WEBVTT00:00:13.000 --> 00:00:15.080啊啊今天很高兴啊00:00:15.080 --> 00:00:16.400跟大家一起来分享一个00:00:16.400 --> 00:00:19.000我们关于这个慢性咳嗽的科普00:00:19.000 --> 00:00:19.860记忆法00:00:22.360 --> 00:00:23.920这些慢性咳嗽呢00:00:23.920 --> 00:00:25.040顾名思义啊00:00:25.040 --> 00:00:29.160是我们那个咳嗽症状持续大于8周00:00:29.160 --> 00:00:30.280我们3-8周00:00:30.280 --> 00:00:31.940是我们一个亚急性咳嗽00:00:31.960 --> 00:00:34.100急性咳嗽是我们小于3周啊00:00:34.240 --> 00:00:35.760所以说呃00:00:35.760 --> 00:00:38.280慢性咳嗽的病的这个诊断标准是00:00:38.280 --> 00:00:39.600咳嗽大于8周00:00:39.600 --> 00:00:41.780但是没有明显的胸胸部00:00:41.960 --> 00:00:43.200这个二线的异常00:00:43.200 --> 00:00:45.120就是排除了肺炎呃00:00:45.120 --> 00:00:49.420结核等相关确定的一个疾病的呃00:00:49.440 --> 00:00:50.680以后我们可能诊断00:00:50.680 --> 00:00:51.860因为慢性咳嗽00:00:52.520 --> 00:00:56.020其慢性咳嗽的症状还是比较多的00:00:56.240 --> 00:00:57.820疾病的可能性也比较00:00:59.160 --> 00:01:01.440复杂发病率逐渐升高00:01:01.440 --> 00:01:02.480尤其我们新冠疫情00:01:02.480 --> 00:01:04.680有很多患者都慢性咳嗽的00:01:04.680 --> 00:01:06.460患者也多了00:01:07.040 --> 00:01:08.280尤其是晚上咳嗽00:01:08.280 --> 00:01:10.460严重影响了患者的生活质量00:01:11.440 --> 00:01:12.360慢性咳嗽了00:01:12.360 --> 00:01:13.360是刚才讲了00:01:13.360 --> 00:01:16.560是咳嗽症状持续大于8周呃00:01:16.560 --> 00:01:18.080胸片胸部线呃00:01:18.080 --> 00:01:20.560影像学没有明显异常啊00:01:20.560 --> 00:01:22.560主要包括下面几类啊00:01:22.560 --> 00:01:24.820主要一个我们咳嗽变形哮喘00:01:25.080 --> 00:01:26.400上期的咳嗽综合征00:01:26.400 --> 00:01:29.060还是生性细胞性支气管炎00:01:29.360 --> 00:01:30.840胃食管反流这些00:01:30.840 --> 00:01:33.120还有很多我们的新一性咳嗽啊00:01:33.120 --> 00:01:34.620包括我们的药物性啊00:01:34.960 --> 00:01:36.540慢性咳嗽都有啊00:01:36.640 --> 00:01:39.680这是我们四个比较常见的咳嗽变性00:01:39.680 --> 00:01:40.240哮喘呢00:01:40.240 --> 00:01:42.720这是这是一个特殊类型的哮喘00:01:42.720 --> 00:01:45.440是以慢性咳嗽为主要表现哎00:01:45.440 --> 00:01:47.220或是说唯一的临床表现00:01:47.480 --> 00:01:47.800主要是00:01:47.800 --> 00:01:50.220气道存在的慢性炎症和高反应00:01:50.560 --> 00:01:52.040当接受那个花粉呢00:01:52.040 --> 00:01:55.480尘螨动物毛发等过敏原以后啊00:01:55.480 --> 00:01:57.740或者受到冷空气以后刺激00:01:57.760 --> 00:01:59.400气道就会痉挛收缩00:01:59.400 --> 00:02:01.280进而引发这个咳嗽啊00:02:01.280 --> 00:02:02.680以刺激性干咳为主00:02:02.680 --> 00:02:04.500多在多半在夜间00:02:04.880 --> 00:02:05.800夜间咳嗽发作00:02:05.800 --> 00:02:08.200啊上气道咳嗽综合征00:02:08.200 --> 00:02:08.800顾名思义00:02:08.800 --> 00:02:11.160是一个上气道的一个炎症反应00:02:11.160 --> 00:02:12.100包括鼻炎00:02:12.480 --> 00:02:13.320那个鼻窦炎00:02:13.320 --> 00:02:14.800那个慢性咽炎00:02:14.800 --> 00:02:15.600扁桃体炎等00:02:15.600 --> 00:02:18.200上呼吸的疾病导致了一个呃00:02:18.200 --> 00:02:21.560分泌物倒流到我们咽喉部进呃00:02:21.560 --> 00:02:22.980甚至进入这个气管00:02:23.160 --> 00:02:26.340刺激我们呼吸道黏膜而引起的咳嗽00:02:26.600 --> 00:02:30.200呃过敏性鼻炎的患者引起这个积毒00:02:30.200 --> 00:02:31.000啊00:02:33.560 --> 00:02:35.160首先慢性呃00:02:35.160 --> 00:02:37.160嗜酸性的细胞性支气管炎00:02:37.160 --> 00:02:39.220那这个病延迟不是很明确00:02:39.920 --> 00:02:42.060可能气道是上腺内细胞的紧呢00:02:42.120 --> 00:02:43.740与组织的炎症反应00:02:43.960 --> 00:02:45.960患者一般没有那个气喘啊00:02:45.960 --> 00:02:47.800呼吸困难等哮喘的症状00:02:47.800 --> 00:02:50.100主要表现为慢慢性的干咳00:02:50.440 --> 00:02:52.700或伴有少许的白色黏痰00:02:53.000 --> 00:02:56.160啊咳嗽要剧烈抵抗皮质激素治疗00:02:56.160 --> 00:02:57.340反应是比较好的00:02:58.560 --> 00:03:00.300胃食管反流性咳嗽啊00:03:00.400 --> 00:03:02.480呃主要是由胃胃溶00:03:02.480 --> 00:03:04.500胃溶物的反流至食管00:03:04.720 --> 00:03:07.220呃到呃刺激咽喉部啊00:03:07.240 --> 00:03:09.240呃跟气道啊引起的咳嗽00:03:09.240 --> 00:03:10.620通常在进食后00:03:11.160 --> 00:03:13.840在屏幕或者弯腰时症状加重00:03:13.840 --> 00:03:16.960可伴有那个烧心反酸胸痛的症状00:03:16.960 --> 00:03:19.480一般一般喜欢暴饮暴食啊00:03:19.480 --> 00:03:21.660睡前进食肥胖的患者00:03:22.200 --> 00:03:24.080呃可能那个某些00:03:24.080 --> 00:03:26.160或者食管下溃疡肌的这个障碍00:03:26.160 --> 00:03:28.080也会导致那个微循环反流00:03:28.080 --> 00:03:29.260进而引起咳嗽00:03:30.200 --> 00:03:32.520刚才我们讲到的药物相关性的咳嗽00:03:32.520 --> 00:03:34.040主要是我们的ACEI类的00:03:34.040 --> 00:03:36.960最多见的啊高呃叫高血压药物00:03:36.960 --> 00:03:39.620比如卡诺普利利拉普利这些啊00:03:39.880 --> 00:03:43.660呃出现干咳呃主要是以干咳为主啊00:03:44.120 --> 00:03:45.920发生率大概在10%到30%00:03:45.920 --> 00:03:47.900是发发生率还是比较高的00:03:48.080 --> 00:03:50.440呃有可能是药物抑制了血管紧张素00:03:50.440 --> 00:03:52.380少少化酶00:03:52.560 --> 00:03:54.960使的是是那个缓期差啊00:03:54.960 --> 00:03:57.940前列腺素等或者体内坠积啊00:03:58.080 --> 00:04:00.040刺激呼吸道感觉神经末00:04:00.040 --> 00:04:02.340端引从而引起的咳嗽00:04:02.840 --> 00:04:05.660一般用药在用药1到2周内出现00:04:05.680 --> 00:04:08.960停药通常会在一个1到2周00:04:08.960 --> 00:04:11.340或者三四周逐渐缓解啊00:04:13.080 --> 00:04:13.680其他原因00:04:13.680 --> 00:04:14.600刚才我讲了啊00:04:14.600 --> 00:04:15.280环境因素00:04:15.280 --> 00:04:16.200性因素因素00:04:16.200 --> 00:04:17.220职业因素啊00:04:17.440 --> 00:04:19.040心因素可能我们焦虑啊00:04:19.040 --> 00:04:23.300紧张啊呃等都会导致慢性咳嗽00:04:24.240 --> 00:04:26.440还有环境是长期暴露的空气污染00:04:26.440 --> 00:04:28.360化学物质刺激烟雾的环境当中00:04:28.360 --> 00:04:29.400包括工厂啊00:04:29.400 --> 00:04:30.680装修的环境当中00:04:30.680 --> 00:04:31.960或者我们刚刚装修的房子00:04:31.960 --> 00:04:34.600住进去也会容易咳嗽啊00:04:34.600 --> 00:04:37.940这可能是有些有害物质窒息呼吸道00:04:38.520 --> 00:04:39.920导致气道黏膜受损00:04:39.920 --> 00:04:41.500引起的慢性炎症反应00:04:42.560 --> 00:04:43.160职业因素00:04:43.160 --> 00:04:46.120职业因素主要是我们那个呃00:04:46.120 --> 00:04:48.080有些那个那个职业环境当中00:04:48.080 --> 00:04:50.820那个粉尘化学物质引起的慢性咳嗽00:04:50.840 --> 00:04:52.960比如说我们教师这个粉笔啊00:04:52.960 --> 00:04:54.720纺织工啊啊00:04:54.720 --> 00:04:58.320还有棉棉棉毛毛絮的棉棉棉花00:04:58.320 --> 00:04:59.440这个粉尘啊00:04:59.440 --> 00:05:01.280导致呼吸道的慢性炎症00:05:01.280 --> 00:05:02.340引发咳嗽00:05:02.680 --> 00:05:04.960化工行业的人工接触甲甲棉00:05:04.960 --> 00:05:06.160有苯的物质00:05:06.160 --> 00:05:08.860也可以刺激气道引起的慢性咳嗽00:05:11.240 --> 00:05:14.000常见的病因呼吸道这个疾病呢00:05:14.000 --> 00:05:16.380有个我们说咳嗽变异哮喘00:05:17.040 --> 00:05:17.720咳嗽变性00:05:17.720 --> 00:05:20.020哮喘的特征主要是慢性咳嗽00:05:20.240 --> 00:05:22.440没有其他的明显的症状00:05:22.440 --> 00:05:23.980气道高反应00:05:24.240 --> 00:05:26.380呃真的是排除其他这个病因00:05:26.480 --> 00:05:28.560一般咳嗽病因哮喘逐年00:05:28.560 --> 00:05:30.720这个最近几年是逐年增加00:05:30.720 --> 00:05:34.080是跟我们诊断那个检出率有关系啊00:05:34.080 --> 00:05:35.880这可能以前也是有的00:05:35.880 --> 00:05:38.580我们有很多手段来诊断慢性咳嗽00:05:38.600 --> 00:05:40.740呃这个变性哮喘啊00:05:41.200 --> 00:05:41.880所以说我们这个00:05:41.880 --> 00:05:43.800这个第一激素还是比较敏感的00:05:43.800 --> 00:05:45.220实际效果是非常好00:05:45.680 --> 00:05:47.540还有就是脏器的咳嗽综合征00:05:47.840 --> 00:05:48.920就是我们鼻咽部00:05:48.920 --> 00:05:50.400鼻咽部的一些那个炎症00:05:50.400 --> 00:05:51.840慢性炎症反应倒流00:05:51.840 --> 00:05:53.460刺激的咽喉咳嗽00:05:53.800 --> 00:05:54.840常伴有流鼻涕啊00:05:54.840 --> 00:05:55.760打喷嚏啊00:05:55.760 --> 00:05:56.360这些字呢00:05:56.360 --> 00:05:58.900我们主要是改善一个一个鼻喷雾剂00:05:59.040 --> 00:06:01.160还有我们咽喉部的一个呃00:06:01.160 --> 00:06:02.280改善我们咽喉部症状00:06:02.280 --> 00:06:05.500的一个一些中成药含片呐00:06:05.560 --> 00:06:05.800啊00:06:05.800 --> 00:06:09.560或者是能起到一个明显的作用啊00:06:09.560 --> 00:06:11.160嗜酸性的细胞性支气管炎00:06:11.160 --> 00:06:12.360那也是一个介绍00:06:12.360 --> 00:06:13.940嗜酸性细胞增多00:06:14.200 --> 00:06:15.200临床表现呢00:06:15.200 --> 00:06:19.320是哮喘但又没有无高反应性啊00:06:19.320 --> 00:06:21.300需要呃呃00:06:21.440 --> 00:06:23.460跟那个哮喘还是相鉴别的00:06:27.880 --> 00:06:30.580其他的那个一些那个常见的病因呢00:06:30.600 --> 00:06:32.500呃包括胃食管反流00:06:36.400 --> 00:06:37.620胃食管反流00:06:37.920 --> 00:06:40.200呃典型的非典型病因呢00:06:40.200 --> 00:06:42.180则和我们反流涉及食管00:06:42.520 --> 00:06:43.120引发了00:06:43.120 --> 00:06:45.620我们那个持续性的一个咳嗽00:06:46.080 --> 00:06:48.540服药调整或行为干预啊00:06:48.760 --> 00:06:49.120其为什么00:06:49.120 --> 00:06:49.720法瘤的话00:06:49.720 --> 00:06:51.480我们都一般用00:06:51.480 --> 00:06:54.020要用一点自制高自制棒抑制剂PPI00:06:54.120 --> 00:06:56.680还有我们的促胃肠动力药啊00:06:56.680 --> 00:06:58.340用了效果还是比较好的00:06:58.720 --> 00:06:59.920呃药物诱发的咳嗽00:06:59.920 --> 00:07:01.420首先是我们要停药啊00:07:01.520 --> 00:07:03.200呃就说更换药物00:07:03.200 --> 00:07:04.800调整那个剂量啊00:07:04.800 --> 00:07:05.400不是新生00:07:05.400 --> 00:07:06.480一般我们都会停药00:07:06.480 --> 00:07:08.060因为现在高血压的药物00:07:08.080 --> 00:07:10.060选择的品种也比较多00:07:10.160 --> 00:07:12.240甚至我们调整为ARBB的00:07:12.240 --> 00:07:13.560或者其他呃00:07:13.560 --> 00:07:15.040那个呃00:07:15.040 --> 00:07:17.160钙离子那个拮抗剂之类的啊00:07:17.160 --> 00:07:17.960都可以00:07:18.480 --> 00:07:20.280还有就是说有种我们心阴性00:07:20.280 --> 00:07:21.500心阴性咳嗽00:07:21.680 --> 00:07:23.320比如说精神因素呃00:07:23.320 --> 00:07:24.280跟紧张啊00:07:24.280 --> 00:07:25.240跟焦虑啊00:07:25.240 --> 00:07:26.200跟那个呃00:07:26.200 --> 00:07:26.760可能就是说00:07:26.760 --> 00:07:29.640我们有一些要用一些个心理干预00:07:29.640 --> 00:07:32.300啊或者就是我们一些强烈症咳00:07:32.400 --> 00:07:34.300强烈的中枢镇咳药00:07:34.800 --> 00:07:35.440这部病人00:07:35.440 --> 00:07:37.960实际上咳嗽不是很明显的啊00:07:37.960 --> 00:07:39.240实际上夜间咳嗽不多00:07:39.240 --> 00:07:43.140所以说也不太影响那个生活质量00:07:46.760 --> 00:07:49.760还有就是我们刚才讲的这个新冠啊00:07:49.760 --> 00:07:52.360新冠新冠引起的一个呃00:07:52.360 --> 00:07:54.220一个咳嗽啊00:07:54.400 --> 00:07:57.720呃就是说我们长期反复咳嗽00:07:57.720 --> 00:07:58.860干咳少痰00:07:59.080 --> 00:08:00.120咳嗽时间不定啊00:08:00.120 --> 00:08:02.280痰夜间可能更加重啊00:08:02.280 --> 00:08:03.160其实这一部分病人00:08:03.160 --> 00:08:05.220在我们现在临床中比较多见啊00:08:05.680 --> 00:08:07.000实际上有个切记00:08:07.000 --> 00:08:09.320这个我们现实当中碰见的00:08:09.320 --> 00:08:10.520已经咳嗽两年的00:08:10.520 --> 00:08:11.580就是第七00:08:11.680 --> 00:08:12.480呃早期这个00:08:12.480 --> 00:08:15.260这种新冠感染以后就一直有点咳嗽00:08:15.920 --> 00:08:18.180但是这个人症状也不是很重00:08:18.400 --> 00:08:21.100有时候呃一天就几次00:08:21.160 --> 00:08:22.560或者几天也就几次00:08:22.560 --> 00:08:22.760反正00:08:22.760 --> 00:08:25.680他一直有个一个慢性的咳嗽的表现00:08:25.680 --> 00:08:27.800啊他一般有一定的咽痒啊00:08:27.800 --> 00:08:28.740有异物感00:08:29.200 --> 00:08:30.460气胸闷气喘00:08:30.840 --> 00:08:31.980不大多见啊00:08:35.079 --> 00:08:36.699啊对生活的影响啊00:08:36.959 --> 00:08:37.839实际上这个00:08:37.839 --> 00:08:39.039首先那个咳嗽00:08:39.039 --> 00:08:41.019最主要的是影响我们的睡眠00:08:41.520 --> 00:08:42.640影响我们睡眠以后呢00:08:42.640 --> 00:08:43.440我们生活质量00:08:43.440 --> 00:08:44.480包括一个疲劳啊00:08:44.480 --> 00:08:46.040如果夜深睡眠不好的00:08:46.040 --> 00:08:46.960容易疲劳啊00:08:46.960 --> 00:08:48.180白天犯困啊00:08:48.520 --> 00:08:50.860实际上这对我们生活最主要的影响00:08:50.880 --> 00:08:52.360还有日常生活的干扰00:08:52.360 --> 00:08:54.460就是说你在工作当中咳嗽啊00:08:54.640 --> 00:08:56.640学习当中那个咳嗽啊00:08:56.640 --> 00:08:58.360会影响一个工作效率00:08:58.360 --> 00:09:00.340也影响学习的深处度啊00:09:00.800 --> 00:09:01.520还是在场合00:09:01.520 --> 00:09:02.320你咳嗽的话00:09:02.320 --> 00:09:04.560可能对自我感觉啊00:09:04.560 --> 00:09:05.880这个都不尊重啊00:09:05.880 --> 00:09:07.300对别人的一个不尊重00:09:07.600 --> 00:09:08.400你说00:09:08.600 --> 00:09:10.960还有就是我们心理状态的变化00:09:10.960 --> 00:09:13.280长期咳嗽心理压力比较大00:09:13.280 --> 00:09:14.320你说影响工作00:09:14.320 --> 00:09:15.320影响生活00:09:15.320 --> 00:09:15.880好吧00:09:15.880 --> 00:09:18.020影响学习以后心理压力比较大00:09:18.400 --> 00:09:20.460而且还容易焦虑00:09:20.560 --> 00:09:22.500焦虑可能抑郁的一些情绪00:09:22.920 --> 00:09:25.760还有健康的警示是直接持续咳嗽啊00:09:25.760 --> 00:09:28.960我们呃有时候考虑这方面00:09:28.960 --> 00:09:30.080包括咳嗽变相这样00:09:30.080 --> 00:09:30.320其实00:09:30.320 --> 00:09:32.240我们也要排除一些器质性的疾病00:09:32.240 --> 00:09:33.440啊包括我们结核啊00:09:33.440 --> 00:09:36.320肿瘤啊包括我们一些少见的一些00:09:36.320 --> 00:09:37.720那个慢性咳嗽啊00:09:37.720 --> 00:09:38.640这种扩张啊00:09:38.640 --> 00:09:40.360慢性支气管炎啊00:09:40.360 --> 00:09:41.980慢阻肺之类的一些啊00:09:46.960 --> 00:09:48.200这诊断的方法00:09:48.200 --> 00:09:50.620首先我们就是一个咳嗽的一个呃00:09:50.840 --> 00:09:52.000问问诊啊00:09:52.000 --> 00:09:54.700实际上一个一个持续的时间啊00:09:54.760 --> 00:09:57.200呃频率性质呃00:09:57.200 --> 00:09:58.780还伴随症状啊00:09:58.800 --> 00:09:59.400有发烧啊00:09:59.400 --> 00:10:01.000过敏啊呼吸道的症状00:10:01.000 --> 00:10:02.360这还有检查的方法是一种00:10:02.360 --> 00:10:03.500我们一个听诊00:10:03.600 --> 00:10:04.480咽喉部的检查00:10:04.480 --> 00:10:07.260还有我们就是一个呃00:10:07.280 --> 00:10:09.380其他的一些个常规的查体啊00:10:09.800 --> 00:10:10.600还影像学的话00:10:10.600 --> 00:10:12.660我们是ICN的胸胸部CT00:10:12.840 --> 00:10:13.720肺功能检查00:10:13.720 --> 00:10:15.880也是评判我们气道的一个主要的00:10:15.880 --> 00:10:17.220还有过敏源的检测00:10:17.280 --> 00:10:19.740还有就是我们的Feno的一个检测啊00:10:20.400 --> 00:10:21.640西医西医的治疗的00:10:21.640 --> 00:10:22.640药物干预的话00:10:22.640 --> 00:10:25.040有时候我们会使用支气管扩张剂00:10:25.040 --> 00:10:25.840抗阻碍药物00:10:25.840 --> 00:10:26.680支气管抑制器00:10:26.680 --> 00:10:29.140支气管主要也是用微时光法律啊00:10:30.120 --> 00:10:32.080还有西医这个手术治疗的话00:10:32.080 --> 00:10:34.640就主要是鼻息肉胀气的咳嗽综合症00:10:34.640 --> 00:10:35.400引起的鼻息肉00:10:35.400 --> 00:10:37.260引起鼻息肉肥大引起的咳嗽00:10:37.480 --> 00:10:39.420像手术纠正啊00:10:46.480 --> 00:10:47.680癌症的方法00:10:47.680 --> 00:10:50.840这当中我们也有一个详细性温00:10:50.840 --> 00:10:52.820这个患者病史也很重要00:10:53.480 --> 00:10:54.420中医治疗00:10:54.600 --> 00:10:55.820中医治疗的话00:10:56.000 --> 00:10:58.280实际上现在中医我们中医治疗00:10:58.280 --> 00:10:58.960中医诊断00:10:58.960 --> 00:11:00.640中医那个呃00:11:00.640 --> 00:11:03.640问诊治实际上我们在这个呃00:11:03.640 --> 00:11:05.480平常当中也用的越来越多啊00:11:05.480 --> 00:11:07.200其实国家对中医的支持力度00:11:07.200 --> 00:11:08.180也是越来越大00:11:08.760 --> 00:11:10.780其实包括我们很多治疗啊00:11:11.000 --> 00:11:13.120中成药的一个药物治疗00:11:13.120 --> 00:11:14.760效果也是非常非常好的00:11:14.760 --> 00:11:16.640包括我们是慢性咳嗽00:11:16.640 --> 00:11:19.460我们会用那些舒缓止咳啊00:11:20.120 --> 00:11:20.320嗯00:11:20.320 --> 00:11:23.000其实中医认为慢性咳嗽与肺功能失00:11:23.000 --> 00:11:23.640调有关系00:11:23.640 --> 00:11:25.380只要做出一个调理啊00:11:25.400 --> 00:11:26.660验证湿疹啊00:11:26.800 --> 00:11:28.320还有就是说呃00:11:28.320 --> 00:11:30.080中药这个山药汤00:11:30.080 --> 00:11:32.280包括我们这个呃00:11:32.280 --> 00:11:32.720山药片00:11:32.720 --> 00:11:34.640我们我们医院有这个山药片啊00:11:34.640 --> 00:11:36.380针灸针这个针灸00:11:37.280 --> 00:11:38.320还有饮食00:11:38.320 --> 00:11:39.560饮食这个运动啊00:11:39.560 --> 00:11:40.920就推荐这个润肺的食物00:11:40.920 --> 00:11:42.540如梨啊百合啊00:11:42.840 --> 00:11:45.140避免刺激性的食物啊好了00:11:47.240 --> 00:11:49.040还有适当的有氧运动啊00:11:49.040 --> 00:11:50.100呼吸训练啊00:11:50.800 --> 00:11:52.800生活环境心心理调节00:11:52.800 --> 00:11:54.660首先保持空气的清新啊00:11:54.720 --> 00:11:56.340开开窗啊00:11:56.400 --> 00:11:58.900通风啊包括室内的一个湿度啊00:11:59.280 --> 00:12:00.300避免过敏啊00:12:00.360 --> 00:12:02.520避免那个猫猫狗啊00:12:02.520 --> 00:12:05.280那个那个外界这个这个刺激啊00:12:05.280 --> 00:12:07.480其实我们今天我在门子上就碰到00:12:07.480 --> 00:12:10.920就碰到一个那个因为养养养猫啊00:12:10.920 --> 00:12:13.220因为长期的一个咳嗽啊00:12:15.240 --> 00:12:17.040呃预防措施说增强体质00:12:17.040 --> 00:12:18.120避免刺激性食物00:12:18.120 --> 00:12:20.700保持这个清新的环境啊00:12:21.880 --> 00:12:23.160还有慢性咳嗽呢00:12:23.160 --> 00:12:25.280实际上我们就是说呃00:12:25.280 --> 00:12:27.480一些那个常见的一个病因00:12:27.480 --> 00:12:29.340如咽炎支气管炎呢00:12:29.400 --> 00:12:30.720啊就说00:12:30.720 --> 00:12:32.240我们就说还有说咳嗽00:12:32.240 --> 00:12:35.980饮食这个调节也要也要注意啊00:12:36.920 --> 00:12:39.280就是说我们如何防治咳嗽啊00:12:39.280 --> 00:12:39.840有00:12:39.840 --> 00:12:41.760其实在防治方面有很多我们医生00:12:41.760 --> 00:12:44.620现在我们在一个健康的科普方面00:12:44.680 --> 00:12:45.080呃00:12:45.080 --> 00:12:47.800实际上包括那个我们医院公众平台00:12:47.800 --> 00:12:50.600我们也会发一些那个慢性咳嗽啊00:12:50.600 --> 00:12:53.140相关的一个知识的一个先讲00:12:53.360 --> 00:12:56.080包括那个我们科室的那个呃00:12:56.080 --> 00:12:59.720那个呃那个宣传也也栏里面00:12:59.720 --> 00:13:02.980也会有一些慢性咳嗽的一些那个啊00:13:03.560 --> 00:13:05.980慢性咳嗽实际上可以缓解啊00:13:06.000 --> 00:13:06.720科学诊断00:13:06.720 --> 00:13:07.400规范治疗00:13:07.400 --> 00:13:08.760预防措施是关键啊00:13:08.760 --> 00:13:10.740是保持健康的一个生活方式00:13:11.720 --> 00:13:14.620如何预防那个我们慢性咳嗽呢00:13:14.680 --> 00:13:16.000所以说我们这个第一00:13:16.000 --> 00:13:16.840就是我们一个生00:13:16.840 --> 00:13:18.700活习惯的一个调整啊00:13:18.800 --> 00:13:20.440呃好的一个作息规律啊00:13:20.440 --> 00:13:22.020保证一个充足的睡眠00:13:22.040 --> 00:13:23.060增强免疫力00:13:23.240 --> 00:13:25.000呃是适度的运动啊00:13:25.000 --> 00:13:26.940促进这个代谢和呼吸功能00:13:27.280 --> 00:13:28.580环境因素的把控00:13:28.760 --> 00:13:29.960呃主要是一个雾00:13:29.960 --> 00:13:31.680呃作为一个空气清新雾霾天00:13:31.680 --> 00:13:33.200口罩啊包括这个00:13:33.200 --> 00:13:34.720我们那个流感高发季节00:13:34.720 --> 00:13:36.640包括我们新冠高发流行的时候00:13:36.640 --> 00:13:37.640我们这个呃00:13:37.640 --> 00:13:39.420避免那个呃00:13:39.640 --> 00:13:40.720这个接触这个00:13:40.720 --> 00:13:41.760这个产量饮料00:13:41.760 --> 00:13:42.640切断传播途径00:13:42.640 --> 00:13:43.660我们戴口罩00:13:44.160 --> 00:13:45.280饮食和疾病的控制00:13:45.280 --> 00:13:47.160所均衡的饮食是00:13:47.160 --> 00:13:50.180适中摄入蔬蔬菜水果的维c啊00:13:50.200 --> 00:13:51.540激励治疗基础疾病00:13:53.440 --> 00:13:54.400因生活关系啊00:13:54.400 --> 00:13:57.700中老年人如何预防慢性咳嗽呢00:13:57.760 --> 00:13:59.440实际上我们主人说注意00:13:59.440 --> 00:14:00.040注意很多细00:14:00.040 --> 00:14:00.800第一个注意细节00:14:00.800 --> 00:14:02.860就是保持空气的流通啊00:14:02.920 --> 00:14:04.440老年人还是骨骼上不开张00:14:04.440 --> 00:14:07.340有些老年人经常这个门窗紧闭啊00:14:07.800 --> 00:14:09.120根据天气情况呢00:14:09.120 --> 00:14:10.480及时添减衣物啊00:14:10.480 --> 00:14:12.080避免那个感冒啊00:14:12.080 --> 00:14:13.900降低呼吸道感染的频率啊00:14:14.040 --> 00:14:15.000还有饮食啊00:14:15.000 --> 00:14:16.380饮食要均衡啊00:14:16.440 --> 00:14:18.900呃可以吃点那个驴啊00:14:19.080 --> 00:14:21.460吃了百合的那个东西了00:14:22.160 --> 00:14:23.640还有就是我们适合运动00:14:23.640 --> 00:14:24.840散步啊打太极啊00:14:24.840 --> 00:14:26.100增强抵抗力00:14:28.160 --> 00:14:29.880啊避规避不良的因素呢00:14:29.880 --> 00:14:31.980尽量远离的吸烟的环境啊00:14:32.160 --> 00:14:33.360现在吸烟环境是00:14:33.360 --> 00:14:35.800现在大家对于吸烟是越来越摒弃啊00:14:35.800 --> 00:14:38.880很多今天我就碰到好几个吸烟的00:14:38.880 --> 00:14:39.960过来咳嗽吸烟00:14:39.960 --> 00:14:41.260过来戒烟的啊00:14:41.760 --> 00:14:45.160现在这个远离我们这个花纹粉尘啊00:14:45.160 --> 00:14:47.860防止这个慢性咳嗽啊00:14:48.560 --> 00:14:49.040慢性咳嗽00:14:49.040 --> 00:14:51.620在饮食方面有很多需要注意的地方00:14:51.720 --> 00:14:53.540首先一个忌辛辣啊00:14:53.680 --> 00:14:55.740忌这个生生冷的食物啊00:14:56.160 --> 00:14:57.460还有就忌油腻00:14:58.000 --> 00:14:58.920以及高肠的00:14:58.920 --> 00:15:01.360高肠的这个食物啊00:15:01.360 --> 00:15:02.200慢性咳嗽00:15:02.200 --> 00:15:06.600了是可以吃哪哪哪些那个那个呃00:15:06.600 --> 00:15:07.640润肺的食物了00:15:07.640 --> 00:15:09.640首先那个我们一点水果类的00:15:09.640 --> 00:15:10.360水果类的话00:15:10.360 --> 00:15:11.200我们就梨啊00:15:11.200 --> 00:15:12.140刚刚说的梨00:15:12.240 --> 00:15:14.660呃那个吃了可以清肺降火00:15:15.160 --> 00:15:16.380润肺生津啊00:15:16.520 --> 00:15:17.920啊这个是比较好的00:15:17.920 --> 00:15:18.920还有我们百合00:15:18.920 --> 00:15:22.060百合啊百合也是有润肺止咳00:15:22.080 --> 00:15:23.500清心安神的作用00:15:24.840 --> 00:15:26.480还有就说枇杷啊00:15:26.480 --> 00:15:27.360我们是枇杷00:15:27.360 --> 00:15:28.320实际上我们当然是比00:15:28.320 --> 00:15:28.560首先00:15:28.560 --> 00:15:30.840我们很多咳嗽药水都有枇杷露啊00:15:30.840 --> 00:15:32.640枇杷膏啊啊啊00:15:32.640 --> 00:15:34.080主要润肺止也00:15:34.080 --> 00:15:35.000润肺止咳啊00:15:35.000 --> 00:15:36.180祛痰的作用啊00:15:36.320 --> 00:15:37.120呃00:15:38.160 --> 00:15:39.480还有就是我们山药00:15:39.480 --> 00:15:41.640山药也也具有健脾益肺啊00:15:41.640 --> 00:15:43.780补肾固固精的作用啊00:15:44.400 --> 00:15:45.600白萝卜白萝卜的话00:15:45.600 --> 00:15:47.440至少对于我们慢性咳嗽患者00:15:47.440 --> 00:15:49.180还是有很好的效果的00:15:49.280 --> 00:15:49.880首先的话00:15:49.880 --> 00:15:50.920我们很多治过的病人00:15:50.920 --> 00:15:52.560我们都推荐用那个呃00:15:52.560 --> 00:15:54.880白萝卜的一个治疗是00:15:54.880 --> 00:15:55.720常吃点白萝卜00:15:55.720 --> 00:15:56.200银耳00:15:56.200 --> 00:15:58.600银耳也是我们主呃这个咳嗽的00:15:58.600 --> 00:16:00.660一个主要的一个润肺的食材啊00:16:00.840 --> 00:16:02.920虽说这个我们生活当中朋呃00:16:02.920 --> 00:16:03.940也很多啊00:16:03.960 --> 00:16:04.360呃00:16:04.360 --> 00:16:06.660需要我们就是在饮食方面注意的00:16:07.320 --> 00:16:07.800啊今天呢00:16:07.800 --> 00:16:11.600我的讲座这这个课件讲到这里啊00:16:11.600 --> 00:16:12.400谢谢