi, Jing Zhi and Chai Hu, add 100g of onion with beard and 15g of ginger with skin, decocted in water for 20 minutes; then, put the medicinal liquid in the bath, and give the baby a bath after the water temperature is suitable, once a day.
4, can use Chinese medicine techniques to treat, choose specific points, dredge the meridians, regulate the body’s immune function, balance yin and yang, dispel the wind and relieve the symptoms – (1) for babies with fever that does not subside, can push the Tianzhu, clear the Tianhe water, push the lower six provinces.
(2) For babies with coughs, you can add the eight trigrams, rub the tiantu, and rub the tanzhong 100 times each.
(3) For babies with runny nose and severe nasal congestion, push the San Guan point 200 times, knead the Ying Xiang point 50 times, and take the Shoulder Well point 5 times.
(4) In addition, daily chiropractic kneading can play a role in dredging the meridians, adjusting the yin and Yang strong, improve the body’s immunity, 3-5 times a day.
5, for often easy to sweat susceptible children, usually can often take some “Yu Ping Feng San”, in order to fix the surface to stop sweating, the role of Qi. From time to time, red dates and barley are often used to cook porridge for
Thirteen, recurrent respiratory tract infection how to carry out dietary management
Children with this disease are characterized by a long and recurrent course of illness and weak constitution. Therefore, in addition to the use of Chinese and Western medicine comprehensive treatment, carefully do a good job of dietary conditioning is an important part of stabilizing the disease and restore health.
1, it is advisable to adopt a high-protein, high vitamin diet, can use milk, eggs, lean meat, fish, soy products and other physiological value of protein, to supplement the consumption of protein decomposition and metabolism, to enhance the body’s immune function. In winter, it is best to eat more lamb, beef, dog meat and other hot meat, so that it can play a warming effect. Should also supply a lot of vitamin C, A, B, of which C, A more important. Vitamin C can improve the body’s resistance, promote the formation of antibodies in the body and improve the phagocytosis of white blood cells. VC is mostly found in some fresh vegetables and fruits, such as jujube, hawthorn, citrus, tomatoes, spinach, cabbage, etc. Vitamin A can maintain healthy epithelial cell tissues, especially respiratory epithelial tissues, which is beneficial to reduce cough symptoms and prevent asthma. Vitamin A is abundant in animal food, such as liver, kidney, egg yolk, cream, etc.
2. You can use foods that have the properties of strengthening the spleen, tonifying the kidneys, benefiting the lungs, regulating the air, relieving cough and expectorant, such as oranges, loquats, dates, lilies, lotus seeds, walnuts, white fungus, yams, coix seeds, honey, pig, cow and sheep lungs. These foods can both strengthen the body and help relieve symptoms, and can be eaten regularly if possible.
3, should also pay attention to the supply of fiber, to eat more fresh vegetables, fruits and a certain amount of coarse grains, in order to keep the intestinal tract open and improve health.
Three food therapy recipes.
Gorgonian wolfberry lean meat pot: 50 grams of lotus meat, 50 grams of gorgonian, 50 grams of wolfberry, 200 grams of lean pork, add the right amount of water to boil soup, a little salt to taste, with meals, for the deficiency of Qi and Yin evidence.
Astragalus chebula tonic lung soup: 20 grams of astragalus, 10 grams of chebula, 10 grams of schisandra, all medicines wrapped in cloth. Pork lung 250 grams, wash and cut with the drugs together, about 1 hour after adding seasoning, drink soup and eat lung. Used for lung deficiency evidence.
Astragalus membranaceus and jujube porridge: Astragalus membranaceus 20 grams (pack), yam 50 grams, coix seed 50 grams, jujube 30 grams, glutinous rice 100 grams, boil porridge, add sugar or honey to eat. Used for evidence of spleen deficiency.
XIV. Prevention of recurrent respiratory tract infections
1, maintain indoor environmental hygiene, air circulation, parents do not smoke, avoid air pollution.
2, appropriate outdoor activities, more sun exposure, to improve the adaptation to the external environment and resistance.
3.According to the age, arrange appropriate physical exercise to enhance physical fitness.
4.Inoculation according to the plan, to enhance the automatic immune function.
5, cold and warmth should be appropriate, with the gas to make changes in clothing, sweating should be dried with a dry towel, and timely replacement of underwear to prevent cold.
6, pay attention to personal oral hygiene, clothing and often use sunlight exposure.
7.During the epidemic of cold and flu, we advocate wearing masks and not going to public places to reduce the chance of infection. Vinegar fumigation method can be used to disinfect the air and prevent the cold. For example, use 3-5m1 of vinegar per cubic meter of space, add 1~2 times of water, place the container and fumigate it until it is all vaporized. Use it once a day for 3~5 days. Close all the doors and windows when fumigating.