Diagnosis And Treatment Of Acute Cough Survey And Rational Use Of Antibiotics

Cough is a common symptom of respiratory system diseases. It is a protective reflex action and benefits to the clearance to secretion and the harmful factor. But it is the severe influence of life and work of patients with the multifarious and violent cough. In clinic, acute cough has various etiologic factors and relates to numerous fields. Among them, there are a lot of patients with acute cough, whose sternum and hemogram are normal. On the one hand. patients easily drive clinical doctor's neglecting; on the other hand, there are some phenomena of mistaken diagnosis and treatment and antibiotics abuse.By clinical retrospective analysis of the patients with acute cough, we understand the clinical treatment situation of acute cough; give a summarization on pathogenic factors and pathogenesis and syndrome differentiation and treatment of exogenous cough; the cognition on acute cough of western medicine; and develop the clinical observations on the effect of TCM treatment of acute cough. The research lays the ground base and new target for clinical treatment of acute cough and provides more information about standardized treatment of acute cough.The clinical research includes two parts, data investigation on situation of diagnosis and treatment of acute cough and exploration on the clinical effectiveness between TCM and western medicine.The first part: The clinical data in the outpatient of Dongzhimeng hospital affiliated to Beijing University of Chinese medicine were analyzed retrospectively. 208 patients with acute cough cases were selected. According to the analysis of clinical treatment data, we find 128 cases treated and 80 cases untreated. Among 128 cases, the 96 csaes who were treated by medicine alone (46.15%), the 17 cases who were treated by going to hodpital alone (8.17%) and 15 cases who were treated by both of them (7.21%). There were 83 cases with application of antibiotics (64.84%). Among 32 cases treated in the hospital, only 8 cases were examined hemogram, but 25 cases applied of antibiotics. There were 3 cases of which 1 case was examined hemogram and 2 cases applied of antibiotics in our hospital and 29 cases of which 7 cases were examined hemogram and 23 cases applied of antibiotics in other hospitals. By analysis on examination of the hemogram in 112 cases without application of antibiotic in our hospital, there were 35 cases with high hemogram (31.25%), 67 cases with normal hemogram (59.82%) and 10 cases with low hemogram (8.93%).The second part: For the sake of further explanation on the non-necessity of application of antibiotics on acute cough, 60 cases of acute cough were selected with certain diagnostic standard. The investigated patients were divided into two groups by random single blind procedure. We made an observation of clinical effects of treatment with TCM on acute cough. The treatment group (30 cases) was received treatment of Chinese herbs by syndrome differentiation and treatment and the control group (30 cases) was treated by azithromycin dispersible tablets and dextromethorphan hydrobromide, chlorpheniramine maleate and pseudoe phedrine hydiochloride solution.Results:The cure-markedly effective rate and effective rate are 76.67% and 93.33% in the treatment group, and 63.33% and 83.33% in the control group, respectively. The difference of treatment group and control group had no statistics meaning by statistical analysis (P>0.05).To sum up, there are some questions about of and treatment acute cough, such as the lack of attention, non-visiting on time, no standard treatment. On the premise that it is not proved the existence of bacterial infections, majority patients applied of antibiotics. By analysis on examination of the hemogram in the cases without application of antibiotic in our hospital, the most hemogram of patients with acute cough were normal, even low. There is not basis of treatment with regular antibiotics for the acute cough. By the grouping comparison of the cases with acute cough, which were selected with normal hemogram, the curative effect of the treatment group was not better than that of the control group. In view of acute cough of the non-bacterium infection, Chinese medicine treatment can guarantee the clinical curative effect. It also has paid great attention to the reasonable application of antibiotic, possibly avoids the antibiotic abuse and resistance.