Chronic obstructive pulmonary disease is an ailment characterized by a partial restriction of airflow in the airways. COPD in the ICD-10 is listed under the code J 44.0-9. The reasons for this disease of the respiratory system are many.
Causes
The main causes of COPD disease are:
- Genetically determined factors (alpha – 1 – antitrypsin deficiency), which influenced the proper growth and development of the lungs, which can be caused by low birth weight, mother’s smoking during pregnancy.
- Inhalation effects: tobacco smoke (active and passive smoking).
- Indoor air pollution associated with the use of bio-organic fuel in homes.
- Air pollution (exhaust fumes of automobiles and industrial plants).
- Industrial air pollution.
- Chronic respiratory infections.
- Immunodeficiency due to decompensation of chronic diseases of other organs and systems, HIV infection.
- Severe interstitial lung diseases leading to hypoventilation of the bronchi: tuberculosis, sarcoidosis, fibrosing alveolitis, pneumoconiosis, silicosis.
- Inadequate and unbalanced nutrition, cachexia.
- Neurological diseases leading to restriction of the function of the diaphragm and respiratory function: myasthenia gravis, relaxation of the diaphragm, an established diagnosis of bronchial asthma or a tendency to bronchial hyperreactivity, bronchiectasis or acquired bronchiectasis confirmed by bronchoscopic examination.
Symptoms
The symptoms of COPD in ICD-10 are listed under the code J 44.0-9, as follows:
- Dyspnea with difficulty breathing out, worse after exercise. A characteristic feature is the constant progression until the appearance of shortness of breath at rest.
- Cough with clear transparent mucus or purulent sputum, with COPD is most often manifested in the morning.
- Dry cough without coughing up sputum with emphysema type COPD.
- Increased respiratory rate. Often patients take a forced position of the body, which alleviates the symptoms of orthopnea: sitting on the bed, leaning forward and resting his hands on his hips.
- Weakness, fatigue.
- Changing 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 grow in the evening.
- Pain in the liver.
- Constant thirst.
Three degrees of COPD are distinguished, the symptoms of each of them are different.
Mild
It is characterized by mild obstruction of the lungs. Clinical symptoms are rare. Diagnosing COPD is becoming a challenge. The appearance of a wet cough is possible, but more often this symptom does not occur. There is a decrease in gas exchange function. In this case, there are no violations of air patency in the bronchi. Pathology does not cause a clear deterioration in the patient's life.
Medium grade
With the pathogenesis of moderate COPD, a cough appears, accompanied by sputum production. A sharp decrease in patient endurance occurs. Exercise leads to shortness of breath. Very often shortness of breath occurs in a relaxed state. The paroxysmal nature of the cough is possible with exacerbations that occur at this stage, with the release of sputum containing pus.
Severe degree
Symptoms of the third stage of the pathology are more noticeable and pronounced. A sharp deterioration due to frequent exacerbations (from 2 times per month). There is an increase in obstruction of lung tissue and the occurrence of obstruction of the bronchi. Shortness of breath and weakness appear, accompanied by darkening in the eyes. Patients are characterized by heavy breathing.
The onset of manifestation and external symptoms is noted, the following symptoms are characteristic:
- increased visibility of blood vessels in the neck;
- weight loss;
- expansion of the chest, with the acquisition of a barrel-shaped form;
- the appearance of a bluish tint of the skin is possible.
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, the adoption of a posture based on an object is recommended. Physical activity causes discomfort. Heart failure develops due to the formation of a pulmonary heart, which complicates the patient's condition. At this stage, the patient receives a disability, since the ability to breathe on their own is lost.
Such patients require constant monitoring and treatment in a hospital. There is a need for the constant use of a portable oxygen canister. For this stage, the patient has a life expectancy of up to 2 years.
Diagnostics
There are many methods for diagnosing COPD. First of all carry out:
- Blood analysis. An 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. A severe stage is characterized by an increase in blood viscosity and the number of red 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.
- Study 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 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 probability of bronchial asthma; establishing the severity and current stage of the disease; assessment of the effectiveness of selected therapy.
- Electrocardiography The data obtained as a result of the ECG allow us to establish signs of hypertrophy of the heart during complications of COPD.
After diagnosing and identifying all the symptoms and treatment of COPD, proceed directly to taking the drugs.
Drug therapy
Treatment of COPD with a medication is based on the use of inhaled drugs that help to expand the airways, as well as some other groups of drugs:
Bronchodilators: theomyphyllin, anticholinergics and 2-adrenergic 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 occurring changes in pulmonary function are not a guarantee and an indicator of long-term effectiveness. The choice of the prescribed type of bronchodilators is based on 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 due to the combined use of several drugs. It also helps to increase the effectiveness of drugs.
For inhalation, the use of the following devices is required:
- nebulizers - with a severe course of the disease and during exacerbations;
- powder inhalers - in cases of stable flow.
Glucocorticoids: fluticasone propionate, budesonide. For such drugs, pronounced anti-inflammatory activity is characteristic. In the treatment of exacerbations of COPD, short courses of up to 14 days are used. Admission is aimed at reducing swelling of the respiratory tract.
With an infectious exacerbation of the course of the disease, antibiotics are prescribed that affect the duration of the elimination of symptoms of COPD. Also, taking antibiotics increases the duration of the periods between relapses of the disease.
Mucolytics and flour regulators: iodine-containing drugs, ambroxol, carbocysteine. They are prescribed for the pathogenesis of COPD for administration among a small number of patients who have viscous sputum. In other cases, such drugs are not recommended for widespread use in patients with COPD.
Antioxidants. A drug with high antioxidant activity is N-acetylcysteine. The tool helps to reduce the incidence of exacerbations of COPD and their duration. Long-term use of the drug by patients with COPD is allowed (up to six months), not exceeding a daily dosage of 600 mg.
Immunoregulators, immunostimulants and immunomodulators. The effectiveness of such drugs does not have convincing evidence, and therefore the continuous use of such drugs is not recommended.
Vaccines
Reducing the mortality rate and severity of exacerbations in patients with COPD contributes to the passage of vaccination against influenza. Vaccination is given once in the fall season (October-November). Some experts have recommended the use of pneumococcal vaccine, with the goal of preventing pneumonia in patients with COPD.
How to treat COPD folk remedies?
Clinical conditions in chronic obstructive pulmonary disease (COPD), despite the complexity of the treatment and the consequences, can be corrected using folk remedies, and sometimes folk methods are even more effective than modern medicines. It should be noted that folk remedies, like pharmacological preparations, should have anti-inflammatory and general strengthening effect, to facilitate the removal of sputum from the bronchi.
One of the most acceptable methods is the treatment with herbal infusions. There are many recipes for herbal preparations. The most effective fees that will help get rid of the symptoms of COPD include the following:
- collection of 1 part sage grass, 2 parts chamomile flowers and 2 parts mallow;
- collection of 1 part of flaxseed, 2 parts of eucalyptus, 2 parts of chamomile flowers and 2 parts of linden flowers;
- collection of 1 part chamomile, mallow, clover grass, licorice root, anise, marshmallow and 3 parts of flaxseed.
Dried herbs are crushed, boiled with boiling water, infused and consumed by patients, as a rule, twice a day for 1-2 months.
A well-known folk remedy for treating symptoms of COPD is black radish and beetroot. For medicinal purposes, infused gruel from grated fruits is used. The infusion is taken within a month, then you need to take a week break.
Syrup from nettle root perfectly relieves symptoms of COPD, namely it removes sputum, relieves cough, relieves inflammation.
Separately, dwell on folk methods of treating COPD with milk. Hot milk is added (depending on the recipe) either butter with honey, or badger fat and lard. There are recipes with onions and garlic, Icelandic moss, anise drops.
An effective home-based cough treatment for COPD is inhalation. Thanks to steam, medicinal substances enter the respiratory tract and lungs, relieving swelling and enhancing metabolic processes. For inhalation, medicinal herbs are used (calendula, mint, chamomile, oregano and others), onions, essential oils, cooked potato peelings, and soda.
Considering folk remedies and methods in the treatment of COPD, it is worth noting the use of mineral salts. Inhalation with saline minerals relieves shortness of breath with COPD.
Thus, along with medical preparations, it is possible to carry out treatment in parallel with alternative methods and means, but before that, you still need to consult a doctor.
Prevention
The main prevention of COPD is the rejection of cigarettes. Chronic obstructive pulmonary disease can occur in a patient who works in harmful enterprises, therefore he needs to know the safety instructions and use respirators. In addition, a good ventilation system must be installed in the office. Particularly dangerous are particles of silicon and cadmium floating in the air.
The risk group includes such specialties as miners, and those who work in “hot” workshops or in the sewing industry. In order to exclude the development of chronic obstructive pulmonary disease, any lung disease and acute respiratory disease must be completely cured. Any neglected diseases can go into chronic forms and subsequently lead to complications.
COPD appears mainly in those who smoke, because pathologies in the lungs appear in smokers with experience - in those who are over forty - fifty years old. Also, the disease may appear due to adverse factors. It must be borne in mind that COPD can appear not only among those who smoke, but also among “passive smokers,” that is, those who do not consume themselves, but inhale the smell of tobacco.
For prevention, respiratory gymnastics with COPD, which is prescribed by the doctor , will be quite effective. It can be completely carried out independently.