Cough is a symptom of a cold, but it is not unique to the cold. If the main symptom of a cold is a cough, or if the other symptoms of a cold, such as nasal congestion, runny nose, or fever, have improved, and only the chronic cough persists, this is cough variant asthma.
Basic overview
Cough variant asthma
Cough is a common symptom of respiratory disease in children, and it often occurs when patients have upper or lower respiratory tract infections such as tuberculosis and asthma. In most cases, the cough gradually improves after antibiotic treatment, but sometimes the cough does not decrease at all after treatment with multiple antibiotics and cough suppressants, but persists.
Cough variant asthma (CVA), also known as cough type asthma, used to be called allergic asthma, allergic bronchitis, allergic cough, cryptogenic asthma, and cough asthma. The disease was first reported by Gluser in 1972 and named as variant asthma. Cough variant asthma is a specific type of asthma in which chronic cough is the main or only clinical manifestation. In the early stages of asthma onset, about 5-6% are characterized by a persistent cough, mostly at night or in the early hours of the morning, often irritating, when it is often misdiagnosed as bronchitis. cough variant asthma is clearly recognized in GINA as a form of asthma with the same pathophysiological changes as asthma, namely a persistent airway inflammatory response and airway hyperresponsiveness. Its prevalence in children ranges from approximately 0.77% to 5.0%.
Because of the persistent metabolic inflammation in the airways of children with asthma and the swelling of the bronchial epithelium, the excitation threshold of the subendothelial stimulus receptors in the airways is lower than normal and, therefore, the sensitivity to various external stimuli is increased and asthma occurs at the slightest stimulus; moreover, asthma is difficult to cure.
Symptoms
1.Cough occurs continuously or repeatedly for more than a month, often at night or in the early morning with episodes of coughing, aggravated by exercise, and with a lot of sputum.
2.Laboratory or other tests show no obvious signs of infection or long-term antibiotic treatment is ineffective.
3. The attack can be reduced with bronchodilators.
4, There is a personal history of allergy that is accompanied by a history of eczema, urticaria, allergic rhinitis, etc., and family history of allergy can also be found.
5.Exercise, cold air, allergens or viral infections trigger asthma attacks.
6.Asthma is seasonal, mostly seen in spring and autumn and recurrent attacks.
7. Chest X-ray shows normal or increased lung texture but no other organic changes.
Children who meet the above characteristics should be diagnosed with cough variant asthma, and be prevented and treated according to the principles of asthma prevention and treatment.
Pathology
Cough variant asthma is a common problem in hospital pediatric clinics. Parents report that their children have been coughing for more than a month, mostly at night or in the early morning, in paroxysms, without wheezing or fever, and with no significant abnormalities on chest x-ray or blood tests. In the past, these children were often diagnosed as “cold” or “bronchitis”. In recent years, with the continuous development of medical science, scholars at home and abroad have discovered that these children may suffer from allergic cough, clinically known as cough variant asthma, which is an insidious form of asthma with cough as the main clinical manifestation. Some data show that the number of patients with allergic cough in cities with significant industrialization and developed coastal areas is increasing year by year, indicating that the environment has a very obvious influence on allergic cough.
Common knowledge
Pediatric cough variant asthma is one of the common respiratory diseases in children. Because of their delicate bronchial mucosa and low ability to resist infection by external germs, inflammation can easily occur and cause coughing. A child’s cough is supposed to be an effective way to eliminate phlegm and foreign bodies from the respiratory tract, but for frequent episodes of allergic cough that are difficult to control, it should be given full attention.
The change of season is a high season for pediatric cough variant asthma, which often manifests itself as a prolonged cough and even wheezing, and recurrent attacks, which parents always consider to be a recurrent cold caused by the baby’s poor health, and take many cold medicines and some even take a lot of anti-inflammatory shots, but the results are not good. In fact, a large proportion of children with what parents consider to be recurrent colds have allergic coughs. The cause of pediatric cough variant asthma, also known as allergic cough, is complex and is influenced by both genetic and environmental factors, with allergies being closely related to the disease, which is in turn influenced by environmental factors such as contact with or inhalation of dust mites, cockroaches, fur, pollen or cold air, seafood and other foods.
General knowledge of cough variant asthma
Autumn and winter are seasons when allergic diseases are likely to occur. With the recent significant temperature changes and large temperature differences between morning and evening, the incidence of childhood variant asthma has increased significantly. Parents should pay attention to prevention and live with.
(1) When the seasons change and the temperature changes suddenly, you should add clothes for your children in time, and at the same time, clothes should be dried and disinfected frequently.
2) Avoid foods that can cause allergic symptoms, such as crabs and shrimp.
3) Don’t keep pets and flowers at home, don’t lay carpets; avoid contact with pollen, dust mites, oil fumes, paint, etc.
(4) Do not let children sleep with long fluffy toys.
(5) Keep ventilation indoors, especially in children’s bedrooms.
Prevent allergic asthma in children in autumn and winter
Autumn and winter are good seasons for allergic diseases. In the Beijing area, air pollution, sand and dense population lead to increased exposure to allergens, making allergic asthma increase year by year. Allergic asthma is one of the most troubling and serious allergic diseases in children, with 80% of the age of onset before 5 years old, and there is a tendency to advance gradually. There are more boys than girls, about 2:1, 1/3 of the patients have a family history of asthma, 1/4 of the children have eczema and about 1/2 have allergic rhinitis.
The symptoms of an allergic asthma attack are coughing, dyspnea and wheezing, which occur most often in the early morning or at night, or in some cases, only a persistent chronic cough. The only time of the year when the disease is more stable is in the summer. Asthma attacks are most frequent in the fall because the bacteria that multiply in the summer die in large numbers and their bodies are the strongest allergens. Winter and spring are also prone to asthma because of the unstable climate and the high number of upper respiratory tract infections. Many children will show a warning that night cough increases and manifests itself as a complicated cough before the respiratory infection deteriorates into asthma, so parents should pay more attention at this time.
According to medical research, dust is the number one allergen that triggers asthma. This is especially true for dust in the home, followed by bacteria and cockroach secretions. In addition to inhaling allergens that can trigger asthma, other allergic factors, such as infections and environmental factors, can also enhance asthma attacks. These include upper respiratory tract viral infections, temperature changes, air pollution impurities, smoke, and cold drinks.
People with asthma should swim more often
Asthma patients, most of them do not want to exercise, because exercise may induce asthma, triggering life-threatening, but “life is movement”, if people do not move, the body immunity for the decline, thus forming a vicious circle, is not conducive to the treatment of asthma, in fact, asthma patients can moderate exercise, swimming is a good asthma fitness activities. What are the benefits of swimming, the following is a brief introduction to you.
1, swimming can improve immunity, prevent colds swimming, because the contact is cold water, so it can improve the body’s ability to adapt to the environment, thereby improving the body’s immunity, reducing the chances of colds, it reduces the chances of asthma.
2.Enhance heart and lung function
When swimming, the respiratory muscle burden is greatly increased, 12-15 kg of water pressure compressing the entire brain cavity, which helps lung capacity, data show that swimming for half an hour a day, adhere to a summer, lung capacity can increase by 500 ml.
3, swimming can effectively exercise the pectoral muscles, diaphragm and intercostal muscles, and improve the ventilation function of the lungs.
Reasonable exercise is beneficial to the treatment and recovery of asthma patients. Come and swim together!
Care methods
Acute phase care
The onset of pediatric cough variant asthma is usually acute, and children with severe disease may have respiratory distress. Nursing staff should report to the doctor in a timely manner, collaborate in rescue and treatment, and reassure the child and his or her family to relieve the child’s tension. Tension and fear can increase the severity of the child’s condition. Pediatric cough variant asthma treatment drugs are mainly bronchodilators, anti-allergic drugs, immunotherapy drugs, nebulized inhalation of drugs is an effective measure to treat asthma, nursing staff should choose the appropriate inhalation device according to the child, young children usually choose mask inhalation, children can choose the mouth method of inhalation, in order to ensure the effectiveness of drug inhalation, accurate compliance with the drug inhalation time dose. Closely monitor the child’s vital signs. Explain in detail to the child’s family about the medication and its adverse effects, and rinse the mouth with water after treatment to prevent adverse effects such as mouth ulcers and hoarseness. For children with mild symptoms, instruct the child to take a semi-recumbent position and pat the child’s back to help the child cough up sputum, keep the airway open, and instruct the child to perform abdominal breathing.
Life care during remission
Allergic asthma is mostly caused by the child’s exposure to allergens. In daily care, we should pay attention to the substances that cause allergy to the child during an attack. Allergens are the main cause of allergic asthma and should be avoided. Pollen, all kinds of mites, fungi and fur of various pets in daily life are common allergens, and some studies have reported that house dust mites are the most important allergens in children with asthma, with a positive rate of 68.8% in children. Keep the environment clean, the air fresh and circulating, the light appropriate, and the temperature appropriate. Some toys in the environment are often places where dust mites gather in large numbers, and quilts, pillowcases and carpets should be washed and exposed to the sun frequently. Families with allergic children should avoid pets, flowers and paint, etc. Children with allergic history should be careful with high-protein and high-energy foods such as shrimp, and reasonable dietary care interventions should be carried out. In our study, the incidence of allergic asthma is higher in spring and winter, which is related to the increase of allergens (such as pollen allergy in spring) and the cold weather in these two seasons, so children should pay attention to keep warm in winter. Nighttime and early morning are also the high incidence of allergic asthma, so nursing staff should strengthen inspection.
Health education
Education for parents of affected children should be emphasized, and home care is an important part of treatment. Parents should listen to lectures by experts to enhance their understanding of allergic asthma, carry out community publicity on allergic asthma during the high season, and introduce the preventive and control measures of allergic asthma, such as most attacks of allergic asthma have precursors, parents should pay more attention to the aura symptoms such as itching sensation in the eyes and nose, sneezing, runny nose, lacrimation and cough of their children, and take corresponding measures to deal with them actively. In daily life, children should be encouraged to enhance their immune system, while exercise intensity should be limited for patients with exercise-induced variant asthma.