Acute bronchitis in children

　　The pathogens are viruses, mycoplasma pneumoniae, or bacteria, or a combination of these. Among viral infections, influenza, adenovirus, type 3 parainfluenza virus, and respiratory syncytial virus are the most common, with mycoplasma pneumoniae also being relatively common. Any virus that can cause upper respiratory tract infection can become a pathogen of bronchitis. On the basis of viral infection, pathogenic bacteria can cause secondary infection. Common bacteria include Streptococcus pneumoniae, group A beta-hemolytic streptococcus, staphylococcus, and Haemophilus influenzae. Sometimes, Bordetella pertussis, Salmonella, or Corynebacterium diphtheriae may be involved. Malnutrition, rickets, allergies, and chronic rhinitis, pharyngitis, and other conditions can all be predisposing factors for the disease.

　　Children with strong physical health are less likely to have complications, but those with malnutrition, weakened immune function, congenital respiratory tract malformations, chronic nasopharyngitis, rickets, and other conditions are more prone to complications such as pneumonia, otitis media, laryngitis, and sinusitis.

　　Sinusitis, manifested as nasal obstruction: varying degrees of severity, often due to the congestion and swelling of the nasal mucosa and increased secretions. Nasal obstruction can cause temporary olfactory impairment; abundant purulent discharge: nasal discharge is often purulent or mucopurulent, yellow or yellow-green, with varying amounts; headache: chronic suppurative sinusitis generally presents with local pain or headache.

　　The onset of the disease can be acute or chronic, with most patients experiencing upper respiratory tract infection symptoms first, which may suddenly lead to frequent and deep dry coughs. Subsequently, there may be bronchial secretions, with dry and moist rales audible in the chest, mainly of moderate non-pulmonary sounds, occasionally limited to one side. Infants and young children do not cough up phlegm, and most of them swallow it through the throat. Mild symptoms may not show any illness, while severe cases may present with fever of 38-39°C, occasionally reaching 40°C, lasting for 2-3 days before subsiding, accompanied by fatigue, affecting sleep and appetite, and even vomiting, diarrhea, abdominal pain, and other gastrointestinal symptoms. Older children may also complain of headaches and chest pain. Cough generally lasts for 7-10 days, sometimes extending to 2-3 weeks or recurring. Without proper treatment, it can lead to pneumonia. White blood cell count is usually normal or slightly low, and an elevated count may indicate secondary bacterial infection.

　　First, nursing

　　1, Pay attention to rest, drink plenty of water, avoid greasy foods.

　　2, Pay attention to bed rest when feverish, choose physical or drug-induced cooling (refer to the care for acute upper respiratory tract infection).

　　3, Keep the indoor air fresh, appropriate ventilation and air exchange, but avoid drafts to prevent the child from catching a cold again.

　　4, It is necessary to frequently assist the child in changing positions, gently pat the back to facilitate the excretion of sputum.

　　Second, prevention

　　1, Strengthen physical exercise, enhance the ability to resist diseases.

　　2, Pay attention to the regulation of cold and dampness, prevent catching a cold, especially in autumn and winter, and pay special attention to keeping the chest warm.

　　3, For those with recurrent episodes, drug prevention can be considered, such as taking Astragalus 6-9 grams per day for 2-3 months, or vaccination can be used to prevent recurrence.

　　1, Chest X-ray examination

　　Lung markings are thickened or normal, occasionally with increased pulmonary hilum shadow.

　　2, Blood biochemistry examination

　　The total number of peripheral blood leukocytes is normal or slightly low, and it increases when caused by bacteria or complicated with bacterial infection, with an increase in neutrophils.

　　1, Malt sugar 60g, tofu 500g, one cup of fresh radish juice, mix and boil, take in two doses, once every other day. It can cool and nourish, strengthen the spleen and digestion, resolve phlegm and calm asthma.

　　2, Tangerine cake 30g, chopped garlic 1.5g, decoct and take internally. It can strengthen the spleen and resolve phlegm, warm the lung and dispel cold, relieve cough and phlegm.

　　3, Vinegar 50ml, sesame oil 20ml, one egg, fry the egg with oil and then stew with vinegar, eat the egg and drink the soup, once in the morning and once in the evening, which can nourish the lung, relieve cough and phlegm, moisten intestines and relieve constipation.

　　First, general treatment

　　For details on rest, diet, adjustment of indoor temperature and humidity, etc., please refer to 'Upper Respiratory Tract Infection'. Infants should frequently change their lying positions to facilitate the excretion of respiratory secretions. When frequent coughing hinders rest, cough suppressants can be administered, but excessive medication should be avoided to prevent inhibition of sputum excretion. When acute bronchitis causes spasm leading to respiratory distress, mild cases can refer to the following traditional Chinese medicine treatment for 'real heat asthma', and severe cases can refer to the treatment for bronchiolitis and bronchial asthma.

　　Second, traditional Chinese medicine treatment

　　This disease is known as exterior syndrome cough in traditional Chinese medicine. Due to different pathogenic factors, it is clinically divided into wind-cold cough, wind-heat cough, and real heat asthma. The treatment method mainly focuses on dispelling wind and cold, clearing heat and promoting lung function, and lowering heat and calming asthma. Clinical differentiation and treatment can be combined.

　　1. Wind-cold cough

　　It is mainly characterized by sudden cough, acute and frequent coughing sound, thin sputum, nasal congestion, clear nasal discharge, sore throat, or accompanied by headache, aversion to cold, or no fever, thin white tongue coating, floating pulse. Treatment is to relieve exterior syndrome with acrid and warm herbs, and to disperse cold and relieve cough. Commonly used Xingsu Powder with modifications.

　　2. Wind-heat cough

　　Cough is not smooth, phlegm is mainly yellow and sticky, throat red and dry, nasal congestion with yellow discharge, or accompanied by fever and sweating, thin yellowish-white tongue coating, floating rapid pulse. Treatment is to relieve exterior syndrome with acrid and cool herbs, and to resolve phlegm and relieve cough. Commonly used Sangju Decoction with modifications.

　　3. Real heat asthma

　　In addition to the above symptoms, the child has a high fever and is accompanied by shortness of breath. Treatment is to resolve phlegm and asthma, and to reduce asthma. Commonly used Mahuang Shigao Decoction with modifications.

　　Third, other treatments

　　Sometimes, a moderate amount of ipecac syrup is needed, 2-15 drops per dose for infants and young children, 1-2ml per dose for older children, 4-6 times a day, which can make phlegm easier to cough up. 10% ammonium chloride solution also has the same effect, with a dose of 0.1-0.2ml/kg per dose. Appropriate antibacterial drugs can be selected in case of concurrent bacterial infection. In addition, for persistent bronchitis, ultra-short wave or ultraviolet radiation can be added.

　　1. 500g of tofu, 60g of malt sugar, 1 cup of fresh radish juice, mix and boil, take 2 doses in two servings. It can cool and nourish, invigorate the spleen and digest food, resolve phlegm and asthma. It is used to treat bronchitis.

　　2. 400g of olives, 500-1000g of radish, decoct the soup and drink it as tea. It can invigorate the spleen and digest food, relieve cough and phlegm, promote Qi and diuresis, and clear heat and detoxify. It is used to treat bronchitis.

　　3. 20ml of sesame oil, 50ml of vinegar, 1 egg, stir-fry the egg with oil and then simmer with vinegar, eat the egg and drink the soup, once in the morning and once in the evening, it can nourish the lung, relieve cough and phlegm, moisten the intestines and defecate, and eliminate toxins. It is used to treat bronchitis.

　　4. 2g of tea leaves and dried tangerine peel, 30g of brown sugar, soaked in boiling water for 6 minutes, take 1 dose after lunch. It can relieve cough and phlegm, invigorate the spleen and open the stomach, and is used to treat bronchitis cough.

　　5. Green tea (such as Longjing tea) 15g, 2 eggs. Clean the eggshells and boil them with the tea in a pot, add 2 bowls of water, and cook until the eggs are cooked, peel them and cook again. Eat the eggs when the water is boiled dry. It can relieve cough and asthma. It is used to treat bronchitis cough.