兒童慢性過敏咳嗽治療秘笈 (3)

　　Is the cough an isolated symptom; if not, what other symptoms exist?

　　Is there any runny nose; if any, what is the colour?

　　Does he snore at night?

　　Is the cough related to position or meals?

　　Is there a previous history of upper respiratory tract infections or allergic disease?

　　Is there a family history of respiratory, allergic, or infectious disease?

　　Is there evidence of environmental triggers?

　　Have any laboratory tests or examinations been done?

　　What treatments have been tried, and what were their effects?

　　What medications, if any, does the child take?

　　3.Avoid unnecessary antibiotics and cough suppressants. Take the medication as prescribed.

　　說了這么多慢性咳嗽的病因治療，那么我們?cè)诩以趺醋o(hù)理慢性咳嗽的寶貝呢？

　　咳嗽是一種癥狀，是機(jī)體重要的自我清潔和保護(hù)機(jī)制，有利于清除呼吸道的分泌物、過敏原和異物，并且具有清除呼吸道刺激因子、抵御感染的作用�？偟脑瓌t是如果寶寶的咳嗽不影響飲食、睡眠，以及其他日�；顒�(dòng)，就不需要給他吃止咳藥。但如果咳嗽較多，影響孩子的學(xué)習(xí)，進(jìn)食，運(yùn)動(dòng)，和睡眠，這時(shí)候就要考慮在醫(yī)生的指導(dǎo)下適當(dāng)選用止咳藥物和家庭療法。

　　★ 有痰的濕咳

　　咳嗽可以幫助痰液排出并防止痰液滯留呼吸道所引起的繼發(fā)感染，所以有痰的咳嗽應(yīng)該以祛痰為主而不是單純止咳，可以選用能讓痰液稀釋從而容易排出的藥物并且多喝水。過多的咳嗽也會(huì)影響睡眠并刺激呼吸道粘膜使痰液增多，在這種情況下可以酌情謹(jǐn)慎地使用止咳藥。

　　★ 無(wú)痰的干咳

　　多喝水，保持氣道濕潤(rùn)。如果有劇烈、陣發(fā)性的干咳，并影響孩子睡眠進(jìn)食和學(xué)習(xí)的，建議在醫(yī)生的指導(dǎo)下選用止咳糖漿。一般來(lái)說，6歲以下的孩子要慎用復(fù)方的感冒咳嗽糖漿，因?yàn)槿绻�有其他藥物同時(shí)服用的話，會(huì)增加重復(fù)服用相同藥物成分和過量服藥的風(fēng)險(xiǎn)；再者中樞鎮(zhèn)咳藥物的成分會(huì)抑制孩子的咳嗽反射，一旦有痰液就會(huì)積聚粘滯在咽部或氣管引起癥狀加重或繼發(fā)感染。另外，國(guó)家食品藥品監(jiān)督管理局也明確規(guī)定在12歲以下的兒童中禁用含有可待因等易引起成癮性的止咳藥水。

　　★多飲水

　　小口多飲水，對(duì)干咳和濕咳都有幫助，稀釋咽喉部的痰液，使之易于排出。

　　3個(gè)月~1歲：咳嗽時(shí)給予溫的液體口服 （比如溫白開水，溫蘋果汁），一天4次，每次5~15毫升。注意不要用蜂蜜水以防肉毒桿菌中毒的風(fēng)險(xiǎn)。

　　1歲以上的兒童：需要時(shí)可以口服2~5毫升的蜂蜜水，可以幫助稀釋痰液減輕咳嗽。有研究發(fā)現(xiàn)蜂蜜水可以幫助減少晚間咳嗽的頻率和嚴(yán)重度。

　　★ 濕化空氣

　　打開浴室的淋浴龍頭，幫助寶寶吸入溫暖的水蒸氣，或者生理鹽水霧化吸入對(duì)減輕陣發(fā)性干咳和稀釋痰液有幫助。

　　★ 飲食

　　建議清淡飲食，規(guī)避油炸，甜膩，辛辣的食物。多吃蔬菜水果，特別是對(duì)潤(rùn)肺止咳和理氣化痰有幫助的，比如梨，銀耳，百合， 蓮子，杏仁，薏苡仁，蓮藕， 蘿卜，山藥，冬瓜，絲瓜，桔子， 枇杷等等。

　　★ 規(guī)避過敏原

　　如果是過敏性疾病引起的咳嗽，則要先明確過敏原，然后日常生活中避免接觸這些致敏物質(zhì)，比如前文提到的霧霾，粉塵，塵螨，霉菌，花粉，煙霧，油煙，貓，狗，油漆味，海鮮等等。

　　It's important to know that a cough is a symptom, not a disease. A cough protects child's body by removing mucus, irritating substances and infections from the respiratory tract. It helps prevent bacterial infections. Generally, cough suppressants is not needed unless it disturbs child's sleep, interrupt meals, or affects school.

　　★ Wet cough: Coughing is useful because it brings up mucus from the lungs and helps prevent bacterial infections. Expectorants are used for a productive cough rather than cough suppressants. An expectorant helps thin the mucus and make it easier to cough mucus up. Drink plenty of water also helps. Use cough suppressants wisely when the cough keeps the child from getting enough rest and increased mucus production and secretion.

　　★ Dry cough: Drink plenty of fluid to keep airway clean and moist. If there is dry, hacking cough that disturbing the child's sleep and meals, choose cough syrup according to doctor's advice. Avoid multi-symptom cold and cough preparations; if you combine them with other medicines, it may increase the risk of overdose from overlapping ingredients. The American Academy of Pediatrics does not recommend cough and cold medications for kids under 6. Cough suppressants act on the center in the brain that controls the cough reflex. Suppressing the urge to cough can create an excess amount of infected phlegm in the airways, which in turn will cause the symptoms to last longer or secondary infections. In addition, China Food and Drug Administration ban cough syrup with codeine in children under the age of 12.

　　★ Drink plenty of fluid: It helps both dry and wet cough. Fluids keep the secretions thin and soothe an irritated throat.

　　For children 3 Months to 1 year of age: Give warm, clear fluids (eg, warm water, apple juice). Dosage is 5 to 15 mL 4 times per day when coughing. Avoid honey because it can cause infantile botulism.

　　For Children 1 Year and Older: Use honey, 2 to 5 mL, as needed. It thins secretions and loosens the cough. Recent research has shown that honey is better than drugstore cough syrups at reducing the frequency and severity of nighttime coughing.

　　★ Humidify the air: Expose the child to warm mist from a shower or try a normal saline nebulisation can help with coughing spasms and loosen the phlegm.

　　★ Diet: Eat lightly and avoid fried, fatty or spicy food. Plenty of vegetables and fruits, including pears, white jelly mushroom, lotus seed, almond, coix seed, lotus root, mooli, yam, white gourd, towel gourd, mandarin, loquat etc.

　　★ Avoid exposure to allergens: If the etiology of cough is allergic disease, then identify the allergens first and avoid exposure to allergens, such as haze, dust, dust mite, mold, pollen, smoke, fume, pets, dust mites, paint taste, and seafood etc.

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