Overview
Pediatric bronchitis refers to inflammation of the bronchi, and the lesions of pediatric capillary bronchitis mainly occur in the small bronchi of the lungs, or capillary bronchi, hence the name “capillary bronchitis”. It is a common acute upper respiratory tract infection in children.
Symptoms
(a) Age is mostly seen in children under 1 year old, especially in infants under 6 months of age.
(B) The disease can occur throughout the year, but is more common in winter and spring.
(c) The onset of the disease is rapid, with pre-cold symptoms, such as coughing and sneezing, followed by worsening of the cough after 1 to 2 days, episodes of dyspnea, wheezing, pallor, cyanosis of the lips, trismus sign, and early wheezing sounds in the lung, followed by wet sounds. In severe cases, the symptoms may be accompanied by congestive heart failure, respiratory failure, hypoxic encephalopathy, and water and electrolyte disturbances. The general temperature does not exceed 38.5°C and the duration of the disease is 1 to 2 weeks.
(D) Blood leukocytes are mostly normal or mildly increased. Blood gas analysis shows hypoxemia as well as decreased or increased partial pressure of arterial blood carbon dioxide. Chest radiographs are characterized by thickened lung texture, increased translucency of both lungs or small patches of shadow and pulmonary atelectasis. A rapid diagnosis of respiratory secretion virus can be done if available to clarify the type of virus.
Etiology
Climate (15%).
Cold is often an important cause and trigger of pediatric bronchitis attacks, and the onset and acute exacerbation of bronchitis in children commonly occurs in the cold winter season, especially when there is a sudden change in climate.
Physical and chemical factors (20%).
Chronic irritation such as irritating fumes, dust, atmospheric pollution (such as sulfur dioxide, nitrogen dioxide, chlorine, ozone, etc.) is often one of the triggering factors for bronchitis in children.
Infection factors (25%).
Infection is an important factor in the development of bronchiectasis in children, mainly viral and bacterial infections, rhinovirus, mucovirus, adenovirus and respiratory syncytial virus being the most common.
Phytonadic dysfunction (12%).
When the parasympathetic response of the respiratory tract is increased, a weak stimulus that does not work in normal people can cause bronchial contraction spasms and increased secretions, resulting in symptoms such as coughing, coughing and shortness of breath.
Allergic factors (10%).
Pediatric bronchitis patients often have a history of allergies.
Physical and chemical reactions (10%).
Inhalation of dust, irritant gases, supercooled air or fumes such as sulfur dioxide, nitrogen dioxide, ammonia, and chlorine can irritate the tracheobronchial mucosa and cause morbidity.
Diagnosis
Clinical diagnosis
(A) Clinical manifestations
1. Initially, there are fever, chills, headache, dry throat, etc.
2. The main symptoms are cough and sputum.
(II) Main types
1.Acute bronchitis starts with dry cough, and the amount of sputum gradually increases and gradually becomes mucopurulent sputum.
2.Chronic bronchitis is mainly a persistent cough, which does not heal for many months and worsens in the morning and evening, especially at night. The amount of sputum is more or less, and the coughing out is fast. The symptoms are lighter in the summer and prone to acute attacks in the winter, making the condition worse. Recurrent attacks are associated with a thin body. It can be complicated by pulmonary atelectasis, emphysema and bronchiectasis.
(C) Physical and chemical tests
1. Early respiratory sounds may be coarse, and vesicular sounds may be heard bilaterally.
2.X-ray examination: acute cases may have no special findings. Chronic cases may have corresponding chronic inflammatory changes.
Differential diagnosis
(a) In milder cases, it must be differentiated from upper respiratory tract infection.
(b) Bronchial foreign body: When there is respiratory obstruction with infection, its respiratory symptoms are similar to those of acute bronchitis, and attention should be paid to inquiring whether there is a history of respiratory foreign body inhalation, which has been treated with poor efficacy, delayed and recurrent. Chest X-ray examination shows obstruction such as pulmonary atelectasis and emphysema.
(iii) Pulmonary hilar bronchial lymph node tuberculosis: according to the history of tuberculosis contact, tuberculin test and chest X-ray examination.
(iv) Capillary bronchitis: Most often seen in infants under 6 months of age with significant acute episodes of wheezing and dyspnea. The body temperature is not high, and the pulmonary rales are not obvious during wheezing episodes, and fine wet rales can be heard after remission.
(E) Bronchopneumonia: When the symptoms of acute bronchitis are severe, it should be differentiated from bronchopneumonia.
Treatment
Western medical treatment of pediatric bronchiectasis
Control of infection
If the acute bronchitis is a bacterial infection, the following antibacterial drugs can be used: cotrimoxazole 0.05/kg/day in two oral doses, penicillin 30-50,000 U/mg/day in two intramuscular injections, methicillin, erythromycin 30-50 mg/kg/day in three to four oral doses.
If there is no clear bacterial infection or mixed infection, use or add virazole 10-15mg/kg/day in 2 doses, or 5mg/kg/day in 2 doses as nebulized inhalation, or try a-interferon 200,000U/day intramuscular injection.
Symptomatic treatment
1, cough expectorant: if the sputum is sticky and not easy to suck out, use nebulized inhalation and choose 10% ammonium chloride combination, must cough flat, pediatric strong phlegm Ling (2-4 years old 1-2 tablets, 5-8 years old 2-3 tablets). Frequent dry cough affects sleep and rest, can take a small amount of cough suppressants, such as promethazine and chlorpromazine 0.5-1mg/kg/time, 2-3 times a day, should pay attention to avoid overdose and too long, affecting the physiological vitality of cilia, so that secretions are not easily discharged.
2.Antispasmodic
Aminophylline: 2-4mg/kg/dose 3-4 times/day orally.
Albuterol: 1-2mg/day under 6 years old, divided into 3-4 times orally or 0.1mg/kg/time, albuterol aerosol (0.5% 1 snap = 0.1mg) 1-2 snap/time 2-3 times a day.
In case of severe wheezing, prednisone 1mg/kg/day can be added, divided into 3 oral doses, 4-7 days as a course of treatment. Beclomethasone propionate aerosol can also be used to reduce the side effects of systemic medication by local application. It is not suitable for infants and children who are difficult to cooperate. Children should take 1-2 snappers (50μg-100μg)/time, 2-4 times a day.
Chinese medicine treatment for pediatric bronchitis
Chinese medicine treatment
1, cough and asthma: in the remission period can be used some cough and asthma Chinese medicine preparations, can also reduce the symptoms to a certain extent.
2, external paste medicine: many infants and young children after the disease, long-term medication can bring some of the toxic effects of drugs, the safety and convenience of external paste Chinese medicine is also a good way. At present, the more used are expectorant, pulling phlegm Bacchus agaricus Yi Qi paste and winter with the three nine paste and so on.
Tui Na Treatment
Through Tui-Na techniques, children with symptoms of bronchitis can be massaged and tui-naed at acupuncture points to unblock their breath to achieve therapeutic effects. Currently, some of the most famous Tui-Na clinics are Shanghai Kang Yao Tui-Na, Qingdao Tui-Na and Beijing Yuming Tui-Na.
Traditional Chinese Medicine Treatment
The magnetic overlay regulates immunity through the theory of diagnosis and treatment, not a single Chinese medicine treatment, for each patient’s physical characteristics and symptom differences, depending on the individual, different points and formulas are selected and different treatment plans are formulated, mainly through a combination of acupuncture, cupping, fumigation, Chinese medicine compresses and other techniques.
Acupoint injection therapy
1.Liquorice injection
Licorice is produced in Xinjiang, decocted, alcohol deproteinized and made into 50% licorice injection, bottled and autoclaved.
Method: The commonly used acupoints are Lung Yu, Zhongfu, Kong most, Fenglong and Ding wheeze. Once every other day, choose 3-4 points unilaterally or bilaterally each time. Each point is injected with 0.5 ml, and the amount of medicine used is about 3 ml each time. 10 times is a course of treatment. Treatment can be accompanied by ear acupuncture (selected points: lung, asthma, adrenal gland).
Note]
1.It is effective in suppressing cough and expectorant.
2.After injection, the local swelling and pain is obvious, and will disappear on its own within a few hours. Use with caution for hypertension and pregnant women.