(1) Chronic bronchitis is a common chronic respiratory disease, mainly affecting elderly patients. Patients often develop the disease during the winter and spring seasons, and the condition is difficult to control, gradually worsening, and even leading to bronchial obstruction, causing pulmonary aortic hypertension. In severe cases, it can be life-threatening. The clinical manifestations of chronic bronchitis during the onset period are mainly cough, expectoration, and asthma. How to prevent acute exacerbation of chronic bronchitis is always the key to clinical treatment. Before that, understanding the mechanism of acute onset of chronic bronchitis and preventing disease progression require our attention.
(2) The etiology and pathogenesis of chronic bronchitis
(3) External causes of chronic bronchitis
(4) Smoking: Smoking is the main factor in the onset of chronic bronchitis, which can lead to damage to bronchial epithelial cells and decreased ciliary motility; Bronchial goblet cell proliferation and increased secretion of mucus; Congestion, edema, and accumulation of mucus in the bronchial mucosa reduce the phagocytic ability of macrophages and other cells; Causing bronchial smooth muscle contraction and increasing airway resistance. The adverse factors caused by smoking mentioned above can make the bronchi more susceptible to bacterial and viral infections.
(5) Air pollution: Stimulating gases can directly harm the bronchial mucosa and cause toxic side effects on bronchial epithelial cells, such as sulfur dioxide increasing sputum volume; Nitrogen dioxide can cause airway obstruction. If the smoke and sulfur dioxide concentration in the environment is greater than 1000 μ g/m ³, the probability of chronic bronchitis is significantly increased.
(6) Infection: The incidence of respiratory tract infections during the onset of chronic bronchitis is approximately 7% to 64%. After viral infection, respiratory epithelium is more prone to bacterial infection.
(7) Other: Chronic bronchitis is also closely related to allergic factors. Allergic reactions can cause bronchial spasms and increase inflammation.
(8) (2) External causes of chronic bronchitis
(9) Under normal circumstances, the respiratory tract has a well-developed defense mechanism, which filters, warms, and humidifies inhaled gases; The ciliary movement and dry cough reflex of the trachea and bronchial mucosa can effectively purify and remove metabolites. If the respiratory defense and immunity of the human body are weakened, it will create basic conditions for the onset of chronic bronchitis, especially for many elderly patients who are prone to chronic bronchitis due to weakened respiratory immunity, decreased immunoglobulin levels, and decline of mononuclear phagocytes.
(10) The treatment methods for chronic onset of chronic bronchitis
(11) The treatment of acute exacerbation of chronic bronchitis mainly focuses on controlling infection, eliminating phlegm, and relieving cough. During the stable period of the disease, it is recommended that patients improve their personal physical fitness and enhance their resistance.
(12) Antiinfective treatment can be administered orally with penicillins, cephalosporins, erythromycin, etc. In severe cases, antibiotics can be administered intravenously. If necessary, bacterial culture and drug sensitivity tests should be conducted to select antibiotics based on the drug sensitivity test.
(13) Nebulization inhalation therapy uses physiological saline nebulization inhalation or ultrasonic nebulization inhalation to dilute bronchial mucus and achieve expectoration. For severe cases, bronchodilators and expectorants can be inhaled through nebulization.
(14) Precautions for preventing acute exacerbation of chronic bronchitis
(15) Quit smoking and avoid inhaling harmful and irritating gases.
(16) Improving physical fitness
(17) When the condition of chronic bronchitis patients is stable, it is recommended to enhance their physical fitness, improve their own immunity, prevent colds, and patients with recurrent respiratory infections. Immune modulators or traditional Chinese medicine can also be used to enhance resistance and prevent infections.
(18) Respiratory Exercise Intervention
(19) Abdominal Breathing: Using diaphragmatic exercise to increase lung ventilation, patients are asked to place one hand on their abdomen. When exhaling, the hand falls in, which can moderately increase pressure. When inhaling, the upper abdomen resists this pressure, allowing the abdomen to gradually rise. This is done 5 times a day for 3 minutes each time. During exhalation, the body is maintained to release pressure.
(20) Breathing and expectoration: Gently tap the back with the palm to promote coughing and expectoration; Or take several deep breaths first, then lean your upper body forward, open your mouth, extend your tongue, and cough dry. By loosening the sticky phlegm, move it towards the upper respiratory tract to cough up the phlegm. After resting for a while, repeatedly expel the phlegm. It should be noted that breathing and expelling phlegm should not be done after meals.
(21) Conclusion: (22) Encourage patients to pay attention to their diet in daily life to improve their immune system, enhance the columnar epithelial cells and mucosal repair ability of the bronchial mucosa, guide patients to engage in outdoor activities, breathe fresh air, and engage in moderate exercise.