哪种感冒要吃消炎药?

2017-12-08 李博然 北京协和医院 中国科学报

秋冬季节,人们最容易被感冒侵袭。随之而来的问题就是:吃不吃药?

秋冬季节,人们最容易被感冒侵袭。随之而来的问题就是:吃不吃药?

有人说吃药7天好,不吃药一个星期就好,可有的人自作决定硬扛了7天,不但身体难受,还影响工作学习。还有人说,感冒不能瞎扛,搞不好扛出大病。那么,我们应怎么对待感冒,有没有个靠谱的说法?

感冒药不会去除病因

在门诊看病,最常见的就是,感冒发烧的患者进入诊室就说“大夫,我感冒了,快给我输液”,或者说“大夫,快给我开点消炎药”。

其实,上呼吸道感染80%左右都是病毒性,注意休息、多喝温水就可以缓解。如果病人高烧,不能吃东西,可以通过输液适当补液,但不需要输消炎药,即抗生素

许多患者有一种错误的观念,不管大病小病,只要感冒发烧就吃抗生素。其实这种做法存在很大隐患。因为抗生素使用以后,微生物可通过产生耐药性来保护自己。如果使用抗生素时间过长、使用的剂量不够或频繁换药,容易诱导细菌产生耐药性,不仅达不到理想的治疗效果,还容易使危重感染的患者将来处于无药可用的境地,因此合理使用抗生素尤为重要。

现实中,很多人年年得感冒,就会根据以往的经验,让大夫开“消炎药”“输液”,其实这么做是不对的。因为不是每次感冒的原因都一样,即使症状相同,治疗方法也会因人因时因地而变化的。

咳嗽发烧是伴随感冒发生的,如果仅仅是病毒感冒的话,是有自限性的,一般来说7~14天就会自己恢复,但如果这其中继发了细菌感染,那么就会加重病情,甚至使病情反复。

我们日常所说的“感冒药”包括咳嗽药以及中成药,都是缓解感冒引起的各种不适,并不能消灭感冒的原因,与我们所说的“消炎药”是不同的,不可以混淆。明确地说,感冒药是缓解症状,让病人不难受的药,但不能消灭病因,消灭病因要靠自身的免疫力,也没有严格意义上可以消灭病毒的药。而抗生素,是由于患者免疫功能低下,在病毒性感冒的基础上,导致了继发性细菌感染,为了除去细菌感染而吃的药。感冒药不会去除病因,同样抗生素也不会缓解症状。

病毒性感冒不应使用抗生素

那么,我们怎么判断自己用不用吃消炎药呢?下面有些一般性建议,仅供参考。不过,一旦出现大问题,还是需要去正规的医院,听从正规医生的指导。

那么,什么情况下感冒可能会由细菌感染引起,应使用抗生素呢?一般来说要符合以下几条。第一,病情严重:大于3~4 天,发热不低于39摄氏度,脓性鼻涕;或面部疼痛这类严重的症状或体征。第二,病情持续:大于10 天无改变,流鼻涕或咳嗽。第三,病情恶化:在典型的病毒性上呼吸道感染持续了5~6日并且初步改善后出现症状或体征(新发的发热、头痛、鼻分泌物)。

那么,一旦患者的鼻涕变成黄色或绿色的,是不是就意味细菌感染,必须要使用抗生素了?答案是否定的,因为黄色或绿色的分泌物并不意味有细菌感染,也不是使用抗生素的绝对指征,只是一个简单易行的参考,病毒性感冒的分泌物也会变颜色。所以要去医院,不要自己胡乱吃药。

一般来说,细菌感染的鼻涕是脓性的,与普通的黄绿色鼻涕是不同的。

此外,还有人认为,使用抗生素可以让感冒好得更快,其实这也是错误的观念。抗生素治疗病毒感染是没有效的,也不会短时间内恢复。一旦医生怀疑有合并细菌感染时,会给病人加用抗生素,是没有错误的。

总的来说,感冒后,如果自行用感冒药3天,症状不但没有减轻,反而加重,则需要到医院就诊,尤其是孩子、孕妇、老人,以免延误治疗。

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    2017-12-11 1e1b8538m79(暂无匿称)

    不错的文章值得推荐

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    2017-12-10 Doctorbin

    病了不能乱吃药啊

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=268710, encodeId=4a64268e1037, content=不错的文章值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Mon Dec 11 22:56:04 CST 2017, time=2017-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268422, encodeId=3f272684228d, content=病了不能乱吃药啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/06/15/d6715bafce42cef990ac18b905ffc96c.JPG, createdBy=e1a3104890, createdName=Doctorbin, createdTime=Sun Dec 10 21:07:08 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1425261, encodeId=37c3142526105, content=<a href='/topic/show?id=2f4265813d5' target=_blank style='color:#2F92EE;'>#消炎药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65813, encryptionId=2f4265813d5, topicName=消炎药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93523955488, createdName=canlab, createdTime=Sun Dec 10 10:25:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267964, encodeId=917c26e9640c, content=一起学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Sat Dec 09 05:30:31 CST 2017, time=2017-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267935, encodeId=a2e226e935b8, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Fri Dec 08 23:47:13 CST 2017, time=2017-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267907, encodeId=c25126e9078a, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Fri Dec 08 22:16:05 CST 2017, time=2017-12-08, status=1, ipAttribution=)]
    2017-12-10 canlab
  4. [GetPortalCommentsPageByObjectIdResponse(id=268710, encodeId=4a64268e1037, content=不错的文章值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Mon Dec 11 22:56:04 CST 2017, time=2017-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268422, encodeId=3f272684228d, content=病了不能乱吃药啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/06/15/d6715bafce42cef990ac18b905ffc96c.JPG, createdBy=e1a3104890, createdName=Doctorbin, createdTime=Sun Dec 10 21:07:08 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1425261, encodeId=37c3142526105, content=<a href='/topic/show?id=2f4265813d5' target=_blank style='color:#2F92EE;'>#消炎药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65813, encryptionId=2f4265813d5, topicName=消炎药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93523955488, createdName=canlab, createdTime=Sun Dec 10 10:25:00 CST 2017, time=2017-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267964, encodeId=917c26e9640c, content=一起学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Sat Dec 09 05:30:31 CST 2017, time=2017-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267935, encodeId=a2e226e935b8, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Fri Dec 08 23:47:13 CST 2017, time=2017-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267907, encodeId=c25126e9078a, content=好资料学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Fri Dec 08 22:16:05 CST 2017, time=2017-12-08, status=1, ipAttribution=)]
    2017-12-09 wzb521zf

    一起学习一下

    0

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    2017-12-08 changjiu

    学习一下谢谢

    0

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    2017-12-08 thlabcde

    好资料学习了!

    0

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