Allergic cough

? Category: Symptoms

? Allergic cough is also known as allergic bronchitis or cough variant asthma. Allergic cough's clinical features are: chronic cough with no cause for more than two months, paroxysmal irritating dry cough, or a small amount of white foam-like sputum; Smoke or paint, dichlorvos and other chemical odors can be aggravated after inhalation; Many antibiotics were ineffective, and there was no obvious abnormality in chest X-ray or CT examination. 40% patients can be complicated with allergic rhinitis symptoms such as sneezing and runny nose, which many doctors abroad call allergic rhinobronchitis.

abstract

Allergic cough is also known as allergic cough (atopy? Cough, AC), allergic cough is a chronic dry cough lasting more than or equal to 8 weeks. The patients have clear atopic factors, including the number of eosinophils in peripheral blood, the increase of total IgE and specific IgE antibodies in serum, etc. However, the lung function and airway responsiveness of these patients are normal, and most of them may be accompanied by eosinophilia in sputum. They are ineffective in the treatment of bronchodilators and respond well to histamine and glucocorticoid treatment. According to the examination results, allergic cough patients should be treated with antihistamines to solve the problem of elevated serum total IgE. At present, the antiallergic probiotic composition has been patented as antiallergic lactic acid bacteria, which is characterized by reducing the production of serum IgE antibody. Previous studies have shown that Jin Fumin can stimulate and regulate natural immunity and acquired immunity.

Main inducement

The inducing factors of allergic cough refer to the factors that induce the acute attack of allergic cough and aggravate the symptoms of allergic cough on the basis of allergic cough's disease.

I. Socio-psychological factors

The relationship between social psychological factors and allergic cough also has important clinical significance. Most allergic cough management manuals or allergic cough management manuals attach great importance to social and psychological factors. Studies have confirmed that patients' low education level, poor compliance and poor medical conditions are related to mortality and morbidity in allergic cough. At present, most authors believe that social psychological factors are closely related to the onset of allergic cough. Lehrer and others suggested that mental factors, psychological factors, emotional factors and personality factors should be considered in allergic cough's research.

Studies have confirmed that in most patients with allergic cough, changes in psychological stress and emotional factors can induce wheezing attacks, which are more obvious in adult patients, such as anxiety, anger, mental tension, panic, depression, anger and annoyance, which can be one of the triggers of allergic cough's attacks. In addition, patients' poor socio-economic status (such as unable to bear the cost of inhaling glucocorticoids and other drugs) and inadequate social medical conditions (such as lack of corresponding anti-inflammatory drugs or atomization devices, inability to master some allergic cough self-management skills, and lack of guidance from allergic cough or allergy specialists) will seriously affect the stability of allergic cough.

Among them, mental stress caused by social and family factors, such as overwork, career setbacks, financial difficulties, poor social medical care conditions and other diseases, as well as troubles and depression caused by family breakdown, marriage failure or lovelorn, can be one of the inducing factors of allergic cough.

Second, climate factors.

Changes in cold air, air humidity and air pressure can all induce allergic cough's attack. In areas with large temperature difference, high humidity or low air pressure, the incidence rate in allergic cough has obviously increased. When allergic cough patients from these areas go to areas with dry climate and high air pressure, the situation in allergic cough can often be alleviated. The mechanism of allergic cough induced by cold air is that cold air can lead to the loss of airway heat, make mast cells release mediators, directly or indirectly induce airway inflammation, and cause allergic cough's attack. Too high or too low temperature is a disadvantage for allergic cough.

According to the phenomenon that patients in allergic cough often feel that their symptoms are aggravated in thunderstorm weather, Robert and others conducted a six-year investigation on the occurrence of thunderstorm weather and the emergency hospitalization of children due to allergic cough, and the results confirmed the existence of "Thunderstorm allergic cough". It was found that under the thunderstorm weather, the possibility of children being hospitalized for allergic cough increased 15%. It was once thought that the increase of pollen concentration in the air was the cause of "thunderstorm allergic cough", but Robert's research confirmed that the occurrence of "thunderstorm allergic cough" was related to the increase of fungal spore concentration in the air in thunderstorm weather, but not to the change of pollen concentration in the air. In thunderstorm weather, the concentration of fungal spores in the air almost doubled.

Third, excessive exercise and hyperventilation.

Examples of exercise-induced allergic cough are very common in clinic. For most patients with allergic cough, exercise is only the inducing factor, while for patients with exercise-induced allergic cough, exercise may be the pathogenic factor. In fact, all patients with allergic cough's disease and some patients with allergic rhinitis can have wheezing symptoms after a certain amount of exercise. Its mechanism is related to hyperventilation caused by excessive exercise, which leads to excessive heat loss in the airway and cold airway environment, thus inducing mast cells to release inflammatory mediators and leading to airway inflammation. Hyperventilation caused by laughter and crying in children with allergic cough often induces wheezing symptoms.

How to treat

For children in allergic cough, antibiotics and antitussive drugs are not effective, but antiasthmatic drugs and antiallergic drugs can relieve cough. Ketoconazole and salbutamol should be selected for treatment. After drug treatment, cough usually disappears within 2~5 days, and some children disappear completely after two weeks to a month or more after taking the drug. The child's long-term cough has damaged the mucosa of the respiratory tract, and the repair of the damaged mucosa needs a process. It takes a long time for children to take drugs to relieve bronchospasm and antiallergic drugs before the drugs can work.

In addition, according to the global standardized treatment plan for asthma formulated by the World Health Organization, the treatment should be gradual and graded according to the severity of symptoms. At the same time, it is advocated to use inhaled hormones, dilate bronchi, take anti-inflammatory and desensitizing drugs for combined treatment. Specific practices include:

1. When the seasons alternate and the temperature changes suddenly, parents should try to keep their children warm and cold to avoid catching a cold.

2. Avoid eating foods that can cause allergic symptoms, such as seafood, cold drinks and carbonated drinks.

3. Don't keep pets and flowers at home, don't lay carpets, and avoid children's contact with pollen, dust mites, lampblack and paint.

4. Don't let children fall asleep with plush toys.

5, in the bathroom or basement, dehumidifier and air filter should be used, and the filter should be replaced regularly.

6, bedding should be dried often.

Allergic cough traditional Chinese medicine prescription

Children in allergic cough often have paroxysmal and irritating dry cough at night, and there are no obvious signs of upper respiratory tract infection and fever in advance. Traditional Chinese medicine believes that it belongs to lung qi deficiency, and the treatment advocates "treating the symptoms if it is urgent, and consolidating the foundation if it is slow".

Prescription for palliative care:

? Ephedra, Orange, Glycyrrhiza and Perilla each 5g, Almond, Mulberry, Poria, Farfara and Zi Yuan each 6g, and Belamcanda each 4g.

Usage:

Decoct with clear water twice a day, depending on the degree of relief.

Combined prescription:

6 grams each of Radix Astragali, Radix Codonopsis, Radix Rehmanniae Preparata, Atractylodis Rhizoma and Poria, 5 grams each of Cortex Mori, Fructus Schisandrae Chinensis, Flos Farfarae and Zi Yuan, and 3 grams of Radix Glycyrrhizae Preparata.

Usage: decoct with clear water, daily 1 post, for 4 weeks.

causal treatment

Allergic cough is a polygenic autosomal dominant genetic disease, and its pathogenesis is based on atopy, that is, allergic children. It is found that Th2 is the main response to allergens in fetus and plays an important role in avoiding immune rejection between mother and baby. The type of immune response to allergens after birth determines whether allergic diseases occur: healthy children tolerate allergens to avoid Th2 reactions, while children who cause allergic symptoms such as allergic cough's disease, asthma, rhinitis, eczema, atopic dermatitis, urticaria, food allergy and drug allergy can be sensitized to allergens and induce an overactive Th2 reaction.

Secondly, under the immune response dominated by Th2 immune response, such as contact with allergens, high levels of allergen antibody IgE are more likely to be produced in the body, which is the most important susceptible factor in allergic cough and the etiological source of repeated allergic cough. Some parents will say that children are never allergic when they are young, but they are easily diagnosed as allergic cough when they go to kindergarten. In fact, this Th2-based immune atopic constitution usually takes a period of sensitization to show up, so most cases in allergic cough appear gradually after birth 1 year-old or school-age children, and some even become ill in adulthood.

At present, the specific mechanisms of allergen tolerance in normal children and lack of tolerance in allergic cough children are not clear. Recent studies show that children's immune tolerance to allergens is mediated by the secretion of IL- 10 and IFN secretion to regulate T cells and induce Th 1 immune response. So as to enhance the immune defense function of children with allergic cough and improve their environmental adaptability.

Allergic cough's treatment

1, Jin Fumin and Five Bacteria were used to stimulate immune cells to produce interferon IFN, IL- 10 and other cytokines, reduce IgE, and make the immune system of TH 1 fully developed.

2. Enhance the intestinal barrier function by adjusting the proportion of flora, reduce the release of inflammatory mediators, and inhibit the excessive activation of TH2 immune cells in peripheral blood.

Allergic cough and allergic asthma have similar etiology. The causes of allergy are numerous and complicated, but they mainly include two aspects, namely, the constitution of allergic cough patients and environmental factors. The constitution of patients includes subjective conditions such as "genetic quality", immune state, mental and psychological state, endocrine and health status, which is an important factor for patients to suffer from allergic cough. Environmental factors, including allergens, irritating gases, virus infection, living area, room conditions, occupational factors, climate, drugs, exercise (hyperventilation), food and food additives, eating habits, social factors and even economic conditions, may be the more important reasons for allergic cough. The rising trend of incidence in allergic cough is also related to the susceptibility and environmental factors caused by patients' allergic constitution. [2]

Oxygen brings health.

In 400 AD, Hippocrates, an ancient Greek medical sage, said, "The instinct of a patient is his doctor, and the best doctor for a patient is himself." He emphasized the strength of the human body itself. Modern medical research shows that the human body has a self-healing system mainly composed of immune system, nervous system and endocrine system. It is this natural self-healing power that human life can survive and multiply in the ever-changing nature. When this natural self-healing power of the human body declines, diseases and aging appear, so increasing the natural self-healing power of the human body is the key to repairing diseases. Negative ions can enhance the self-healing ability of human body. Clinical experiments have proved that negative oxygen ions can increase people's vital capacity by entering the human body through the respiratory tract. After testing, inhaling air negative oxygen ions in the glass mask for 30 minutes can increase the amount of oxygen absorbed by the lungs by 20%, while the amount of carbon dioxide discharged can increase by 14.5%. Therefore, negative oxygen ions can improve and increase lung function, and have a significant auxiliary treatment effect on respiratory and bronchial diseases.

By increasing the concentration of negative oxygen ions in the room, various bacteria, viruses and harmful gases can be effectively removed. Scientific experiments have proved that when the concentration of negative ions in indoor air reaches about 20,000 per cubic centimeter, the suspended particles in the air will be reduced by more than 98%. It has an excellent effect on ultrafine particles below PM2. 5 and fine particles that can enter the lungs, and the infectious sources of diseases such as bacterial viruses and dust mites in the air are almost zero. [3] ?

food therapy

Radish honey drink (used to treat cough-suitable for long-term treatment)

Ingredients: 5 pieces of white radish, 3 pieces of ginger, 3 pieces of jujube and 30 grams of honey.

Production method: Boil radish, ginger and jujube in water for about 30 minutes, remove residues, add honey and cook again. Heat it. 1 ~ twice a day.

Indications: Radish is pungent, sweet and cool, and has the functions of clearing away heat and promoting fluid production, cooling blood to stop bleeding, resolving phlegm and relieving cough. Its alcohol extract has a strong antibacterial effect on Gram-positive bacteria. Ginger is a commonly used medicine for expelling wind and cold, stopping vomiting and lowering qi, and jujube is often used as a medicine for regulating stomach, nourishing blood and harmonizing. Honey moistens dryness and relieves cough. This beverage has the functions of respecting cold, dispersing lung, expelling wind and relieving cough. [ 1]

Catalogue of western medicines

1, anti-inflammatory drugs:

① Ned of glucocorticoid prednisone

② Anti-leukotrienes, zafirlukast and zileuton.

③ Inflammatory mediators, cromoglycine and ketotifen.

④ Inflammatory mediators antagonists and fexofenadine

2, bronchodilator:

①β2 receptor agonist, terbutaline and salmeterol.

② xanthine and aminophylline

③ Anticholinergic drugs and ipratropium.

3. At present, the most commonly used commodity names are as follows:

? Shunerning, Pumick, Ai Chang, Merrill Lynch, Thikra, Hisumi, Kairuitan, Shu Chuanling, finnigan, Mu Shutan, etc.

Catalogue of traditional Chinese medicine

Treatment principles: clearing away heat and toxic materials, invigorating spleen and eliminating dampness, tonifying kidney and absorbing qi, relieving cough and resolving phlegm, etc.

Xiaoer Stemona cough syrup, Chuanbei loquat syrup, Chuanbei Sydney paste, Xiaoqinglong mixture, Xiaokechuan syrup, Xiaoer Kechuan granule, Xiaoqinglong granule, Guben Kechuan tablet, etc.

Allergic cough, a child, used cough medicine with caution.

Physiologically speaking, cough is a protective reflex, which can clean the respiratory tract and make it unobstructed. As long as the sputum is discharged, the cough will often relieve itself. And cough medicine can stop cough because it can act on cough reflex. However, due to the immature respiratory system of children, the reflex ability to cough is poor, the bronchial cavity is narrow, the blood vessels are rich, the cilia are not moving smoothly, and the sputum is not easy to be discharged. If you take too many cough medicines such as Kebiqing, Combefen and Schisandra chinensis, it is easy to cause a lot of sputum to stay in the respiratory tract, causing tracheal obstruction, chest tightness, dyspnea, rapid pulse, etc., and even secondary bacterial infection.

Treatment of allergic cough in children.

Allergic cough is a serious allergic disease in children, which is prone to bronchitis, pneumonia and other diseases. Eighty percent of children get sick before the age of five, and the best treatment is between the ages of five and seven. As long as the correct desensitization treatment is taken, the condition of most children can be controlled, the allergic constitution can be improved, and the goal of radical cure can be achieved.

Abuse of antibiotics and hormones should be avoided in the treatment of children with allergic cough. We can find out the allergen by finding the allergen and carry out desensitization treatment. Anti-allergic drugs such as chlorpheniramine and ketotifen can also be used as bronchodilators such as salbutamol and aminophylline. Parents should be fully aware of their children's allergic cough and avoid giving their babies adverse reactions such as excessive abuse of cold medicine. desensitization treatment

Desensitization therapy is most suitable for allergic rhinitis or allergic asthma caused by inhaled allergens. Because inhaled allergens are scattered everywhere, it is difficult to avoid them, so desensitization treatment is an important measure to prevent the recurrence of asthma. Among them, desensitization therapy is divided into three ways: desensitization needle, sublingual administration and desensitization patch.

1. Sublingual desensitization therapy

In 200 1 year, who published a white paper saying that sublingual desensitization therapy can completely replace the traditional subcutaneous injection therapy. Sublingual desensitization therapy is currently only for patients who are allergic to dermatophagoides farinae and house dust mites. This method is safe to use and should improve the compliance of patients. The use method is: different maintenance doses are used according to different ages. Take 1-3 minutes under the tongue at a relatively fixed time every day, which is convenient to use. Doses in the incremental phase are divided into 1, 2 and 3. Maintenance doses are divided into No.4 and No.5 .. General/kloc-No.4 maintenance under 0/4 years old,/kloc-No.5 maintenance over 0/4 years old.

2. Desensitization sticker

? "Injection desensitization" used in hospitals is a method of making allergens into a certain concentration of leaching solution, and by gradually increasing the dose and concentration, repeatedly injecting patients with artificially prepared specific antigens, so that patients gradually develop tolerance to antigens without allergic reactions. Nano-desensitization therapy is based on the principle of "injection desensitization", which changes the route of administration and enters the body through percutaneous penetration. Tio2 _ 2 (titanium dioxide) nanocrystals were added to the dry powder of various allergens and equipped with far infrared cleaners. Under the catalysis of light and far infrared rays, Tio2 _ 2 nanocrystals can effectively decompose the organic matter in allergen dry powder and produce free small molecular antigens. At the same TiO _ 2 (TiO _ 2 nanocrystals can decompose the protein of hair cuticle under photocatalysis, which increases the gap between epithelial tissues and is beneficial to promote the continuous penetration of small molecular antigens into skin and human body to the greatest extent. Under the long-term continuous stimulation of these antigens, the body gradually develops immune tolerance and no longer reacts to allergens, thus achieving the goal of complete desensitization of the body.

harm

It is precisely because of allergic cough's recurrent attacks and incurability that cough can easily cause other diseases, which can spread tracheal diseases to neighboring bronchioles and combine with the whole respiratory tract infection, making the condition worse and presenting symptoms such as sticky phlegm, runny nose, asthma and rhinitis. In addition, persistent severe cough also seriously affects daily rest, affects people's mood, especially consumes physical strength, and can cause the destruction of elastic tissue of alveolar wall and induce chronic respiratory diseases such as emphysema. If the infected bacteria are not removed in time, it will also cause different degrees of damage to the kidney. Therefore, allergic cough's control focuses on prevention, and it is much more difficult to treat severe cases.

On the issue of prevention and treatment in allergic cough, patients generally reported that it might be better to use a large number of antibiotics to eliminate respiratory tract infection at first, but it is easy to produce drug resistance when used too much, and the treatment effect is not obvious. However, treatment with bronchodilators can relieve cough, which is also the basic condition for diagnosis of allergic cough. Clinically, cough variant asthma is often misdiagnosed as bronchitis and recurrent respiratory infections. Some typical cases have been treated with antibiotics according to bacterial infection because of unclear diagnosis, and the application of antibiotics has been escalating because of unsatisfactory treatment, which has affected the physical and mental health of patients and brought economic burden to families. Therefore, it is urgent for many patients to find a safe and thorough treatment for allergic cough.

Disadvantages of traditional therapy

prevent

1. When the outdoor environment temperature drops to 25-26℃, there will be more allergens such as dust mites and molds. At this time, we should pay attention to avoiding allergens;

2. When the seasons alternate and the temperature suddenly changes, parents should try their best to prepare their children for cold and warmth to avoid catching a cold;

3. Avoid eating foods that can cause allergic symptoms, such as seafood;

4, avoid three cold: cold drinks, air conditioners, air conditioners are too cold;

5, avoid the three major: laughing, shouting, crying;

6. Exercise properly. Children should avoid strenuous exercise in dry and cold environment. For example, it is forbidden to engage in continuous strenuous exercise on ice and snow. Warm environment, high humidity or intermittent exercise should be encouraged. When engaging in sports, the principle is not to feel chest tightness, shortness of breath and physical discomfort. When symptoms appear, you should stop exercising and take more rest.