What Is a Wheezing Cough?

Asthmatic bronchitis is a clinical syndrome that refers generally to a group of infants with acute bronchitis with wheezing. Lung parenchyma is rarely affected. Some sick children can develop bronchial asthma.

Basic Information

Causes of asthmatic bronchitis

Infection factor

A variety of viral and bacterial infections can cause it. The more common are syncytial virus, parainfluenza virus, influenza virus, adenovirus, rhinovirus, and mycoplasma pneumoniae. Some cases can be complicated by bacterial infection based on viral infection.

2. Anatomical characteristics

The trachea and bronchi of infants are relatively narrow, the elastic fibers around them are not fully developed, the mucous membrane is susceptible to infection or other stimuli and the blood vessels are constricted due to swelling and congestion.

3. Allergic physical factors

Patients tend to have allergic constitution, that is, children or relatives have eczema, food or drug allergies, allergic rhinitis, urticaria, asthma and other allergic diseases.

Clinical manifestations of asthmatic bronchitis

1. Younger onset, more common in children 1 to 3 years old.

2. Often secondary to upper respiratory tract infections. Most have low to moderate fever. The exhalation time was prolonged, accompanied by wheezing and rough wet snoring, and there was no obvious seizure of wheezing.

3. After treatment, the symptoms are reduced on the 5th to 7th days.

4. Some cases may have recurrence, mostly caused by reinfection.

5. The prognosis is good. Some cases can develop bronchial asthma. High-risk factors include a history of allergies, high eosinophils, and elevated serum IgE.

Asthmatic bronchitis examination

X-rays show various forms of infiltrates in the lungs, showing a segmental distribution, more common in the lung field below.

Blood routine changes with the source of infection. Viral infections generally reduce the total number of white blood cells and neutrophils, while bacterial infections increase. There was no specific manifestation of blood routine in mycoplasma infection or mixed infection.

If necessary, the corresponding specific antibody detection can be improved. Such as mycoplasma antibodies, specific viral antibodies, etc., are helpful for the rational use of antibiotics, planned medication time and treatment, and prognosis.

Asthmatic bronchitis diagnosis

The 1988 National Pediatric Asthma Conference proposed the diagnostic criteria for scoring infantile asthma (scoring method). The principle of scoring for authors who repeatedly wheeze under the age of 3 years:

1. Infants and young children who suffer from bronchiolitis or wheezing-like bronchitis have recurrent wheezing episodes 3 times, 2 points.

2. Those who have wheezing in the lungs have 2 points.

3. Sudden onset of wheezing symptoms for 1 minute.

4. The child has 1 point of other allergies.

5. One or two relatives have a history of eczema, dermatitis, or asthma.

Those with a total score> 5 points were diagnosed with infantile asthma wheezing episodes, only 2 times or a total score 4 points, the initial diagnosis was asthmatic bronchitis, and follow-up observation continued.

Asthmatic bronchitis treatment

General treatment

Pay attention to rest. Babies must often pat their backs and change their position so that respiratory secretions can be easily discharged. For severe cases, refer to the treatment of bronchiolitis and bronchial asthma.

2. Anti-infective treatment

For empirical use of bacterial infections, penicillin or cephalosporins are generally used, orally or intravenously. When considering mycoplasma infection, macrolide antibiotics are preferred. Viral infections do not require antibiotics. The medication will be adjusted later based on clinical and laboratory inspections.

3. Symptomatic treatment

Use physical cooling and drug cooling to prevent high fever and convulsions during fever; use 2 agonists to aerosolize inhalation, relieve cough and wheezing, and promote sputum; oral cough and phlegm drugs. Severe cases are treated according to the period of bronchial asthma attack.

4. Chinese Medicine Law

TCM is called exogenous cough. Due to different pathogenic factors, it is clinically divided into wind-cold cough, wind-heat cough, and real-heat asthma. The main treatment method is to clear the wind and dispel cold, clear the heat, declare lungs, reduce fever, and asthma. Can be combined with clinical syndrome management.

(1) Wind-cold cough is characterized by sudden cough and frequent rapid coughing, thin sputum, nasal congestion, runny nose, itching or headache, chills or no fever, white fur, and floating pulse. Governance with Xin Wen Jie table, scattered cold and cough. Xingsu San addition and subtraction.

(2) Wind-heat cough , unpleasant coughing, sputum mainly yellow and sticky, red throat, dry nose, yellow nose and stuffy nose, or sweating with fever, yellowish white tongue coating, floating pulse. Governance by Xinliang solution, Xuanfei cough. Common mulberry drink addition and subtraction.

(3) In addition to the symptoms mentioned above, children with high fever and asthma have high fever, accompanied by wheezing. Governance to Xuanfei Huatan, Jiangni asthma. Common Ma Xing Shi Gan Decoction.