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--> 00:07.061\n嗯，\n\n00:07.061 --> 00:07.787\n大家好，\n\n00:07.987 --> 00:11.536\n那么我们本期给大家介绍的是一个咳，\n\n00:11.536 --> 00:16.736\n不停破解慢性咳嗽真相的一个相关医疗分享。\n\n00:21.059 --> 00:21.184\n嗯，\n\n00:21.184 --> 00:24.708\n我们将从咳嗽为何赖着不走，\n\n00:25.259 --> 00:27.259\n以及揪出幕后黑手，\n\n00:27.659 --> 00:30.108\n还有咳嗽的对症出击治疗图，\n\n00:30.559 --> 00:33.109\n以及咳嗽居家自主缓解技巧，\n\n00:33.359 --> 00:36.258\n还有咳嗽的长期管理复诊，\n\n00:36.609 --> 00:40.609\n以及咳嗽的相关答疑与行动清单等六个方面。\n\n00:41.277 --> 00:42.877\n来介绍我们的本期话题。\n\n00:44.919 --> 00:47.470\n那么我们的咳嗽为什么赖着不走呢？\n\n00:49.846 --> 00:50.320\n首先，\n\n00:50.320 --> 00:52.145\n我们要明白什么是，\n\n00:52.145 --> 00:53.096\n慢性咳嗽，\n\n00:53.096 --> 00:55.445\n还有慢性咳嗽有什么解释的信号。\n\n00:56.245 --> 00:56.645\n嗯，\n\n00:56.695 --> 01:00.096\n首先是一个定义明确的时间界限。\n\n01:01.305 --> 01:05.504\n慢性咳嗽是指成成人持续咳嗽8周，\n\n01:05.705 --> 01:11.305\n或者是儿童咳嗽持续时间超过四周及以上，\n\n01:11.504 --> 01:13.455\n那么叫慢性咳嗽。\n\n01:14.472 --> 01:16.372\n这是身体发出的长期警报，\n\n01:16.671 --> 01:19.872\n提醒我们这不是普通的短暂咳嗽，\n\n01:20.071 --> 01:23.122\n那么需要引起我们高度的重视。\n\n01:23.821 --> 01:28.272\n那么慢性咳嗽它有哪些警惕的危险信号呢？\n\n01:29.247 --> 01:38.296\n如果说夜间有咳醒、有咳痰带血、有气短、有体重下降等危险性信号，\n\n01:38.597 --> 01:41.546\n那么提示可能存在一个严重的疾病，\n\n01:41.796 --> 01:43.647\n那么我们需要及时的就医。\n\n01:44.579 --> 01:45.603\n不能够忽视。\n\n01:49.625 --> 01:54.325\n那么我们咳嗽有四个常见的一个病因。\n\n01:55.351 --> 01:55.501\n那么，\n\n01:55.501 --> 02:01.452\n它分别是我们的上气道咳嗽综合征、咳嗽变异性哮喘，\n\n02:01.652 --> 02:07.202\n还有非哮喘性嗜酸粒细胞性支气管炎以及我们的胃食管反流。\n\n02:07.902 --> 02:08.352\n那么，\n\n02:08.352 --> 02:10.751\n我们先来看我们的第一个常见病因，\n\n02:10.852 --> 02:11.227\n嗯，\n\n02:11.227 --> 02:13.102\n上气道咳嗽综合征。\n\n02:13.776 --> 02:16.626\n那么它的一个典型表现是鼻后低落感，\n\n02:17.076 --> 02:22.326\n那么经常因为鼻腔鼻窦疾病导致我们的分泌物倒流，\n\n02:22.776 --> 02:25.175\n刺激咽喉引起咳嗽，\n\n02:25.475 --> 02:28.576\n它约占慢性咳嗽患者的1/3。\n\n02:29.828 --> 02:30.027\n嗯，\n\n02:30.427 --> 02:34.578\n就是我们生活中有很多人就是说经常会感觉鼻塞，\n\n02:34.828 --> 02:36.477\n或者说是感觉鼻涕。\n\n02:37.574 --> 02:38.375\n但是有的时候。\n\n02:40.229 --> 02:43.904\n他可能就是导致你长期咳嗽的原因。\n\n02:45.800 --> 02:47.076\n另外一个是我们的咳嗽，\n\n02:47.076 --> 02:47.951\n变异型哮喘，\n\n02:48.300 --> 02:50.701\n那么它是以咳嗽为主要症状，\n\n02:51.001 --> 02:54.001\n经常是在夜间或者是运动后加重。\n\n02:54.679 --> 02:55.080\n患者，\n\n02:55.080 --> 02:56.929\n可能无明显的喘息，\n\n02:57.330 --> 02:57.979\n但是呢，\n\n02:57.979 --> 03:00.029\n存在一个气道的高反应性。\n\n03:01.054 --> 03:01.255\n嗯，\n\n03:01.804 --> 03:03.630\n咳嗽变形、哮喘的话，\n\n03:03.630 --> 03:06.604\n我们是需要通过肺功能检查等确诊。\n\n03:07.876 --> 03:09.076\n如果说，\n\n03:10.227 --> 03:11.526\n你经常咳嗽。\n\n03:12.830 --> 03:14.630\n在夜间或运动后加重，\n\n03:14.630 --> 03:17.979\n或者是和这个季节天气变化有关系。\n\n03:18.774 --> 03:20.673\n或者是在接触过敏原之后，\n\n03:20.673 --> 03:24.024\n那么就要高度警惕是不是我们的咳嗽变异性哮喘。\n\n03:24.854 --> 03:25.078\n那么，\n\n03:25.078 --> 03:28.804\n这个是需要去呼吸科做我们的肺功能检测来检，\n\n03:28.854 --> 03:30.304\n来明确诊断。\n\n03:31.026 --> 03:35.975\n那么第三点是非哮喘性嗜酸粒细胞性支气管炎。\n\n03:36.725 --> 03:38.850\n那么它的关键特征呢，\n\n03:38.850 --> 03:41.776\n是痰液中的嗜酸粒细胞明显升高。\n\n03:42.533 --> 03:42.957\n患者，\n\n03:42.957 --> 03:44.332\n通常是没有气喘，\n\n03:44.382 --> 03:46.082\n但是咳嗽比较剧烈。\n\n03:47.063 --> 03:49.764\n他对糖皮质激素治疗比较敏感，\n\n03:50.063 --> 03:52.014\n那么容易被误诊为哮喘。\n\n03:53.046 --> 03:55.645\n另一点是我们的胃食管反流。\n\n03:56.046 --> 03:56.645\n那么。\n\n03:58.421 --> 03:59.472\n它的主要症状呢，\n\n03:59.472 --> 04:01.072\n就是会有反酸，\n\n04:01.222 --> 04:02.121\n有烧心。\n\n04:03.660 --> 04:03.886\n当然，\n\n04:03.886 --> 04:06.285\n部分患者是没有典型的反流的症状，\n\n04:06.285 --> 04:07.210\n容易被忽视。\n\n04:08.042 --> 04:08.341\n嗯，\n\n04:08.341 --> 04:13.891\n它的原因就是因为我们反流的胃酸刺激了我们食管下段还有咽喉部，\n\n04:14.091 --> 04:15.841\n那么引起了我们咳嗽。\n\n04:18.809 --> 04:21.484\n那么第二点是揪出我们的幕后黑手。\n\n04:21.484 --> 04:23.910\n那么我们咳嗽有哪些幕后黑手呢？\n\n04:24.859 --> 04:28.160\n我们的医生是如何抽丝剥茧做诊断呢？\n\n04:28.410 --> 04:31.109\n首先是要进行一个病史的回顾。\n\n04:31.691 --> 04:36.141\n也就是说我们的医生会详细的询问咳嗽起病的时间，\n\n04:36.441 --> 04:38.541\n那么诱因、伴随症状，\n\n04:38.691 --> 04:40.391\n还有既往的用药史。\n\n04:41.377 --> 04:43.127\n排查是否因药物，\n\n04:43.177 --> 04:46.076\n比如说ACEI类药物引起的咳嗽，\n\n04:46.076 --> 04:47.601\n那么我们的ACEI类呢，\n\n04:47.601 --> 04:48.777\n是我们的一个。\n\n04:49.679 --> 04:50.480\n普利类的药物，\n\n04:50.480 --> 04:52.829\n它主要是有利尿降压的效果。\n\n04:53.480 --> 04:54.005\n那么，\n\n04:54.005 --> 04:55.105\n影像检查呢，\n\n04:55.105 --> 05:02.230\n是通过我们的胸部X光或CT检查来排除肺部肿瘤。\n\n05:03.070 --> 05:04.970\n结核等器质性病变，\n\n05:05.220 --> 05:08.570\n那么为后续病因诊断提供一个基础的依据。\n\n05:08.920 --> 05:09.595\n同时呢，\n\n05:09.595 --> 05:11.519\n我们还会做一些功能性检查。\n\n05:12.330 --> 05:15.730\n比如说肺功能检查、诱导痰细胞学检查，\n\n05:16.080 --> 05:18.781\n24小时食管PH、H监测，\n\n05:19.031 --> 05:21.980\n以及针对不同病因进行定向检查，\n\n05:22.330 --> 05:23.881\n明确我们的诊断方向。\n\n05:25.032 --> 05:27.782\n那么还有其他一些被忽视的诱因？\n\n05:28.665 --> 05:28.865\n嗯，\n\n05:29.365 --> 05:31.615\n比如说一些少见因素，\n\n05:31.665 --> 05:34.165\n那么感染后的气道高反应，\n\n05:34.515 --> 05:35.966\n慢性支气管炎，\n\n05:36.316 --> 05:37.615\n支气管扩张，\n\n05:38.066 --> 05:40.365\n还有甲状腺结节外压。\n\n05:41.161 --> 05:46.186\n间质性肺病以及职业粉尘暴露等虽然不常见，\n\n05:46.186 --> 05:48.710\n但也是慢性咳嗽的潜在诱因，\n\n05:48.911 --> 05:50.161\n需要综合考虑。\n\n05:50.561 --> 05:51.061\n那么，\n\n05:51.061 --> 05:54.110\n气道后感染后气道的高反应，\n\n05:54.311 --> 06:00.860\n就比如说我们有的病人他感染了甲流新冠或者一些慢慢性炎症或肺炎，\n\n06:01.110 --> 06:02.960\n那么可能在治疗之后呢，\n\n06:02.960 --> 06:05.460\n它还是会存在一个持续的咳嗽。\n\n06:06.041 --> 06:08.541\n那么这个时候我们就考虑是一个气道的高反应。\n\n06:09.291 --> 06:10.941\n那么慢性支气管炎呢，\n\n06:10.941 --> 06:13.117\n可能会常见于我们的老年患者，\n\n06:13.117 --> 06:15.992\n就有的患者可能会长期就有一直咳嗽，\n\n06:16.191 --> 06:17.191\n可能是干咳，\n\n06:17.191 --> 06:17.992\n有可能有痰，\n\n06:18.191 --> 06:19.016\n但是后面呢，\n\n06:19.016 --> 06:19.916\n因为炎症加重了，\n\n06:19.916 --> 06:21.141\n可能就会咳嗽的加重。\n\n06:22.346 --> 06:22.596\n嗯，\n\n06:23.096 --> 06:24.747\n那么支气管扩张呢，\n\n06:25.096 --> 06:27.897\n这个我们病人可能会出现有咳黄脓痰，\n\n06:27.946 --> 06:29.296\n甚至有咳血。\n\n06:30.411 --> 06:30.636\n那么，\n\n06:30.636 --> 06:31.937\n甲状腺结节外压的话，\n\n06:31.937 --> 06:33.062\n这个，\n\n06:33.062 --> 06:36.161\n我们可以做一个超声来给他明确诊断。\n\n06:37.186 --> 06:37.585\n嗯，\n\n06:37.885 --> 06:39.135\n像间质性肺病，\n\n06:39.135 --> 06:40.536\n还有职业粉尘暴露呢，\n\n06:40.536 --> 06:43.585\n这些就是和我们的一个工作的环境。\n\n06:45.348 --> 06:45.574\n嗯，\n\n06:45.574 --> 06:46.299\n有关系。\n\n06:49.552 --> 06:50.701\n那么对于慢性咳嗽，\n\n06:50.701 --> 06:53.052\n我们要怎么去对它对症治疗呢？\n\n06:53.351 --> 06:57.101\n我们现在从我们的这个治疗图上来给大家来慢慢解释。\n\n06:58.011 --> 06:58.411\n那么，\n\n06:58.411 --> 07:01.587\n我们上气道与咳嗽与哮喘型咳嗽呢，\n\n07:01.587 --> 07:03.236\n它有许多用药的方案，\n\n07:03.236 --> 07:08.011\n并且他们的用药的方案也会根据病因不同而不同。\n\n07:08.361 --> 07:10.861\n你比如说上气道咳嗽综合征治疗，\n\n07:11.212 --> 07:13.837\n我们首先要选用鼻用激素，\n\n07:13.837 --> 07:15.062\n还有抗阻胺药。\n\n07:16.010 --> 07:16.161\n嗯，\n\n07:16.161 --> 07:17.960\n疗程要6到八周，\n\n07:18.260 --> 07:19.661\n那么鼻用激素呢，\n\n07:19.661 --> 07:21.411\n就比如说我们常见的信必可。\n\n07:22.259 --> 07:22.408\n嗯，\n\n07:22.408 --> 07:23.808\n这种吸入的。\n\n07:26.071 --> 07:26.321\n嗯，\n\n07:26.321 --> 07:28.071\n那么合并鼻窦炎的话，\n\n07:28.071 --> 07:31.221\n可能我们需要加用生理盐水冲洗，\n\n07:31.371 --> 07:32.871\n还有短期的抗生素。\n\n07:33.270 --> 07:33.670\n嗯，\n\n07:34.020 --> 07:35.721\n在治疗过程中一定要注意，\n\n07:35.721 --> 07:37.020\n要足够疗程的使用。\n\n07:37.020 --> 07:38.721\n因为如果说抗生素疗程不够，\n\n07:38.721 --> 07:39.621\n很容易复发。\n\n07:41.059 --> 07:43.260\n那么哮喘型咳嗽的治疗呢，\n\n07:43.410 --> 07:45.709\n我们是遵循哮喘的阶梯治疗，\n\n07:46.059 --> 07:48.160\n首先是低剂量的吸入激素，\n\n07:48.160 --> 07:50.609\n联合支气管舒张剂为核心。\n\n07:51.796 --> 07:54.622\n那么他即便症状有缓解后，\n\n07:54.622 --> 07:56.846\n仍然需要维持3.6个月。\n\n07:57.420 --> 07:58.471\n为了防止复发，\n\n07:58.770 --> 08:00.971\n那么在我们治疗的过程中，\n\n08:00.971 --> 08:03.571\n有患者就是感觉自己症状好了，\n\n08:03.621 --> 08:05.270\n他可能自己就放弃治疗。\n\n08:05.471 --> 08:05.971\n然后，\n\n08:05.971 --> 08:08.145\n大概过了一个周或者是过了两天，\n\n08:08.145 --> 08:09.971\n他发现自己又开始咳嗽了。\n\n08:10.170 --> 08:10.645\n所以说，\n\n08:10.645 --> 08:14.221\n我们在治疗的时候一定要注意足够的时间。\n\n08:18.434 --> 08:18.660\n那么，\n\n08:18.660 --> 08:20.984\n反流与嗜酸炎症的对策，\n\n08:21.535 --> 08:21.910\n嗯，\n\n08:21.910 --> 08:23.760\n我们首先是生活方式的调整，\n\n08:23.760 --> 08:25.734\n还有药物治疗要双管齐下。\n\n08:26.135 --> 08:26.535\n嗯，\n\n08:26.535 --> 08:28.734\n睡前的话是三个小时进食，\n\n08:28.984 --> 08:30.535\n一个是抬高床头，\n\n08:30.885 --> 08:33.585\n减少油腻与咖啡因摄入，\n\n08:33.934 --> 08:36.534\n那么同时要给予自制棒抑制剂。\n\n08:37.229 --> 08:37.929\n主量8周。\n\n08:39.921 --> 08:40.171\n嗯，\n\n08:40.322 --> 08:42.971\n这是我们一个反流相关咳嗽的治疗。\n\n08:43.671 --> 08:44.096\n那么，\n\n08:44.096 --> 08:45.846\n我们嗜酸炎症的治疗呢，\n\n08:45.846 --> 08:48.921\n主要是要首选中剂量的吸入激素。\n\n08:49.882 --> 08:51.382\n疗程要4.8周，\n\n08:51.831 --> 08:53.307\n那么如果是重症的话，\n\n08:53.307 --> 08:55.031\n可以短期口服泼尼松。\n\n08:55.531 --> 08:55.882\n嗯，\n\n08:55.882 --> 08:58.132\n停药后需复查诱导痰。\n\n08:58.382 --> 08:59.057\n那还有，\n\n08:59.057 --> 09:03.432\n要在医生的指导下进行一个激素的减量。\n\n09:07.445 --> 09:10.695\n那么我们有哪一些咳嗽的缓解技巧呢？\n\n09:10.695 --> 09:12.245\n就在家里的时候。\n\n09:13.684 --> 09:16.234\n首先是呼吸训练与气道保湿。\n\n09:17.504 --> 09:18.004\n那么，\n\n09:18.004 --> 09:19.703\n我们如何呼吸训练呢？\n\n09:19.903 --> 09:20.304\n嗯，\n\n09:20.304 --> 09:27.054\n首先是要每日两次两次的缩唇呼吸与腹式呼吸训练。\n\n09:27.304 --> 09:27.804\n那么，\n\n09:27.804 --> 09:29.254\n通过延长呼吸相，\n\n09:29.254 --> 09:31.054\n降低迷走神经张力。\n\n09:31.658 --> 09:32.757\n减少咳嗽冲动，\n\n09:33.158 --> 09:33.557\n嗯，\n\n09:33.557 --> 09:35.182\n但是我们需要持之以恒，\n\n09:35.182 --> 09:40.958\n可能需要训练很久才能够看到一些效果。\n\n09:41.408 --> 09:43.507\n还有就是我们的气道保湿，\n\n09:43.857 --> 09:47.357\n比如说维持室内湿度50.60。\n\n09:48.630 --> 09:51.406\n百分比要多喝温水，\n\n09:51.806 --> 09:55.306\n同时含服冷冻菠萝块或者是冰块，\n\n09:55.705 --> 09:58.906\n那么还要利用我们的低温与水分双重镇静。\n\n09:59.835 --> 09:59.935\n嗯，\n\n09:59.935 --> 10:00.736\n咽喉黏膜。\n\n10:01.969 --> 10:04.219\n那么同时我们还要避免刺激，\n\n10:04.570 --> 10:07.070\n就是要避免含酒精口含片，\n\n10:07.469 --> 10:09.219\n以免加重干燥刺激。\n\n10:09.570 --> 10:11.869\n正确使用吸入装置，\n\n10:12.270 --> 10:15.570\n那么减少因为操作失误导致疗效不佳。\n\n10:16.445 --> 10:19.945\n那么这是我们训练还有气道保持的三种方式。\n\n10:22.700 --> 10:26.301\n那么假如说诱发场景的预防策略。\n\n10:27.601 --> 10:27.752\n嗯，\n\n10:27.752 --> 10:30.601\n我们如何去预防诱发呢？\n\n10:31.663 --> 10:31.812\n嗯，\n\n10:31.812 --> 10:34.562\n我们比如说冷空气诱发，\n\n10:34.812 --> 10:40.862\n那么我们可以在出门的时候前用鼻呼吸预热空气，\n\n10:41.513 --> 10:44.413\n减少冷空气对气道的直接刺激。\n\n10:45.065 --> 10:46.466\n降低咳嗽发作的风险，\n\n10:46.966 --> 10:48.565\n或者是可以戴个口罩。\n\n10:48.966 --> 10:50.265\n那么，\n\n10:50.366 --> 10:52.065\n运动诱发如何预防呢？\n\n10:52.315 --> 10:54.366\n我们在运动前要热身，\n\n10:54.416 --> 10:56.265\n还要配合节拍呼吸，\n\n10:56.565 --> 10:58.216\n减少气道的震荡，\n\n10:58.565 --> 11:01.265\n降低运动诱发咳嗽的可能性。\n\n11:02.658 --> 11:03.357\n那么，\n\n11:03.357 --> 11:06.607\n还有我们讲话过久诱发如何预防呢？\n\n11:06.757 --> 11:10.307\n我们长时间说话前要含服我们的糖果，\n\n11:10.458 --> 11:12.057\n保持咽部湿润，\n\n11:12.257 --> 11:14.357\n减少因干燥引起的咳嗽。\n\n11:15.211 --> 11:15.411\n那么，\n\n11:15.411 --> 11:17.961\n情绪紧张诱发我们要如何预防呢？\n\n11:18.262 --> 11:20.562\n我们要采用袖吹、吹三步法，\n\n11:20.562 --> 11:22.062\n快速放松喉肌，\n\n11:22.361 --> 11:24.512\n缓解情绪紧张引起的咳嗽。\n\n11:27.036 --> 11:27.312\n那么，\n\n11:27.312 --> 11:29.786\n慢性咳嗽长期管理复诊，\n\n11:30.036 --> 11:31.486\n我们该如何做呢？\n\n11:32.236 --> 11:34.387\n首先是建立个人咳嗽档案。\n\n11:35.190 --> 11:36.190\n记录关键信息，\n\n11:36.440 --> 11:42.390\n使用一个简易的表格记录我们自己每日咳嗽的频率、诱因还有用药反应，\n\n11:42.840 --> 11:45.289\n并附可量化的视觉评分尺，\n\n11:45.739 --> 11:48.489\n便于复诊时与医生快速回顾疗效。\n\n11:48.840 --> 11:49.515\n同时呢，\n\n11:49.515 --> 11:50.989\n要保存我们的检测报告。\n\n11:51.190 --> 11:53.340\n保存检测报告用于用药清单，\n\n11:53.489 --> 11:55.640\n要避免重复拍片或者是换药。\n\n11:55.890 --> 11:59.539\n那么以此来为医生提供一个全面的病情的资料。\n\n12:03.205 --> 12:03.604\n嗯，\n\n12:03.604 --> 12:05.854\n我们什么时候需要升级转诊呢？\n\n12:06.155 --> 12:06.655\n还有，\n\n12:06.655 --> 12:08.429\n我们在升级转诊的时候，\n\n12:08.429 --> 12:10.755\n我们要有一个把握转诊的时机。\n\n12:11.581 --> 12:11.831\n比如说，\n\n12:11.831 --> 12:13.731\n我们足量规范治疗8周后，\n\n12:13.731 --> 12:15.081\n没有明显的缓解，\n\n12:15.231 --> 12:18.031\n或者是出现了咯血、声音嘶哑，\n\n12:18.031 --> 12:18.932\n超过了3周，\n\n12:19.182 --> 12:23.731\n还有进行性的呼吸困难、反复的肺炎等红气征。\n\n12:24.031 --> 12:27.081\n那么我们就需要升级转诊到上级医院。\n\n12:28.281 --> 12:28.481\n嗯，\n\n12:28.531 --> 12:30.682\n那在转诊过程中，\n\n12:30.682 --> 12:31.956\n我们需要注意什么呢？\n\n12:31.956 --> 12:33.781\n首先是携带完整的资料。\n\n12:34.598 --> 12:37.198\n比如说转诊时携带完整的咳嗽日记，\n\n12:37.499 --> 12:40.598\n你像光盘既往的用药记录，\n\n12:40.749 --> 12:41.898\n还有过敏史。\n\n12:43.309 --> 12:45.383\n以便进入高阶评估流程。\n\n12:50.418 --> 12:50.893\n那么，\n\n12:50.893 --> 12:54.268\n对于慢性咳嗽的答疑和行动清单有哪些呢？\n\n12:56.278 --> 12:58.978\n首先是我们患者最关心的五个误区，\n\n12:59.427 --> 13:01.627\n一个是止咳糖浆根治误区。\n\n13:02.588 --> 13:02.737\n嗯，\n\n13:02.737 --> 13:06.088\n慢性咳嗽它不能单纯靠止咳糖浆根治，\n\n13:06.338 --> 13:10.937\n我们需要找清楚慢性咳嗽的病因来针对病因治疗。\n\n13:12.067 --> 13:15.067\n那么在有没有找对病因之前呢，\n\n13:15.067 --> 13:19.918\n我们可以选择蜂蜜水润喉替代含糖止咳糖浆。\n\n13:21.020 --> 13:21.520\n那么，\n\n13:22.020 --> 13:22.419\n嗯，\n\n13:22.770 --> 13:24.570\n关于抗生素耐用的误区，\n\n13:24.869 --> 13:25.594\n你比如说，\n\n13:25.594 --> 13:28.320\n我们有的患者可能一咳嗽我们就吃抗生素，\n\n13:28.320 --> 13:31.020\n或者是一感觉不舒服就去吃抗生素，\n\n13:31.020 --> 13:31.645\n吃头孢，\n\n13:31.645 --> 13:32.419\n吃沙星。\n\n13:32.770 --> 13:33.219\n其实，\n\n13:33.219 --> 13:34.520\n这样是不正确的，\n\n13:34.570 --> 13:37.419\n因为不是所有的咳嗽都是炎症引起的。\n\n13:37.921 --> 13:38.122\n当然，\n\n13:38.122 --> 13:43.421\n我们说的炎症是指的是细菌或者是病毒或者其他的一些病原体。\n\n13:44.572 --> 13:44.971\n嗯，\n\n13:44.971 --> 13:49.046\n在如果说我们没有发现有细菌感染就吃抗生素的话，\n\n13:49.046 --> 13:51.372\n可能会导致我们的一个药物的滥用，\n\n13:51.521 --> 13:53.271\n从而引起我们身体耐药。\n\n13:54.018 --> 13:54.317\n嗯，\n\n13:54.367 --> 13:57.168\n这个会为后续的治疗带来非常麻烦，\n\n13:57.567 --> 13:57.893\n嗯，\n\n13:57.893 --> 13:58.817\n麻烦的副作用。\n\n13:59.520 --> 13:59.945\n因此，\n\n13:59.945 --> 14:01.495\n如果有抗生素的使用的话，\n\n14:01.495 --> 14:03.820\n需要在医生的指导下合理的应用。\n\n14:04.924 --> 14:05.375\n那么，\n\n14:05.375 --> 14:06.775\n关于激素成瘾误区，\n\n14:07.325 --> 14:07.674\n嗯，\n\n14:07.674 --> 14:09.250\n我们激素吸入的话，\n\n14:09.250 --> 14:12.424\n在医生指导下使用是不会成瘾的。\n\n14:12.775 --> 14:13.325\n而且，\n\n14:13.325 --> 14:14.400\n使用激素的话，\n\n14:14.400 --> 14:16.825\n它是可以有效的控制我们的炎症。\n\n14:17.903 --> 14:18.103\n嗯，\n\n14:18.603 --> 14:21.653\n我们的很多病人他在就是用激素的时候，\n\n14:21.653 --> 14:23.002\n他可能会感觉很紧张，\n\n14:23.052 --> 14:24.302\n还有很害怕。\n\n14:24.302 --> 14:26.877\n他会觉得这个东西会不会依赖呀，\n\n14:26.877 --> 14:27.552\n吸完之后，\n\n14:27.552 --> 14:29.002\n我的身体会不会坏掉？\n\n14:29.353 --> 14:29.752\n嗯，\n\n14:29.903 --> 14:31.302\n一般是不会的。\n\n14:32.169 --> 14:32.369\n嗯，\n\n14:32.419 --> 14:35.119\n我们短期内在医生指导下，\n\n14:35.320 --> 14:36.719\n它不会成瘾，\n\n14:37.020 --> 14:40.169\n反而会有助于我们病情的快速好转，\n\n14:40.270 --> 14:41.619\n还有和康复。\n\n14:42.921 --> 14:43.171\n嗯，\n\n14:43.271 --> 14:46.721\n但是它需要在我们医生的指导下使用。\n\n14:47.421 --> 14:47.896\n那么，\n\n14:47.896 --> 14:49.872\n关于患者最关心的五个误区，\n\n14:50.072 --> 14:52.171\n一个是胃药按需服用误区，\n\n14:52.271 --> 14:54.521\n那么胃药需要主疗程使用，\n\n14:54.521 --> 14:56.521\n不能仅在胃痛时服用，\n\n14:56.572 --> 14:58.971\n否则无法有效控制胃食管反流。\n\n14:59.221 --> 15:01.122\n还有一个吸烟的耐受误区，\n\n15:01.471 --> 15:01.846\n嗯，\n\n15:01.846 --> 15:04.971\n气道炎症不会因为吸烟耐受而好转。\n\n15:05.570 --> 15:07.320\n吸烟反而会加重咳嗽，\n\n15:07.421 --> 15:09.221\n因此我们需要常规的戒烟。\n\n15:09.620 --> 15:10.070\n那么，\n\n15:10.070 --> 15:13.320\n我们的7日行动计划与志愿指引是哪些呢？\n\n15:13.370 --> 15:14.320\n一到两天呢，\n\n15:14.320 --> 15:16.570\n我们需要完成咳嗽日记与用药核查，\n\n15:16.971 --> 15:19.070\n详细记录信息，\n\n15:19.070 --> 15:20.820\n为后续治疗提供依据。\n\n15:20.971 --> 15:21.471\n那么，\n\n15:21.471 --> 15:22.296\n在第三日呢，\n\n15:22.296 --> 15:24.221\n需要预约复诊并准备资料，\n\n15:24.270 --> 15:25.520\n确保携带齐全，\n\n15:25.520 --> 15:27.221\n以便医生全面了解病情。\n\n15:27.520 --> 15:27.895\n那么，\n\n15:27.895 --> 15:29.020\n到四到五天的时候，\n\n15:29.020 --> 15:30.421\n要改造卧室的环境，\n\n15:30.671 --> 15:32.471\n如保持适宜的湿度，\n\n15:32.570 --> 15:33.870\n开始呼吸训练，\n\n15:33.870 --> 15:35.270\n改善咳嗽的症状。\n\n15:36.015 --> 15:37.015\n第6.7天呢，\n\n15:37.015 --> 15:39.966\n要评估初步疗效果并记录疑问，\n\n15:40.315 --> 15:42.015\n同时要关注治疗反应，\n\n15:42.015 --> 15:44.065\n为下一次的复诊提供反馈。\n\n15:44.861 --> 15:45.062\n好，\n\n15:45.062 --> 15:46.262\n谢谢您的观看。\n\n","v0347cg10004d768flaljhtfgrge13bg",952,703,"2026-01-26 13:12:47"," 慢性咳嗽的原因、症状与治疗方法 - 专业指南  "," 慢性咳嗽,咳嗽原因,咳嗽症状,咳嗽治疗,长期咳嗽,咳嗽缓解,咳嗽诊断  "," 本视频详细解析慢性咳嗽的常见原因（如哮喘、胃食管反流等）、典型症状及科学治疗方案，帮助您了解如何有效缓解长期咳嗽问题，并提供专业医疗建议。适合长期受咳嗽困扰的人群观看。","2026-06-11 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