Audience friends:
At the invitation of china national radio, I am very happy to introduce the diagnosis and treatment of several chronic respiratory diseases here. The clinical manifestations and differential diagnosis of chronic bronchitis, bronchiectasis, bronchial asthma, emphysema and cor pulmonale are discussed with you to help patients understand and master their own conditions and achieve the purpose of receiving correct treatment. In the past, some patients have mistaken chronic bronchitis, bronchiectasis, bronchial asthma, emphysema, cor pulmonale and bronchitis for chronic bronchitis, which is very unscientific. So, what is chronic bronchitis?
-Chronic bronchitis is mainly characterized by cough and expectoration, and some patients may be accompanied by mild asthma and chest tightness. The disease may recur because of a cold or the stimulation of harmful gases, and it will recover from time to time. Generally, those who attack for more than three months in a year can be regarded as chronic bronchitis. The incidence of chronic bronchitis in normal population is 4%, and the incidence of chronic bronchitis over 50 years old can be increased to 16%, indicating that the older the age, the higher the incidence. Chronic bronchitis can also be divided into simple type and wheezing type. Simple type has only two symptoms: cough and expectoration. In addition to coughing and expectoration, wheezing also has symptoms of shortness of breath, and some patients are accompanied by wheezing. Chronic bronchitis can be completely cured, but there are two treatments at this stage. First, complete cure can make patients turn to healthy people. Secondly, if the treatment is stopped because of carelessness, the disease can turn into emphysema and pulmonary heart disease that will linger for life. Therefore, at this stage, patients need to establish confidence in treatment, get rid of bad habits, choose good drugs, and persist in treatment for a long time until they are completely cured. Preventing colds is an important factor to prevent the recurrence of chronic bronchitis. The specific measures are to wash your face with cold water from summer to increase your body's tolerance to cold. We should completely quit smoking and drinking, try to avoid inhaling harmful gases, avoid eating spicy and greasy things, adhere to regular daily life, and use Chinese herbal medicines such as Radix Astragali, Radix Saposhnikoviae and Rhizoma Atractylodis Macrocephalae to replace tea for a long time, which can increase the body's resistance. These measures are very important for the adjuvant treatment of chronic bronchitis and the prevention of recurrence.
Let me talk about emphysema. Emphysema is mainly developed on the basis of chronic bronchitis. Other chronic lung diseases such as bronchial asthma, cavitary tuberculosis, chronic lung disease, pneumoconiosis, bronchiectasis and other diseases can develop into this disease. The clinical manifestations of emphysema are wheezing and sulking, dyspnea is the most obvious, and cough and expectoration are relatively mild. The mechanism of symptoms is that due to some chronic lung diseases, gas exchange is blocked for a long time, so that alveoli lose their elasticity, they can't inhale or exhale gas normally, their vital capacity is weakened, and the residual gas in the lungs stays, resulting in shortness of breath, chest tightness, dyspnea and other symptoms. Asthma is the most prominent symptom of emphysema patients, which will be aggravated by a little exercise and the weather change will be aggravated. Patients can't live without cough and asthma drugs all year round, and when they stop taking them, they feel wheezing and suffocating. In order to enable patients to master their own condition, I will introduce the staging standard of emphysema as follows:
Stage I emphysema: I feel short of breath on the second floor, and I can still do my daily work.
Secondary emphysema: I feel wheezing when walking flat at normal speed, but I can barely keep working.
Stage Ⅲ emphysema: Daily activities such as dressing, washing face, talking, urinating and defecating can cause shortness of breath, inability to work, and basic loss of working ability.
Stage Ⅳ emphysema: When standing or walking for a few steps after rest, I feel short of breath and completely lose my ability to work.
Emphysema is the turning point of chronic lung disease. At this time, the alveoli are relaxed, the elasticity is reduced, and the gas exchange function is weakened, which has formed an organic lesion. Therefore, it is difficult to completely cure the disease and make the patient recover. However, physiologically speaking, the cardiopulmonary compensation ability is still quite strong. If the symptoms are effectively controlled for a long time, Chinese medicine is added to enhance the body's resistance, there is still hope for a radical cure. I used Cordyceps Hong Ju Pill to treat emphysema in clinic, and it can be cured in three to four months. Therefore, patients should be given confidence in treatment. Emphysema patients should not be pessimistic and disappointed. With active treatment, it can still be cured.
Talk about pulmonary heart disease again: Pulmonary heart disease is developed on the basis of emphysema. In emphysema stage, the alveoli of patients are damaged for a long time, and the gas exchange function is weakened, which leads to the corresponding decline of pulmonary blood small circulation function. In order to meet the human body's demand for oxygen, the heart must strive to input blood to the lungs. In the process of pulmonary blood circulation, the right heart is overloaded for a long time, which leads to the thickening of the right heart (the mechanism of myocardial thickening is similar). Weightlifters often grasp heavy objects with both hands, so that the muscles of their arms are developed and protruding, but the thickening and expansion of their hearts will cause weakness in contraction. The power of small circulation decreases, resulting in insufficient oxygen content in blood. Therefore, in the stage of cor pulmonale, patients are often in a state of hypoxia, especially after exercise. Its symptoms can be as follows: asthma, palpitation, dyspnea, pale face, edema of lower limbs, cyanosis of lip nails, and pulse rate of more than 65,438+000 beats/minute. Cold or hot weather will aggravate the condition, and patients often suffer from pain. Pulmonary heart disease belongs to the category of asthma, phlegm, edema and lung distension in traditional Chinese medicine. The severe heart failure stage of cor pulmonale is more critical. During this period, the patient's cardiopulmonary function is seriously decreased, electrolyte is disordered, and it is easy to form moderate acid-base and complicated with pulmonary encephalopathy. If the treatment is a little sparse, the patient may die soon. Generally, western medicine is used in hospital treatment at this stage. Although there are measures such as anti-inflammatory, cardiotonic, diuresis, oxygen delivery, infusion and correction of moderate acid and alkali, it is also half the effort and dangerous, which is of no help. I have been engaged in clinical research on lung diseases for many years, and often encounter serious heart failure caused by cor pulmonale. Whether it is the generic type of yang deficiency and water deficiency or the type of phlegm and blood stasis invading the heart, as long as the patient is still alive, he can take the liquid medicine, throw Wuling Sanshen Decoction (Cor Pulmonale Kangning Capsule) and cooperate with the treatment of Cordyceps Hong Ju Pill, which can generally turn the patient from danger to safety. The prescription components of Wuling Sanshen Decoction (Feiyuankangning Capsule) are Poria, Polyporus, Alismatis Rhizoma, Ramulus Cinnamomi, Atractylodis Rhizoma, Ginseng Radix, Salvia Miltiorrhiza Radix and Notoginseng Radix. The first five ingredients are all Wuling powder, and the last three ingredients are all added by myself. Wuling San Fang published Treatise on Febrile Diseases. Modern research is used to treat chronic nephritis, cardiogenic edema, ascites due to liver cirrhosis and other diseases, treat asthma due to qi deficiency, and add Danshen to dilate coronary artery and increase coronary flow. The bones of Panax notoginseng are called hemostatic drugs. According to modern research, it can reduce myocardial oxygen consumption and increase cardiac output, and it is a real cardiotonic. I use this prescription to treat severe heart failure caused by cor pulmonale, and generally I can get satisfactory results. Let me introduce a case: patient Liu Shangyou, male, 67 years old, a teacher (now retired) from Group 6 of Liuyuan, Shiyuan, Hanzhong Township, Wancheng District, Nanyang City, Henan Province, was first diagnosed on June 6th. 1992. He has been suffering from chronic bronchitis complicated with emphysema for more than 40 years and was diagnosed with cor pulmonale six years ago. At the time of seeing a doctor, the symptoms were: asthma, palpitation, inability to lie flat, vain face, edema of lower limbs, short and urgent urination, cold limbs, lethargy, weak and unclear speech, body temperature of 35.5, pulse 1 18 times/minute, and cyanosis of labia. Therefore, Wuling Sanshen Decoction (Corpulmonale Kangning Capsule) was prepared, and the dosage of ginseng was increased, and "Cordyceps Hong Ju Pill" was added to instruct it to take it frequently. After one dose, the patient's symptoms eased and became alive, and he took three more doses. Patients' diet increased, edema and edema disappeared, their language increased, their cough decreased sharply, and they were able to lie down. Later, the dosage of ginseng was reduced, and Houttuynia cordata, Fritillaria cirrhosa and ten doses were added.