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1、秋冬季節(jié)常見病及預防Common disease in fall and winter,北京國際醫(yī)療中心謝桂嵐醫(yī)生International Medical CenterDr. Xie Guilan,Introduction of the Doctor,Dr. Xie Guilan (KEI KO) MD, PhDInternal MedicineHematologyDr.Xie graduated from Chin
2、a Medical University in 1970, then she worked in the 1st Affiliated Hospital of China Medical University for around 20 years as an Internal Medicine doctor and medical lecturer. In 1989, Dr. Xie was awarded with the Sasa
3、kawa medical scholarship and went to study in Japan under the instruction of Dr. Uchino Haruto (world famous professor in Hematology) in the University of Kyoto medical school. Dr. Xie also has practiced at the Settsu H
4、ospital of Osaka and Aeba Hospital and also worked as a lecturer at Syoutoku Medical College, therefore she has deep understanding of the medical system of Japan as well as the needs of Japanese patients. Dr. Xie worked
5、 in Beijing for Japanese people for years, because of her extraordinary clinical skills and fluent Japanese language, she is trusted and respected by many Japanese patients.,醫(yī)生簡介,謝桂嵐醫(yī)生大內(nèi)科血液科謝桂嵐教授 1970年畢業(yè)于中國醫(yī)科大學醫(yī)療系,畢業(yè)后
6、留校,在該大學第一臨床醫(yī)學院內(nèi)科工作。作為內(nèi)科主治醫(yī)師和講師,從事醫(yī)療、教學工作20年余年。1989年經(jīng)中國衛(wèi)生部全國統(tǒng)一日本語考試合格,獲日本笹川醫(yī)學獎學金,赴日本著名京都大學醫(yī)學部,在著名的教授內(nèi)野治人先生(院長,日本血液學會會長)指導下研究。期間,又考入關(guān)西醫(yī)科大學研究生院攻讀白血病的研究,并取得醫(yī)學博士學位稱號。留學期間,為中日友好竭盡全力,獲得關(guān)西醫(yī)科大學田代裕學長頒發(fā)的感謝獎狀。在日本留學期間,曾擔任過大阪聖徳女子醫(yī)學専科
7、學校講師,又在大阪摂津病院、アエバ等病院臨床工作,因此,對日本人患者,日本醫(yī)院的情況很有了解。1998年作為海外留學人才被聘請到北京首都醫(yī)科大學附屬第二臨床學院工作。作為主任醫(yī)師教授活躍在醫(yī)療,教學,科研第一線。獲得北京自然科學基金,曾在歐美,日本及中國核心雜志上發(fā)表過數(shù)十篇學術(shù)論文。擔當北京免疫學會常務(wù)理事,受聘于國內(nèi)多家醫(yī)學雜志常務(wù)編委。并在北京日本人醫(yī)院工作多年。謝教授日語精通,既有10年日本留學經(jīng)歷,又有醫(yī)科大學附屬醫(yī)院和日本
8、人醫(yī)院工作經(jīng)驗,因此,受到日本人患者的信賴和好評。,講座大綱(Outline),急性上呼吸道感染(Acute Upper Respiratory Tract Inflammation) 急性上呼吸道感染簡稱上感,又稱普通感冒。是包括鼻腔、咽或喉部急性炎癥的總稱。廣義的上感不是一個疾病診斷,而是一組疾病,包括普通感冒、病毒性咽炎、喉炎、皰疹性咽峽炎、咽結(jié)膜熱、細菌性咽-扁桃體炎。狹義的上感又稱普通感冒,是最常見的急性
9、呼吸道感染性疾病,多呈自限性,但發(fā)生率較高。成人每年發(fā)生2~4次,兒童發(fā)生率更高,每年6~8次。全年皆可發(fā)病,冬春季較多。 Acute upper respiratory tract inflammation (upper respiratory inflammation for short), also called common cold, is a acute infection in nasal, pharyn
10、x and larynx. Broadly speaking, URI is not a kind of disease, it’s a series including common cold, viral pharyngitis, laryngitis, herpangina, pharyngo-conjunctival fever and bacterial pharyngotonsillitis. In narrow sense
11、, the URI is called common cold. It’s the most common acute respiratory inflection. It’s self-limited and highly occurrence. Adults will have 2-4 times per year- and children have higher rate that will have 6-8 times per
12、 year. It can happen in all the year, while easily happens in winter and spring.病因 急性上呼吸道感染有70%~80%由病毒引起。另有20%~30%的上感由細菌引起。細菌感染可直接感染或繼發(fā)于病毒感染之后。 各種導致全身或呼吸道局部防御功能降低的原因,如受涼、淋雨、氣候突變、過度疲勞等可使原已存在于上呼吸道
13、的或從外界侵入的病毒或細菌迅速繁殖,從而誘發(fā)本病。老幼體弱,免疫功能低下或患有慢性呼吸道疾病的患者易感。 70%-80% of AURI is caused by virus. Other 20%-30% is caused by bacteria. Bacterial infection will happen directly or after viral infection. All that ca
14、n decrease the protection of body and respiratory tract such as getting cold, caught in a rain, weather changes and exhausted will lead the virus or bacteria reproduce quickly which have existed or invade in the upper re
15、spiratory tract, and will cause the AURI. Older people, children, people who are weak, have low immunity or have chronic respiratory infection will easily get AURI.,講座大綱(Outline),臨床表現(xiàn) (Chronic Symptom)根據(jù)病因和病變范圍的不同,臨床表現(xiàn)可
16、有不同的類型: According to the pathogenesis and the extent of disease, the chronic symptoms will be following types:1.普通感冒 Common Cold2.急性病毒性咽炎或喉炎 Acute Viral Pharyngitis or Laryngitis (1)急性病毒性咽炎 Acut
17、e Viral Phrayngitis (2)急性病毒性喉炎 Acute Viral Laryngitis3.急性皰疹性咽峽炎 Herpangina4.咽結(jié)膜熱 Pharyngo-conjunctival Fever5.細菌性咽-扁桃體炎 Bacterial Pharyngotonsillitis,講座大綱(Outline),治療方案 (Treatment) 1.對
18、癥治療 (Symptomatic Treatment) (1)休息 (Relax) (2)解熱鎮(zhèn)痛 (Antipyretic Analgesics) (3)減充血劑 (Decongestants) (4)抗組胺藥 (Antihistamine) (5)鎮(zhèn)咳劑 (Antitussive) 2.病因治療(Etiological Treatment) (1)抗菌藥物治療
19、 (Antibacterial Agents Treatment) (2)抗病毒藥物治療(Antiviral Agents Treatment) 3.中醫(yī)中藥治療 (Traditional Chinese Medicine Treatment),講座大綱(Outline),預防 (Prevention) 1.避免誘因 (Avoid the Triggers) 避免受涼、淋雨、過度疲勞;避
20、免與感冒患者接觸,避免臟手接觸口、眼、鼻。年老體弱易感者更應(yīng)注意防護,上呼吸道感染流行時應(yīng)戴口罩,避免在人多的公共場合出入。 You should avoid getting cold, being caught in rain and exhaustion. Stay away from the people who get cold. Do not touch your mouth, eyes and nose wit
21、h dirty hands. Older people should have better protection, wear masks during the URI season, and avoid to the public. 2.增強體質(zhì) (Keep Healthy) 堅持適度有規(guī)律的戶外運動,提高機體免疫力與耐寒能力是預防本病的主要方法。 Take enough outdoor ex
22、ercise regularly. It will enhance the immunity and cold-resistance and helps to prevent from URI. 3.免疫調(diào)節(jié)藥物和疫苗 (Immunomodulator and Vaccine) 對于經(jīng)常、反復發(fā)生本病以及老年免疫力低下的患者,可酌情應(yīng)用免疫增強劑。目前除流感病毒外,尚沒有針對其他病毒的疫苗。
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