Soğuk Algınlığı Ve Klinik Yaklaşımlar

Year 2018, , 27 - 31, 31.01.2018

Selim Öncel

https://doi.org/10.30934/kusbed.348505

Abstract

Soğuk algınlığı tıpta “üst solunum yolu enfeksiyonu”, “akut nazofarenjit” veya “akut rinofarenjit” olarak adlandırdığımız durumdur. Ebers papirüsünde (İ.Ö. 16. yy.) “Soğuk Algınlığı” diye bir başlık vardır. Ayaşlı Şaban Şifai (18. yy.), çocuklarda soğuk algınlığının tedavisinde hacamat ve soğuk uygulamayı önermiştir. Geredeli İshak bin Murad, 1390'da soğuk algınlığının ateş, öksürük ve balgamla seyredeni için “tumagu” terimini kullanmıştır. Hildegard von Bingen'e (12. yy.) göre, nezle beyinde soğuk, nemli maddelerin birikmesi ve bir zehire dönüşmesiyle meydana gelir. Benjamin Franklin (18. yy.) soğuk algınlığının insanların birbirlerine yakın durmalarıyla daha kolay yayıldığını gözlemlemiştir.

Soğuk algınlığının en sık etkeni rinovirüstür. Soğuk algınlığı daha çok damlacıklarla değil, doğrudan temasla bulaşır. Rino- ve koronavirüslerle solunum hücresi tahribatı az olurken adenovirüsler ve influenza virüsleriyle hücreler neredeyse bütünüyle harap olmaktadır. Soğuk algınlığının semptomatolojisi, bir hiperenflamasyon sendromudur dolayısıyla bu hastalık, antienflamatuar özelliği olan bir analjezik/antipiretikle tedavi edilmelidir.

Altı yaşından küçük çocuklar, yılda ortalama altı-sekiz kez soğuk algınlığı geçirirler. Komplikasyon olarak akut otitis media, akut bakteriyel rinosinüzit, astma alevlenmesi ve alt solunum yolu enfeksiyonu gelişebilir.

Tedavide izotonik tuzlu suyla burun yıkaması, gargara, bal ve çinkonun yararı saptanmıştır. Artırılmış sıvı alımının, nezle-grip ilacı olarak satılan müstahzarların, C vitamininin, ekinazeyanın ve Çin bitkisel ilaçlarının tedavide yeri yoktur. El hijyeni ve bazı probiyotikler, profilakside yararlı bulunmuştur.

Keywords

soğuk algınlığı, rinovirüs, C vitamini, ekinezya

Common Cold And Clinical Approaches

Abstract

The common cold is what we call “upper respiratory tract infection”, “acute nasopharyngitis”, or “acute rhinopharyngitis” in medicine. There is a chapter titled “Common Cold” in Ebers papyrus (16th century B.C.). Şaban Şifai of Ayaş (18th century B.C.) proposed bloodletting and cold application in children with common cold. İshak bin Murad of Gerede used the term “tumagu” for the common cold with fever, coughing, and expectoration in 1390. According to Hildegard von Bingen (12th century B.C.), rhinitis arises from accumulation of cold and damp substances and their transformation to a toxin in the brain. Benjamin Franklin (18th century B.C.) has observed that common cold spreads more easily when people stay closer to each other.

Rhinovirus is the most frequent pathogen of the common cold. Common cold spreads with direct contact rather than with droplets. Adenovirus and influenza viruses almost completely destruct respiratory epithelium whereas rhinovirus and coronavirus cause less cellular damage. The symptomatology of common cold is a hyperinflammation syndrome, and therefore the treatment of common cold should be carried out with an antipyretic/analgesic agent with anti-inflammatory properties.

Children less than six years of age experience an average of six to eight bouts of the common cold in a year. Complications include acute otitis media, acute bacterial rhinosinüsitis, asthma exacerbations, and lower respiratory infections.

Nasal irrigation with isotonic saline, gargling, honey, and zinc preparations have been shown to have some benefit. Excessive fluid intake, over-the-counter common cold preparations, vitamin C, echinacea, and Chinese herbal medicine are not advisable for treatment. Hand hygiene and some probiotics may be useful for prophylaxis.

Keywords

Common cold, rhinovirus, vitamin c, echinacea

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