On Monday afternoon, a mother brought her child to see a doctor. The child was only a few months old. The child was not in a good mood, and his lungs were full of wheezing and small wet rales. The child has obvious wheezing and obvious breathing difficulties. Even without a stethoscope, the child can hear the wheezing sound of the child with ears, which is in line with the characteristics of typical "bronchiolitis".

　　I speak to my child’s mother In view of the child''s condition, it is recommended that this situation require infusion treatment, because it is the first time to asthma, and chest radiographs must also be taken. The child''s mother asked me if I could prescribe some medicine first, and I told her that in this case, I dare not delay it. As a result, the mother took the child away and did nothing.

　　Mothers who are breastfeeding are wise mothers who can insist on breastfeeding, and children rarely get sick, which is really a good thing, but I found some commonalities. Many mothers of breast milk over-exaggerate the benefits of breast milk, thinking that as long as children who eat breast milk will not get sick. When you are sick, the test should still be tested, and the treatment should be actively treated. Do not let your child resist the disease according to his own ideas.

　　 Seeing a doctor is really a science, how to reasonably seek medical treatment and treatment, and how to avoid over-treatment is a science. It requires the constant mission of doctors and the trust of parents. Nowadays, lack of trust leads parents to seek medical treatment on the premise of distrust, so it is easy to appear uncooperative treatment, but the final victim is the child.

　　 Recently, I have seen many wheezing children in the outpatient clinic. Wheezing is only a symptom, and wheezing can be caused by many reasons. There are many causes of wheezing, and it is necessary to make a differential diagnosis under the guidance of a doctor and a reasonable laboratory test. Even so, there may be a misdiagnosis. A few days ago, I just wrote a case where I personally experienced a misdiagnosis. Therefore, parents should not think about wheezing too simple, timely medical treatment, active testing, regular follow-up, and timely hospitalization in severe cases, these are very important. Most taboo treatment in a hospital for a day or two, I feel dissatisfied, and another hospital; a doctor is not optimistic, and another doctor, may delay the condition.

　　The clinical manifestations of wheezing caused by different causes are different, including the time of onset, the frequency of attacks, the time of wheezing termination and the response to treatment. In other words, children have a variety of wheezing diseases, which is a heterogeneous disease.

　　Studies have shown that there are many causes of wheezing in infants and young children.

　　 Part of infantile wheezing is asthma. Bronchial asthma is the most common wheezing disease in childhood. The incidence of asthma has continued to rise in the past ten years. The incidence rate increased from 0.11％～2.03％ in 1990 to 0.25％～4.63％in 2000. The essence of asthma is allergic inflammation of the airways. The main causes of asthma are various allergens, including indoor and outdoor allergens. Indoor allergens mainly include mites, molds, and cockroaches. Outdoor allergens are mainly various pollen and atmospheric pollutants. These factors cause chronic airway allergic inflammation. Asthma induced by food allergies cannot be ignored, such as food protein allergies, etc., and this year has also attracted more and more attention from doctors.

　　 There are many infants and young children wheezing related to viral infections, among which respiratory syncytial virus is the most common, accounting for 78.2％ which causes the wheezing disease virus, such as the most common bronchiolitis in our clinic is infants The most common wheezing disease in early childhood can occur multiple times. The essential problem is inflammation of the bronchiole caused by viruses, especially respiratory syncytial virus (RSV). The infiltrating inflammatory cells are neutrophils and lymphocytes. The main eosinophils instead of asthma. This is clearly different from asthma. When wheezing occurs, the child''s airway epithelial cells are necrotic and fall off, and the mucus secretion is increased, forming a mucus plug to block the airway. In addition, the airway wall edema thickens, the airway inner diameter becomes smaller, and the airflow resistance increases, resulting in wheezing. Viral infections such as bronchiolitis are mainly located in the bronchiole, where airway smooth muscle is poorly developed or no smooth muscle is present, so airway smooth muscle contraction is not the main cause of wheezing. Therefore, such children often need to be hospitalized to give antibiotics, antiviral and other treatment.

The viruses that cause wheezing include rhinovirus, adenovirus, influenza virus, and parainfluenza virus. Mycoplasma infection is also one of the important causes of wheezing.

Furthermore, wheezing in infants and young children is also related to the maturation of bronchopulmonary development, and premature babies and babies whose parents smoke are prone to wheezing. In addition, bronchial lymph node tuberculosis, foreign body in the airway, gastroesophageal reflux, etc. can also cause wheezing. Some factors can aggravate wheezing, such as congenital heart disease, low immune function, bronchopulmonary dysplasia, and a history of familial allergic diseases that can make wheezing repeated and make the condition worse.

　　How to make an asthma diagnosis from wheezing in infants and young children, there are still some difficulties. First of all, we cannot completely diagnose asthma based on the number of attacks, because virus-induced wheezing can also have more than 3 wheezings; secondly, asthma also has its first attack. In order to avoid the expansion of the diagnosis of asthma, my country has proposed a scoring diagnostic method. Its specific content is: Where age