I. Overview of pharyngitis Pharyngitis is mainly divided into acute pharyngitis, chronic pharyngitis and atrophic pharyngitis. Acute pharyngitis is an acute inflammation of the pharyngeal mucosa, submucosal tissue and its lymphatic tissue, often as part of an upper respiratory tract infection. It can occur alone or secondary to acute rhinitis. It occurs mostly in the fall and winter and at the beginning of winter and spring. Chronic pharyngitis is a chronic inflammation of the mucosa, submucosa, and lymphatic tissues of the pharynx, often as part of a chronic inflammation of the upper respiratory tract. It is mostly seen in adults, has a long course, has stubborn symptoms, and is not easily cured. Atrophic pharyngitis often spreads from atrophic rhinitis, the cause of which is unknown and rarely seen clinically. (2) Bacterial infections Streptococcus, Staphylococcus and S. pneumoniae are the main causes, among which group A type B streptococcus causes more severe symptoms. If bacteria or toxins enter the bloodstream, or even septic lesions of distant organs, it is called acute septic pharyngitis. (3) physical and chemical factors such as high temperature, dust, smoke, irritating gases, etc. 2, the etiology of chronic pharyngitis (1) local factors ① acute pharyngitis repeated episodes into chronic. ② chronic inflammatory stimulation of the upper respiratory tract, such as chronic sinusitis, inflammation of the nasopharynx, etc., can be due to its inflammatory secretions flowing through the posterior nostril to the back wall of the pharynx to stimulate the mucosa, but also because it makes the patient breathe with the mouth open for a long time, causing excessive drying of the mucosa and lead to chronic pharyngitis. In addition, chronic tonsillitis, dental caries, etc. can also cause chronic pharyngitis. ③ long-term excessive smoking and alcohol, or stimulated by dust, harmful gases, can cause the disease. ④ Occupational factors (teachers, singers, etc.) and physical factors can also be the cause of the disease. (2) Systemic factors A variety of chronic diseases, such as anemia, dyspepsia, reflux esophagitis, cardiovascular disease, chronic lower respiratory tract inflammation, liver and kidney disease, can cause this disease. In addition, endocrine disorders, autonomic dysfunction, vitamin deficiency and immune dysfunction are related to this disease. Systemic symptoms are generally mild, but the degree varies depending on age, immunity, and virulence of viruses and bacteria, and in severe cases, fever, headache, loss of appetite, and aching limbs. -The duration of the disease is usually about 1 week. On examination, acute diffuse congestion of the oropharynx and nasopharyngeal mucosa, edema of the palatal arch and uvula, and redness and swelling of the lymphatic follicles and lateral cords of the posterior pharynx are seen. In cases of bacterial infection, yellowish-white exudate may appear in the center of the posterior pharyngeal lymphatic follicles. The submandibular lymph nodes are enlarged and have pressure pain. Patients with chronic pharyngitis may have various discomforts in the pharynx, such as foreign body sensation, burning, dryness, itching, irritation, and mild pain. As the posterior wall of the pharynx is often irritated by thicker secretions, there is often a more frequent irritating cough in the morning, which can cause vomiting in severe cases and often no secretions are coughed up when coughing. The above symptoms vary from person to person and vary in severity, and are often aggravated by excessive use of the voice, cold or fatigue. Systemic symptoms are usually not obvious. Examination: Chronic simple pharyngitis shows diffuse mucosal congestion, vasodilatation, and dark red color, with a little mucous secretion attached to the posterior pharyngeal wall. The uvula is thickened, worm-like and drooping, sometimes in contact with the root of the tongue. Chronic hypertrophic pharyngitis is seen with mucosal hypertrophy and diffuse congestion. The posterior pharyngeal wall has more granular elevated lymphoid follicles, which may be scattered or fused into a mass. The lateral pharyngeal cords on both sides are also congested and hypertrophied. Patients with atrophic pharyngitis feel dryness in the pharynx and sometimes cough up foul-smelling scabs. The examination shows that the pharyngeal mucosa is dry, atrophied and thin, pale and shiny, and the mucosa of the posterior pharyngeal wall is often covered with sticky mucus or foul-smelling yellow-brown scabs. The diagnosis of pharyngitis is not difficult to make based on the history, symptoms and local examination. To identify the causative organism, pharyngeal bacterial culture can be performed. Acute pharyngitis should be noted as a precursor or concomitant symptom of acute infectious diseases (such as measles, scarlet fever, influenza and pertussis), which is especially important in pediatric patients. In addition, if pseudomembrane necrosis is present in the mouth, pharynx, or tonsils, blood tests should be performed to rule out blood disorders. Acute pharyngitis can cause otitis media, sinusitis, laryngitis, tracheobronchitis, and pneumonia. If the pathogenic bacteria and their toxins invade the blood circulation, it can cause acute nephritis, rheumatic fever, sepsis and other systemic complications. Early malignant lesions of the nose, pharynx, larynx, esophagus and neck only have symptoms similar to those of chronic pharyngitis, so occult lesions in these areas should be ruled out and a thorough examination should be done to avoid misdiagnosis. Atrophic pharyngitis should be distinguished from dry syndrome, which in addition to a dry pharynx, dry mouth, dry eyes and connective tissue disease, serological examination can clarify the diagnosis. V. Treatment of pharyngitis 1. Acute pharyngitis treatment (1) heavy infection, systemic symptoms are more obvious, bed rest, drink more water and a liquid diet, the choice of antiviral drugs and antibiotics or sulfonamides, but also with antiviral and antibacterial effect of Chinese medicine preparations. (2) For those with mild systemic symptoms or no systemic symptoms, local treatment can be used: gargling with compound borax solution, oral administration of Dumefen throat tablets, iodine tablets and silver yellow tablets, etc. 4~6 tablets per day. In addition, 1%-3% iodine glycerin and 2% silver nitrate can be applied to the swollen lymphatic follicles of the posterior pharyngeal wall, which has anti-inflammatory effect. (3) Chinese herbal medicine According to Chinese medicine, this disease is mostly due to external wind-heat, so it is advisable to remove wind and heat, clear heat and detoxify the toxin, using Yin Qiao San plus reduction, and can also use Liu Shen Wan, etc. 2, chronic pharyngitis treatment (1) to remove the causes of the disease, quit smoking and alcohol, improve the work and living environment (to avoid dust and harmful gases), active treatment of chronic inflammation of the nose and nasopharynx, correct constipation and indigestion, treatment of systemic diseases to enhance resistance is very important to the prevention and treatment of the disease. (2) Traditional Chinese medicine Chinese medicine believes that chronic pharyngitis is due to yin deficiency and fire, deficiency fire, resulting in the loss of nourishment of the throat. The treatment is to nourish Yin and lower the fire, using Zengliang Tang plus or minus. Can also use double flowers, maitong appropriate amount, plus two fat sea, with boiling water bubble drink in lieu of tea. (3) local therapy ① chronic simple pharyngitis: commonly used compound borax solution, furacilin solution, 2% boric acid solution containing gargle, or containing throat tablets, such as iodine throat tablets, peppermint throat tablets, silver tablets and taking the six sacred pills and golden voice clear sound pill. Chronic hypertrophic pharyngitis: In addition to the above methods, the lymphatic follicles of the posterior pharyngeal wall should be treated with chemicals such as 10% silver nitrate solution to cauterize the hypertrophic lymphatic follicles, and also with freezing or laser treatment. However, the scope of treatment should not be too large and too deep to prevent future pharyngeal dryness, pharyngeal mucosa atrophy. 3, the treatment of atrophic pharyngitis available in small doses of iodine (2% iodine glycerin) coated on the mucosa of the posterior pharyngeal wall, can promote glandular secretion, improve the symptoms of dryness. Nebulization treatment can also reduce the symptoms of dryness. Vitamin A, B2, C and E can promote the growth of mucosal epithelium.