Don't be careless about coughing and chest tightness, they may be atypical asthma symptoms

Author: Tang Qin, Researcher of Chinese Medical Association

Reviewer: Zhang Jing, deputy chief physician, Peking University Third Hospital

In daily life, some people have been coughing intermittently for more than half a month, and the symptoms have not improved, but seem to be even more serious. If this happens, it is recommended to go to the hospital for treatment in time, because this may be an atypical symptom of asthma.

Figure 1 Copyright image, no permission to reprint

1. Typical asthma and atypical asthma

Many people's understanding of asthma may come from the plots of movies and TV dramas: "When you are nervous or afraid, it is easy to have an attack, and if you don't take medicine in time, it may even lead to death." However, the asthma symptoms in movies and TV dramas are often more obvious, that is, the so-called typical symptoms, while in real life there are some less obvious asthma symptoms, that is, atypical asthma, which are often missed.

Asthma, as the name suggests, has two characteristics: "Wheezing" is a wheezing sound, which sounds a bit like the sound of a whistle or a flute. In more serious cases, there will be a "roaring" sound like pulling a bellows; "Chewing" represents repeated attacks of shortness of breath or difficulty breathing. Therefore, a very typical symptom of asthma is shortness of breath and wheezing. In addition, the eyes, nose and skin will also have corresponding symptoms, such as nasal allergy symptoms such as runny nose and sneezing, eye allergy symptoms such as itchy eyes and conjunctival edema, and skin allergy symptoms such as itchy skin and wheals. These symptoms may persist for a long time and can be very dangerous if you do not take medication or seek medical attention in time.

Common symptoms of atypical asthma may be coughing, chest tightness, and wheezing after exercise. Because these symptoms do not necessarily mean asthma, many people ignore them and delay treatment.

Figure 2 Copyright image, no permission to reprint

2. How is atypical asthma triggered?

The causes of atypical asthma are relatively complex. Family heredity, external stimulation, abnormal physical changes, etc. may all lead to the onset of the disease, and the triggering factors of different individuals are also different.

First of all , atypical asthma is somewhat hereditary, so if someone in the family has a history of asthma, the probability of getting the disease will be relatively high, and the closer the blood relationship with the patient, the higher the probability of getting the disease.

Secondly , environmental stimuli may cause asthma, mainly household dust mites, hair and dander of domestic pets, cockroaches, down products, mold, as well as trees, grasses, pollen, etc., which may irritate the bronchial mucosa and lead to the occurrence of atypical asthma.

Thirdly , food allergies and drug allergies can cause allergies. Foods that are more likely to cause allergies include seafood, eggs, milk, nuts, etc., and drugs include aspirin, alcohol, propranolol, etc. When the immune cells of patients with atypical asthma encounter these allergens, they will become abnormal, thus inducing asthma.

Finally , respiratory viral infections, negative emotional influences, inhalation of cold air during exercise, changes in hormone levels, women's menstrual period and pregnancy, etc., may all trigger attacks of atypical asthma.

3. Treatment of atypical asthma

The key points of atypical asthma treatment are emergency treatment and control therapy. Emergency treatment means sending the patient to the hospital as soon as possible and then treating the patient after diagnosis by a doctor; control therapy is a long-term treatment method used by asthma patients in their daily lives.

The drugs or methods used for control treatment mainly include inhaled corticosteroids, long-acting beta-receptor agonists, leukotriene antagonists, omalizumab, allergen immunotherapy, aspirin desensitization therapy, etc. It should be noted that these treatment drugs or methods are not suitable for all patients. For example, aspirin desensitization therapy can be used for patients with atypical asthma caused by aspirin use, but it is not clear whether it is applicable to other situations.

Figure 3 Copyright image, no permission to reprint

Traditional Chinese medicine also has treatments for atypical asthma. If it is caused by external cold evil, Xiaoqinglong Decoction and Shegan Mahuang Decoction can be taken; if it is caused by internal wind, Qianjin Dingchuan Decoction is mainly taken; if both conditions are present, Xiaoqinglong Decoction and Shigao Decoction are mainly used. The above methods are all taken internally, and can be combined with plastering, acupuncture, cupping, autohemotherapy and other means to achieve a good overall therapeutic effect.

I still want to remind you that no matter whether it is Western medicine or Chinese medicine, you should not take drugs randomly, because atypical asthma is a disease with a relatively complex pathogenesis, and not every treatment method is suitable for all asthma patients. It is recommended that patients go to the hospital for a detailed examination to determine what type of asthma they have and then consult a doctor to choose the appropriate treatment plan.

References

[1] Song Ping, Shi Shaoshun. Research progress in the treatment of asthma with traditional Chinese and Western medicine [J]. Journal of Practical Chinese Medicine Internal Medicine, 2021, 35(2): 135-142.