The cough diagnosis and treatment guide _49138 by heku

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									?Coughing, rhinitis, exudate, respiratory




?The cough diagnosis and treatment
guide

?

Chronic cough medicine clinic in common, misdiagnosis and widespread.
Chinese society of respiratory disease chapters organize national
asthma study group has developed a national experts concerned the
cough diagnosis and treatment guidelines (draft), to strengthen and
standardize the internal cough diagnosis and treatment. The cough
diagnosis and treatment guide at this meeting the official release,
this is the traditional first cough Guide. The scope of the General
Hospital of gastroesophageal reflux disease center Zhang Pu Desai

    Etiology

Endobronchial tuberculosis in the Western world very rare, but it is
not uncommon in China, often manifested clinically chronic cough.
Europe and the United States and Japan are coughing guide
endobronchial tuberculosis is not involved, taking into account the
actual situation of China, guide clearly endobronchial tuberculosis
causes include chronic cough. Eosinophilic bronchitis (EB) is the
major cause of chronic cough, induced sputum cytology is a key method
of diagnosis, EB guide has induced sputum examination into chronic
cough Diagnostics routine examination.

We have 194 patients with chronic cough patients etiology of survey,
the etiology of chronic cough in China and abroad. In addition to the
postnasal drip syndrome (rhinitis, sinusitis/17%), cough variant
asthma (CVA, 14%) and gastro-esophageal reflux cough (GERC, 12%), EB
is also an important cause of chronic cough, and is the first cause
(22%), and both to Europe and the United States reports vary.

Professor Fujimura, Japan's first chronic cough due to asthma (43.6%),
followed by allergic cough 35.8%, the third is sinus bronchial
syndromes (25.5%), while the prevalence of GERC only 2.4%,
significantly lower than China and Europe, the prevalence of chronic
cough, hint causes exist areas or racial differences.

    Pathogenesis

Fujimura, study shows, CVA patients after treatment with inhaled
corticosteroid, airway hyperresponsiveness has dropped dramatically,
and there was no apparent change in cough sensitivity, prompting the
cough hypersensitivity is not the basic features of asthma.

My research shows that EB and CVA patients also exists eosinophils
inflammation, but inflammation characteristics there are many
differences. EB's centre of Eosinophilic inflammation and airway,
bronchial propria eosinophils, mast cell infiltration and submucosal
basement membrane thickness are significantly smaller than the CVA,
bronchoalveolar lavage (BALF) Eosinophilic rare, induced sputum
inflammatory mediators leukotriene C4, eosinophil cationic protein,
BALF histamine levels are below the CVA.

I am on 24 hour esophageal pH monitoring results showed that patients
with GERC to remote (low) reflux, prompting the reflux of stimulation
of the throat or mistreatment of a suction-line cannot interpret GERC
pathogenesis. Animal experiments showed that acid reflux can cause
irritation of the airway neurogenic inflammation, neuropeptide
release and plasma diffusion increases, this may be an important GERC
pathogenesis.



Keywords:
?Coughing, rhinitis, exudate, respiratory

								
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