Pulmonary interstitial fibrosis

　　Diffuse pulmonary interstitial fibrosis is an inflammatory disease of pulmonary interstitium caused by various reasons, the lesion mainly involves pulmonary interstitium, can also involve alveolar epithelial cells and pulmonary blood vessels. The etiology is clear in some cases, and unclear in others.

　　1. Environmental factors: inhalation of inorganic dust such as asbestos, coal; organic dust such as mold dust, cotton dust; as well as smoke dust, sulfur dioxide and other toxic gases.

　　2. Repeated infections caused by viruses, bacteria, fungi, parasites, etc., are often the trigger for the acute onset of this disease and also a condition for the aggravation of the disease.

　　3. Drug effects and radiation injury.

　　4. Secondary to systemic lupus erythematosus and other autoimmune diseases.

　　In severe cases, pulmonary interstitial fibrosis can develop into right ventricular failure; in the late stage, honeycomb lung will appear; most of pulmonary interstitial fibrosis has no mediastinal and hilar lymph node enlargement, pleura is not invaded, but often due to lung bulla rupture, pneumothorax occurs; pulmonary interstitial fibrosis is mostly caused by viruses and will form necrotizing bronchitis and bronchopneumonia, the course is prolonged and easy to evolve into chronic pneumonia, if the inflammation continues to develop, lung abscess, empyema and other diseases may occur.

　　About 15% of IPF cases have an acute course, often discovered due to upper respiratory tract infection, with progressive worsening of dyspnea, and more than 6 months die of respiratory and circulatory failure. The vast majority of IPF are chronic type (there may also be subacute type between), although called chronic, the average survival time is only 3.2 years. The chronic type does not seem to evolve from the acute type, and the exact relationship is not yet understood.

　　First, main symptoms

　　1. Dyspnea of labor: Dyspnea of labor and progressive worsening, shallow and rapid breathing, with possible flaring of the nostrils and participation of accessory muscles in breathing, but most do not have orthopnea.

　　2. Cough and sputum: Early cough is absent, and later there may be dry cough or a small amount of mucous sputum. Secondary infection is easy to occur, and purulent sputum or sputum may appear, and blood sputum may occasionally occur.

　　3. General symptoms may include weight loss, fatigue, loss of appetite, joint pain, etc., which are generally rare. Acute type may have fever.

　　Second, common signs

　　1. Dyspnea and cyanosis.

　　2. Chest expansion and reduced diaphragmatic mobility.

　　3. Velcro sounds in the middle and lower lungs, with certain characteristics.

　　4. Clubbing of fingers and toes.

　　5. Corresponding signs of terminal respiratory failure and right heart failure.

　　Pulmonary interstitial fibrosis how to prevent

　　1. Pay attention to avoiding cold and keeping warm to prevent catching a cold.

　　2. Avoid contact with foreign bodies that are known to be the cause of the disease.

　　3. Pay attention to dietary nutrition.

　　Pulmonary interstitial fibrosis requires which laboratory tests to be done

　　1. Progressive dyspnea, dry cough, lung moist rales or crepitations.2. X-ray examination:

　　Early stage presents as a ground-glass appearance, and the typical changes are diffuse linear, nodular, fluffy, reticular shadows, and reduction in lung volume.3. Laboratory tests:

　　4. Pulmonary function tests: visible ESR, LDH increased, generally without special significance.Visible reduction in lung volume, decreased diffusion function, and hypoxemia.

　　5. Lung tissue biopsy:Provide pathological evidence.

　　1. Provide a diet rich in high-quality protein, various vitamins, and a high proportion of carbohydrates (carbonated drinks excluded). For example: eggs, brown rice, corn flour, buckwheat flour, fruits, and vegetables, etc.

　　2. Eat less spicy, fried, and other irritant greasy foods.

　　3. Severe pulmonary fibrosis patients can be given soft or semi-liquid food.

　　4. Drink plenty of water. Patients with heart failure should drink in moderation.

　　5. Avoid eating foods that are known to cause allergies and trigger asthma.

　　6. Avoid smoking, drinking, and excessive salt in food.

　　7. Choose food according to your daily physical condition: Pulmonary fibrosis patients should not only pay attention to the influence of the four properties (cold, hot, warm, cool) of food on the disease, but also master the four properties of food, choose food, arrange the diet properly, avoid eating food that is not suitable for the body, and trigger or exacerbate the occurrence of the disease. Specific situations should follow the doctor's advice.

　　Treating pulmonary interstitial fibrosis is like treating other difficult diseases, which is a project. Treatment goals: strive to reverse parts and time, control the progression of the disease, improve symptoms, and improve the quality of life. The most common clinical cases are alveolitis and pulmonary interstitial fibrosis related to autoimmune diseases. They can appear before or several years after the onset of autoimmune disease. In the early stage, they are often treated as lung infections.

　　It is noteworthy that when diagnosed with pulmonary interstitial fibrosis, people often doubt its reversibility and tend to give up treatment efforts. In fact, most cases in the early stage are characterized by coexistence of alveolitis and partial fibrosis, and the alveolitis is completely reversible. The repair process of the alveoli attacked by inflammation is the process of absorption and fibrosis, and whether the normal lung tissue can be restored or fibrosis depends on whether the necrotic tissue fragments can be completely absorbed. If not, they will be replaced by fibrous tissue. Therefore, when lung damage occurs, it is necessary to start standardized treatment as soon as possible to avoid the occurrence of more irreversible fibrotic tissue, which may cause damage to lung function. This is equally important for both doctors and patients.

　　First, Western medicine treatment

　　1. Hormonal therapy:Prednisone 30-40 mg, taken orally 2-3 times a day, gradually reduced to maintenance dose, 5-10 mg, once a day.

　　2. Treatment of complications:Antibacterial treatment, select antibiotics according to the pathogen.

　　3. Bronchodilators:Aminophylline,舒喘灵 et al.

　　4. Oxygen therapy:Applicable to advanced patients.

　　Second, traditional Chinese medicine treatment

　　1. Deficiency of lung Qi:Low voice cough and asthma, prone to fatigue, spontaneous sweating and aversion to wind, prone to colds, pale tongue with white coating, thin and weak pulse. Treatment: Tonify lung Qi, relieve cough and asthma. Prescription: Raw astragalus 30g, raw baizhu, apricot kernel, artemisia, fritillaria, earthworm each 10g, Fang Feng 6g, Tai Zi Ren 15g, Mahuang 6g, raw gancao 6g. Patent medicine: Yu Ping Feng Keli.

　　2. Deficiency of both Qi and Yin, phlegm and blood stasis in the lung:Dry cough without phlegm or with little phlegm, shortness of breath, worse with exertion, fatigue, dry mouth and throat, feverish sensation in the five interiors, sore loins and weak knees, pale red tongue with thin white coating or little coating, thin and slippery or weak pulse. Treatment: Nourish the lung and kidney, resolve phlegm and activate blood. Prescription: Tai Zi Ren, prepared rehmannia, schisandra chinensis, Chinese yam, poria each 15g,麦冬 30g, Wu Wei Zi 10g, danpi 10g, alisma 10g, raw astragalus 30g, lily 30g, walnut meat 15g, salvia miltiorrhiza 30g, artemisia 10g, Sichuan be powder 6g (take with water). Patent medicine: Sheng Mai Yin oral liquid, Liu Wei Di Huang Wan.

　　3. Yang deficiency of the spleen and kidney, blood stasis inside:Cough and asthma with weakness, worse with exertion, shortness of breath, edema of the lower limbs, feeling cold and pale complexion, lips purple, thin and pale tongue coating, deep and fine pulse. Treatment: Invigorate the spleen and warm the kidney, resolve phlegm and activate blood. Prescription: Prepared aconite 10g, cassia bark 5g, prepared rehmannia 15g, schisandra chinensis 15g, Chinese yam 15g, poria 15g, danpi 10g, alisma 0g, raw astragalus 30g, salvia miltiorrhiza 30g, artemisia 10g, apricot kernel 10g, earthworm 10g, epimedium 10g. Patent medicine: Ren Shen Jian Pi Wan, Jin Gui Shen Qi Wan.