WEBVTT00:00:00.440 --> 00:00:01.980家晚上好00:00:02.600 --> 00:00:07.360那么我们今天的话来学习一下呃00:00:07.360 --> 00:00:09.840慢性咳嗽的一个科普00:00:09.840 --> 00:00:11.820以及相关的一个预防00:00:14.160 --> 00:00:15.320那么慢性咳嗽的话00:00:15.320 --> 00:00:17.000在我们日常生活当中呢00:00:17.000 --> 00:00:19.300也是非常多见的00:00:19.640 --> 00:00:22.640那么首先我们对这个慢性咳嗽00:00:22.640 --> 00:00:23.660那个定义00:00:24.200 --> 00:00:28.260指的是咳嗽症状持续8周以上00:00:28.720 --> 00:00:31.340无明显胸部的x线的异常00:00:31.640 --> 00:00:33.320而且呢需要排除00:00:33.320 --> 00:00:35.700其他的一些相关的这个疾病00:00:37.480 --> 00:00:40.220那么我们慢性的咳嗽概述当中00:00:40.240 --> 00:00:42.240这个是咳嗽00:00:42.240 --> 00:00:44.180是作为一个常见的一个症状00:00:44.520 --> 00:00:48.820那么在多种疾病呢当中都有可能00:00:49.080 --> 00:00:54.340而且这个发病率的话也是呃上升00:00:54.520 --> 00:00:57.460严重影响患者的这个生活质量00:01:00.400 --> 00:01:01.880那么我们的慢性咳嗽00:01:01.880 --> 00:01:05.000是指咳嗽症状持续8周以上00:01:05.000 --> 00:01:08.520胸部x线检查是无明显的异常的00:01:08.520 --> 00:01:09.540这个咳嗽00:01:10.160 --> 00:01:13.420那么其成因呢是较为复杂00:01:13.560 --> 00:01:15.540主要包括以下几类00:01:16.440 --> 00:01:18.840那么这个呃呀00:01:18.840 --> 00:01:21.260有咳嗽变异型的一个哮喘00:01:21.480 --> 00:01:24.380包括上气道的一个咳嗽综合症00:01:24.800 --> 00:01:26.920还有那个13心理细胞性的00:01:26.920 --> 00:01:28.820这个支气支气管炎00:01:29.720 --> 00:01:31.880还有一个比较容易忽视的呢00:01:31.880 --> 00:01:34.700就是一个胃食管性的这个咳嗽00:01:36.440 --> 00:01:38.860那么在咳嗽变异性哮喘当中的话00:01:39.120 --> 00:01:41.700呃是一种特殊类型的这个哮喘00:01:41.880 --> 00:01:43.600它是以慢性咳嗽为主要00:01:43.600 --> 00:01:46.100或者是唯一的一个临床表现00:01:46.600 --> 00:01:49.320它主要是由于气道存在慢性炎症00:01:49.320 --> 00:01:51.020和这个高反应性00:01:51.360 --> 00:01:54.100当接触了这个花粉尘螨00:01:54.480 --> 00:01:56.280动物毛发等过敏源00:01:56.280 --> 00:01:59.900或者受到冷空气运动等刺激时00:02:00.080 --> 00:02:02.480气道会发生痉挛收缩00:02:02.480 --> 00:02:04.100进而引发咳嗽00:02:04.400 --> 00:02:07.480所以通常呢是以刺激性的干咳为主00:02:07.480 --> 00:02:11.380而且是多在夜间或者凌晨的发作00:02:12.320 --> 00:02:15.320那么另外一种表现的话00:02:15.320 --> 00:02:16.600主要是一个上气00:02:16.600 --> 00:02:17.720道咳嗽综合征00:02:17.720 --> 00:02:20.600那它是属于这种各种鼻炎啊00:02:20.600 --> 00:02:21.700鼻窦炎啊00:02:22.040 --> 00:02:23.600慢性的咽炎00:02:23.600 --> 00:02:24.880包括扁桃体炎等00:02:24.880 --> 00:02:25.560上呼吸道的00:02:25.560 --> 00:02:26.160这个疾病00:02:26.160 --> 00:02:30.380可以导致囊分泌物倒流至咽喉部00:02:30.720 --> 00:02:31.040嗯00:02:31.040 --> 00:02:32.200甚至进入气管00:02:32.200 --> 00:02:34.040然后刺激呼吸道粘膜00:02:34.040 --> 00:02:36.060从而引起咳嗽00:02:36.440 --> 00:02:38.560比如这是个过敏性鼻炎的患者00:02:38.560 --> 00:02:39.880在接触过敏源以后00:02:39.880 --> 00:02:42.100鼻腔会产生大量的一个分泌物00:02:43.440 --> 00:02:45.760这些分泌物向后流到咽喉部00:02:45.760 --> 00:02:46.800就会引起咳嗽00:02:46.800 --> 00:02:49.660常伴有鼻塞流涕鼻痒等症状00:02:51.120 --> 00:02:51.880呃还有一个00:02:51.880 --> 00:02:54.240是嗜酸性粒细胞性支气管炎的话00:02:54.240 --> 00:02:56.780这个病因呢是上部十分明确00:02:57.240 --> 00:02:59.120可能是与气道湿酸00:02:59.120 --> 00:03:00.200心理细胞请问00:03:00.200 --> 00:03:02.420为主的这个炎性反应有关00:03:02.760 --> 00:03:05.120患者呢是一般没有这个气喘00:03:05.120 --> 00:03:06.120呼吸困难等00:03:06.120 --> 00:03:07.660哮喘的典型症状00:03:07.800 --> 00:03:10.740主要表现就是慢性干咳00:03:11.080 --> 00:03:13.860或者有少许的白色的烟痰00:03:14.280 --> 00:03:15.660咳嗽比较剧烈00:03:15.760 --> 00:03:19.620对糖皮质激素治疗反应良好00:03:21.720 --> 00:03:24.280那么在胃食管反流性咳嗽方面的话00:03:24.280 --> 00:03:25.120我们也是00:03:25.120 --> 00:03:27.040主要是因为胃内容物00:03:27.040 --> 00:03:28.620反流至这个食道00:03:28.680 --> 00:03:30.340甚至反流到咽喉部00:03:30.440 --> 00:03:33.320刺激咽喉以及气道引起的咳嗽00:03:33.320 --> 00:03:34.900通常是在进食00:03:35.200 --> 00:03:37.320平卧或者弯腰的时候咳嗽加重00:03:37.320 --> 00:03:38.480可伴有烧心啊00:03:38.480 --> 00:03:40.420反酸啊胸痛等症状00:03:40.600 --> 00:03:42.680一些生活习惯如暴饮暴食啊00:03:42.680 --> 00:03:44.020睡前进食啊00:03:44.440 --> 00:03:46.800肥胖等以及某些疾病00:03:46.800 --> 00:03:49.280导致的食管下括约肌功能障碍00:03:49.280 --> 00:03:51.240都可能诱发胃食管反流00:03:51.240 --> 00:03:53.300进而引起咳嗽00:03:56.200 --> 00:03:58.240那么还有一类就是药物相关的00:03:58.240 --> 00:04:01.560这个因素的话我们也知道就是呃00:04:01.560 --> 00:04:02.400降血压当中00:04:02.400 --> 00:04:04.720这个血管紧张素转换酶抑制剂00:04:04.720 --> 00:04:06.500就是我们说的那个Acer00:04:06.800 --> 00:04:08.320这一类的降压药呢00:04:08.320 --> 00:04:10.080比如说是呃00:04:10.080 --> 00:04:10.920卡托普利亚00:04:10.920 --> 00:04:12.340伊娜普利亚等等00:04:12.360 --> 00:04:12.920那么服用00:04:12.920 --> 00:04:13.840这类药物之后00:04:13.840 --> 00:04:16.200部分患者会出现干咳的不良反应00:04:16.200 --> 00:04:17.200这个发生率呢00:04:17.200 --> 00:04:19.580也是在10%到30%00:04:20.120 --> 00:04:21.000那么它的机制00:04:21.000 --> 00:04:21.480可能是00:04:21.480 --> 00:04:23.800药物抑制了血管紧张素转换酶00:04:23.800 --> 00:04:26.320是呃环积肽啊00:04:26.320 --> 00:04:27.280前列腺素等00:04:27.280 --> 00:04:29.540这个物质在体内的一个寄居00:04:29.960 --> 00:04:32.180刺激呼吸道感觉神经末梢00:04:32.440 --> 00:04:34.880从而呢呃引起的咳嗽00:04:34.880 --> 00:04:37.220一般在用药后一到两周内出现00:04:37.480 --> 00:04:38.200停药后呢00:04:38.200 --> 00:04:40.300咳嗽症状通常会在数天00:04:41.200 --> 00:04:42.280几几周内呢00:04:42.280 --> 00:04:43.460逐渐的缓解00:04:46.360 --> 00:04:47.560其他诱因的话00:04:47.560 --> 00:04:48.720我们也可以看到00:04:48.720 --> 00:04:50.500包括一些环境的因素00:04:50.640 --> 00:04:53.040比如长期暴露在空气污染00:04:53.040 --> 00:04:55.420化学物烟雾等环境当中00:04:55.680 --> 00:04:56.960如在工厂啊00:04:56.960 --> 00:04:58.280装修环境当中工作00:04:58.280 --> 00:05:00.160或者长期处于吸烟的一个环境00:05:00.160 --> 00:05:02.120这些有害的物质呢00:05:02.120 --> 00:05:03.580也会刺激呼吸道00:05:03.640 --> 00:05:05.780引起气道粘膜的这个受损00:05:05.920 --> 00:05:07.520呃引起慢性炎症啊00:05:07.520 --> 00:05:09.180从而引发咳嗽00:05:09.760 --> 00:05:11.080那么心理因素方面的话00:05:11.080 --> 00:05:12.440我们有些焦虑啊00:05:12.440 --> 00:05:13.940抑郁啊紧张等00:05:14.240 --> 00:05:16.240这个精神心理因素呢00:05:16.240 --> 00:05:18.940也可能是导致这个慢性的一个咳嗽00:05:19.120 --> 00:05:21.280当人处于精神紧张状态时呢00:05:21.280 --> 00:05:24.540就会影响继而出现这个咳嗽00:05:24.880 --> 00:05:26.440那么还有一些职业的因素00:05:26.440 --> 00:05:29.140比如某些职业环境当中的这个粉尘00:05:29.560 --> 00:05:30.480化学物质等等00:05:30.480 --> 00:05:32.940可以引起慢性的一个咳嗽00:05:33.240 --> 00:05:34.700比如老师啊00:05:34.760 --> 00:05:35.520纺织功能等00:05:35.520 --> 00:05:38.580长期接触这个粉笔灰或者棉尘等等00:05:39.000 --> 00:05:40.480那么可能导致呼吸道的00:05:40.480 --> 00:05:42.100一个慢性的一个炎症00:05:42.280 --> 00:05:43.700引发这个咳嗽00:05:43.840 --> 00:05:45.400在化工行业的功能呢00:05:45.400 --> 00:05:47.800接触的那些甲醛啊00:05:47.800 --> 00:05:49.280苯啊等化学物质呢00:05:49.280 --> 00:05:51.900也可能引起这个刺激呼吸道00:05:52.080 --> 00:05:54.820继而引起这个慢性的咳嗽00:05:58.640 --> 00:05:59.680那么我们刚刚说的00:05:59.680 --> 00:06:00.760常见的病因当中00:06:00.760 --> 00:06:01.960这个呼吸道疾病的话00:06:01.960 --> 00:06:04.320我们这个呃四大类啊00:06:04.320 --> 00:06:05.040那么咳嗽00:06:05.040 --> 00:06:06.360变异性的这个哮喘的话00:06:06.360 --> 00:06:08.820它的特征主要就是一个慢性的咳嗽00:06:09.040 --> 00:06:10.980没有其他明显的症状00:06:11.120 --> 00:06:14.080那因为就是气道高反应性引起的00:06:14.080 --> 00:06:15.120那么诊断呢00:06:15.120 --> 00:06:16.620需排除其他原因00:06:17.160 --> 00:06:18.560那么我们上气道的00:06:18.560 --> 00:06:19.760这个咳嗽综合征的话00:06:19.760 --> 00:06:22.280病因主要还是这个鼻部的疾病00:06:22.280 --> 00:06:23.840引起分泌物的一个倒流00:06:23.840 --> 00:06:25.980刺激咽喉至咳嗽00:06:26.000 --> 00:06:27.960常伴有流鼻涕啊00:06:27.960 --> 00:06:29.180打喷嚏等等00:06:29.960 --> 00:06:30.480那么在00:06:30.480 --> 00:06:32.480嗜酸性粒细胞性支气管炎当中的话00:06:32.480 --> 00:06:33.520我们的特点主要就是00:06:33.520 --> 00:06:35.880一个气道的这个嗜酸性粒细胞增装00:06:35.880 --> 00:06:38.680增多那么临床出现类似哮喘00:06:38.680 --> 00:06:40.100但无高反应性00:06:40.240 --> 00:06:42.060那么诊断需鉴别00:06:43.320 --> 00:06:45.620那么在常见病因当中的话00:06:45.920 --> 00:06:47.920呃我们这个胃食道反流性的00:06:47.920 --> 00:06:48.680一个咳嗽的话00:06:48.680 --> 00:06:50.580是一个非典型的一个病因00:06:51.040 --> 00:06:53.640那么在反流物刺激食管00:06:53.640 --> 00:06:56.620然后引发持续性的咳嗽00:06:56.920 --> 00:06:59.280那么这个服药啊调整00:06:59.280 --> 00:07:01.500或需进行一个行为的一个干预00:07:02.920 --> 00:07:04.720那在药物诱发咳嗽当中的话00:07:04.720 --> 00:07:06.760我们就前面说到这个呃00:07:06.760 --> 00:07:07.560降血压药的00:07:07.560 --> 00:07:10.460这个血管紧张素抑制剂的副作用00:07:10.520 --> 00:07:13.080那么它可能导致这个呃00:07:13.080 --> 00:07:15.180没有痰的一个干咳00:07:15.360 --> 00:07:17.440那么我们主要就是一个更换药物00:07:17.440 --> 00:07:18.820或者调整剂量00:07:19.120 --> 00:07:20.520呃有需要的话00:07:20.520 --> 00:07:22.980还是要咨询这个呃00:07:23.240 --> 00:07:26.060执业的一个医师进行调整00:07:26.360 --> 00:07:28.200在心阴性的这个咳嗽方面的00:07:28.200 --> 00:07:30.940主要还是一个有精神因素影响00:07:31.160 --> 00:07:34.040那么就咳嗽是与紧张啊00:07:34.040 --> 00:07:35.860焦虑情绪相关的00:07:36.200 --> 00:07:38.120那么可能是需要这个一定的00:07:38.120 --> 00:07:39.160这个心理治疗00:07:39.160 --> 00:07:41.760或者一些个中枢镇咳的00:07:41.760 --> 00:07:44.140这个药物的一个辅助的治疗00:07:47.960 --> 00:07:50.520那么还有我们也比较常见的00:07:50.520 --> 00:07:53.240这个新冠病毒00:07:53.240 --> 00:07:55.260对吧那么他这个咳嗽呢00:07:55.400 --> 00:07:56.640这个症状表现的话00:07:56.640 --> 00:07:57.620主要是00:07:57.680 --> 00:08:00.820还有这个慢长期的这个反复的咳嗽00:08:01.480 --> 00:08:03.320也是干咳或者少痰00:08:03.320 --> 00:08:05.140但是咳嗽时间呢也不定00:08:05.280 --> 00:08:06.700夜间可能加重00:08:07.000 --> 00:08:08.240那么相关症状的话00:08:08.240 --> 00:08:10.320可能还有一些个咽痒啊00:08:10.320 --> 00:08:11.920咽干啊异物感啊00:08:11.920 --> 00:08:13.340胸闷气喘等00:08:13.480 --> 00:08:15.740这个症状呢就比较复杂多变00:08:18.280 --> 00:08:19.680对于生活的影响的话00:08:19.680 --> 00:08:20.680那么肯定00:08:20.680 --> 00:08:22.400第一就是一个睡眠质量的影响00:08:22.400 --> 00:08:24.280你夜间这个咳嗽频发00:08:24.280 --> 00:08:26.780那么你这个睡眠时间相对就减少00:08:27.040 --> 00:08:28.640然后恶性循环00:08:28.640 --> 00:08:31.740导致白天这个工作疲乏无力00:08:32.160 --> 00:08:34.700而且影响这个生活的这个品质00:08:35.000 --> 00:08:37.240那么在日常生活的干扰当中00:08:37.240 --> 00:08:39.740也是因为咳嗽影响这个工作效率00:08:40.040 --> 00:08:41.160那包括学习啊00:08:41.160 --> 00:08:42.780专注力的下降啊00:08:42.920 --> 00:08:45.000还有一些就是在社交场合00:08:45.000 --> 00:08:46.320这个反复咳嗽的话00:08:46.320 --> 00:08:50.600也会造成这个自己和他人的00:08:50.600 --> 00:08:52.580这个对健康的这个困扰00:08:53.200 --> 00:08:55.160那么在心理状态变化方面00:08:55.160 --> 00:08:55.600他也是00:08:55.600 --> 00:08:57.680如果是一个长期的一个疾病的话00:08:57.680 --> 00:09:00.480也是呃对心理压力呢00:09:00.480 --> 00:09:01.240也是增大00:09:01.240 --> 00:09:04.600可能引发相关的一些个焦虑啊00:09:04.600 --> 00:09:06.020抑郁的这个情绪00:09:06.960 --> 00:09:09.120呃所以我们在这个咳嗽00:09:09.120 --> 00:09:11.720作为一个健康的一个警示方面的话00:09:11.720 --> 00:09:14.720我们如果出现这个持续的咳嗽00:09:14.720 --> 00:09:15.740需要重视00:09:16.520 --> 00:09:20.760那么在预防这个长期慢性的咳嗽00:09:20.760 --> 00:09:23.060对一个身心健康的一个影响00:09:23.360 --> 00:09:25.520就一旦有出现这种情况的话00:09:25.520 --> 00:09:27.860还是希望能够及时就医00:09:28.200 --> 00:09:29.060刻不容缓00:09:31.200 --> 00:09:32.040那么这个咳嗽00:09:32.040 --> 00:09:33.320我们这个诊断方法方面00:09:33.320 --> 00:09:34.400话完主要就是一个00:09:34.400 --> 00:09:36.660对一个病史的一个详细的一个询问00:09:37.120 --> 00:09:39.540那么主要有这个以下的5点00:09:40.320 --> 00:09:40.680第一00:09:40.680 --> 00:09:43.780这就是对病因病史的一个询问00:09:44.120 --> 00:09:46.440它主要是一个涵盖起病的时间啊00:09:46.440 --> 00:09:47.440持续时长啊00:09:47.440 --> 00:09:48.900频率啊性质啊00:09:49.280 --> 00:09:50.360相关症状与00:09:50.360 --> 00:09:51.120既往史啊00:09:51.120 --> 00:09:52.520比如有发热咳痰00:09:52.520 --> 00:09:54.940过敏史呼吸道疾病等等00:09:55.680 --> 00:09:56.840在诊断方法方面00:09:56.840 --> 00:09:58.000这个在体格检查00:09:58.000 --> 00:10:00.920我们也重点要关注这个呼吸系统00:10:00.920 --> 00:10:02.800包括肺部的这个听诊啊00:10:02.800 --> 00:10:04.420咽喉部的一个检查00:10:04.680 --> 00:10:06.120寻找异常的一个体征00:10:06.120 --> 00:10:08.540以及辅助的诊断00:10:09.440 --> 00:10:11.200对影像学的功能检查的话00:10:11.200 --> 00:10:12.760我们也是呃00:10:12.760 --> 00:10:15.580采用胸部x线或者CT的一个检查00:10:15.760 --> 00:10:17.560那么包括肺功能的检查00:10:17.560 --> 00:10:19.080来评估这个气道00:10:19.080 --> 00:10:19.940必要时00:10:20.200 --> 00:10:23.820进行相关的这个过敏源的一个检测00:10:25.440 --> 00:10:26.640在药物治疗方面的话00:10:26.640 --> 00:10:29.040我们这个可以针对不同病因00:10:29.040 --> 00:10:31.540使用这个包括支气管扩张剂啊00:10:31.560 --> 00:10:32.820抗阻胺药啊00:10:32.840 --> 00:10:35.200自制棒抑制剂啊等等00:10:35.200 --> 00:10:36.800来抑制症状00:10:36.800 --> 00:10:38.300或者是个源头00:10:39.320 --> 00:10:41.040那么最后的话00:10:41.040 --> 00:10:43.740我们只还有一个就是手术的治疗00:10:43.840 --> 00:10:46.400那比如说是对解剖结构异常00:10:46.400 --> 00:10:48.000如鼻息肉啊00:10:48.000 --> 00:10:50.020扁桃体肥大引起的咳嗽00:10:50.160 --> 00:10:52.020那么我们还是要考虑00:10:52.280 --> 00:10:54.520对这个原发病的00:10:54.520 --> 00:10:56.340一个手术的一个纠正00:10:59.720 --> 00:11:02.520诊断方法我们主要还是就是一个呃00:11:02.520 --> 00:11:03.760包括有几以下几类啊00:11:03.760 --> 00:11:05.520点包括一个中医治疗00:11:05.520 --> 00:11:09.680那么也是这个对中医的这个理念00:11:09.680 --> 00:11:10.800我们认为慢性咳嗽00:11:10.800 --> 00:11:12.040与肺功能失调有关00:11:12.040 --> 00:11:14.980所以治疗注重这个整体的一个调理00:11:15.000 --> 00:11:16.700需要也是辨证实质00:11:17.040 --> 00:11:20.940那么比如中药方剂当中有山药糖啊00:11:21.080 --> 00:11:21.320呃00:11:21.320 --> 00:11:22.400桑菊饮等等00:11:22.400 --> 00:11:24.460或者是结合针灸推拿00:11:24.560 --> 00:11:25.240调节人体00:11:25.240 --> 00:11:27.060达到这个止咳的一个效果00:11:27.680 --> 00:11:29.040在饮食与运动方面00:11:29.040 --> 00:11:31.760我们也建议推荐这个润肺的食物00:11:31.760 --> 00:11:33.460如梨啊百合啊00:11:33.720 --> 00:11:35.560就是避免辛辣的刺激00:11:35.560 --> 00:11:37.600结合有氧运动和呼吸训练00:11:37.600 --> 00:11:38.740改善症状00:11:39.120 --> 00:11:41.560那么在生活环境与心理调节方面00:11:41.560 --> 00:11:44.200我们也是需要保持这个空气00:11:44.200 --> 00:11:45.080的一个清新00:11:45.080 --> 00:11:46.800控制室内的这个湿度00:11:46.800 --> 00:11:48.020避免过敏源00:11:48.320 --> 00:11:48.600啊00:11:48.600 --> 00:11:51.240保持良好的一个呃心态00:11:51.240 --> 00:11:52.740以减轻这个咳嗽00:11:55.000 --> 00:11:56.200那在预防措施方面00:11:56.200 --> 00:11:58.640我们主要还是一个要锻炼00:11:58.640 --> 00:12:00.220增强这个体质00:12:00.800 --> 00:12:01.980那么避免呢00:12:02.400 --> 00:12:02.800呃00:12:02.800 --> 00:12:04.900食用这个刺激性的一个食物00:12:05.000 --> 00:12:07.980或者是接触相关的一个物质00:12:08.320 --> 00:12:10.740呃保持这个环境的一个清洁00:12:11.040 --> 00:12:12.480然后呃00:12:12.480 --> 00:12:13.920在医生的指导下呢00:12:13.920 --> 00:12:15.340规范用药00:12:19.200 --> 00:12:20.060呃00:12:20.560 --> 00:12:22.720以下我们还有这个互动问答环节00:12:22.720 --> 00:12:26.940那么这边我们就呃略过了00:12:27.200 --> 00:12:27.480呃00:12:27.480 --> 00:12:29.880希望我们在这个慢性咳嗽知识啊00:12:29.880 --> 00:12:32.060包括一些咳嗽饮食调理00:12:32.400 --> 00:12:33.720和防止咳嗽方面00:12:33.720 --> 00:12:36.180也可以给大家一些个建议00:12:38.160 --> 00:12:42.000那么接下来我们是看一看00:12:42.000 --> 00:12:44.740是如何预防这个慢性的一个咳嗽00:12:45.640 --> 00:12:47.120那主要也是三块啊00:12:47.120 --> 00:12:47.480第一呢00:12:47.480 --> 00:12:49.980就是一个生活习惯的一个调整00:12:50.360 --> 00:12:52.040包括一个规律的一个作息00:12:52.040 --> 00:12:55.060保证充足睡眠以增强免疫力00:12:55.280 --> 00:12:56.640适度的一个运动锻炼00:12:56.640 --> 00:12:58.880以身体代谢以及呼吸功能00:12:58.880 --> 00:13:00.420来促进这个00:13:01.760 --> 00:13:03.060呃提高免疫力00:13:03.200 --> 00:13:04.520那在环境因素方面的话00:13:04.520 --> 00:13:06.640我们也是要把控这个空气的00:13:06.640 --> 00:13:07.540一个清洁00:13:07.800 --> 00:13:09.640雾霾天气的话要戴口罩00:13:09.640 --> 00:13:13.980在控制室内湿度是基本上在40%-60%00:13:14.240 --> 00:13:16.360那么定期呢清洁家居00:13:16.360 --> 00:13:17.500防过敏源00:13:18.240 --> 00:13:19.520在饮食方面的话呢00:13:19.520 --> 00:13:22.140我们还是提倡一个均衡饮食00:13:22.640 --> 00:13:25.780多摄入蔬果来增强营养00:13:26.040 --> 00:13:27.640还有就是积极治疗00:13:27.640 --> 00:13:29.540相关的一个基础病00:13:29.920 --> 00:13:31.780避免这个炎症牵引00:13:32.040 --> 00:13:34.220引发这个慢性的一个咳嗽00:13:34.920 --> 00:13:36.880所以还是要早发现00:13:36.880 --> 00:13:37.700早治疗00:13:39.520 --> 00:13:40.680那在中老年方面00:13:40.680 --> 00:13:42.360我们是如何预防慢性咳嗽00:13:42.360 --> 00:13:43.360那么第一00:13:43.360 --> 00:13:45.620我们就是注重这个生活的一个细节00:13:45.880 --> 00:13:49.040还是要保持室内的一个空气的流通00:13:49.040 --> 00:13:50.900定期开窗换气00:13:51.200 --> 00:13:51.760根据天00:13:51.760 --> 00:13:54.400气来几天添减这个衣物00:13:54.400 --> 00:13:55.940避免受寒感冒00:13:56.160 --> 00:13:58.220降低呼吸道感染的一个几率00:13:58.600 --> 00:14:01.420第二点还是一个合理的饮食和锻炼00:14:01.600 --> 00:14:02.240饮食上呢00:14:02.240 --> 00:14:03.600要注重营养均衡00:14:03.600 --> 00:14:05.260多吃润肺的食物00:14:05.720 --> 00:14:07.920那么适度的一个运动00:14:07.920 --> 00:14:09.440包括老年人的话00:14:09.440 --> 00:14:11.720主要还像推荐这个散步啊00:14:11.720 --> 00:14:12.440打太极啊00:14:12.440 --> 00:14:14.660来增强身体的一个抵抗力00:14:15.000 --> 00:14:16.080那么第三点的话00:14:16.080 --> 00:14:18.180就是一个规避不良的一个因素00:14:18.560 --> 00:14:18.720呃00:14:18.720 --> 00:14:22.260我们可以尽量远离吸烟的一个环境00:14:22.440 --> 00:14:24.520包括减少一些接触花粉啊00:14:24.520 --> 00:14:26.380粉尘的这种机会00:14:26.560 --> 00:14:29.440那么如果患者患有这个基础病的00:14:29.440 --> 00:14:31.780我们还是需要规范的一个治疗00:14:32.000 --> 00:14:34.120防止这个病情啊00:14:34.120 --> 00:14:36.780引引发这个慢性的一个咳嗽00:14:40.520 --> 00:14:43.280呃那么患者慢性的一个咳嗽呢00:14:43.280 --> 00:14:45.680在行上我们需要注意的地方有哪些00:14:45.680 --> 00:14:48.740呢些相关的禁忌我们也了解一下00:14:49.040 --> 00:14:51.680呃第一就是要忌辛辣的00:14:51.680 --> 00:14:53.320一个刺激性的一个食物00:14:53.320 --> 00:14:54.680包括像辣椒啊00:14:54.680 --> 00:14:55.880花椒啊芥末啊00:14:55.880 --> 00:14:56.980生姜等等00:14:57.560 --> 00:14:59.920呃那么第二就是要忌生冷的食物00:14:59.920 --> 00:15:01.660像这个冰激凌啊00:15:01.880 --> 00:15:03.120冰饮料等等00:15:03.120 --> 00:15:05.680第三就是忌油腻及高糖的一个食物00:15:05.680 --> 00:15:07.360包括油炸的肥肉00:15:07.360 --> 00:15:08.700油腻食物等等00:15:09.400 --> 00:15:10.960那么我们慢性咳嗽患者00:15:10.960 --> 00:15:13.900可以多吃哪些润肺的食物呢00:15:14.000 --> 00:15:15.600比方说是水果00:15:15.600 --> 00:15:16.400像梨00:15:16.920 --> 00:15:17.720枇杷00:15:17.920 --> 00:15:21.040柚子那么蔬菜类的00:15:21.040 --> 00:15:22.640包括有百合啊00:15:22.640 --> 00:15:24.780山药啊白萝卜等等00:15:25.120 --> 00:15:26.040那么其他类的00:15:26.040 --> 00:15:28.300我们包括有一些银耳啊00:15:28.600 --> 00:15:30.040这个嗯00:15:30.040 --> 00:15:31.100蜂蜜啊00:15:31.640 --> 00:15:33.540都可以作为杏仁啊00:15:33.680 --> 00:15:34.600作为一个00:15:34.600 --> 00:15:35.400呃00:15:35.880 --> 00:15:37.200常见的润肺饮材00:15:37.200 --> 00:15:40.300这个富含他胶质和多种氨基酸的00:15:40.880 --> 00:15:41.560好的00:15:41.560 --> 00:15:45.420本次会议这个学习都就到此结束00:15:45.840 --> 00:15:46.700谢谢大家