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Acute nasopharyngitis

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[Intro]

Overview: acute nasopharyngitis (acute nasopharyngitis) is all nasopharyngeal mucosa, submucosa and lymphoid tissue of acute inflammation, mainly in the pharyngeal tonsils, also known as common cold, referred to as influenza, commonly known as "cold" acute upper respiratory tract infection is the most common types in adults and older children showed more for the prodromal symptoms of upper respiratory tract infection, mostly self-limiting, but the high incidence, affecting a wide range of people, a large amount of economic loss is quite huge, and can cause a variety of complications.

[Cause]

acute nasopharyngitis is what causes it?

(a) causes

pathogens of cold virus, common who have rhinovirus, coronavirus, influenza and parainfluenza virus, rarely included respiratory syncytial virus, adenovirus, enterovirus, reovirus (reovirus), herpes simplex virus and EB virus. mycoplasma pneumoniae, A, C, G group streptococci pathogenic and non-biological factors such as allergic rhinitis, atrophic rhinitis, vasomotor rhinitis, deviated septum, foreign bodies can cause flu-like symptoms, not a real sense of self- the cold.

1. rhinovirus colds in 1956 patients from the isolated, is a small group of rna viruses are, for the non-enveloped single-stranded rna viruses are a group, for the non-enveloped single-stranded rna virus with a diameter of 15 ~ 30nm, ether-resistant, not acid (pH 3 in the solution easily inactivated), in a dry environment to survive for 3 days. according to the serum neutralization test serum has more than 120 strains of diploid cells in culture to set optimal growth temperature of 33 ℃, -70 ℃, when the long-term survival, at 4 ℃ also survive for several weeks, and 56 ℃ 30min that can be inactivated. 30% to 50% of patients with flu viruses from the nose caused by a serotype.

2. coronavirus coronavirus is a group for an enveloped single-stranded rna viruses are sensitive to the ether and acid. Diameter of 80 ~ 150nm, has a unique rod coated tablets (peplomers) protruding from the cyst, the proliferation in the cytoplasm by cytoplasmic budding and mature network. At least three (B814, 229E, and 0C43) can cause respiratory tract infections, including 229E and OC43, children and adults, the cause of upper respiratory tract infections, colds in adults accounted for 15% to 20%, and occasionally can cause pneumonia and epidemic chest pain.

3. adenovirus is no capsule, endoreduplication of double-stranded dna virus with a diameter of 70 ~ 90nm, icosahedral symmetry, -20 ℃ low temperature than and stability. Have been isolated from human serum strain 41, there are more middle line. Clinically manifested as various types of infection.

4. respiratory syncytial virus in 1956, first in the laboratory from the gorilla suffered from respiratory tract infection isolate, is an enveloped single-stranded rna viruses, the diameter of 120 ~ 200nm, is vice mucus lung virus, Virus Unit, only one serotype. The virus is very unstable at room temperature for 2 days, 100-fold reduction in virus at 4 ℃ refrigerator for 4-6 days also reduced 100-fold. Children, the main pathogens of lower respiratory tract infections in adults usually cause mild upper respiratory tract infection, but in the elderly and immunosuppressed patients more than the critical condition.

5. other viruses in the enterovirus Coxsackie virus, ECHO virus, reovirus type 1 to 3, herpes simplex virus type 1 and eb virus Even as the common cold pathogen.

(B) the pathogenesis

rhinovirus colds primarily in patients with nasopharyngeal secretions caused by contact with contaminated sexual transmission (hand - eye, hand - nose), there are also routes of transmission by droplets, which is far less acute nasopharyngitis and influenza important. rhinovirus infection peak in viral replication in the 48h concentration, dissemination phase will last up to three weeks. individual susceptibility and nutritional health status and upper respiratory tract abnormalities (such as swelling of the tonsils), and smoking and other factors. cold itself does not cause colds. Common cold and flu season, due in part to the type of the virus may also lead to the cold room with a family member or the crowd increased and crowded. Symptoms of infection by the host physiological effects of fatigue, depression, allergic disease and nasopharyngeal menstrual period, and so can increase the symptoms.

to rhinovirus, for example, nasal or eye is the portal into the body, the nasopharynx is the initial site of infection. regional lymph adenoid epithelial M cells contain rhinovirus intercellular adhesion molecule-I (ICAM-1) receptor, the virus first adhesion here, and nasal mucociliary activity by the arrival of the nasopharynx. At this time the virus replicated quickly and spread to the nose forward. nasal biopsy and nasal epithelial cells secrete fluid research suggests that inflammatory mediators (bradykinin, prostate gonadotropin), interleukin-1 and -8 secretion, clinical symptoms of influenza may be responsible in part. The role of histamine is not clear, although the intranasal instillation of histamine can cause cold symptoms, but treatment is not certain antihistamines. Parasympathetic blockers relieve cold symptoms and effective, suggesting that reflex mechanisms in the pathogenesis of influenza also have a role. immune response (IgA, interferon) are usually short-lived, with the diversity of viral antigen and drift, so repeated several times in a lifetime infection.

pathological changes in virulence and infection with viruses related to the scope. airway mucosal edema, hyperemia, there exudate (leakage or seepage), but no significant change in cell populations to repair more quickly, generally do not cause tissue damage. Different viruses can cause varying degrees of cell proliferation and degeneration. Destruction of nasal cilia duration of up to 2 to 10 weeks. When severe infection, sinus, eustachian tube and middle ear canal may be blocked, resulting in secondary infection.

[Sign]

What are the early symptoms of acute nasopharyngitis?

one. symptom

incubation period ranging from 1 to 3 days, varies with the virus, enterovirus shortest gland virus and respiratory syncytial virus longer. Sudden onset. Most of the first, nose and throat burning sensation, followed by nasal congestion, sneezing, runny nose, malaise and muscle aches. Symptoms reached a peak at 48h (virus shelling), acute nasopharyngitis usually do not heat or only low heat, especially rhinovirus or coronavirus infection. May have conjunctival hyperemia, tearing, photophobia, swollen eyelids, throat mucosal edema. throat and bronchitis due to the presence or absence and due to virus. nasal discharge initially clear nasal discharge a large number of water samples, or purulent mucus into the future. viscous purulent secretions does not necessarily mean secondary bacterial infection. cough is usually not severe, the duration of up to 2 weeks. purulent sputum or severe lower respiratory tract symptoms suggestive of a virus other than rhinovirus merger or secondary bacterial infection. When the child cold symptoms more severe than in adults, often have lower respiratory symptoms and gastrointestinal symptoms (vomiting, diarrhea, etc.). Colds are mostly self-limiting, without complications, duration of 4 to 10 days.

infant patients, acute onset, often high fever, convulsions, meningeal irritation and abdominal pain, diarrhea, dehydration and other symptoms of systemic poisoning, often misdiagnosed as acute infectious diseases. Therefore, the above symptoms infants and young children, and nasal congestion, runny nose, fever, etc., should take into account the possibility of the disease. Cervical lymph node enlargement and tenderness on the diagnosis.

two. diagnosis

characteristics based on clinical symptoms, upper respiratory tract symptoms and systemic symptoms are relatively mild, and the exclusion of allergy rhinitis, and other non-infectious inflammation of the upper respiratory tract, can make a diagnosis. Because viral culture and serum diagnosis requires a certain equipment, supplies and time-consuming, and in addition to influenza viruses and respiratory syncytial virus, antiviral drugs can be applied effectively, the most specific etiological diagnosis of viral infections of no practical significance.

[Aftertreat]

acute nasopharyngitis ate?

therapeutic side of acute nasopharyngitis (the following information for reference only, details need to consult a doctor)

1, Yin-hua fermented porridge: honeysuckle 9 grams, SSP 9 grams, decoction to the residue, add 60 grams of rice, sugar amount, porridge eating.

2, Yin-hua mint drink: silver flower 30 grams, 10 grams mint, fresh reed rhizome 60 grams. First silver Flower, reed rhizome 500 ml of water, cook for 15 minutes, following the mint boil 3 minutes, filter out the amount of sugar added, warm clothes, served 3-4 times. .

3, light blue drink coriander: coriander 15 grams, very light blue (with root) 3, the two wash, add water, boil and cook for 5 minutes.

4, tofu, tempeh Onion soup: 250 Kocse block of tofu, 12 g semen washed with 15 g light blue section of the two together to release the casserole, add water to boil, switch to simmer for 5 minutes, hot Dayton clothing.

5, lentil flower rugosa drink: lentils took 20 grams of agastache 12 grams, Yin-hua 10 grams of sugar amount. The lentil flower, rugosa, silver flower wash, amount of boiling water, seasoning with sugar Beverage Service.

6, rugosa leaves porridge: fresh rugosa leaves 20 grams, decoction stand. First with 100 grams of rice porridge, boiled join Jianhao rugosa, rugosa Serve porridge, daily doses of 2 times.

7, onions milk drink

light blue 2, milk (or milk) 30 ml. Cut open the light blue wash, with stamped into the cup with milk, the steam cooked onions can be. 3 to 4 times a day, take 2 to 3 days.

8, Jiang Tang drink

ginger 5 grams of brown sugar l0 grams. Will be washed and shredded ginger, into the inner cup to boiling water, cover and soak for 5 minutes, then transferred to brown sugar, should be enough spicy, hot to take. Service cover is to take sweat.

9, light blue fragrant soup

to be onions, parsley root, cabbage head, the amount, Jianshui tea , hot to take take the sweat.

vinegar radish dish

raw carrots 250 grams of rice vinegar amount. The radish slices, Garmisch vinegar hours. When the dish with rice daily. Day one. Xin liang Xie table can, digestion detoxification. ,

10, chrysanthemum ribes

Hangzhou chrysanthemum 30 grams, the amount of sugar. chrysanthemum tea will be placed within the water soak, add sugar.

11, mulberry leaves, mint drink

5 g of mulberry leaves, chrysanthemum, 5 grams, 3 grams mint, bitter bamboo 30 grams.

will be on the medicinal water washed into the pot, the ten minutes with open blisters, ready to drink.

fengreganmao both the goods on the role of Xin liang Xie table, but also as a preventive agent for drinking tea.

12, kudzu fermented porridge

powder Gegen 10 g, semen 10 grams, 3 light blue stem (Wash ), ophiopogon 10 grams, 50 grams of rice.

the powder puerarin, Semen, radix into the casserole, add 500 ml of water, set the fire to boil for about 5 to 10 minutes, filtered residue, in the concoction Add rice, cook the porridge. Cut short the light blue section, will become when placed in ones, mixing Serve, warm clothing.

the porridge in Pueraria, tempeh, light blue relieving Quxie, Radix, rice yin and stomach, there Qufeng gentle, not fierce fever, yin without getting tired characteristics, is fengreganmao diet quality goods.

13, mulberry loquat porridge

mulberry leaves 18 grams, loquat leaf 10 grams sugar 100 grams, raw chine 30 grams, 6 grams mint, stems meter 60 grams.

chopped wash the drugs, the amount of water, boiling juice, into the rice and cook until thick porridge rice flower, hot clothes. Day one, even for 3 days.

mulberry leaves, Chine, mint heat fluid, loquat Su lung cough, sugar cane, rice stalk fluid and stomach, lung and stomach Yun for heat, heat the wind outside influenza patients.

14, sweating SSP 20 g soy porridge, nepeta 6 grams, 6 grams of wind, gardenia 3 grams, 60 grams of gypsum, ginger, 3, 2 light blue stem, 100 grams of rice.

the first after the drug into the casserole Jianfei cook about 5 to 10 minutes, filtered juice to the residue, then add rice, cook the porridge.

acute nasopharyngitis what to eat for good health?

1, plum, hawthorn and other acid foods, can improve loss of appetite.

2, should drink more water.

3, thin soft diet should be light: often due to a cold and stomach function in patients affected by rare soft light food easy to digest and absorb, reduce the burden on the spleen and stomach. So Yi Shi white rice, milk, cornmeal porridge, rice soup, bad side, a bowl of soup, lotus root starch paste, almond powder, paste and other liquid or liquid diet.

4, eat vitamin-rich fruits and vegetables, such as rape, amaranth, spinach, spinach, wild rice, watermelon, melon, sponge gourd, cucumber, tomatoes, lotus root, citrus, apple, apricot, loquat, sugar cane, water chestnuts and so on. .

acute nasopharyngitis better not to eat what food?

1, avoid using greasy Hunxing and sweet foods, so meat and fish, rice sweets, fried cakes, etc. should not be taken.

2, should not eat chili, dog, lamb, etc. sim hot food, so as not to hurt the gas burning Tianjin, to help the fire phlegm.

3, avoid alcohol and tea.

[Prevent]

acute nasopharyngitis should be how to prevent?

[Treat]

treatment of acute nasopharyngitis Notes?

prevention:

1. active exercise, enhance disease resistance, keep warm and avoid cold. Quit alcohol, avoid spicy.

2. sick pay attention to rest, more water, increasing nutrition.

3. repeated acute onset should be considered for pharyngeal tonsil removal.

4. Avoid contact with flu patients, especially hand contact.

5. Experimental studies have reported the application to kill the virus tissue and maintain good personal hygiene can reduce the spread of rhinovirus colds.

6. vitamin c is often advocated for the prevention of colds, but not strictly controlled trials designed to obtain supporting evidence.

7. interferon α-2b in the application of post-exposure prevention, there is cause nasal congestion and other adverse reactions to stop the study.

Chinese medicine treatment of acute nasopharyngitis

is cold cold cold evil outside attack , declared due to lung failure. Visible symptoms: chills, heavy, light fever, no sweating, headache, body pain, runny stuffy nose, cough, spit thin white sputum, thirst or thirsty like hot, thin white fur. Xin Wen governing law should form the main solution. Often used ephedra, Nepeta, wind, sage, etc. relieving cold medicine. On behalf of prescriptions for the "onion soup sauce", "Jing anti-sepsis scattered." Service medicine can use a cold heat powder, granules are bupleurum drink, cold soft capsules, Chuan Xiong Cha Tiao San, through Lifei pills and so on. After taking drink porridge or soup, sweating slightly, to help disperse the drug cold. Suffering from cold also take prescription flu: light blue 5, SSP 9 grams, ginger, 3, Shuijianbi day one; or ginger 30 grams, brown sugar 30 grams, decoction taken three times.

fengreganmao wind heat of the evil committed table, due to lung disharmony. Symptoms of fever weight, micro-evil wind, head pain, sweat, throat swelling and pain, cough, sputum, sticky or yellow, yellow nasal discharge nasal congestion, thirst-hi drinks, tongue side of red, yellow and thin white fur. Xin liang Xie governing law should be the main table. Often used in chrysanthemum, mint, mulberry and so on. On behalf of prescriptions for the "Yin qiao San," "Sang ju Yin." Service medicine can be used yinqiaojiedu pills (tablets), Ling Jiedu pills, Sang ju cold tablets, granules, etc. Isatidis. Such as severe fever, sore throat, obviously, can be equipped with service shuanghuanglian oral (granules), oral detoxification. These drugs have good heat and detoxification. Suffering fengreganmao to the water, diet should be light, you can drink carrot soup or pear soup. Patients can take prescription Fengreganmao: mint 3 grams, reed rhizome 30 g, Isatidis 15 grams, raw licorice 6 days, day one; or bamboo leaves 10 grams, 3 grams mint, almond 9 grams, forsythia 9 grams, day one.

western medicine treatment of acute nasopharyngitis

(a) treatment

1. commonly used symptomatic treatment

(1) ipratropium bromide (ipratropium bromide) spray: comfort agents controlled trials to prove to alleviate runny nose, sneezing and effective, especially the early course of 1 day use. The main adverse reaction is 15% to 20% of patients in the tears stained mucus.

(2) Pseudoephedrine: effects on respiratory mucosa α-adrenergic receptors, relieve nasal congestion, heart and other peripheral vascular α-receptors had little effect. Relieve nasal congestion, can improve sleep. Not long-term application is limited to 3 to 5 days.

(3) antihistamines: first-generation antihistamines such as chlorpheniramine maleate (chlorpheniramine) to reduce sneezing and rhinorrhea effective, the elderly who have prostate hypertrophy with caution. The lack of non-sedating antihistamine anticholinergic effect, the effect is uncertain.

(4) anti-inflammatory agents: In the fever and muscle aches, headache, patients can choose. To acetaminophen (paracetamol) most commonly used. Anti-HIV drugs should be avoided with more than Zipf set simultaneously. Repeated application of aspirin can increase the amount of viral shedding, and improve the role of mild symptoms, not recommended.

(5) antitussive agent: to protect the cough reflex is generally not in favor of the application, but the drama cough can affect the rest appropriate application to dextromethorphan used more often.

2. may be useful in medicine or treatment

(1) Vitamin C: the role of uncertainty. infection has been reported from the first day of high doses of vitamin c (8.0g / d) reduces the duration of symptoms and alleviate the condition. However, most authors have a negative attitude.

(2) zinc gluconate agent (zinc gluconates): In vitro experiments showed that the inhibition of rhinovirus, a controlled clinical trial showed that shorter duration of symptoms, but the results very inconsistent, and adverse reactions.

(3) respiratory gas humidification heating: rhinovirus replication because the optimum temperature is 33 ℃, so the promotion of respiratory gas humidification heating treatment of a cold.

3. ribavirin antiviral therapy (ribavirin) for influenza and parainfluenza virus, respiratory syncytial virus have a certain inhibitory effect, clinical application is limited to children under respiratory tract infection with respiratory syncytial virus. Of rhinovirus and other respiratory viruses is currently no effective antiviral drugs.

4. the application of antibiotics generally should not and need antibiotics. A placebo-controlled study showed that the nose and throat wash material to train streptococcus pneumoniae, haemophilus influenzae or moraxella catarrhalis growth of sub-group (20%) antibiotic therapy showed improvement in symptom scores. Therefore, there is bacterial colonization, increased neutrophil respiratory secretions, there sinusitis, otitis media and other complications, chronic obstructive pulmonary disease (COPD) and other underlying diseases and duration of colds over 1 week patients may be appropriate antibiotics.

5. infant patients may be due to complications of systemic toxicity or life-threatening. Therefore, the treatment must be appropriate. To bed rest, adequate supply of fresh fruit juices and hot drinks. And to symptomatic treatment, such as fever, sedatives applications. Serious illness, the need of intravenous fluids, intravenous infusion or bolus while broad-spectrum antibiotics plus adequate amount of hormones to control the progression of the disease, that is soon to be cured. Topical antibiotics plus 1% ephedrine nose drops convergence nasal mucosa, nasopharynx, nasal drops flow, up to local treatment purposes. After the acute inflammation can be the nasal cavity and nasopharynx secretions pumping clean, and then topical. At the same time the use of exhaust replacement method, liquid can enter the sinus, and play a role in the treatment or prevention of sinusitis. Necessary resectable pharyngeal tonsils.

(b) the prognosis

prognosis is comparatively good.

[Examine]

acute nasopharyngitis should do what check?

1. viral infection of peripheral blood white blood cell count normal or low. The proportion of lymphocytes increased. bacterial infection, white blood cell count was increased and a left shift phenomenon. neutrophils was increased and a left shift phenomenon.

2. pathogen inspection under normal circumstances do. If necessary, and immunofluorescence, enzyme-linked immunosorbent assay, serological diagnosis or virus isolation and identification method to determine the type of virus; bacterial culture and drug susceptibility testing to help diagnose and treat bacterial infections.

3. indirect nasopharyngeal mirror or fiber microscope easy to get a glimpse of nasopharyngeal nasopharyngeal lesions, can be seen drying nasopharyngeal congestion or swelling, a discharge.

4. chest x-ray examination, no exceptions.

[Diff]

acute nasopharyngitis diseases easily confused?

1. with the flu identification

(1) for the extensive epidemic of influenza epidemiology to winter and spring-based, acute nasopharyngitis occurred for the whole year, in autumn, winter and spring more common.

(2) Clinical manifestations: systemic poisoning symptoms of influenza, often as high fever, 39 ~ 40 ℃, for 3 to 5 days, headache, body pain, common and serious, fatigue, weakness early stage, sustainable 2 to 3 weeks, can be accompanied by nasal congestion, sneezing, sore throat, chest discomfort and cough common and more severe, may be complicated by bronchitis, pneumonia, or even life-threatening. bronchitis and changes in soft palate mucosa particulate catarrhal symptoms typical of influenza. acute nasopharyngitis mainly nasal congestion, sneezing, sore throat, mild systemic symptoms, headache, body aches and fatigue, less weak and mild, less heat, some may have mild to moderate chest discomfort and cough, complications rare.

(3) auxiliary examination

x-ray examination: Flu more prone to pulmonary complications of acute nasopharyngitis, such as bronchitis or pneumonia, the chest x-ray contribute to the clinical diagnosis of bias.

② laboratory tests: A. virus isolation, by collecting nasal secretions, nasal swabs, throat swabs for virus isolation and culture to determine the boil pathogens, viruses train about 3 to 10 days. B. Determination of rapid influenza, sensitivity> 70%, specificity> 90%, about 24h. C. serum antibody detection, this method requires determination of acute and convalescent antibody titers. D. Inferior turbinate mucosa indian film examination, flu patients often on the first day of illness began to appear a lot of variability columnar epithelial cells within the cytoplasm or nucleus aniline blue addicted to inclusion of acute nasopharyngitis is a pus-based, inclusions rare.

2. and nasal disease identification

(1) allergic rhinitis: a history of allergies, was seasonal ( hay fever) or perennial sneezing, rhinorrhea, nasal congestion with itching. characteristics and symptoms of nasal secretions increase in eosinophils contribute to the diagnosis.

(2) vasomotor rhinitis: no history of allergy to nasal intermittent vascular filling, sneezing and runny characterized, dry air can make symptoms worse . according to medical history and other non-purulent nasal discharge and crusts with viral or bacterial infection phase identification.

(3) atrophic rhinitis: nasal abnormalities smooth, thin lamina propria and blood vessels to reduce, hyposmia and have formed crusts and odor, easy to identify.

(4) deviated nasal septum, nasal polyps: nasal endoscopy can confirm the diagnosis.

3. with certain acute infectious diseases (such as measles, encephalitis, epidemic cerebrospinal meningitis, polio, typhoid, typhus) and the precursor of hiv infection identification phase of the upper respiratory tract inflammation, according to a history of symptoms, dynamic observation and relevant laboratory tests, identification is not difficult.

[Disease]

acute cervicitis may be caused by the diseases?

acute cervicitis related diseases

tuberculous cervicitis cervicitis amebic acute cervicitis female bladder neck obstruction during pregnancy cervical

more female pelvis symptoms

intrauterine fractures leucorrhea candida albicans vaginal discharge amenorrhea amenorrhea - galactorrhea - not sterile three flat pelvis incomplete abortion ovulation flat narrow birth canal birth canal birth canal laceration, hematoma, postpartum hemorrhage, postpartum lochia are not foul the net is no longer postpartum period cramps postpartum puerperal uterine contraction abnormalities productivity infection postpartum lochia long-term pelvic pain


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