I. Respiratory system diseases are common diseases in China
The respiratory system consists of the nose, pharynx, larynx, trachea, bronchi and alveoli.
As the respiratory system is connected to the external environment and exposed to the general environment of human life, human beings need to constantly inhale fresh air and expel carbon dioxide from the body, and about 10,000L of gas goes in and out of the respiratory tract every day.
In the process of breathing, dust in the external environment, including various pathogenic microorganisms, protein allergens, harmful gases, etc., can enter the respiratory tract and lungs causing various diseases.
Therefore, respiratory system diseases are a common disease. It includes cold, bronchitis, bronchiectasis, emphysema, pulmonary heart disease, pneumonia, asthma and so on, which can develop throughout the year, especially in winter and spring.
Second, the elderly are prone to respiratory diseases.
The elderly are prone to respiratory diseases, especially infectious diseases such as pneumonia, because of the reduced metabolic function of the tissues and therefore the reduced ability to clean the respiratory tract; at the same time, as the body’s resistance is reduced, the immune function is reduced.
The clinical manifestations of pneumonia in the elderly are mostly atypical and can include low fever, light cough, fast breathing, nausea, vomiting, loss of appetite, mental atrophy, and weakness.
Third, smoking and respiratory diseases
Yunnan is a large tobacco province, smoking a lot of people, Qujing is no exception.
Cigarette smoke burning, a total of more than 4,000 kinds of ingredients, of which more than 400 kinds of pathogenic.
Smoke first contact is the respiratory mucosa, can cause irritating cough, and can lead to dry respiratory mucosa, long-term can lead to chronic congestion of the airway mucosa, often combined with chronic cough, sputum, and finally will cause chronic bronchitis and even lead to emphysema, pulmonary heart disease, etc.
Fourth, pollen and bronchial asthma
In Yunnan, with four seasons like spring, flowers bloom, especially in spring, there are various kinds of pollen in the air, and some people have allergic reactions to some of these pollens, causing allergic rhinitis, allergic conjunctivitis, allergic skin disease and bronchial asthma and other diseases.
Various allergenic pollens are an important group of allergens that cause allergic asthma, and there are hundreds of plant pollens known to cause allergy in humans.
V. Prevention and treatment of common respiratory diseases
(I) Acute upper respiratory tract infections
Acute upper respiratory tract infection is the collective name for acute inflammation of the nasal cavity, pharynx or throat, and is the most common type of infectious disease. Most of them are caused by viruses, and a few are caused by bacteria.
They are classified as common cold, influenza, pharyngitis and bronchitis.
Clinical manifestations: In general, the onset of the disease is rapid, with dryness of the oropharynx, foreign body sensation, and in severe cases, sore throat, and some patients feel generalized aches and pains and weakness, and can basically recover within a week.
Cold is the most common epidemic disease. The common cold requires only adequate rest and symptomatic medication, mainly anti-allergy, and it will pass in three to five days.
Severe influenza, with its fierce onset, high fever and severe systemic symptoms, especially in the elderly and children, should be taken seriously and hospitalized. Because it can cause serious complications.
Health tips.
(1) It is best for patients to avoid going to crowded places to avoid infecting others. If in winter be sure to wear a mask.
It is advisable to drink plenty of boiled water and to eat a light, thin, soft and less greasy diet. For those who have high fever and poor appetite, it is appropriate to have liquid or semi-liquid food, such as rice soup, egg flower soup, soy milk, etc.
(2) For those who have high fever and dry mouth and throat, cool and juicy food can be eaten.
(3) Diet is suitable for small amount and multiple meals: if the appetite is better after the fever is reduced, it can be changed to semi-liquid diet, such as noodle sheet soup, clear chicken soup, noodles, etc.
(4) Eat more vegetables, fruits and other foods: replenish the loss of nutrients caused by fever and enhance the ability to resist diseases. Vegetables and fruits can promote appetite and help digestion, as well as replenish a large amount of vitamins and various trace elements needed by the body.
(5) Prevent cross-infection.
In the good season of respiratory tract infection, especially in autumn and winter, you should wear a mask when you go out; fumigate the room with vinegar; isolate the respiratory tract for patients.
(ii) Acute bronchitis and bronchiectasis
Acute tracheitis and bronchitis are acute inflammation of the tracheal and bronchial mucosa caused by infection, physical and chemical irritation or allergy.
Clinical manifestations: mainly cough and sputum, first dry or a small amount of mucus sputum, then turning into mucopurulent, sputum volume increases, cough intensifies, and occasionally blood in sputum. In the presence of bronchospasm, there may be shortness of breath and a feeling of tightness behind the sternum. There may be fever (about 38℃) and general malaise, but it is self-limiting and subsides after 3-5 d.
Treatment.
(1) Symptomatic treatment: cough suppression, antipyretic and analgesic when the body temperature is high, etc;
(2) Rest, keep warm, and drink more water.
(3) If there is a combined bacterial infection, antibacterial drugs may be used.
Prevention.
(1) Actively exercise to enhance physical fitness;
(2) Do not smoke and do not drink alcohol.
(3) Prevent colds;
(C) Chronic bronchitis
It is a chronic non-specific inflammation of the trachea, bronchial mucosa and surrounding tissues caused by infectious or non-infectious factors.
Clinically, cough and sputum are the main symptoms, or accompanied by wheezing, and the onset lasts for 3 months each year and for 2 or more years. If other diseases with symptoms of cough, cough and wheeze are excluded (such as tuberculosis, pneumoconiosis, lung abscess, heart disease, cardiac insufficiency, bronchiectasis, bronchial asthma, chronic nasopharyngeal disorders, etc.). The diagnosis of chronic bronchitis can then be made.
In the early stage, the symptoms are mild and mostly occur in winter and are relieved after spring; in the late stage, the inflammation is aggravated and the symptoms exist for years, regardless of the season. The disease progresses and can be complicated by obstructive emphysema, pulmonary heart disease, which seriously affects the labor force and physical health.
Treatment.
1, the treatment of the acute exacerbation
(1) control infection: the main cause of acute exacerbation of chronic bronchitis is respiratory tract infection, mainly bacteria, need to give antimicrobial therapy, if the causative bacteria can be cultured, can be selected according to drug sensitivity test antimicrobial drugs.
(2) Cough suppression and expectoration: symptomatic treatment is given according to the situation.
(3) With shortness of breath, antispasmodic and wheezing drugs, such as aminophylline and doxorubicin tablets, can be added.
2.Treatment in remission.
(1) The remission period is mainly to strengthen the physical exercise and improve their own resistance to disease.
(2) Quit smoking: Smoking is an important cause of chronic bronchitis, and quitting smoking is the main link in the treatment of recurrent chronic bronchial attacks.
(3) Strengthen personal hygiene, develop good living habits, pay attention to keeping warm and prevent colds.
(iv) Chronic obstructive pulmonary disease (COPD)
Chronic obstructive pulmonary disease (hereinafter referred to as COPD) is a common respiratory disease that seriously endangers the physical and mental health of patients.
COPD is a preventable and treatable disease characterized by airflow limitation. COPD is a preventable and treatable disease characterized by airflow limitation, which is not completely reversible, progressive and associated with an abnormal inflammatory response of the lungs to the inhalation of harmful gases or particles such as tobacco smoke.
COPD primarily involves the lungs, but can also cause systemic (or extrapulmonary) adverse effects. Pulmonary function tests are important to clarify the presence of airflow limitation.
1.Symptoms
(1) Chronic cough: It is often the first symptom. Initially, it is an intermittent cough, which is heavier in the morning and later can be present in the morning and evening or throughout the day, and the cough is often not significant at night. A few patients have no cough symptoms, but pulmonary function tests show obvious airflow restriction.
(2) Coughing sputum: small amount of mucus sputum, more in the early morning. In case of co-infection, the sputum volume increases, and purulent sputum may be present. In a few patients, cough is not accompanied by sputum.
(3) Shortness of breath or dyspnea: It is a typical manifestation of COPD. In the early stage, the shortness of breath appears only after activity, then it gradually worsens, and in severe cases, the shortness of breath is felt even during daily activities and even at rest.
(4) Wheezing: Some patients, especially the severe ones, may have wheezing symptoms.
(5) Systemic symptoms: weight loss, loss of appetite, peripheral muscle atrophy and dysfunction, mental depression and/or anxiety, etc.
2.Pulmonary function tests
Pulmonary function tests, especially ventilation function tests, are important for the diagnosis of COPD and the assessment of the severity of the disease.
First second expiratory volume as a percentage of forceful lung volume (FEV1/FVC%) is a sensitive indicator to evaluate airflow limitation. First second expiratory volume as a percentage of expected value (FEV1% expected value) is often used to assess the severity of COPD with little variability and is easy to perform. An FEV1/FVC <70% after inhalation of bronchodilators is indicative of incomplete reversible airflow limitation. < span="">
3. Diagnosis
The diagnosis is determined based on a comprehensive analysis of smoking and other risk factors for the development of the disease, clinical symptoms, signs and pulmonary function tests.
The diagnosis must rely on pulmonary function tests, and incomplete reversible airflow limitation is a necessary condition for COPD diagnosis. Incomplete reversible airflow limitation can be identified as FEV1/FVC <70% after inhalation of bronchodilators.
In a few patients, there is no cough, sputum or shortness of breath, but only FEV1/FVC<70% is found during pulmonary function tests, which can be diagnosed as COPD after excluding other diseases.
4.Complications
COPD can be complicated by spontaneous pneumothorax, pulmonary hypertension, chronic pulmonary heart disease, venous thromboembolism, respiratory insufficiency or failure, and other diseases.
5.Treatment
(1) Treatment of acute exacerbation of COPD
During acute exacerbation, hospitalization is required if the following conditions occur.
1.Significant aggravation of symptoms, such as short-term dyspnea at rest, etc;
2. New signs or aggravation of existing signs, such as cyanosis, peripheral edema, etc;
3.New arrhythmia;
4.Severe concomitant diseases;
5.Failure of initial treatment plan;
6.Advanced age;
7.Unclear diagnosis;
8.Out-of-hospital treatment is ineffective.
(2) Stable treatment
①Education and management
Educate and supervise smoking cessation and avoid exposure to secondhand smoke in COPD patients who smoke. Smoking cessation has been clearly shown to be effective in slowing the progressive decline of lung function.
Advise patients to avoid or prevent inhalation of dust, smoke and noxious gases as much as possible;
Patients should acquire some basic knowledge about COPD and learn the key points and methods of self-management of the disease.
②Oxygen therapy
Long-term oxygen therapy has beneficial effects on the hemodynamics, respiratory physiology, exercise tolerance and mental status of patients with COPD combined with chronic respiratory failure, which can improve patients’ quality of life and increase survival rate. Long-term home oxygen therapy is advocated under the guidance of a physician.
Oxygen therapy method: generally use nasal catheter oxygen, oxygen flow rate of 1.0-2.0L/min, oxygen duration >15h/day, must be long-term adherence.
③Rehabilitation therapy
Rehabilitation therapy is applicable to patients with moderate COPD or above.
Among them, respiratory physiological treatment includes correct coughing, sputum excretion methods and lip retraction breathing, etc.; muscle training includes whole body exercise and respiratory muscle exercise, such as walking, bicycling, abdominal breathing exercise, etc.; scientific nutritional support and strengthening health education are also important aspects of rehabilitation treatment.
④Medication
1. Bronchodilators: mainly include β2 agonists and anticholinergics. Inhalation therapy is preferred.
Short-acting agents are suitable for patients with COPD at all levels and are used as needed to relieve symptoms;
Long-acting agents are suitable for patients with moderate or above, to prevent and alleviate symptoms and increase exercise endurance.
Main agents: salbutamol, formoterol, etc.
2.Anticholinergics: Short-acting anticholinergics (SAMA) mainly include ipratropium bromide
3.Methylxanthines: including short-acting and long-acting dosage forms.
Including aminophylline, doxorubicin, etc.
4.Glucocorticoids
Long-term regular inhaled glucocorticosteroids are suitable for patients with severe and very severe and repeated acute exacerbations, which can reduce the number of acute exacerbations, increase exercise tolerance and improve quality of life, but cannot stop the downward trend of FEV1.
The combination of inhaled glucocorticoids and long-acting β2 agonists is more effective than single agents.
Long-term oral, intramuscular or intravenous glucocorticoid therapy is not recommended.