Special medicine for respiratory diseases

There is currently no universal "special effect" that can cure all respiratory diseases. The "special effect" in public perception is essentially targeted medicine for specific pathogens, specific disease processes, and specific constitutions. If used correctly, it is called "special effect." If used incorrectly, it will not only be useless but may cause harm to the body.

A while ago, I was supporting the respiratory clinic at a community health service center. Among the more than 30 patients in the morning, the first thing I asked when I sat down halfway was, "Does the doctor have any special medicine for the respiratory tract?" It's fine if it's more expensive, I don't want it to take too long." I couldn't help but understand at the same time. After all, when the fever reaches 39 degrees and the cough makes it hard to sleep, everyone hopes to take a pill and get better immediately.

Don't tell me, there are actually patients who come for follow-up consultations with the evaluation of "special medicine". Last week, there was a sophomore boy who had a fever for three days and coughed up yellow phlegm. The blood test result showed that his white blood cells had soared to 14. The CT scan showed that there was a small exudation in the right lung. He was prescribed the most common amoxicillin and clavulanate potassium, which cost only a few tens of dollars. Three days later, he came back and said that the fever had gone down and there was less phlegm. He called it a miracle drug. I joked with him and said that if you have the flu, this medicine will cost you half a cent. Essentially, this is just a symptom of bacterial infection. For common respiratory pathogenic bacteria such as Streptococcus pneumoniae and Haemophilus influenzae, β-lactam and macrolide antibiotics can indeed cure the disease as long as their drug sensitivities match. This is also the reason why "anti-inflammatory drugs are effective drugs" in the eyes of many elders. Of course, many clinicians are opposed to using antibiotics at the outset. Many mild bacterial infections can be recovered by one's own immunity, and misuse will increase the risk of drug resistance. This must be judged based on the course of the disease and the patient's basic condition. There is no absolute standard answer.

If your infection is viral, antibiotics are totally wrong. At present, there are not many drugs with clear evidence-based evidence for respiratory viruses. The most common ones are oseltamivir and mabaloxavir for influenza. If used within 48 hours of the onset of illness, it can indeed shorten the course of the disease by 1-2 days and reduce the risk of severe illness. Many patients who have just gotten the flu have their fever subsided the next day after taking it, and they think it is a "special medicine." But there is a lot of controversy here. One group of doctors believes that as long as the flu is diagnosed, it is recommended to take medication as soon as possible to reduce discomfort and the risk of transmission. The other group believes that mild patients with normal immunity can completely handle it and there is no need to take medication. On the contrary, they may have side effects of nausea and diarrhea. I met an aunt who took oseltamivir for a common cold. Her fever did not go away but she had diarrhea for two days. She was diagnosed with a common rhinovirus infection. She stopped taking medication and drank more water for two days. As for the COVID-19 special drugs that everyone often hears about, such as Paxlovid and Azivudine, they are only used for high-risk groups to prevent severe disease. Not only are they useless for ordinary young people who are infected, but they may increase the burden on the liver and kidneys. They are not special drugs in the public sense at all.

Having said this, someone must ask, are Chinese patent medicines considered effective medicines? This controversy is even greater. Most Western medicine systems believe that most respiratory Chinese patent medicines do not have enough evidence-based evidence in large samples and are not recommended for routine use. ； However, the traditional Chinese medicine system pays attention to syndrome differentiation and treatment, and the effect is really fast after the syndrome is diagnosed. I caught a cold last winter, with runny nose and white phlegm. I stupidly took Lanqin Oral Liquid at first, and the more I took it, the colder my throat became and the worse the cough became. Later, I asked my colleagues in the Department of Traditional Chinese Medicine for Tongxuanlifei Pills. After taking it twice, I got better. Regardless of my situation at that time, this medicine was a special medicine. On the other hand, if you have a cold due to wind-heat, sore throat and coughing up yellow phlegm, taking Tongxuanlifei Pills will only add fuel to the fire. If you switch to Lianhua Qingwen, it may be effective very quickly. To put it bluntly, there is no good or bad, only right or wrong.

There is another type of medicine that many people regard as specific medicines, which are symptomatic medicines that can relieve discomfort immediately after taking them. For example, if you have a cough that makes you unable to sleep all night, or even causes chest pain, taking a tablet of dextromethorphan or trimethoprim can calm the cough in half an hour. ； When the fever reaches 38.5 degrees or above, the whole body aches. If you take ibuprofen or acetaminophen, you will be relieved and feel better within an hour. These medicines do not kill viruses or bacteria, but they can help you suffer less and avoid complications such as coughing into pneumothorax and fever and convulsions. They are real "special medicines" for patients who are feeling extremely uncomfortable at the moment.

Harmful, in fact, there is really no need to chase after any "special medicine" to buy. I have seen too many people buy imported so-called "respiratory miracle medicines" through connections. In fact, they are imported cephalosporins, which are several times more expensive than domestic ones, but the effect is not much different. There are also people who have stocked up a drawer of oseltamivir and various kinds of Chinese patent medicines and did not take them until they expired. It is a pure waste of money. If you really want to find a "miracle drug" that suits you, it's better to spend 20 yuan to check your blood routine and make a corresponding antigen to find out what kind of infection you have and what your constitution is. It's much more reliable than buying a "miracle drug" worth hundreds of yuan, right?