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--> 00:14.680\n嗯，\n\n00:14.730 --> 00:20.231\n今天很高兴和大家分享一下咳嗽变异性哮喘。\n\n00:21.090 --> 00:21.291\n嗯，\n\n00:22.291 --> 00:23.891\n咳嗽变异性哮喘呢，\n\n00:23.891 --> 00:24.416\n是，\n\n00:24.416 --> 00:25.041\n首先呢，\n\n00:25.041 --> 00:29.190\n我们今天从五个方面来阐述一下咳嗽变异性哮喘。\n\n00:29.961 --> 00:30.162\n嗯，\n\n00:30.162 --> 00:32.562\n咳嗽变异性哮喘的概述。\n\n00:32.611 --> 00:33.712\n另外一方面呢，\n\n00:33.712 --> 00:34.712\n从第二个方面，\n\n00:34.712 --> 00:38.687\n从咳嗽变异性哮喘的症状介绍一下。\n\n00:38.687 --> 00:40.587\n另外一个就是，\n\n00:40.587 --> 00:42.512\n咳嗽变异性哮喘的诊断。\n\n00:42.861 --> 00:43.512\n另外，\n\n00:43.661 --> 00:44.062\n嗯，\n\n00:44.111 --> 00:47.012\n着重介绍一下咳嗽变异性哮喘的治疗，\n\n00:47.012 --> 00:48.411\n以及，\n\n00:48.411 --> 00:52.361\n第五个部分是咳嗽变异性哮喘的非药物治疗。\n\n00:53.340 --> 00:53.441\n嗯，\n\n00:53.441 --> 00:56.691\n首先我们讲一下咳嗽变异性哮喘的定义，\n\n00:56.691 --> 00:57.890\n临床定义，\n\n00:58.291 --> 00:58.691\n嗯，\n\n00:58.741 --> 01:01.191\n咳嗽变异性哮喘是。\n\n01:02.160 --> 01:02.261\n嗯，\n\n01:02.261 --> 01:05.210\n像一种特殊类型的哮喘，\n\n01:05.661 --> 01:08.011\n主要表现为持续性的干咳，\n\n01:08.210 --> 01:10.310\n无明显的喘息症状。\n\n01:11.152 --> 01:11.352\n嗯，\n\n01:11.352 --> 01:12.803\n咳嗽变异性哮喘呢，\n\n01:12.803 --> 01:16.377\n常常在夜间或者清晨的时候呢，\n\n01:16.377 --> 01:17.602\n咳嗽加剧，\n\n01:18.053 --> 01:22.627\n运动冷空气以及刺激物以后呢，\n\n01:22.627 --> 01:23.902\n可诱发咳嗽。\n\n01:24.303 --> 01:24.703\n嗯，\n\n01:25.152 --> 01:25.902\n往往呢，\n\n01:25.902 --> 01:27.953\n由于缺乏喘息，\n\n01:28.002 --> 01:30.727\n咳嗽变异性哮喘的症状呢，\n\n01:30.727 --> 01:36.652\n容易被误诊为普通的感冒以及支气管支气管炎。\n\n01:37.407 --> 01:38.182\n所以说呢，\n\n01:38.182 --> 01:38.782\n往往呢，\n\n01:38.782 --> 01:39.682\n是耽误了，\n\n01:39.782 --> 01:40.182\n嗯，\n\n01:40.282 --> 01:40.932\n治疗。\n\n01:42.872 --> 01:43.147\n嗯，\n\n01:43.147 --> 01:45.122\n咳嗽类变异性哮喘呢，\n\n01:45.122 --> 01:46.472\n它主要的诊断呢，\n\n01:46.472 --> 01:48.722\n是一个是慢性咳嗽的症状。\n\n01:49.122 --> 01:49.522\n嗯，\n\n01:49.522 --> 01:51.071\n它主要是慢性，\n\n01:51.421 --> 01:51.772\n嗯，\n\n01:51.772 --> 01:54.897\n咳嗽通过通常是指通过，\n\n01:54.897 --> 01:57.972\n咳嗽持续超过8周以上的咳嗽。\n\n01:58.599 --> 02:02.800\n患者可因长期的咳嗽而影响日常生活。\n\n02:03.612 --> 02:04.063\n另外呢，\n\n02:04.112 --> 02:04.688\n夜，\n\n02:04.688 --> 02:08.113\n它的主要的咳嗽特点是夜间咳嗽加剧，\n\n02:08.513 --> 02:11.412\n是慢性咳嗽的特征之一。\n\n02:11.613 --> 02:12.337\n患者呢，\n\n02:12.337 --> 02:17.013\n常常在躺下或者早晨起来醒起来的时候咳嗽。\n\n02:17.686 --> 02:18.886\n加剧加重，\n\n02:19.285 --> 02:20.561\n另外一个，\n\n02:20.561 --> 02:23.585\n一方面就是运动以后出现咳嗽。\n\n02:23.936 --> 02:24.335\n嗯，\n\n02:24.835 --> 02:25.735\n运动后呢，\n\n02:25.735 --> 02:28.636\n出现咳嗽是慢性咳嗽的常见的表现。\n\n02:28.835 --> 02:31.110\n患者在体力活动后呢，\n\n02:31.110 --> 02:33.335\n会往往出现有咳嗽症状。\n\n02:33.636 --> 02:34.785\n另外，\n\n02:34.835 --> 02:38.261\n与咳嗽是没有痰或者少痰的，\n\n02:38.261 --> 02:40.636\n与普通感冒引起的咳嗽不同，\n\n02:40.785 --> 02:42.360\n慢性咳嗽的患者呢，\n\n02:42.360 --> 02:47.785\n往往咳嗽时仅有咳嗽时无痰。\n\n02:48.119 --> 02:49.919\n或者有少量的粘痰，\n\n02:50.119 --> 02:53.119\n另外有一个就是气道高反应。\n\n02:53.669 --> 02:53.994\n嗯，\n\n02:53.994 --> 02:55.093\n气道高反应呢，\n\n02:55.093 --> 02:56.869\n是指就是，\n\n02:56.919 --> 02:58.119\n气道的炎症，\n\n02:58.369 --> 02:59.218\n是指呢，\n\n02:59.218 --> 02:59.819\n气道。\n\n03:00.910 --> 03:02.710\n高反应性的原因之一，\n\n03:02.759 --> 03:10.410\n也是炎症细胞释放的化学介质可引起气道平滑肌收缩导致的。\n\n03:10.460 --> 03:11.910\n另外气道重塑，\n\n03:12.210 --> 03:15.860\n长期的气道炎症会导致气道的结构。\n\n03:16.697 --> 03:16.897\n嗯，\n\n03:16.998 --> 03:20.248\n然后改变及气道重塑，\n\n03:20.498 --> 03:24.998\n这种增增加气道对各种刺激的敏感性。\n\n03:25.197 --> 03:25.748\n另外，\n\n03:25.748 --> 03:27.498\n神经调节异常，\n\n03:27.947 --> 03:29.973\n气道的神经调节异常呢，\n\n03:29.973 --> 03:33.822\n也可能导致气道平滑肌的过度的反应，\n\n03:33.822 --> 03:37.548\n从而引起或加重气道高反应性。\n\n03:38.207 --> 03:39.606\n另外有遗传因素，\n\n03:39.906 --> 03:40.307\n嗯，\n\n03:40.557 --> 03:43.207\n遗传因素在气道高反应中呢，\n\n03:43.207 --> 03:44.856\n扮演着重要的角色，\n\n03:45.257 --> 03:45.606\n嗯，\n\n03:45.606 --> 03:54.957\n有些基因基因异变可能可使个可使个体更容易发展成为气道高反应性。\n\n03:56.248 --> 03:56.923\n下面呢，\n\n03:56.923 --> 04:00.598\n我们着重介绍一下咳嗽变异性哮喘的主要症状。\n\n04:00.949 --> 04:04.248\n咳嗽变异性哮喘主要是刺激性的干咳。\n\n04:04.899 --> 04:05.298\n嗯，\n\n04:05.748 --> 04:07.223\n咳嗽变异性哮喘呢，\n\n04:07.223 --> 04:11.649\n常在夜间或者清晨出现剧烈的干咳，\n\n04:11.848 --> 04:14.598\n影响睡眠和日常活动。\n\n04:14.949 --> 04:15.673\n另外呢，\n\n04:15.673 --> 04:18.049\n运动和运动以后呢，\n\n04:18.049 --> 04:19.648\n咳嗽出现加剧，\n\n04:20.199 --> 04:24.049\n往往在运动后由于气道反应性的增加，\n\n04:24.248 --> 04:26.348\n咳嗽变异性哮喘的患者呢。\n\n04:26.365 --> 04:28.365\n咳嗽症状会明显的加剧，\n\n04:28.615 --> 04:31.515\n另外对特定的刺激物的敏感，\n\n04:31.816 --> 04:38.941\n接触冷空气或者烟雾或者其他刺激物时咳嗽变异性哮喘的患者呢，\n\n04:38.941 --> 04:41.365\n会出现持续的干咳反应。\n\n04:42.265 --> 04:42.415\n嗯，\n\n04:42.415 --> 04:43.065\n另外呢，\n\n04:43.065 --> 04:45.464\n还有可能出现有其他的症状，\n\n04:45.665 --> 04:50.165\n如胸闷或呼吸困难患者在咳嗽的同时呢，\n\n04:50.165 --> 04:51.915\n可能会感到胸闷，\n\n04:52.214 --> 04:53.165\n吸气时呢，\n\n04:53.165 --> 04:54.065\n有压迫感，\n\n04:54.165 --> 04:56.265\n尤其在体力活动以后。\n\n04:56.415 --> 04:56.940\n另外，\n\n04:56.940 --> 04:59.165\n夜间或晨起咳嗽时，\n\n04:59.315 --> 05:01.815\n咳嗽变异性哮喘的患者呢，\n\n05:01.864 --> 05:03.765\n那咳嗽会有加剧，\n\n05:04.065 --> 05:07.714\n往往在夜间或者清晨醒来时的咳嗽加剧。\n\n05:07.714 --> 05:08.790\n这种症状呢，\n\n05:08.790 --> 05:12.315\n可能会导致睡眠的质量减。\n\n05:12.537 --> 05:14.988\n及另外在运动后的咳嗽，\n\n05:15.088 --> 05:18.662\n在进行体力活动后或运动后，\n\n05:18.662 --> 05:21.388\n患者可能会出现持续性的咳嗽。\n\n05:21.738 --> 05:27.138\n这是一个咳嗽咳嗽变异性哮喘的典型的表现之一。\n\n05:27.787 --> 05:33.238\n咳嗽变异性哮喘的症状与发展的时间和诱因，\n\n05:33.437 --> 05:33.812\n嗯，\n\n05:33.812 --> 05:35.888\n我们着重介绍一下啊，\n\n05:35.888 --> 05:42.437\n咳嗽变性哮喘常在夜间或晨清晨时出现剧烈的咳嗽可与体内的激。\n\n05:42.532 --> 05:45.583\n素水平的变化有关有关可能啊，\n\n05:45.632 --> 05:49.183\n另外一个冷空气也可导致气道的收缩。\n\n05:49.483 --> 05:53.782\n咳嗽变异性哮喘的患者在吸入冷空气以后呢，\n\n05:53.782 --> 05:55.882\n容易出现咳嗽症状的。\n\n05:56.821 --> 05:57.170\n加剧，\n\n05:57.571 --> 05:57.946\n嗯，\n\n05:57.946 --> 06:00.321\n另外一个就是运动以后的咳嗽。\n\n06:00.621 --> 06:01.996\n运动后的咳嗽呢，\n\n06:01.996 --> 06:05.670\n是咳嗽变异性哮喘的典型的症状之一。\n\n06:05.721 --> 06:06.871\n剧烈运动后呢，\n\n06:06.871 --> 06:10.371\n气道反应性的增加可导致咳嗽发作。\n\n06:10.670 --> 06:13.670\n另外一个就是情绪波动引发咳嗽，\n\n06:13.920 --> 06:20.545\n情绪波动如紧张焦虑可也可导致自主神经功能的失调啊，\n\n06:20.545 --> 06:24.520\n失调进而诱发咳嗽变异性哮喘患者的咳嗽。\n\n06:27.803 --> 06:28.053\n嗯。\n\n06:29.933 --> 06:34.058\n另外我们讲一下咳嗽变异性性的哮喘的诊断，\n\n06:34.058 --> 06:35.032\n临床症状，\n\n06:35.083 --> 06:37.933\n主要的临床症状是持续性的干咳，\n\n06:38.333 --> 06:40.183\n另外一个是过敏性的鼻炎，\n\n06:40.183 --> 06:43.782\n或者胸闷和呼吸的困难。\n\n06:44.627 --> 06:44.826\n嗯，\n\n06:45.627 --> 06:47.752\n咳嗽变异性哮喘的患者呢，\n\n06:47.752 --> 06:49.877\n典型的症状是长期的干咳，\n\n06:49.877 --> 06:53.326\n尤其是夜间或运动后咳嗽加剧，\n\n06:53.427 --> 06:55.076\n但无明显的喘息。\n\n06:55.427 --> 06:56.027\n另外，\n\n06:56.027 --> 06:58.777\n有很多的鼻过敏性鼻炎的患者，\n\n06:59.177 --> 06:59.527\n嗯，\n\n06:59.527 --> 07:01.627\n许多的就是，\n\n07:01.976 --> 07:04.101\n咳嗽病性哮喘患者呢，\n\n07:04.101 --> 07:07.302\n他同时伴有鼻炎的症状，\n\n07:07.302 --> 07:09.502\n有过敏性鼻炎，\n\n07:09.502 --> 07:12.627\n如经常有打喷嚏流清涕，\n\n07:12.877 --> 07:13.277\n嗯，\n\n07:13.576 --> 07:14.552\n这些症状呢，\n\n07:14.552 --> 07:14.826\n也有。\n\n07:14.877 --> 07:16.976\n有可能与咳嗽同时存在，\n\n07:17.277 --> 07:21.627\n另外患者会出现有胸闷呼吸困难的症状。\n\n07:21.877 --> 07:23.152\n部分患者呢，\n\n07:23.152 --> 07:24.502\n在咳嗽的同时呢，\n\n07:24.502 --> 07:27.976\n可能会感到胸闷呼吸困难，\n\n07:27.976 --> 07:29.377\n轻度的呼吸困难，\n\n07:29.427 --> 07:31.627\n尤其在体力活动以后呢，\n\n07:31.627 --> 07:33.326\n尤为的明显。\n\n07:34.082 --> 07:34.432\n嗯，\n\n07:34.432 --> 07:35.907\n咳嗽变异性哮喘呢，\n\n07:35.907 --> 07:38.957\n我们就是常常的辅助检查，\n\n07:38.957 --> 07:40.381\n有肺功能的检查。\n\n07:41.312 --> 07:42.511\n肺功能的检查呢，\n\n07:42.511 --> 07:48.087\n能不能往往能伴随我们就是协助我们来诊断这一疾病。\n\n07:48.337 --> 07:55.337\n另外一个就是雾化的治疗也能协助这个对本病的那个诊断的，\n\n07:55.337 --> 07:56.736\n协助本病的诊断。\n\n07:56.736 --> 07:57.261\n首先，\n\n07:57.261 --> 08:00.087\n我们讲一下肺功能的检查，\n\n08:00.087 --> 08:02.437\n呼气风流数值的测定，\n\n08:02.687 --> 08:07.587\n通过检测肺功能测量呼吸峰值的流速，\n\n08:07.736 --> 08:08.136\n嗯，\n\n08:08.536 --> 08:11.136\n可评估气道阻塞的。\n\n08:11.440 --> 08:11.890\n程度，\n\n08:12.239 --> 08:12.589\n嗯，\n\n08:12.589 --> 08:15.614\n这个对那个咳嗽变异性哮喘的诊断呢，\n\n08:15.614 --> 08:17.239\n具有重要的意义。\n\n08:19.059 --> 08:19.459\n另外，\n\n08:19.459 --> 08:21.709\n支气管激发试验，\n\n08:21.910 --> 08:28.109\n激支气管的激发试验是通过吸入特定的药物观察气道反应，\n\n08:28.209 --> 08:30.760\n有助于诊断咳嗽变异性哮喘，\n\n08:31.160 --> 08:34.510\n尤其是对常规的肺功能的检测。\n\n08:34.809 --> 08:35.184\n嗯，\n\n08:35.184 --> 08:37.359\n结果不明确的情况下，\n\n08:37.510 --> 08:42.210\n另外一个就是肺功能当中的肺容量的测定。\n\n08:42.460 --> 08:43.734\n肺容量的测定呢，\n\n08:43.734 --> 08:46.359\n可以评估肺部的总体的功能。\n\n08:46.460 --> 08:49.034\n对咳嗽变异性哮喘患者来说呢，\n\n08:49.034 --> 08:49.460\n可以。\n\n08:49.513 --> 08:53.064\n帮助了解疾病对肺功能的影响程度，\n\n08:53.164 --> 08:56.088\n也是一个对我们肺功能的检测呢。\n\n08:56.088 --> 08:57.013\n对，\n\n08:57.263 --> 08:59.814\n首先对诊断咳嗽变异性哮喘，\n\n08:59.914 --> 09:06.564\n另外是对对那个疾病的就是说疗效的评估是一个重要的手段。\n\n09:06.914 --> 09:09.838\n另外一个就是另外一个辅助阶段，\n\n09:09.838 --> 09:10.164\n嗯，\n\n09:10.213 --> 09:13.213\n检查就是血液以及影像学的检查。\n\n09:13.797 --> 09:15.122\n血液检查当中呢，\n\n09:15.122 --> 09:17.947\n我们可以查特定的炎症，\n\n09:18.247 --> 09:22.247\n嗯标志标志物如嗜酸性粒细胞的技术，\n\n09:22.547 --> 09:22.898\n嗯，\n\n09:22.898 --> 09:27.447\n对本病就是咳嗽肺应性哮喘的诊断是有帮助的。\n\n09:27.447 --> 09:29.797\n另外一个就是肺功能的检测，\n\n09:30.047 --> 09:34.547\n刚刚说了对肺功能的检测可以评估气道的通气功能，\n\n09:34.997 --> 09:35.372\n嗯，\n\n09:35.372 --> 09:40.547\n对于咳嗽变异性哮喘的诊断及治疗监测是至关重要的。\n\n09:40.648 --> 09:44.047\n另外一个就是胸部的X光检测。\n\n09:44.211 --> 09:45.661\n胸部的X光检测呢，\n\n09:45.661 --> 09:52.387\n有助于排除其他可能导致的咳嗽的咳嗽的肺部疾病，\n\n09:52.387 --> 09:54.562\n如肺炎或者结核等等。\n\n09:54.961 --> 09:55.461\n另外，\n\n09:55.461 --> 09:56.836\n我们往往，\n\n09:56.836 --> 10:01.461\n就是常常借助于就是那个CT的扫描，\n\n10:01.711 --> 10:04.086\n高分辨率的CT扫描呢，\n\n10:04.086 --> 10:08.111\n可以提示肺部的结核结构的详细信息，\n\n10:08.211 --> 10:14.111\n有助于发现咳嗽变异性哮喘其以及其他的肺部的相关的气道。\n\n10:14.216 --> 10:15.265\n疾病，\n\n10:15.265 --> 10:15.841\n下面呢，\n\n10:15.841 --> 10:19.616\n我们来着重介绍一下咳嗽变异性哮喘的治疗。\n\n10:20.166 --> 10:20.541\n嗯，\n\n10:20.541 --> 10:22.916\n咳嗽哮变异性哮喘的治疗呢，\n\n10:22.916 --> 10:23.616\n药物呢，\n\n10:23.616 --> 10:26.565\n我们常常是用糖皮质激素的吸入。\n\n10:26.966 --> 10:27.315\n嗯，\n\n10:27.315 --> 10:27.890\n首先呢，\n\n10:27.890 --> 10:30.841\n要控制炎症吸入糖皮质激素呢，\n\n10:30.841 --> 10:33.116\n是有效的减少气道的炎症，\n\n10:33.265 --> 10:36.416\n缓解咳嗽病性哮喘患者的症状。\n\n10:36.866 --> 10:37.390\n另外，\n\n10:37.390 --> 10:41.216\n减少急性的糖皮质激素呢，\n\n10:41.216 --> 10:42.091\n吸入以后呢，\n\n10:42.091 --> 10:43.565\n可减少急性发作。\n\n10:44.265 --> 10:44.789\n定期呢，\n\n10:44.789 --> 10:47.390\n使用糖皮吸入性的糖皮质激素呢，\n\n10:47.390 --> 10:50.614\n可降低咳嗽病性哮喘的急性发作的风险，\n\n10:50.914 --> 10:53.465\n改善患者的生活质量。\n\n10:53.614 --> 10:54.215\n另外，\n\n10:54.364 --> 10:54.765\n嗯，\n\n10:55.215 --> 10:59.414\n吸入糖皮质激素就是它的副作用的管理呢，\n\n10:59.465 --> 11:04.315\n虽然是虽然是吸入糖皮质激素有潜在的副作用，\n\n11:04.315 --> 11:05.614\n但通过。\n\n11:07.065 --> 11:09.215\n正常的使用以及监测呢，\n\n11:09.364 --> 11:11.840\n可以最小化的，\n\n11:11.840 --> 11:16.164\n可以最小化的发生这些药物的风险。\n\n11:16.414 --> 11:17.015\n另外，\n\n11:17.164 --> 11:18.565\n药物治疗当中呢，\n\n11:18.565 --> 11:20.664\n有白三烯受体的拮抗剂。\n\n11:21.306 --> 11:23.981\n白山烯受体的拮抗剂的作用呢，\n\n11:23.981 --> 11:27.056\n我们这里要着重介绍一下，\n\n11:27.056 --> 11:33.606\n这是一个通过白山烯作用减少白山烯拮抗。\n\n11:33.606 --> 11:34.880\n白山烯拮抗剂呢，\n\n11:34.880 --> 11:37.056\n是通过阻断白山烯的作用，\n\n11:37.505 --> 11:40.955\n然后减少气道的炎症和痉挛，\n\n11:41.156 --> 11:43.356\n有效的控制咳嗽症状。\n\n11:43.455 --> 11:47.306\n用常用的白三七。\n\n11:48.486 --> 11:52.435\n受体拮抗剂是那个蒙鲁斯特，\n\n11:52.986 --> 11:56.736\n这个用于治疗咳嗽变异性哮喘的效果是相当，\n\n11:56.736 --> 12:00.536\n就是说是有疗效而且是肯定的。\n\n12:00.835 --> 12:01.236\n嗯，\n\n12:01.335 --> 12:02.036\n另外呢，\n\n12:02.036 --> 12:07.536\n就是患者是在使用白山拮抗拮抗剂使用时应遵医嘱，\n\n12:07.685 --> 12:11.286\n注意药物之间的作用以及潜在的副作用。\n\n12:11.286 --> 12:15.585\n另外一个就是贝塔二受体激动剂以及其他药物的运用。\n\n12:15.986 --> 12:16.385\n嗯，\n\n12:16.385 --> 12:18.685\n贝塔二受体激动剂的使用呢。\n\n12:18.741 --> 12:24.890\n是如沙丁胺醇可迅速缓解咳嗽变异性哮喘患者的咳嗽症状，\n\n12:24.890 --> 12:28.041\n但需注意剂量以及使用的频率。\n\n12:28.241 --> 12:31.041\n另外一个就是吸入性的糖皮质激素，\n\n12:31.291 --> 12:33.716\n这吸入性的糖皮质激素呢，\n\n12:33.716 --> 12:35.666\n如一个是布地奈德，\n\n12:35.666 --> 12:38.341\n另外是丙酸丙酸氟替卡松，\n\n12:38.491 --> 12:41.591\n可长期控制咳嗽变异性哮喘的症状，\n\n12:41.690 --> 12:45.890\n减少气道的炎症以及改善肺功能。\n\n12:45.940 --> 12:48.341\n另外一个就是白三烯的药物的。\n\n12:48.718 --> 12:48.818\n嗯，\n\n12:48.818 --> 12:49.768\n作用，\n\n12:50.669 --> 12:55.718\n抗白塞烯药物如门门鲁斯特可以治疗咳嗽变异性哮喘，\n\n12:55.718 --> 13:00.943\n尤其是伴有变异性鼻炎的患者当中的疗效是，\n\n13:00.943 --> 13:01.869\n显著的。\n\n13:02.068 --> 13:05.068\n另外就是磷酸二酯酶抑制剂，\n\n13:05.218 --> 13:11.169\n磷酸二酯酶抑制剂如罗夫斯特作为咳嗽变异性哮喘的辅助治疗，\n\n13:11.268 --> 13:13.268\n能减少炎症的。\n\n13:14.080 --> 13:14.479\n反应。\n\n13:15.854 --> 13:16.479\n下面呢，\n\n13:16.479 --> 13:20.153\n我们着重介绍一下咳嗽变异性哮喘的非药物治疗。\n\n13:20.604 --> 13:20.953\n嗯，\n\n13:20.953 --> 13:21.578\n首先呢，\n\n13:21.578 --> 13:22.554\n我们要接，\n\n13:22.554 --> 13:24.129\n因为咳嗽变异性哮喘呢，\n\n13:24.129 --> 13:26.554\n首先是有个过敏源。\n\n13:26.653 --> 13:29.554\n首先我们要避免接触过敏源，\n\n13:29.854 --> 13:30.254\n嗯，\n\n13:30.453 --> 13:32.653\n识别和远离过敏源。\n\n13:33.783 --> 13:33.908\n嗯，\n\n13:33.908 --> 13:35.757\n咳嗽变异性哮喘的患者呢，\n\n13:35.757 --> 13:39.982\n应避免接触花粉尘螨等过敏源，\n\n13:40.132 --> 13:43.932\n以减少咳嗽频率的减少咳嗽的发作。\n\n13:44.132 --> 13:44.833\n另外呢，\n\n13:44.833 --> 13:45.732\n在室内呢，\n\n13:45.732 --> 13:52.132\n可以建议使用空气的净化器以及定期清洁家居，\n\n13:52.333 --> 13:59.982\n可可以有效的减少室内的空气当中的过敏源以及降低哮喘的风险。\n\n14:00.432 --> 14:00.783\n嗯，\n\n14:00.783 --> 14:02.682\n另外在食物当中呢。\n\n14:04.731 --> 14:05.257\n要使用，\n\n14:05.257 --> 14:05.481\n嗯，\n\n14:05.481 --> 14:09.007\n避免食用可引起过敏的食物，\n\n14:09.007 --> 14:12.406\n如海鲜、牛奶等等。\n\n14:12.406 --> 14:16.481\n有些这个是有助于控制咳嗽、变异性哮喘的症状。\n\n14:16.932 --> 14:17.606\n另外呢，\n\n14:17.606 --> 14:18.731\n我们要保持。\n\n14:19.981 --> 14:20.181\n嗯。\n\n14:21.216 --> 14:21.541\n另外呢，\n\n14:21.541 --> 14:23.966\n我们要保持良好的生活习惯，\n\n14:24.216 --> 14:25.890\n避免过敏源的接触，\n\n14:25.890 --> 14:28.515\n减少尘室内的尘螨，\n\n14:28.966 --> 14:29.366\n嗯，\n\n14:29.466 --> 14:30.116\n以及。\n\n14:31.377 --> 14:32.802\n宠物皮毛啊，\n\n14:32.802 --> 14:38.577\n皮屑的过敏源的接触有助于控制咳嗽变异性哮喘症状。\n\n14:38.577 --> 14:39.151\n另外呢，\n\n14:39.151 --> 14:41.177\n要保持室内空气的流通，\n\n14:41.377 --> 14:44.526\n定期开窗使用净化空气净化器，\n\n14:44.776 --> 14:49.101\n以减少空气当中的污染物以及过敏源，\n\n14:49.101 --> 14:51.627\n以及改善呼吸环境。\n\n14:52.395 --> 14:52.546\n嗯，\n\n14:52.546 --> 14:54.270\n在合理饮食当中呢，\n\n14:54.270 --> 14:57.195\n我们要均衡摄入各种的营养素，\n\n14:57.645 --> 14:58.046\n嗯，\n\n14:58.046 --> 15:01.195\n避免辛辣的油腻的食物，\n\n15:01.195 --> 15:02.745\n减少咳嗽的发作，\n\n15:02.895 --> 15:06.995\n对控对控制咳嗽变异性哮喘也是有益的。\n\n15:07.245 --> 15:07.895\n另外呢，\n\n15:07.895 --> 15:09.296\n可以适度的运动，\n\n15:09.495 --> 15:11.796\n选择适合的运动方式，\n\n15:11.995 --> 15:14.695\n游泳瑜伽增强体质，\n\n15:14.695 --> 15:16.195\n减少呼吸功能，\n\n15:16.296 --> 15:20.395\n有助于缓解咳嗽变异性哮喘的症状。\n\n15:24.596 --> 15:27.320\n环境控制环境的因素有很多，\n\n15:27.320 --> 15:28.596\n我们比如呢，\n\n15:28.596 --> 15:30.221\n可以减少室内的过敏源，\n\n15:30.221 --> 15:34.596\n定期的进行的清洁地面、地毯、窗帘，\n\n15:34.995 --> 15:36.770\n使用空气净化器，\n\n15:36.770 --> 15:40.395\n减少宠物皮毛发以及尘螨等过敏原，\n\n15:40.445 --> 15:42.395\n以缓解咳嗽病性哮喘。\n\n15:42.745 --> 15:43.695\n另外一个呢，\n\n15:43.695 --> 15:45.745\n就是要控制室内的湿度，\n\n15:45.745 --> 15:50.895\n温度使用除使用那个除湿器，\n\n15:50.895 --> 15:54.346\n保持室内的温度在适适宜的范围内。\n\n15:54.706 --> 15:56.257\n内通常，\n\n15:56.356 --> 16:00.156\n室内的湿度保持在30%.50%，\n\n16:00.156 --> 16:02.757\n以减少霉菌以及螨虫的。\n\n16:03.479 --> 16:03.880\n生长，\n\n16:04.130 --> 16:05.630\n另外一个是避免，\n\n16:05.830 --> 16:06.179\n嗯，\n\n16:06.179 --> 16:07.380\n烟草烟雾。\n\n16:09.356 --> 16:13.606\n吸烟和二手烟会加剧咳嗽变异性哮喘，\n\n16:13.856 --> 16:14.231\n嗯，\n\n16:14.231 --> 16:15.882\n创造无烟环境，\n\n16:15.882 --> 16:19.132\n对咳嗽控制那个咳嗽变异性哮喘呢，\n\n16:19.132 --> 16:20.706\n也是至关重要的，\n\n16:21.257 --> 16:21.656\n嗯。\n\n16:23.848 --> 16:24.198\n下面呢，\n\n16:24.198 --> 16:25.448\n我们总结一下啊，\n\n16:25.499 --> 16:31.773\n咳嗽变异性哮喘的首先的诊断标准是以慢性咳嗽持续8周以上，\n\n16:31.773 --> 16:32.898\n以干咳为主，\n\n16:33.198 --> 16:39.198\n夜间以及凌凌晨加重诱因是因为运动及冷空气。\n\n16:39.499 --> 16:44.448\n然后第二个就是没有无症无感染症象的是无发烧感，\n\n16:44.499 --> 16:46.799\n咳嗽咳浓痰等表现。\n\n16:46.799 --> 16:47.773\n但抗生素呢，\n\n16:47.773 --> 16:48.999\n运用是无效的。\n\n16:49.049 --> 16:49.598\n另外，\n\n16:49.848 --> 16:53.898\n它这个咳嗽变异性哮喘有气道高反应性。\n\n16:54.213 --> 16:54.614\n嗯，\n\n16:54.864 --> 16:56.814\n往往在做肺功能时呢，\n\n16:56.814 --> 16:59.114\n支气管激发试验是阳性的。\n\n16:59.414 --> 17:00.064\n另外，\n\n17:00.114 --> 17:03.789\n应用糖皮质激素以及支气管扩张剂呢，\n\n17:03.789 --> 17:06.614\n能够缓解咳嗽及症状。\n\n17:06.813 --> 17:07.864\n另外，\n\n17:07.864 --> 17:08.963\n在辅助检查，\n\n17:08.963 --> 17:10.163\n当检查当中呢，\n\n17:10.163 --> 17:13.864\n嗜酸性粒细胞的会增高明显增高。\n\n17:14.532 --> 17:14.708\n嗯，\n\n17:14.708 --> 17:16.807\n在应用药物的治疗上，\n\n17:16.807 --> 17:17.458\n上面呢，\n\n17:17.458 --> 17:19.682\n我们一线用药是用于糖皮质激素，\n\n17:19.682 --> 17:23.432\n加上贝塔受体制动剂鲁布地奈德，\n\n17:23.432 --> 17:28.333\n加上就是福德。\n\n17:29.451 --> 17:32.826\n福莫特罗另外一个就是，\n\n17:32.826 --> 17:34.500\n建议这疗程呢，\n\n17:34.500 --> 17:40.401\n我们至少要有8周部分的治疗时间和要可以延长。\n\n17:40.850 --> 17:41.475\n另外呢，\n\n17:41.475 --> 17:42.951\n可以辅助运用药，\n\n17:43.000 --> 17:51.000\n可如白山烯的拮受体拮抗剂可以用于合并有过敏性鼻炎的患者。\n\n17:51.201 --> 17:51.850\n另外呢，\n\n17:51.850 --> 17:53.500\n就是非药物管理，\n\n17:53.500 --> 17:58.250\n我们可以避免过敏源冷空气以及增强体质。\n\n17:58.701 --> 17:59.051\n嗯，\n\n17:59.051 --> 17:59.651\n我们需要。\n\n17:59.697 --> 18:01.171\n要注意事项当中呢，\n\n18:01.171 --> 18:03.947\n要警惕就是那个咳嗽变异性哮喘呢，\n\n18:03.947 --> 18:06.697\n进一步进进展为典型的哮喘，\n\n18:06.996 --> 18:09.621\n因为有30%.50%的患者呢，\n\n18:09.621 --> 18:11.597\n可发展成为典型的哮喘，\n\n18:11.746 --> 18:13.097\n所以说呢，\n\n18:13.097 --> 18:14.822\n咳嗽病性哮喘的患者呢，\n\n18:14.822 --> 18:19.447\n需要定期的随访肺肺功能另外。\n\n18:20.883 --> 18:25.432\n也需与反复的呼吸道感染来进行鉴别。\n\n18:28.568 --> 18:30.793\n首先要需要鉴别，\n\n18:30.793 --> 18:31.793\n其他的没什么，\n\n18:31.793 --> 18:34.343\n我们今天那个分享就到这里，\n\n18:34.343 --> 18:35.218\n谢谢大家。\n\n18:51.266 --> 18:51.666\n哦，\n\n18:51.817 --> 18:53.016\n结束共享。\n\n","v0347cg10004d61a7v2ljht5uhgqmh30",1137,788,"2026-01-24 22:59:04","咳嗽变异性哮喘的症状、诊断与治疗 | 权威指南  ","咳嗽变异性哮喘,慢性咳嗽,哮喘症状,咳嗽治疗,过敏性咳嗽,哮喘诊断,咳嗽病因  ","咳嗽变异性哮喘是一种以慢性咳嗽为主要表现的哮喘类型。本文详解其症状特征、诊断标准、常见诱因及治疗方案，帮助区分普通咳嗽与哮喘，提供权威防治建议。","2026-04-02 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