Chronic obstructive pulmonary disease (COPD) is a common chronic disease characterized by chronic bronchitis and/or emphysema with airflow obstruction, which can further develop into cor pulmonale and respiratory failure. It is not as well-known as hypertension and diabetes, nor as frightening as cancer, but it is one of the three major causes of death in the world and is called the "silent killer".
Among adults over 30 years old worldwide, the prevalence rate is nearly 12%. There are about 100 million COPD patients in adults aged 20 and above in my country, and the prevalence rate increases with age. The prevalence rate in people over 60 years old is as high as 27.4%, and one in four elderly people is a COPD patient. Many people simply do not realize that they are ill and wait until they are short of breath to check. At this time, lung function loss is often more than 50%, and it is easy to miss the best time for treatment.
The main clinical manifestations of COPD are symptoms such as persistent cough, sputum and dyspnea, with high disability rate and high mortality rate.
Who is prone to COPD?
The exact cause of COPD is still unclear, and it is the result of multiple factors. Long-term smoking is the most common factor causing COPD. Exposure to occupational dust or chemicals, long-term use of biofuels in rural areas, passive smoking, indoor and outdoor air pollution, airway hyperresponsiveness, and bronchial asthma are all high-risk factors for COPD. Age and body mass index are also closely related to COPD. The older you are, the higher the probability of COPD; the lower your body mass index, the higher the incidence of COPD.
How to tell if you have COPD?
If the patient has a history of exposure to risk factors, has chronic cough, sputum, or shortness of breath after activity, COPD should be highly suspected. At present, lung function screening is the easiest, most economical, and most accurate method for diagnosing COPD. Just "blow a breath" can help patients achieve the ideal effect of "early detection and early treatment".
How to prevent and treat COPD?
COPD is a common disease that can be prevented and treated. Since COPD is a disease caused by the combined effects of genetic and environmental factors, the following measures can be taken to prevent the onset of COPD: quit smoking and avoid secondhand smoke; reduce exposure to occupational dust and harmful gases; reduce indoor and outdoor air pollution; get pneumonia and influenza vaccines to prevent respiratory infections in infants and children.
If COPD is diagnosed, as long as early, standardized and reasonable treatment and self-management are carried out, the condition of most patients can be controlled, acute attacks can be avoided, and the progression of the disease can be delayed. The goal of COPD treatment is to alleviate symptoms, improve exercise ability, improve quality of life, alleviate and prevent lung function decline, prevent the progression of the disease, and reduce mortality.
Quitting smoking is the top priority in preventing and treating COPD. At any stage of the disease, quitting smoking is beneficial to preventing the occurrence and development of chronic obstructive pulmonary disease; take medication on time, do not stop taking medication on your own, and follow up at the hospital regularly; perform respiratory function rehabilitation training such as abdominal breathing and pursed lip breathing training.
Early identification of acute exacerbation of COPD. When shortness of breath worsens, cough intensifies, sputum volume increases or sputum becomes purulent, you should be aware of the acute exacerbation of COPD and seek medical attention in time. Treatments for COPD include inhaled drugs, oxygen therapy, non-invasive ventilation, pulmonary rehabilitation and surgical operations.
What are pulmonary rehabilitation treatments for COPD patients?
- The specific method of abdominal breathing is that the patient can take a standing position, and the weak can also take a sitting or supine position. Place one hand on the abdomen and the other hand on the chest. When inhaling, bulge the abdomen and try to use the abdominal muscles to push the hand on the abdomen forward; when exhaling, use a little force on the hand on the abdomen to exhale the gas in the lungs and help the abdomen recover. Generally, the inhalation time is 2s, the exhalation time is 4-6s, and the ratio of inhalation to exhalation time is 1:2 or 1:3. Try to breathe about 7-8 times per minute, twice a day, 10-15 minutes each time.
- The specific method of pursed lip breathing is to close your lips tightly and inhale through your nose. When exhaling, exhale slowly like a whistle, and maintain for 4-6 seconds. Inhalation time: exhalation time = 1:2, which can be practiced in the early morning, half an hour after a meal, or before sleep.
Respiratory muscle strength training - a new physical therapy method
The diaphragm nerve (diaphragm) and abdominal muscles are stimulated by synergistic feedback electrical stimulation through external electrodes to make the diaphragm and abdominal muscles contract regularly, forming deep and slow abdominal breathing, gradually enhancing the strength and endurance of the respiratory muscles, promoting the expulsion of CO₂ from the lungs, and achieving respiratory rehabilitation.
Expectoration training
① Coughing training: first take a deep breath, hold your breath slightly, and then contract your abdominal muscles to cough up the phlegm. You can first use the way of exhaling to move the phlegm, and then cough it out forcefully. When you are weak, you can lean your body forward 20°-45°, which is easier to cough up the phlegm.
② Postural drainage: By changing your body position, use gravity to help sputum discharge.
③ Chest percussion tremor: Use your hands or a mechanical percussion device to percuss the chest wall to produce vibrations, so that sputum moves to the larger bronchi for easy discharge.
Exercise training
① Aerobic exercise, such as walking, jogging, breathing exercises, etc., can enhance physical fitness and improve cardiopulmonary function. However, attention should be paid to the intensity and time of exercise to avoid excessive fatigue, and outdoor exercise should also be avoided in cold weather and when the air quality is poor.
② Muscle training: Appropriate muscle training can improve physical mobility and improve the quality of life. Including strength training of the upper and lower limbs.
Nutritional therapy
Malnutrition can cause a decrease in the strength and endurance of the respiratory muscles of COPD patients, making patients prone to respiratory muscle fatigue and ventilation dysfunction, leading to a decrease in the patient's body immunity. Studies have found that a protein-rich diet is the best way for COPD patients to eat, and it can reduce metabolic and cardiovascular risks.
Psychological therapy
COPD patients suffer from long-term disease problems, and their quality of life decreases due to repeated hospitalizations, and they are prone to psychological problems. Psychological support and treatment can change patients' adverse cognitive and behavioral factors, and improve rehabilitation compliance and confidence.
