儿童迁延性细菌性支气管炎的中西医研究进展

Progress of Chinese and Western Medicine Research on Prolonged Bacterial Bronchitis in Children

摘要: 咳嗽是儿童就医主要原因之一，迁延性细菌性支气管炎(PBB)是儿童慢性湿咳较为常见的原因，国内目前对该病重视程度较低，其检查手段、治疗方案尚未普及，常误诊为哮喘，笔者通过收集国内外文献，归纳总结PBB的传统医学病因病机、治疗手段，现代医学发病机制、诊疗手段、治疗方案，中西医结合诊疗等方面的研究进展。总体来说，国内外专家认为在儿童PBB中，最初，一般是病毒或细菌性感染，损害肺部的防御能力，导致黏液分泌过多、黏液纤毛清除率降低和细菌过度生长，伴有气管和支气管黏膜肥大，导致支气管生物膜的持续损伤。治疗上传统医学主要有辨证论治，名家成方，针灸，穴位贴敷，现代医学推荐抗生素治疗，支气管镜介入。近年来，在国家政策支持下，中西医结合诊疗走向主流。通过对PBB的诊断手段，治疗手段的梳理，希望为该病的临床诊疗提供新的借鉴思路。

Abstract: Cough is one of the main reasons for children to seek medical treatment, prolonged bacterial bronchitis (PBB) is a more common cause of children’s chronic wet cough, the domestic emphasis on this disease is relatively low, the means of examination, treatment options have not yet been popularized, and is often misdiagnosed as asthma. The author, through the collection of domestic and foreign literature, summarizes the etiology of the PBB traditional medical etiology, treatment means, the pathogenesis, treatment means, diagnostic means, and research progress in the combination of Chinese and Western medicine and diagnosis and treatment. Overall, domestic and foreign experts believe that in children with PBB, initially, it is usually a viral or bacterial infection that impairs the lung’s defense ability, leading to mucus hypersecretion, reduced mucus cilia clearance and bacterial overgrowth, accompanied by hypertrophy of the tracheal and bronchial mucosa, resulting in sustained damage to the bronchial biofilm. The treatment of traditional medicine mainly includes dialectic treatment, famous prescription, acupuncture, acupoints paste, modern medicine recommends antibiotic treatment, bronchoscopy intervention. In recent years, with the support of national policy, the combination of Chinese and Western medicine treatment has gone mainstream. By combing the diagnostic means, treatment means of PBB, we hope to provide new ideas for the clinical diagnosis and treatment of this disease.