COPD - treatment. Chronic obstructive pulmonary disease: causes, symptoms

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COPD - treatment. Chronic obstructive pulmonary disease: causes, symptoms
COPD - treatment. Chronic obstructive pulmonary disease: causes, symptoms
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Chronic obstructive pulmonary disease (COPD) develops gradually and is characterized by a progressive increase in symptoms of chronic respiratory failure.

COPD treatment
COPD treatment

COPD can develop as an independent disease, it is characterized by airflow limitation caused by an abnormal inflammatory process, which, in turn, occurs as a result of constant irritants (smoking, hazardous industries). Often the diagnosis of COPD combines two diseases at once, for example, chronic bronchitis and emphysema. This combination is often seen in long-term smokers.

One of the main causes of disability of the population is COPD. Disability, reduced quality of life and, unfortunately, mortality - all this accompanies this disease. According to statistics, about 11 million people suffer from this disease in Russia, and the incidence is increasing every year.

Risk factors

The following factors contribute to the development of COPD:

  • smoking, including passive smoking;
  • frequent pneumonia;
  • bad environment;
  • harmful industries (work in a mine, exposure to cement dust from builders, metal processing);
  • heredity (lack of alpha1-antitrypsin can contribute to the development of bronchiectasis and emphysema);
  • prematurity in children;
  • low social status, unfavorable living conditions.
COPD symptoms and treatment
COPD symptoms and treatment

COPD: symptoms and treatment

At the initial stage of development, COPD does not manifest itself in any way. The clinical picture of the disease occurs with prolonged exposure to adverse factors, such as smoking for more than 10 years or working in hazardous industries. The main symptoms of this disease are chronic cough, especially in the morning, a large amount of sputum when coughing and shortness of breath. At first, it appears during physical exertion, and with the development of the disease - even with slight exertion. It becomes difficult for patients to eat, and breathing requires large energy costs, shortness of breath appears even at rest.

Patients lose weight and become physically weak. Symptoms of COPD periodically increase and exacerbate. The disease proceeds with periods of remission and exacerbation. Deterioration of the physical condition of patients during periods of exacerbation can be from minor to life-threatening. Chronic obstructive pulmonary disease lasts for years. The further the disease develops, the more severe the exacerbation.

Four stages of the disease

There are only 4 degrees of severity of this disease. Symptoms do not appear immediately. Often, patients seek medical help late, when an irreversible process develops in the lungs and they are diagnosed with COPD. Disease stages:

  1. Mild - usually no clinical symptoms.
  2. Moderate - may have a cough in the morning with or without phlegm, shortness of breath on exertion.
  3. Severe - cough with a lot of sputum, shortness of breath even with little exertion.
  4. Extremely severe - threatens the life of the patient, the patient is losing weight, shortness of breath even at rest, cough.
COPD severity
COPD severity

Often, patients at the initial stages do not seek help from a doctor, precious time for treatment has already been lost, this is the insidiousness of COPD. The first and second degrees of severity usually occur without pronounced symptoms. Worries only cough. Severe shortness of breath appears in the patient, as a rule, only at the 3rd stage of COPD. The degrees from the first to the last in patients can proceed with minimal symptoms in the remission phase, but it is worth a little hypothermia or a cold, the condition worsens sharply, an exacerbation of the disease occurs.

Disease diagnosis

Diagnosis of COPD is based on spirometry - this is the main study for diagnosis.

Spirometry is a measurement of respiratory function. The patient is invited to take a deep breath and the same maximum exhalation into the tube of a special device. After these steps, the computer connected to the device will evaluate the indicators, and if they differ from the norm, the study is repeated 30 minutes after inhaling the medicine through the inhaler.

Diagnosis of COPD
Diagnosis of COPD

This test will help your pulmonologist determine if coughing and shortness of breath are symptoms of COPD or another disease such as asthma.

To clarify the diagnosis, the doctor may prescribe additional examination methods:

  • complete blood count;
  • blood gas measurement;
  • general sputum analysis;
  • bronchoscopy;
  • bronchography;
  • CT (X-ray computed tomography);
  • ECG (electrocardiogram);
  • lung x-ray or fluorography.

How to stop the progression of the disease?

Smoking cessation is an effective and proven method that can stop the progression of COPD and the decline in lung function. Other methods can alleviate the course of the disease or delay the exacerbation, the progression of the disease is not able to stop. In addition, the ongoing treatment in patients who quit smoking is much more effective than in those who could not give up this habit.

Prevention of influenza and pneumonia will help prevent the disease from exacerbating and further development of the disease. It is necessary to get flu shots annually before the winter season, preferably in October.

Pneumonia booster needed every 5 years.

COPD disability
COPD disability

COPD treatment

There are several treatments for COPD. These include:

  • drug therapy;
  • oxygen therapy;
  • pulmonary rehabilitation;
  • surgical treatment.

Drug Therapy

If drug therapy for COPD is chosen, treatment consists of continuous (lifelong) use of inhalers. An effective drug that helps relieve shortness of breath and improve the patient's condition is selected by a pulmonologist or therapist.

Short-acting beta-agonists (rescue inhalers) can quickly relieve shortness of breath and are used only in emergency cases.

Short-acting anticholinergics can improve lung function, relieve severe symptoms of the disease and improve the general condition of the patient. With mild symptoms, they may not be used constantly, but only as needed.

COPD treatment. Preparations
COPD treatment. Preparations

For patients with severe symptoms, long-acting bronchodilators are prescribed in the last stages of COPD treatment. Drugs:

  • Long-acting beta2-agonists (Formoterol, Salmeterol, Arformoterol) can reduce the number of exacerbations, improve the quality of life of the patient and alleviate the symptoms of the disease.
  • Long-acting M-anticholinergics (Tiotropium) will help improve lung function, reduce shortness of breath and relieve symptoms of the disease.
  • For treatment, a combination of beta-2-agonists and anticholinergics is often used - it is much more effective than using them separately.
  • Theophylline (Teo-Dur, Slo-bid) reduces the frequency of COPD exacerbations, treatment with this drug complements the action of bronchodilators.
  • Glucocorticoids, which have powerful anti-inflammatory effects, are widely used for the treatment of COPD in the form of tablets, injections or inhalations. Inhaled drugs such as Fluticasone and Budisonin may reduce the number of exacerbations, increase the period of remission, but will not improve respiratory function. They are often given in combination with long-acting bronchodilators. Systemic glucocorticoids in the form of tablets or injections are prescribed only during periods of exacerbation of the disease and for a short time, because. have a range of adverse side effects.
  • Mucolytic drugs such as Carbocestein and Ambroxol significantly improve sputum production in patients and have a positive effect on their general condition.
  • Antioxidants are also used to treat this condition. The drug "Acetylcestein" is able to increase periods of remission and reduce the number of exacerbations. This drug is used in combination with glucocorticoids and bronchodilators.

COPD non-drug treatment

In combination with drugs for the treatment of the disease, non-drug methods are also widely used. These are oxygen therapy and rehabilitation programs. In addition, patients with COPD should understand that it is necessary to completely stop smoking, because. without this condition, not only recovery is impossible, but the disease will also progress at a faster pace.

Special attention should be paid to the quality and nutrition of patients with COPD. Treatment and improvement of the quality of life for patients with a similar diagnosis largely depends on themselves.

Oxygen therapy

Patients with a similar diagnosis often suffer from hypoxia - this is a decrease in oxygen in the blood. Therefore, not only the respiratory system suffers, but also all organs, because. they don't get enough oxygen. Patients may develop a range of adverse he alth conditions.

To improve the condition of patients and eliminate hypoxia and the consequences of respiratory failure in COPD, treatment is carried out with oxygen therapy. Preliminary, the level of oxygen in the blood is measured in patients. To do this, use such a study as the measurement of blood gases in arterial blood. Blood sampling is carried out only by a doctor, because. blood for research should be taken exclusively arterial, venous will not work. It is also possible to measure the level of oxygen using a pulse oximeter device. It is put on the finger and the measurement is taken.

Oxygen therapy patients should receive not only in a hospital, but also at home.

Food

About 30% of patients with COPD experience difficulty in eating, this is due to severe shortness of breath. Often they simply refuse to eat, and significant weight loss occurs. Patients weaken, immunity decreases, and in this state, infection can be added. You cannot refuse to eat. For such patients, fractional meals are recommended.

COPD patients should eat often and in small portions. Eat foods rich in proteins and carbohydrates. Before eating, it is advisable to rest a little. Be sure to include multivitamins and nutritional supplements in your diet (they provide an additional source of calories and nutrients).

COPD treatment with folk remedies
COPD treatment with folk remedies

Rehab

Patients with this disease are recommended annual spa treatment and special lung programs. In the physiotherapy rooms, they can be taught special breathing exercises, which must be done at home. Such interventions can significantly improve the quality of life and reduce the need for hospitalization in patients diagnosed with COPD. Symptoms and traditional treatment are discussed. Let us once again emphasize that a lot depends on the patients themselves, effective treatment is possible only with a complete cessation of smoking.

Treatment of COPD with folk remedies can also bring positive results. This disease existed before, only its name changed over time and traditional medicine coped with it quite successfully. Now, when there are scientifically based methods of treatment, folk experience can complement the effect of medical drugs.

In folk medicine, the following herbs are successfully used to treat COPD: sage, mallow, chamomile, eucalyptus, linden flowers, sweet clover, licorice root, marshmallow root, flax seeds, anise berries, etc. Decoctions are prepared from this medicinal raw material, infusions or used for inhalation.

COPD - case history

Let's turn to the history of this disease. The concept itself - chronic obstructive pulmonary disease - appeared only at the end of the 20th century, and such terms as "bronchitis" and "pneumonia" were first heard only in 1826. Further, 12 years later (1838), the well-known clinician Grigory Ivanovich Sokolsky described another disease - pneumosclerosis. At that time, most medical scientists assumed that pneumosclerosis was the cause of most diseases of the lower respiratory tract. Such damage to the lung tissue is called "chronic interstitial pneumonia".

In the next few decades, scientists around the world studied the course and proposed treatments for COPD. The history of the disease includes dozens of scientific works of physicians. So, for example, the great Soviet scientist, the organizer of the pathological and anatomical service in the USSR, Ippolit Vasilyevich Davydovsky, made invaluable contributions to the study of this disease. He described diseases such as chronic bronchitis, lung abscess, bronchiectasis, and called chronic pneumonia "chronic non-specific pulmonary consumption".

In 2002, Alexei Nikolaevich Kokosov, Candidate of Medical Sciences, published his work on the history of COPD. In it, he pointed out that in the pre-war period and during the Second World War, the lack of proper and timely treatment, coupled with enormous physical exertion, hypothermia, stress and malnutrition, led to an increase in cardiopulmonary insufficiency among front-line veterans. Many symposiums and works of physicians have been devoted to this issue. At the same time, Professor Vladimir Nikitich Vinogradov proposed the term COPD (chronic nonspecific lung disease), but this name did not take root.

A little later, the concept of COPD appeared and was interpreted as a collective concept that includes several diseases of the respiratory system. Scientists around the world continue to study the problems associated with COPD and offer new methods of diagnosis and treatment. But regardless of them, doctors agree on one thing: quitting smoking is the main condition for successful treatment.

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