Respiratory disease names

Clinically recognized high-incidence respiratory diseases can be divided into two categories: infectious and non-infectious according to the cause and location of the disease. The core common names include the common cold, influenza, acute bronchitis, chronic obstructive pulmonary disease (COPD), bronchial asthma, pneumonia, tuberculosis, lung cancer, allergic rhinitis, and interstitial pulmonary fibrosis. These 10 categories account for more than 90% of the outpatient visits to the respiratory department.

During the half-day I spent last week in the community assistance clinic, I answered 28 calls covering 6 of them - 12 common colds, 7 influenza B, 4 old patients with acute exacerbation of COPD, and 2 students with allergic rhinitis attacks. Among the remaining 3, one was newly diagnosed with cough variant asthma.

Many people are confused about the difference between common colds and influenza, and even many doctors in grassroots clinics are accustomed to directly classify influenza as a "severe cold" and prescribe cold medicine and antipyretics to dismiss it. However, according to the current guidelines of the respiratory department of tertiary hospitals, influenza is an independent respiratory tract infection, specifically referring to systemic respiratory infections caused by influenza viruses. Especially for the elderly with high blood pressure and diabetes, taking neuraminidase inhibitor antiviral drugs within 48 hours after diagnosis can reduce the risk of severe illness by more than 60%. The controversy between these two classification methods is essentially the difference in diagnosis and treatment scenarios: there is no rapid testing conditions at the grassroots level, and treating severe colds can also cover most mild patients, but the top three hospitals have testing conditions, and accurate classification can avoid missed diagnosis of severe cases.

Speaking of classification differences, the classification of allergic rhinitis is also an interesting point. In otolaryngology textbooks, it is customary to classify it as an inflammatory disease of the nose, but our respiratory department has always classified it as a respiratory allergic disease. After all, 80% of asthma patients have a history of allergic rhinitis for many years. To put it bluntly, the problems of the upper and lower respiratory tracts are inherently connected. Don’t treat it as a respiratory disease just because you have an itchy nose and sneezing. If it goes on for a long time, it may affect the lower respiratory tract and develop into asthma.

Last month, there was a child who was a sophomore in high school. He had allergic rhinitis for three years. Every time he had an attack, he bought some loratadine. This time, he coughed for more than a month after the start of school. He coughed so much that he couldn't sleep at night. There was nothing wrong with the CT scan. After an airway provocation test, he was diagnosed with cough variant asthma. This kind of asthma has "asthma" in its name, but most people don't have typical wheezing symptoms. The only symptom is a stubborn dry cough. Many people treat it as pharyngitis or bronchitis and it doesn't work for half a year. In fact, spraying inhaled corticosteroids for two weeks can basically relieve the symptoms.

Many people are scared to death when they hear the names "pulmonary fibrosis" and "interstitial pneumonia". When searching online, they think they are incurable diseases. In fact, these two are just broad categories. When broken down into specific categories, the difference is huge - there are inflammatory interstitial changes caused by influenza and mycoplasma infection, and hormones can basically be completely absorbed after a week.； There are interstitial lesions secondary to connective tissue diseases such as rheumatoid syndrome and Sjogren's syndrome. If the primary disease is controlled well, long-term stability can be achieved. ； Only idiopathic pulmonary fibrosis with no known cause has a poor prognosis. Don’t sentence yourself to death just because of the name. I treated an aunt two years ago. The CT scan showed interstitial pneumonia. She cried at home for three days. Later, it was found out that it was a side effect of taking statin lipid-lowering drugs. I stopped taking the drug and took low-dose hormones for two months. After the follow-up CT scan, everything was fine.

Oh, and there is also tuberculosis. Nowadays, many people still think that tuberculosis is still a typical symptom of "coughing, coughing up blood, low fever and night sweats", but now at least one-third of clinical tuberculosis patients do not have any obvious symptoms. Even if a physical examination and CT scan found small nodules or patches in the lungs, they almost thought it was lung cancer and went for a puncture. Finally, they did a sputum search for acid-fast bacilli or a PPD test to confirm the diagnosis. Taking anti-tuberculosis drugs for 6-9 months can basically cure it, so there is no need to panic.

In fact, to put it bluntly, the names of these diseases are labels given by the medical community to unify diagnosis and treatment standards. Ordinary people do not need to worry about the precise definition of each name. If you are really uncomfortable, don’t just check the Baidu entry. Seeing a doctor from a regular hospital is much more useful than worrying at home for a long time.