Chronic obstructive pulmonary disease is a disease characterized by partial airflow limitation in the airways. COPD in the ICD-10 is listed under the code J 44.0-9. There are many reasons for such a disease of the respiratory system.
Reasons
The main causes of COPD are:
- Genetically determined factors (deficiency of alpha-1-antitrypsin) that affected the proper growth and development of the lungs, which can be low birth weight, maternal smoking during pregnancy.
- Inhalation exposure: tobacco smoke (active and passive smoking).
- Indoor air pollution from biofuel use in homes.
- Atmospheric pollution (exhaust gases from cars and industrial plants).
- Air pollution at work.
- Chronic respiratory infections.
- Immunodeficiency due to decompensation of chronic diseases of other organs and systems, HIV infection.
- Severe interstitial lung disease leading to bronchial hypoventilation: tuberculosis, sarcoidosis, fibrosingalveolitis, pneumoconiosis, silicosis.
- Inadequate and unbalanced nutrition, cachexia.
- Neurological diseases leading to limitation of diaphragmatic and respiratory function: myasthenia gravis, relaxation of the diaphragm, established diagnosis of bronchial asthma or a tendency to bronchial hyperreactivity confirmed by bronchoscopic examination, bronchiectasis or acquired bronchiectasis.
Symptoms
Symptoms of COPD, listed under the ICD-10 code J 44.0-9, are as follows:
- Shortness of breath with difficult expiration, worse after exercise. A characteristic feature is the constant progression until the appearance of shortness of breath at rest.
- Cough with clear mucous or purulent sputum, most commonly seen in COPD in the morning.
- Dry hacking cough without sputum in emphysematous type of COPD.
- Increased respiratory rate. Often, patients adopt a forced body position that relieves orthopnea symptoms: sitting on the bed, leaning forward and resting their hands on their hips.
- Weakness, fatigue.
- Change in the fingers: thickening of the terminal phalanges (symptom of "drumsticks", deformation and swelling of the nail plates (symptom of "watch glasses").
- Cyanosis (cyanosis) of the lips, tip of the nose, tips of the ears. In severe COPD - total cyanosis of the skin.
- Noisy exhalation through closed lips to reduce the load on the bronchial tree.
In the advanced stages of the disease, chronic heart failure develops, accompanied by:
- Dense cold swelling of the legs, which increase in the evening.
- Pain in the liver.
- Constant thirst.
There are three degrees of COPD, each with different symptoms.
Mild degree
Characterized by mild obstruction of the lungs. Clinical symptoms are rare. Diagnosing COPD is becoming a difficult task. A wet cough may occur, but more often this symptom does not appear. There is a decrease in the function of gas exchange. At the same time, there are no violations of air permeability in the bronchi. Pathology does not cause a clear deterioration in the life of the patient.
Medium degree
In the pathogenesis of moderate COPD, the appearance of a cough, accompanied by sputum production, is noted. There is a sharp decrease in the endurance of the patient. Physical activity leads to shortness of breath. Very often shortness of breath occurs in a relaxed state. A paroxysmal cough is possible during exacerbations that occur at this stage, with the release of sputum containing pus.
Severe
Symptoms of the third stage of the course of the pathology are more noticeable and pronounced. A sharp deterioration in the condition due to frequent exacerbations (from 2 times a month). There is an increase in obstruction of lung tissue and the occurrence of bronchial obstruction. There is shortness of breath and weakness, accompanied by darkening in the eyes. Patients are characterized by heavy breathing.
The onset of manifestation and external symptoms is noted, the following signs are characteristic:
- increasing the visibility of blood vessels in the neck;
- weight loss;
- chest expansion, barrel-shaped;
- may cause bluish skin tone.
This degree is characterized by a low life expectancy of patients.
Extremely severe
The pathogenesis of COPD of this degree is characterized by the development of respiratory failure. The patient is worried about coughing, wheezing in the chest and shortness of breath in a relaxed state. To facilitate exhalation, it is recommended to take a pose based on an object. Physical activity causes discomfort. There is a development of heart failure due to the formation of cor pulmonale, which complicates the patient's condition. At this stage, the patient becomes disabled, as the ability to breathe independently is lost.
Such patients require constant monitoring and treatment in a hospital. There is a need for the constant use of a portable oxygen cartridge. This stage is characterized by a patient's life expectancy of up to 2 years.
Diagnosis
There are many methods for diagnosing COPD. Spend first:
- Blood test. The exacerbation is accompanied by neutrophilic leukocytosis and an increase in ESR. With a stable course of the disease, there are no significant changes in the number of leukocytes. For a severe stage, an increase in blood viscosity and the numberred blood cells, as well as a high level of hemoglobin.
- Sputum analysis. The results of a cytological study provide information on the severity of inflammation and its nature. With an exacerbation of the disease, the presence of pus in the sputum is noted, the viscosity increases.
- Examination of the function of external respiration. It is possible to assess the degree of bronchial patency by determining the volume of peak expiratory flow. It should be borne in mind that a decrease in the values of the indicator is also possible with other diseases of the respiratory organs.
- Bronchodilation test. This procedure is carried out for the following purposes: determining the prognosis of the course of the disease; exclusion of the likelihood of bronchial asthma; establishing the severity and current stage of the disease; evaluation of the effectiveness of selected therapy.
- Electrocardiography. The data obtained as a result of the ECG, allow you to establish signs of hypertrophy of the heart in COPD complications.
After diagnosing and determining all the symptoms and treatment of COPD, they proceed directly to taking the drugs.
Drug therapy
The treatment of COPD with medication is based on the use of inhaled drugs that help expand the airways, as well as some other groups of drugs:
Broncholytics: theomiphylline, anticholinergics and 2-agonists. The inhalation route of administration of bronchodilators is the most preferred and quite effective. In the case of short-term use of bronchodilator drugs, the resulting changeslung function is not a guarantee or indicator of long-term effectiveness. The choice of the prescribed type of bronchodilators is made on the basis of the individual characteristics of the patient, the availability of the drug and the absence of possible side effects.
If the pathogenesis of COPD is accompanied by heart disease, in particular in the case of elderly patients, anticholinergics are prescribed. Reducing the risk of side effects is achievable through the combined use of several agents. It also helps to increase the effectiveness of the drugs.
Inhalation requires the use of the following devices:
- nebulizers - in severe cases of the disease and during exacerbations;
- Dowder inhalers - in cases of stable flow.
Glucocorticoids: fluticasone propionate, budesonide. For such drugs, a pronounced anti-inflammatory activity is characteristic. In the treatment of exacerbations of COPD, short courses of up to 14 days are used. Reception is aimed at reducing swelling of the respiratory tract.
In case of an infectious exacerbation of the course of the disease, antibiotics are prescribed that affect the duration of the process of eliminating COPD symptoms. Also, taking antibiotics helps to increase the duration of periods between relapses of the disease.
Mucolytics and mucoregulators: iodine-containing drugs, ambroxol, carbocysteine. They are prescribed for the pathogenesis of COPD for admission among a small number of patients who have viscous sputum. In other cases, such drugs are not recommended forwidespread use in patients with COPD.
Antioxidants. The drug with high antioxidant activity is N-acetylcysteine. The tool helps to reduce the frequency of COPD exacerbations and their duration. Long-term use of the drug by COPD patients (up to six months) is allowed, not exceeding the daily dosage of 600 mg.
Immunoregulators, immunostimulators and immunomodulators. The effectiveness of such drugs has no convincing evidence, and therefore the continuous use of such drugs is not recommended.
Vaccines
Reducing the mortality rate and the severity of exacerbations in patients with COPD contributes to the passage of influenza vaccination. The appointment of vaccination is made once in the autumn season (October-November). Some experts recommend the use of pneumococcal vaccine to prevent pneumonia in patients with COPD.
How to treat COPD with folk remedies?
Clinical conditions in chronic obstructive pulmonary disease (COPD), despite the complexity of treatment and consequences, can be corrected with the help of folk remedies, and sometimes folk methods are even more effective than modern drugs. It should be noted that folk remedies, like pharmacological drugs, should have an anti-inflammatory and restorative effect, facilitate the removal of sputum from the bronchi.
One of the most acceptable methods is the treatment with herbal infusions. There are many herbal recipes. To the mosteffective collections that will help get rid of COPD symptoms include the following:
- collection of 1 part sage herb, 2 parts chamomile flowers and 2 parts mallow;
- collection of 1 part linseed, 2 parts eucalyptus, 2 parts chamomile flowers and 2 parts linden flowers;
- collection of 1 part chamomile, mallow, sweet clover grass, licorice root, anise, marshmallow and 3 parts flaxseed.
Dried herbs are crushed, brewed with boiling water, infused and used by patients, as a rule, twice a day for 1-2 months.
A well-known folk remedy for the treatment of COPD symptoms is black radish and beetroot. For medicinal purposes, a slurry of grated fruits infused with water is used. The infusion is taken for a month, then you need to take a week break.
Nettle Root Syrup is an excellent remedy for COPD symptoms, namely, it removes phlegm, relieves cough, and relieves inflammation.
Separately, we should dwell on folk methods of treating COPD with the use of milk. Hot milk is added (depending on the recipe) either butter with honey, or badger fat and lard. There are recipes with onion and garlic, Icelandic moss, anise drops.
Effective home remedy for cough in COPD - inhalation. Thanks to steam, medicinal substances enter the respiratory tract and lungs, relieving swelling and enhancing metabolic processes. For inhalations, medicinal herbs are used (calendula, mint, chamomile, oregano and others), onions,essential oils, boiled potato peels, baking soda.
Considering folk remedies and methods in the treatment of COPD, it is worth noting the use of mineral s alts. S alt inhalation relieves shortness of breath in COPD.
Thus, along with medications, you can simultaneously carry out treatment with folk methods and remedies, but before that, still get a consultation from your doctor.
Prevention
The main prevention of COPD is the refusal of cigarettes. Chronic obstructive pulmonary disease may appear in a patient who works in hazardous industries, so he needs to know the safety instructions and use respirators. In addition, a good ventilation system must be installed in the office. Particles of silicon and cadmium floating in the air are of great danger.
The risk group includes such professions as miners and those who work in "hot" shops or in the clothing industry. In order to exclude the development of chronic obstructive pulmonary disease, it is necessary to completely cure any lung diseases and acute respiratory diseases. Any neglected disease can become chronic and lead to complications in the future.
COPD appears mainly in those who smoke, because pathologies in the lungs appear in long-term smokers - those who are over forty to fifty years old. Also, the disease may appear due to adverse factors. It must be borne in mind that COPD can appear not only in those who smoke, but alsoand "passive smokers", that is, those who do not use themselves, but inhale the smell of tobacco.
For prevention, breathing exercises for COPD, which is prescribed by a doctor, will be quite effective. You can do it yourself.
