Middle lobe syndrome

　　1. Etiology

　　The causes of this syndrome are roughly: non-specific inflammation or tuberculous lymphadenopathy compression, distal obstruction caused by bronchiectasis, obstruction by mucus, pus plug, or foreign body, bronchial mucosal tuberculosis or non-specific inflammation leading to luminal stenosis or obstruction, obstruction of the middle lobe bronchus by bronchial cancer or benign tumor, and enlargement of primary or metastatic lymphoma compressing the bronchus.

　　2. Pathogenesis

　　Middle lobe syndrome, also known as Brock syndrome or Graham-Burford-Mayer syndrome, refers to the condition caused by compression and obstruction of the bronchus by enlarged lymph nodes outside the bronchus.

　　Complications such as pneumonia can occur with middle lobe syndrome.

　　1. It refers to the inflammation of the terminal airways, alveoli, and pulmonary interstitium, which can be caused by disease microorganisms, physical and chemical factors, immune injury, allergy, and drugs. Bacterial pneumonia is the most common type of pneumonia and one of the most common infectious diseases. Pneumonia is caused by various pathogenic bacteria and is characterized by pulmonary congestion, edema, inflammatory cell infiltration, and exudative lesions. It is common in clinical practice and can occur in any population, with main clinical manifestations including fever, cough, expectoration, dyspnea, and shadowing of inflammatory infiltration visible on chest X-rays.

　　2, It refers to lung parenchymal inflammation including terminal airways, alveolar cavities, and interstitial lung tissue. The most common cause is infection, but it can also be caused by physical and chemical factors, immunological factors, and drugs.

　　There may be recurrent coughing, expectoration, sometimes accompanied by hemoptysis or fever, and wet rales can be heard in the lungs.

　　Rales are additional sounds to the respiratory sounds, caused by partial obstruction of the tracheobronchial lumen and other lesions; depending on the nature of the sound, they can be classified into dry rales and wet rales. Dry rales are generally divided into snoring and whistle sounds; wet rales have coarse, medium, and fine sounds, and the nature of crackles and fine wet rales are very similar.

　　Actively treat the primary disease, prevent complications, and follow a reasonable diet according to the doctor's advice. The diet should be light, with an emphasis on vegetables and fruits, a reasonable diet balance, and sufficient nutrition.

　　1, Regular follow-up

　　If there are no clinical symptoms, regular follow-up can be done for a period of time. If symptoms occur, antibiotics can be used to control secondary infections.

　　2, Anti-tuberculosis drug treatment and stent placement

　　For those with active bronchial lymph node tuberculosis caused by compression, early treatment with anti-tuberculosis drugs should be considered. The treatment of middle lobe syndrome can make the lymph nodes shrink and has the possibility of lung reexpansion. For those with severe bronchial stenosis where drug treatment is ineffective, consideration can be given to the placement of a bronchial stent.

　　3, Surgical treatment

　　In cases with recurrent infection and hemoptysis, and when there is damage to the lung substance, consideration should be given to surgical resection of the middle lobe syndrome. For those diagnosed with bronchogenic carcinoma, radical surgery should be performed, followed by adjuvant chemotherapy.

　　4, Fiberoptic bronchoscopy

　　Removing foreign bodies through fiberoptic bronchoscopy, sputum examination, and blood clot, can make the lung reexpand.

　　There may be an increase in white blood cells, mainly neutrophils, an accelerated erythrocyte sedimentation rate, and according to the cause, tubercle bacilli and tumor cells may be found in sputum.

　　1, Chest X-ray examination:Visible triangular, uniform shadows with the tip pointing towards the hilum, the diaphragm raised in front, and the volume of the middle lobe reduced.

　　2, Bronchoscopy:Visible stenosis of the middle lobe bronchus, congestion, inflammatory edema, pus, mucus plug, and granuloma, etc.

　　3, Chest CT examination:Pulmonary hilar lymph nodes and bronchial stenosis, tumor obstruction, and other conditions can be found.

　　What foods are good for the middle lobe syndrome patient: it is advisable to have light, eat more vegetables and fruits, properly balance the diet, and ensure sufficient nutrition.

　　Eat more foods that are beneficial for the lungs, such as:

　　1, Pear:It has the effects of clearing heat and detoxifying, moistening the lungs and producing saliva, and relieving cough and expectoration. It can be eaten raw, juiced, cooked, or made into a paste. It has a good therapeutic effect on lung heat cough, measles, elderly cough, bronchitis, and other conditions. If taken with juice of water chestnuts, honey, sugarcane, and other ingredients, the effect is even better.

　　2, Grapes:It has the effects of replenishing the liver and kidney, benefiting the Qi and blood, promoting the production of saliva, and benefiting urination. Eating raw can nourish the Yin and relieve restlessness. Boiling the juice with honey into a paste and taking it with hot water is particularly effective for restlessness and thirst.

　　3. Pomegranate:It has the effects of generating fluid and stopping thirst. It can be used for those with insufficient fluid, dry mouth and throat. Grind pomegranate juice or decoct it for drinking, which can clear heat and detoxify, and moisten the lungs and relieve cough.

　　4. Citrus fruits:It has the effects of generating fluid and relieving cough, moistening the lungs and stopping sputum, awakening drunkenness, and diuresis, which is suitable for people with weak bodies, insufficient fluid and thirst after febrile diseases, and those with alcohol-induced thirst. Jucing or honey frying can be used to treat lung heat cough especially well.

　　5. Sugarcane:The juice of sugarcane is mild and sweet, and is a good product for clearing heat, generating fluid, moisturizing and nourishing. It can help the spleen and harmonize the middle, resolve phlegm and suppress cough, treat dysphagia and relieve cough, and is known as the 'Heavenly Reviving Pulse Soup'. It can be used to treat symptoms such as dry mouth and throat, insufficient fluid, dry stools, high fever and thirst, etc.

　　6. Persimmon:It has the effects of moistening the lungs and relieving cough, clearing heat and generating fluid, resolving phlegm and softening hardness. Fresh persimmon raw can treat symptoms such as phthisis cough, consumptive fever, copious sputum, emaciation and hemoptysis, etc. Red and soft ripe persimmons can treat symptoms such as thirst caused by febrile diseases, dry mouth and chapped lips, restlessness in the heart, etc.

　　7. Lily:It can moisten the lungs and relieve cough, calm the mind and detoxify, and has a good therapeutic effect on tuberculosis, bronchitis, bronchiectasis and various autumn dryness symptoms. Cooked or decocted, it can treat symptoms such as chronic cough, dry cough, sore throat, etc.

　　8. Radish:It can clear heat and resolve phlegm, generate fluid and relieve cough, benefit the stomach and promote digestion. Raw food can treat symptoms such as thirst caused by febrile diseases, lung heat cough, thick sputum, etc. If it is mixed with juice from sugarcane, pear, lotus root, etc., the effect is even better.

　　9. Water chestnut:It has the effects of clearing heat and generating fluid, transforming dampness and removing phlegm, cooling blood and detoxifying, which can treat symptoms such as injury of fluid in febrile diseases, dry mouth and throat, lung heat cough, thick yellow sputum, etc. Drinking with lotus root juice is even better. 10 Silver ear can moisten the lungs and resolve phlegm, nourish yin and generate fluid, can be used in dishes or cooked and eaten, can treat symptoms such as yin deficiency and lung dryness, dry cough without sputum or thick and sticky sputum, dry throat and thirst, etc. The efficacy of eating with lily is especially good.

　　1. Treatment

　　Targeted treatment based on different etiologies, tumors caused by tumors should be surgically removed early. If it is tuberculosis or inflammation, anti-tuberculosis or anti-infection treatment should be given. Through fiberoptic bronchoscopy lavage, the obstruction caused by mucus and pus plugs can be relieved and the therapeutic effect can be achieved.

　　2. Prognosis

　　Targeted treatment based on different etiologies, such as inflammation and tuberculosis, should be treated with anti-inflammatory or anti-tuberculosis therapy, and the prognosis is generally good. Tumors should be surgically removed early, and the prognosis is generally poor.