Cough sound when Hugh -- an interview with Academician Zhong Nanshan, President of the Chinese Medical Association

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Life, who has not had a cough? Cough is a protective reflex of the body, but it is also a pathological symptom. Don't think twice cough is s


Life, who has not had a cough? Cough is a protective reflex of the body, but it is also a pathological symptom. Don't think twice cough is small, a lot of people cough for two months still can not stop, some of this medicine because they caused endless cough.

In order to guide the diagnosis and treatment of medical workers, led by academician Zhong Nanshan's chronic cough prevention group in 2005 announced at the end of the first Chinese cough diagnosis and treatment guidelines, the misdiagnosis rate was as high as 64% of the chronic cough for the diagnosis and treatment standard. As ordinary people, should understand what, life should pay attention to what? What should we do with the doctor's diagnosis and treatment? To this end, the reporter on the topic of chronic cough, an exclusive interview with Zhong Nanshan, President of the Chinese medical association.

Beijing reference: what are the most common causes of cough?

Zhong Nanshan: cough caused by many reasons, the most common cough in respiratory diseases, almost all respiratory diseases can have a cough. Such as acute and chronic pharyngitis and laryngitis, manifested irritating cough, serious when accompanied by hoarseness; acute bronchitis, as non persistent single or paroxysmal cough; chronic bronchitis cough in winter attack, sustainable months; bronchiectasis recurrent cough hemoptysis, daily sputum volume up to hundreds of mL; early lung cancer dry cough and hemoptysis, peripheral lung cancer can be accompanied by chest pain; lung abscess, cough, purulent smelly phlegm; tuberculosis weak cough, bloody sputum; lobar pneumonia cough, sputum rust; Klebsiella Bacillus pneumonia, sputum red brick, jelly; virus infection, white sticky phlegm occupation; pneumoconiosis is chronic cough, shortness of breath and chest pain; pertussis with recurrent spastic cough with high pulmonary embolism can roar like cock; cough, hemoptysis, breathing Difficulty, chest pain, etc.. In addition, some asthma does not appear wheezing, and the performance of chronic cough, known as variant asthma.

In addition to respiratory diseases, other diseases can also have a cough. Such as acute pulmonary edema, cough with pink foam sputum; chronic left ventricular dysfunction often have chronic cough, procumbent or activities after aggravating arrhythmia can occur; cough; anti laryngeal nerve paralysis, tracheoesophageal fistula after cough and gastroesophageal reflux disease after eating bed cough. In addition, some drugs such as Lotensin, Bea Knapp Leigh and captopril can also cause cough.

"Beijing reference": which cough patients should see a doctor?

Zhong Nanshan: most cough, especially after a cold cough, in young adults often can disappear on their own, or quickly improve after taking medicine. Elderly, infants and young children after a cold cough can not be ignored. As a result of some serious manifestations of the disease; no obvious cause of irritating cough; cough lasts for a long time; with chest pain or shortness of breath, wheezing and other symptoms, to timely medical treatment.

"Beijing reference": how long cough chronic cough? What is its diagnostic criteria?

Zhong Nanshan: the outpatient department of respiration often encounter some chronic cough patients, duration more than 8 weeks, chest X-ray or CT examination without abnormal findings, clinical patients usually called unexplained chronic cough, chronic cough. The misdiagnosis rate of these chronic cough patients is very high. According to the statistics of Guangzhou Institute of respiratory diseases, 64% of patients with chronic cough were misdiagnosed as "chronic bronchitis" or "bronchitis", with an average time of misdiagnosis of 5 years and a maximum of up to 20 years.

"Beijing reference": if the cough for more than 8 weeks, but not persistent, such as cold cough once every month, for one or two weeks, repeated attack, which belongs to the scope of chronic cough?

Zhong Nanshan: cold repeatedly cough, if not timely treatment, easy to develop persistent chronic bronchitis, chronic bronchitis and other diseases, although it does not belong to the scope of chronic cough, but should pay enough attention to.

"Beijing reference": no significant changes in the chest X-ray of chronic cough, a common and easily overlooked cough, how to identify with chronic bronchitis?

Zhong Nanshan: cough in patients with chronic bronchitis is often accompanied by cough, cough a lot of white foamy sputum or white mucus sputum; patients with chronic bronchitis and cough longer duration, delayed healing of disease for more than 2 years, the annual incidence continued for more than 2 months.

"Beijing reference": how to identify asthma with cough and asthma?

Zhong Nanshan: there is a kind of asthma called cough variant asthma, cough symptoms and no symptoms only. For patients with cough, common anti-inflammatory effect after the treatment is not good; or recurrent or difficult to cure; cough has obvious seasonal, morning or night intensified. General stimulation, such as cold wind, smoke stimulation can induce cough. If there is such a situation, cough variant asthma cannot be ruled out. Pulmonary function tests (such as bronchial provocation test, peak day and night flow velocity monitoring) should be performed to confirm the diagnosis.

Gastroesophageal reflux is also easy to cause chronic cough

"Beijing reference": people should understand what the knowledge of chronic cough?

Zhong Nanshan: many patients with chronic cough course for several years, seriously affecting the quality of life, sleep is not good, the interference study and work, especially some women, because of the chronic cough associated with symptoms of urinary incontinence, suffered great pain.

Although a lot of diseases caused by chronic cough, but should not be limited to the trachea to find reasons, but also pay attention to the nasopharynx and digestive tract. Clinically, there is a common chronic cough caused by gastroesophageal reflux and chronic sinusitis. Gastroesophageal reflux disease is often associated with increased cough during and after eating. In addition, due to the cold, upper respiratory tract infection caused by the high reactivity of the trachea, will lead to chronic cough. Should pay attention to the X-ray showed no lesions of chronic cough in the clinical common and easily overlooked type of cough diagnosis, auxiliary examination stressed from easy to difficult, from common diseases to a rare disease, avoid big net check, in order to reduce the patient's medical expenses.

The cause of the disease with appropriate diet

"Beijing reference": cough treatment of many drugs are non prescription drugs (OTC), people often buy their own medicine to eat, how do you think?

Zhong Nanshan: is there a cough when we should pay attention to the nature of cough, cough onset urgency, duration, onset season, severity, relationship with posture, fatigue, eating, or inducement, associated symptoms, diagnosis as soon as possible to get timely treatment. Although a lot of drugs for the treatment of cough are non prescription drugs, but the treatment of chronic cough must be clear about the causes of cough, do not be free to buy a cough and expectorant drugs to deal with.

"Beijing reference": people with cough, there are a lot of food such as "recipe", mangosteen, Kawabe Ri, lily, should not eat, there is no effect?

Zhong Nanshan: people tend to love with mangosteen, pear, Lily diet to treat chronic cough, but for chronic cough patients, these methods can only play a supporting role.

The most important thing is to deal with chronic cough cough, rather than just diet therapy. Because if the course of disease is longer and longer, it is easy to merge other complications.

In addition, the diet also need symptomatic, both to understand their physical, but also to understand the nature of food. The dietotherapy method of cough must follow the principle of traditional Chinese medicine, know some basic knowledge of traditional Chinese medicine. For example, according to the different symptoms of cough, cough is divided into 5 types. Cold cough spit: dilute sputum, headache, stuffy nose, runny, cold and have a fever; wind heat cough: have fever, sore throat, dry mouth, spit out; Zaohuo cough: dry cough, phlegm, throat dry lips and less; phlegm cough: phlegm and viscous throat grunt, may appear chest tightness. Shortness of breath and other symptoms; Yin deficiency cough: cough hair, pale face, zygomatic (two eyes under the facial bone) red, not to mention gas or foot have a fever, and sometimes bloody sputum or hemoptysis.

It is understood that the white radish to diet is mainly to cold cough; with lotus root juice, pear juice diet is to heat cough; fresh ripe papaya is the treatment of phlegm heat cough; with orange skin is auxiliary treatment of phlegm cough; lily is relative to the lung qi or yin deficiency cough for cough. So, once treated with diet cough, to pay special attention to the different conditions of different foods.

More than two articles from the Guangzhou Institute of respiratory diseases website


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