Features of the treatment of chronic bronchitis. Forms, symptoms and treatment of bronchitis Chronic bronchitis course

Chronic bronchitis is a long-term sluggish or progressive inflammation in the bronchi. It is necessary to talk about it in cases where the central symptom of the disease is cough, which occurs in a patient over a three-month period (in total for a year or at the same time), at least 2 years in a row. All other cases of prolonged cough due to confirmed inflammation in the bronchi are classified as either acute or recurrent bronchitis.

The allocation of such a strict time frame for the diagnosis of chronic bronchitis is not accidental. Since diseases of the bronchial tree are among the most common, such restrictions have been introduced. If every case of a long-term one were perceived as chronic bronchitis, then there would not be a single person who would not have this diagnosis recorded. This is especially true for smokers and people with harmful working conditions in relation to the broncho-pulmonary system. Constant irritation of the bronchial mucosa leads to the maintenance of the inflammatory process.

Another point of relevance of the allocation of time frames for chronic bronchitis is the pathogenetic mechanisms of the disease. This means that only an inflammatory process that exists for a certain time can cause structural changes in the bronchi. Their result is a violation of bronchial patency, outflow of bronchial secretions, mechanisms of local immunity, which makes it impossible to completely cure the disease. On their background, the infection is activated. In case of further progression of inflammation, the process turns into chronic obstructive pulmonary disease. Its abbreviation is COPD. In such cases, we already have to talk about clinical manifestations, not only in the form of a cough, but also about signs of respiratory failure.

Symptoms of chronic bronchitis

Cough

Refers to the main symptoms of uncomplicated chronic bronchitis. According to its characteristics, the course and specific clinical variants of the disease are determined. It can be either dry or wet. Cough with expectoration of sputum indicates insufficient mucociliary clearance and refers to the protective mechanisms of the natural cleaning of the bronchial tree from excess mucus. The mechanism of its occurrence is associated with reflex influences, which are caused by irritation of the receptor apparatus of the bronchial and tracheal mucosa. In this case, the impulses are concentrated in the cough center of the brain, which leads to a reflex contraction of the respiratory muscles. With small bronchi, the situation is much more difficult, since there are practically no receptors in them. Consequently, the spread of the inflammatory process to this silent zone, with a narrow lumen, leads to its rapid and complete obturation. The defense mechanism in the form of a cough will not arise.

If chronic bronchitis is initially accompanied by manifestations of bronchial obstruction as a result of bronchospasm, this leads to a dry, unproductive cough. Sometimes it becomes paroxysmal, hacking. Such an attack ends with the expectoration of a small amount of mucus. Accompanying a dry cough with remote wheezing during forced expiration indicates the presence of impaired patency of the small bronchi.

Dyspnea

Typical cases of chronic bronchitis without bronchial obstruction are not accompanied by shortness of breath. For its occurrence, the inflammatory process must either be very active and progressively increase, or proceed for a long time (tens of years). Such patients cannot even clearly note the time when they fell ill. Dry cough with scanty sputum, especially in the morning, becomes a normal norm for them and is not perceived as a pathology at all. Therefore, the occurrence of shortness of breath in the complication of chronic bronchitis with respiratory failure is marked by patients as the onset of the disease. The most characteristic such clinical variant of the appearance of shortness of breath for smokers with a long history of smoking and those with frequent seasonal exacerbations of cough.

In a completely different way, shortness of breath manifests itself and is regarded in obstructive forms of chronic bronchitis. In such cases, it occurs, almost from the very beginning of the disease. In the initial stages of the process, it can occur only during physical exertion, accompanied by a cough. But the progression of this symptom is quickly noted with its occurrence at minimal exertion and even at rest.

Sputum

In the initial stages of chronic bronchitis, as well as in remission of a long process, its amount can be scarce. In this case, it is represented by mucous secretions at the end of a coughing fit. Its color can be from colorless transparent to yellow-brown or black (miners). It all depends on the cause of the disease.

The progression of the disease or its exacerbation is marked by expectoration of mucopurulent or purulent sputum. It has a greenish tint and high viscosity. The appearance of such sputum indicates the activation of the microbial flora and requires appropriate medical correction. By the amount and time of purulent sputum discharge, one can presumably determine the presence of complications of chronic bronchitis. If a large amount (about 60-100 ml) of purulent discharge from the respiratory tract is released once in the morning along with a cough, this indicates the presence of bronchiectasis (saccular dilatations of the bronchi, where mucus with pus accumulates).

Wheezing

If there is sputum in the lumen of the bronchus of any caliber, this obstructs the airflow. As a result, air turbulence occurs, which is manifested by wheezing. According to the characteristics of this symptom, one can roughly determine which bronchi are involved in the inflammatory process and the nature of its course. For remission of chronic bronchitis, dry rales are most characteristic, which are determined by auscultation. If the process aggravates, the amount of sputum increases and moist rales (large, medium or fine bubbling) can be heard, according to the diameter of the affected bronchi. The progression of bronchial obstruction of small-caliber bronchi is indicated by the appearance of high-pitched whistling rales on expiration, which can be heard at a distance.

Hemoptysis

Does not apply to the typical manifestations of chronic bronchitis. It can occur only with a long course of this disease and always indicates its progression or serious complications. According to the severity of hemoptysis, you can determine their presence. Of course, if these are small streaks of blood, blood-stained or dirty brown sputum, then its appearance at the end of a coughing fit can be considered quite natural. But, when blood is released more often or in large quantities, it is worth thinking about the cancerous transformation of the bronchial mucosa or hemorrhagic bronchitis.

asthmatic syndrome

Characteristic only for chronic bronchitis with the presence of bronchial obstruction. It can be caused both by a long course of a chronic inflammatory process, the result of which is the narrowing of the bronchus and its rigidity, and by bronchospasm. This suggests that the asthmatic syndrome in the form of attacks of shortness of breath and a feeling of lack of air with difficulty exhaling can occur at any stage of the disease. It all depends on the reactivity of the patient's bronchi to the effects of environmental factors (tobacco smoke, room dust, changes in air temperature). Over time, such coughing attacks begin to occur not only in the morning, but also at night and throughout the day.

Cyanosis

Typical cases of uncomplicated chronic bronchitis do not result in discoloration of the skin. But its obstructive forms, accompanied by the addition of respiratory failure, almost always cause cyanosis. It can be represented by acrocyanosis - cyanosis of the extremities, tip of the nose and ears, or diffuse cyanosis of the skin over the entire surface. Its occurrence indicates the decompensation of the disease and the irreversible loss of the ability of the bronchi to adequately conduct air to the lungs. At the same time, blood oxygenation is sharply reduced. Such blood is not able to provide normal metabolic processes in the tissues, which leads to their hypoxia. In practice, this is manifested by cyanosis.

Along with the difficulty in the intake of air, the possibility of removing the spent respiratory mixture also suffers. As a result, an excess of carbon dioxide in the alveolar lumen and blood. Clinically, this is manifested by increased cyanosis, sleep disturbance and, and, sweating and weakness. The prolonged existence of hypoxia leads to the appearance of additional signs in the form of deformation of the nail plates (like watch glasses) and thickening of the distal digital phalanges (like drumsticks).

auscultatory data

They are an important element in the diagnosis of chronic bronchitis. With the transition of the process to COPD, a change occurs not only in the bronchi, but also in the restructuring of the lung tissue. Auscultatory, this is recorded as hard breathing with possible weakening in emphysema, and scattered dry rales of different timbres. The appearance of dry wheezing of the whistling type, mainly in the expiratory phase, indicates the defeat of the smallest bronchi.

Chronic bronchitis without signs of bronchial obstruction in remission does not manifest itself at all. In the exacerbation phase, coarse rales may appear against the background of hard breathing, and in the presence of sputum, moist rales. Their character depends on the caliber of the affected bronchi. In chronic bronchitis at the stage of COPD, the auscultatory picture is supplemented by signs of cardiopulmonary insufficiency in the form of an accent of 2 tones on the pulmonary artery, hepatomegaly, tension of the jugular veins.

Causes of chronic bronchitis

In the occurrence of a chronic inflammatory process in the bronchi, the following reasons may be involved:

hereditary predisposition and congenital features of the bronchial tree. A very important group of reasons for which the bronchi are initially susceptible to any harmful environmental factors. Minimal provocateurs cause bronchospasm and increased mucus production. Its obstructed outflow contributes to the activation of the infection, the maintenance of inflammation with the possibility of developing bronchial obstruction;

Tobacco smoke. The main risk group for the development of chronic bronchitis are smokers;

Work in conditions of occupational hazards. In such cases, constant inhalation of air contaminated with coal or other types of dust leads to its deposition in the bronchi. The natural reaction of the body to foreign particles is inflammatory. Naturally, under the conditions of the continued influx of dust particles, self-cleaning mechanisms cannot manage to remove all accumulated deposits. This is the basis of process timing;

Chemical pollutants. All chemical compounds, the vapors of which are regularly inhaled by a person, like dust cause a bronchial reaction in the form of inflammation or bronchospasm;

Climatic conditions. Climatic conditions are rarely the root cause of chronic bronchitis. But they have a general unfavorable background against which all other causes are realized. These include low air temperatures, high humidity and industrial air pollution;

Decreased immunity. It becomes a favorable background for triggering the microbial factor, as one of the causes of chronic bronchitis.

The mechanism for triggering a chronic inflammatory process in the bronchus wall is quite complex. It is impossible to single out only one factor that implements it first. The exception is cases of professional and chronic bronchitis of smokers.

Chronic bronchitis in children

Chronic bronchitis in childhood has its own characteristics in relation to the causes of the development and course of the inflammatory process. First of all, it is worth pointing out that the rule of three months of coughing a year for two consecutive years in pediatric practice does not always work. This means that in children under the age of three, such a diagnosis cannot be made at all. It is this age group of children that can suffer from bronchitis for most of the year, even being in hospital, but the diagnosis will be recurrent, acute or obstructive bronchitis. But it will never be chronic.

The explanation for this approach is the spontaneous resolution of all inflammatory changes in the bronchi when the child reaches a certain age. Usually, this turning point happens after three years. Most children with stubborn bronchitis get rid of this problem for good. Only in that part of sick babies, in which this did not happen and the symptoms of bronchitis continue to remind themselves of themselves with constant exacerbations, cough with sputum and signs of impaired bronchial patency, the diagnosis of chronic bronchitis becomes eligible. This is also logical from a pathogenetic point of view, since structural changes are already registered in the bronchi of such children, violating mucociliary clearance and the processes of natural bronchial cleansing.

Causes of chronic bronchitis in children

If in adults in the etiology of chronic bronchitis the main place is given to smoking and polluted air, then in children the infection comes to the fore. This is due to the imperfection of the immune defense mechanisms of the child's body against the background of constant contact with various pathogens. In educational and preschool institutions among limited groups of children, circulating pathogens are characterized by particular aggressiveness. The main place among them is given to respiratory viruses (, parainfluenza, RS viruses), hemophilic infection, marcellus, and streptococci, pneumococci, atypical pathogens.

Introduced into the bronchi of a child, the infection cannot always be fully neutralized by immune cells, which leads to its spread to the lymph nodes, or persistent penetration into the epithelium of the mucous membrane. Therefore, even after clinical improvement during the treatment of bronchitis, any hypothermia of a general nature or inhalation of cool air can cause a second exacerbation of the process.

The last cause of chronic bronchitis in children is the increased reactivity of the bronchial tree. Its result is excessive secretion of mucus and bronchial spasm. These causal mechanisms underlie the obstructive forms of chronic bronchitis. The cough reflex in children is also slightly inhibited compared to adults, which leads to a violation of sputum excretion with an aggravation of the condition.

Clinical Features

Among the symptoms of chronic bronchitis in children, it is not so much a cough that comes to the fore as a violation of the general condition. The younger the child, the more this pattern is observed. Almost every exacerbation is accompanied by a hyperthermic reaction, a decrease in appetite and activity of the child. It is possible to follow the nature of sputum only in older children, as they can collect it for analysis. Children of younger age groups cannot do this, because they simply swallow it.

As in adults, sputum may be clear mucous or yellow-green mucopurulent. Chronic bronchitis with bronchial obstruction always causes anxiety in the child, shortness of breath, wheezing, which can be heard even at a distance (remote wheezing). They can be both wet and whistling, dry, heard on exhalation or in both phases of the respiratory cycle. Emphysema and persistent signs of respiratory failure occur only in children with a long course of chronic bronchitis.

Treatment of chronic bronchitis

In the treatment of chronic bronchitis, etiopathogenetic drug therapy is used. It is not always possible to completely get rid of this problem, but it is quite realistic to achieve stabilization of the condition and maximum slowdown in the progression of the disease. For this can be used:

Antibacterial agents;

expectorants;

Bronchodilators;

Anti-inflammatory and antihistamines;

inhalation therapy;

Physiotherapeutic methods (halotherapy);

Normalization of lifestyle.

Antibiotic therapy for chronic bronchitis

It is prescribed in case of exacerbation of the process, which is accompanied by signs of intoxication, fever or expectoration of mucopurulent sputum in large quantities. Semi-synthetic aminopenicillins potentiated by beta-lactamase inhibitors (augmentin, amoxiclav), macrolides (azithromycin, macropen), cephalosporins (ceftriaxone, cefuroxime), fluoroquinolones (lefofloxacin, cyprom, avelox) can be prescribed. An antibiotic must be prescribed taking into account the results of sputum culture.

Expectorants for chronic bronchitis

Appointed in all cases of this disease. Two groups of agents are used: sputum disintegrators and expectorants. The first, contribute to the transformation of viscous sputum into liquid, the second - improve mucociliary clearance. In total, they get relief from coughing up sputum. ACC, lazolvan, flavamed, bromhexine are used.

Bronchodilators and anti-inflammatory drugs

This group of drugs helps to improve bronchial patency by expanding the lumen of the airways. Glucocorticoid anti-inflammatory drugs reduce the amount of secreted mucus and the activity of inflammatory cells in the mucous membrane. There are several types of such funds. They differ in their effects on different pathways of bronchodilation and elimination of obstruction:

Direct relaxation of the smooth muscles of the bronchi: aminophylline, theophylline, neophylline;

Action on cholinergic receptors (anticholinergics): ipratropium bromide (Atrovent), spirotropium bromide (Spiriva);

Adrenergic receptor agonists: salbutamol (Ventolin), fenoterol (Berotek);

Reduction of inflammation and secretion of bronchial mucus: fluticasone (flexotide);

Combined drugs: berodual, symbicort, seretide.

All these drugs, with the exception of aminophylline and its analogues, are available as individual metered mini-inhalers. Their convenience is that the patient can carry the drug with him and use it as needed. The active substance that enters the zone of inflammation at the time of inhalation quickly stops the symptoms of the disease.

Inhalations for chronic bronchitis

Along with individual inhalers, there are special ultrasonic devices - nebulizers. These devices are capable of pulverizing liquid medicines so that they can enter the smallest bronchioles along with the air we breathe. Such a correct and rational use of medicinal bases makes inhalation in chronic bronchitis the main method of treatment.

The cost of a nebulizer allows it to be purchased by almost every patient with chronic bronchitis. This has not only medical, but also economic feasibility. Indeed, as a drug used during inhalation, a remedy of any group, which is in a liquid state, can act.

Namely:

Dioxidine is an antiseptic agent with a wide antibacterial spectrum of action. Used for exacerbation of chronic bacterial bronchitis. For inhalation, the drug is diluted with saline 1:4. Single dose about 4 ml;

Chlorophyllipt is a local antiseptic drug. The solution is prepared by diluting it with physiological saline 1:10. A single dose of the prepared mixture is about 4 ml;

alkaline solutions. This can be either a ready-made soda preparation (sodium bicarbonate), or home-made (one teaspoon of soda per 200 ml of saline);

Atrovent is a bronchodilator drug of anticholinergic type of action. It is sold in pharmacies in liquid form. For inhalation, dilute 2 ml of the drug in 2 ml of saline. This is the single dose;

Berotek is a long-acting beta-adrenergic receptor agonist. For inhalation, 0.5-1.5 ml of the drug is used. Be sure to dilute with saline to 4 ml;

Ventolin is a short-acting beta-agonist. Produced in special nebulls, which contain a single dose of the drug. Diluted with saline 1:1;

Flexotide is a gluticocorticoid inhaled hormone fluticasone. Available in ready-made nebulls. For one inhalation, one nebula is needed, the contents of which are diluted with saline to 3-4 ml;

Acetylcysteine ​​(fluimucil) is a drug that loosens sputum. The product is intended for inhalation, therefore it contains a ready-made diluted medicinal mixture. Single dose about 4 ml;

Lasolvan is a mucolytic and expectorant. Produced in special vials for inhalation administration. A single dose of the finished solution is 3-5 ml.

The necessary drugs are simply poured into a special nebulizer receiver and inhaled after it is turned on. The frequency of admission and specific means should be prescribed and controlled exclusively by a specialized specialist.

How to cure chronic bronchitis forever?

The answer to this question lies in the way of life of a person and the characteristics of the air that he breathes every day. Based on this, even the ancient peoples noticed that all broncho-pulmonary diseases are cured after staying in deep salt caves. In our time, the number of this pathology has increased significantly, but there is practically no opportunity to visit such natural caves. Therefore, scientists were able to recreate these very natural ideal microclimatic conditions that help the body cope with chronic bronchitis. A positive effect has been noted not only in relation to this pathology, but also to many other diseases.

This method of treatment is called halotherapy. Sessions are held in a special halochamber, in which optimal microclimatic conditions are created. This is, first of all, ideally clean air with optimal humidity and temperature indicators, enriched with various aerosol components, the basis of which is always the salt component. This method is very simple, does not require any manipulations and medicines. It is desirable to include it in the treatment of any chronic bronchitis. Mild forms of the disease can be cured forever, while severe ones greatly facilitate their course and require smaller doses of medications. For this, 2 single 3-4-week courses of treatment per year are sufficient. The number of daily sessions is not limited. The main thing is that there are small time intervals between them.

Conducted by scientists, randomized studies have shown the effectiveness of halotherapy in various diseases:

With bronchial asthma, chronic bronchitis (obstructive and simple). Improvement in the condition in the study group of patients was 76%;

Chronic sinusitis (sinusitis, frontal sinusitis, sphenoiditis, ethmoiditis). The condition of patients improved by an average of 71%;

Skin-allergic diseases. Positive dynamics amounted to 89-92%;

Depressive and anxiety syndromes. Improvement is noted but 71-72%;

Rheumatic injury. Dynamics of a positive nature by 80%;

Astheno-vegetative syndrome and fatigue. The result of the improvement of the condition is 94%;

Immune dysfunction of various origins. Immunogram parameters improved in 72% of cases.

Education: Moscow Medical Institute. I. M. Sechenov, specialty - "Medicine" in 1991, in 1993 "Occupational diseases", in 1996 "Therapy".

Chronic bronchitis is an inflammatory disease of the bronchial tree, characterized by the appearance of cough with sputum and shortness of breath. The inflammatory process proceeds with constant exacerbations and remissions.

Chronic bronchitis should only be treated conservatively. What are the methods of conservative treatment? These are all methods of non-invasive treatment, namely drug treatment, treatment using inhalation through inhalers, folk and physiotherapy treatment.

It should be noted that drug treatment is the most effective remedy for chronic bronchitis. This treatment includes both tablet forms of drugs and injections. Usually, medications such as antibiotics and antivirals are prescribed to treat disease in adults, followed by anti-inflammatory drugs, mucolytics, antitussives, antihistamines, hormones, and bronchodilators.

Medicines in tablets and for injections

• One of the very first drugs for the treatment of chronic bronchitis in adults are antibiotics that act against the bacteria that caused an exacerbation of the disease in the bronchi. It should be remembered that if within 3 days after the start of antibiotic treatment the general condition has not improved, and the temperature has not returned to normal, then another antibiotic should be prescribed, since this one did not give the desired effect.

The following antibiotics are used to treat chronic bronchitis:

Antibiotics of the penicillin series: Amoxicillin (Amoxil, Flemoxin), Amoxicillin with clavulanic acid (Augmentin, Flemoxin Solutab), which have a broad spectrum of antibacterial activity, i.e. effective for gram-positive (staphylococcal, streptococcal, pneumococcal flora) and gram-negative (legionella, proteus, mycoplasma, ureaplasma, Pseudomonas aeruginosa) infections. Antibiotics of the penicillin series are prescribed 1000 mg, they must be taken 2 times a day. They need to treat chronic bronchitis for 7-14 days.

Antibiotics of the cephalosporin series - Norfloxacin, Ciprofloxacin, Ofloxacin have a pronounced antibacterial and bacteriostatic effect only for gram-negative flora, such a narrow focus on bacteria makes their action much stronger than simply broad-spectrum antibacterial drugs. For adults, the drug is prescribed 200 mg 2 times a day. The course of treatment is on average 10-14 days.

Antibiotics from the group of macrolides - Klabaks, Fromilid, Azithromycin, Rovamycin have a bacteriostatic effect and are effective mainly for intracellular forms of infections, which makes them indispensable in the treatment of chronic bronchitis. For adults, drugs are prescribed at 500 mg, it should be taken at the same time, on an empty stomach 1-2 times a day. It takes 3-7 days to treat this disease.

Antibiotics from the group of fluoroquinolones - Ciprofloxacin, Levofloxacin, Leflok belong to broad-spectrum antibacterial drugs, but these drugs are effectively used only for the treatment of the bronchopulmonary system, another name for this group is respiratory fluoroquinolones. It is necessary to treat chronic bronchitis in adults with these drugs for no more than 7 days at a dose of 500 mg 1 time per day. Leflok has an injectable form of release, which allows you to perform intravenous or intramuscular injections. It is also necessary to remember that antibiotic injections should be taken only for severe exacerbations.

• If viruses contributed to the exacerbation of the disease, then drugs against viruses are prescribed:

• Mucolytics are substances that promote expectoration of sputum. Depending on which cough prevails in the patient, different drugs are prescribed:

When a dry cough predominates, drugs are prescribed that help thin the sputum, i.e. reduce its viscosity - this is Acetylcysteine ​​​​(Acysteine, Mukobene, Mukoneks) 200 mg 4 times a day, 400 mg 2 times a day or 800 mg 1 time per day. You can also use plantain syrup, which is taken 1 tablespoon 3 times a day. Cough at first becomes unproductive, and then productive with the release of a large amount of sputum. It takes a long time to treat a cough, up to 10-15 days.

When a wet cough immediately appears during the disease, drugs from the ambroxol group (Flavamed, Abrol, Ambroxol) are prescribed for adults. The drugs are prescribed 75 mg 1 time per day or 30 mg 3 times a day. If a cough with a large amount of sputum, then Erespal should be added to this group of drugs, which should be taken 1 tablet 2 times a day, if a cough with a small amount of sputum, then such a drug is not needed. Cough should be treated for 10-20 days.

One of the representatives of this group, Lasolvan, has an injectable form of release and allows you to perform intramuscular injections. Due to the speed of action of the therapeutic substance, injections are considered more effective.

Inhalation therapy

Inhalations with the delivery of medicinal substances through inhalers directly into the bronchi are one of the effective methods of treating chronic bronchitis.

Inhalations are done with drugs - hormones, antihistamines, mucolytics and bronchodilators. With the help of inhalation, the active substances enter in sufficient quantities directly into the focus of the inflammatory process, and do not require the initial passage of the gastrointestinal tract and absorption into the blood. Inhalations deliver unchanged drugs in active forms.

Also, inhalations can be carried out with soda and aromatic oils, which have antibacterial and bronchodilatory effects. For inhalation, such oils are suitable: pine, lavender, tea tree, eucalyptus and thyme.

For inhalation, you can use special inhalers - nebulizers, as well as, albeit less effective inhalers, but at home from a pot or kettle.

Non-traditional methods

Alternative methods of treatment are well suited for chronic bronchitis in remission. Alternative methods reduce the frequency of exacerbations of the disease, as well as improve overall well-being, increase immunity and give strength.

Alternative methods of treatment with the use of decoctions and infusions of herbs help the body in the fight against cough and reduce the amount of sputum secreted by the bronchi. Suitable for decoctions: plantain grass, medicinal chamomile, licorice root, sage leaves, mint, linden, marshmallow root.

Alternative methods of treatment with the use of rubbing contribute to a better purification of the bronchi from bacteria, viruses and sputum, normalize the function of the lungs and bronchi in general. Honey, goose, mutton or badger fat is suitable for rubbing.

Video: Chronic bronchitis. Description, symptoms and treatment

Chronic form of bronchitis- a disease in which a person is tormented by a cough for more than 2 years, during the year it lasts from 3 months or more. To achieve the maximum effect of therapy, it is important to learn how to treat chronic bronchitis at different ages and what you need to pay attention to when choosing medications, using folk remedies and physiotherapy.

When a prolonged cough does not give rest, it must be treated, but in addition to medicines, bad habits should be abandoned

Goal of therapy for chronic bronchitis

Goal of chronic bronchitis treatment:

1. Prevention of complications and pulmonary insufficiency.
2. Normalization of bronchial patency.
3. Suppression of the spread of infection.

In addition to the above, the meaning of the treatment of the disease is to eliminate negative symptoms and restore the damaged bronchial mucosa.

Drug treatment of chronic bronchitis

An effective treatment regimen for chronic bronchitis involves complex therapy that affects all areas of the manifestation of the disease.

With an exacerbation of chronic bronchitis of a simple, obstructive or purulent form, antibacterial drugs are used - they quickly eliminate inflammation and help get rid of various infections.

To treat inflammation of the bronchus, antibiotics of the following groups are used:

In the treatment of bronchitis, penicillins should be used - broad-spectrum antibiotics.

1. Medicines of a wide spectrum of action, have a minimum of contraindications, but do not have the desired effect in the treatment of an advanced form of chronic bronchitis. The minimum duration of therapy is 4 to 7 days.
2. Cephalosporins. Means of the latest generation, rarely lead to an allergic reaction, are effective in acute chronic bronchitis.
3. Macrolides. Medicines of this subgroup inhibit the spread of harmful microorganisms. Re-treatment is allowed after at least 4 months, as bacteria quickly become resistant to macrolides. The duration of continuous reception should not exceed 5 days.
4. Fluoroquinolones. Used in the treatment of diseases in adults - they affect only the affected areas of the respiratory system.

Broad Spectrum Antibiotic

Probiotics

They are used to restore the intestinal microflora after taking antibiotics.

Affordable probiotic to take along with antibiotics

Bronchodilators

This group of medicines contributes to a moderate expansion of the bronchi, accelerates the process of their purification from accumulated mucus.

Mucolytics

They are used to eliminate coughing attacks in chronic obstructive bronchitis, contribute to liquefying sputum and removing mucus from the bronchi

An affordable mucolytic for all ages

Antitussives

Reason for use- the presence of intense dry cough, which most often occurs at the beginning of the inflammatory process.

Antitussive mixture

Antiviral

They are used if the exacerbation of the disease occurred against the background of influenza or SARS.

An antiviral agent that can be taken by both adults and children, observing dosages

Hormonal

If the use of bronchodilators and mucolytics does not help alleviate the condition, the following hormonal drugs are prescribed for chronic bronchitis:

Before taking, carefully read the instructions, there may be contraindications

Treatment with folk remedies

From chronic bronchitis, in addition to drug treatment, the following folk remedies help to get rid of:

As an alternative treatment, you can use garlic, honey, herbal infusions.

1. Elecampane root infusion. Pour 1 tbsp. l. chopped root 250 ml of water, boil for 15 minutes over low heat, then let it brew for 45 minutes. Use 1 tbsp. l. 3 times a day 30 minutes before meals. This recipe has an expectorant effect.
2. Turnip syrup. The top and core are removed from the turnip. The resulting container is filled with 2–3 tbsp. l. honey, close the lid on top and leave to infuse all night. The syrup should be taken 1 tbsp. l. up to 5 times per day. The tool helps to get rid of dry cough.
3. Lemon with glycerin. Boil 1 lemon for 5 minutes, then let it cool and mix in a container the juice of half the fruit with 2 tbsp. l. glycerin. Add to the resulting mixture 3 tbsp. l. honey, insist in a dark, cool place for 3-4 hours. Take 1 tbsp. l. 30 minutes before meals 3 times a day. The medicine helps to relieve inflammation and increase sputum discharge.
4. Black radish. Place the fruit with a tail in a vessel, cut off the top and remove the core. Fill the resulting container with 1 tbsp. l. honey, leave for 2-3 hours. Take 1 tbsp. l. up to 4 times a day for at least 1 week. One of the best remedies that relieves coughing fits and promotes sputum discharge.
5. A decoction of pine buds. Pour 250 ml of boiling water 1 tbsp. l. pine buds, steam for half an hour, then let it brew for 20 minutes. Drink 1 tbsp. l. 3 times a day. The decoction helps relieve coughing.
6. Herbal infusion. Mix 3 tsp. peppermint and coltsfoot with 5 tsp. calendula flowers, pour 3 liters of boiling water, leave for 3 hours. Next, the infusion should be filtered and consumed 150 ml up to 6 times a day for 3 months. The medicine helps to get rid of shortness of breath and eliminate coughing fits.
7. Sage tea. Pour 250 ml of milk 1 tbsp. l. chopped herbs, bring to a boil, strain and boil again. Drinking a warm infusion before bed will help prevent nighttime coughing spells.
8. Thyme. Pour 2 tbsp. l. herbs 300 ml of hot water and boil for 30 minutes in a water bath. Strain and take 100 ml 3 times a day. The remedy relieves cough and shortness of breath, eliminates chills.
9. Herbal collection. Mix 1 tbsp. l. chopped coltsfoot, knotweed and black elderberry, pour 300 ml of boiling water, leave for 2 hours. Drink a warm collection to alleviate coughing fits.
10. Plantain. Steam 350 ml of boiling water 15 g of crushed plantain leaves, let it brew for 2 hours. Take 3 times a day at regular intervals, 150 ml. The remedy is used in the treatment of dry cough.

When taking medications at the same time and using non-traditional methods, it is important to ensure that the interval between taking different drugs is at least 1 hour.

Physiotherapy

To speed up the healing process, a number of physiotherapeutic procedures are used, which include:

1. UHF. The procedure consists in the impact of an electromagnetic field of ultrahigh frequency on the respiratory organs.
2. Ultrasound. The use of high-frequency vibrations of the particles of the medium, which have a resolving, anti-edematous and anti-inflammatory effect.
3. Inhalations. Conducted in the hospital and at home. An effective recipe is to combine 2 ml of 0.1% solutions of adrenaline, atropine and diphenhydramine, pour the resulting mixture into an inhaler and spray 2-3 times a day. The duration of this method is up to 3 months.
4. Electrophoresis. In the chronic form of the disease, a solution of calcium chloride or potassium iodide is used for electrophoresis.
5. - a modern method of treatment, the essence of which is being in a room with the most favorable level of humidity and temperature. At the same time, the air is saturated with saline solutions. This technique helps to reduce the use of drugs and reduces the risk of remissions.

The essence of the method is to be in a salt room

Properly selected therapy for chronic bronchitis will help get rid of the infection, eliminate swelling and inflammation in the respiratory system, improve sputum output, which will lead to the normalization of the patient's condition as a whole. To reduce the number of relapses, avoid hypothermia, stop smoking, eat a balanced diet and take time to exercise.

Chronic bronchitis is a disease in which the inflammatory process develops in the lungs. In the chronic form, some functions are impaired, such as cleansing and protective.

The following principles underlie the typification of chronic bronchitis:

• the nature of the inflammatory process: simple, purulent and mucopurulent bronchitis,
• cause (etiology)
• exacerbation phase: the presence of an exacerbation or remission,
• the presence of complications: hemoptysis, respiratory failure, pulmonary hypertension, pulmonary emphysema,
• functional changes: obstructive and non-obstructive,
• course of the disease: continuous, secretive (latent), with frequent or rare exacerbations,
• level of damage: damage to small or large bronchi.

The classification is conditional, among physicians there is no general principle for the division of chronic bronchitis by type. But in medical practice, this classification is more often used.

Is bronchitis a viral or bacterial disease? We answered this question in detail in ours.

Symptoms

The main symptom of chronic bronchitis is a frequent cough that lasts 3 or more months.

Important! If periods of exacerbation of a severe cough are repeated several times within two years, a diagnostic examination is required.

Cough is often accompanied by difficult to separate viscous sputum of various nature (mucous, purulent, mucopurulent). During dampness, the cough intensifies. The most painful cough occurs in the morning, the rest of the time it is dry. In some patients, a debilitating cough may not stop around the clock.

In addition, patients may experience nausea, sometimes reaching vomiting, cyanosis of the skin during an attack. Temperature is within normal limits. In acute course, it can rise to 37-38 ° C.

In the initial stages, moderate shortness of breath is observed. With advanced disease, shortness of breath becomes permanent.

Important. Persistent shortness of breath indicates a progressive course of the disease, which can lead to emphysema.

Causes

In rare cases, it can be hereditary.

With a genetic predisposition, the bronchi are susceptible to any provocateurs of the disease.

Chronic bronchitis can develop against the background of acute bronchitis, but can also be caused by non-infectious causes.

Etiology of chronic bronchitis:

• bacterial,
• dust (occur in workers of hazardous industries),
• mycoplasma,
• arising from chemical factors (prolonged inhalation of chemicals, smoking),
• against the background of physical factors (exposure to cold or dry air).

Chronic bronchitis often occurs in people who have problems with the respiratory system, who have had pharyngitis, sinusitis. At risk are employees of tobacco factories, cloth factories, flour mills. Smokers and residents of cities with strong gas pollution are especially susceptible to the disease.

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Treatment in adults

Treatment of chronic bronchitis should be comprehensive.

The prognosis is often favorable, the ability to work in patients is not lost.

When treating, it is important to exclude irritating factors: limit visits to harmful work, if the reason is in it, limit smoking, use humidifiers at home.

How to heal with herbs

Herbal treatment gives positive dynamics. Patients are shown preparations based on the root of ninesil, marshmallow, thermopsis herbs.

The following herbs are used to treat bronchitis:

• horsetail,
• coltsfoot,
• naked licorice,
• plantain,
• wild rosemary,
• sage leaves,
• Linden blossom,
• creeping thyme,
• oregano,
• hypericum,
• drupe leaves,
• succession grass.

Take them in the form of herbal infusions. Pine buds, essential oils of coniferous trees have a disinfecting property.

How to treat - choose drugs

In chronic bronchitis with fever and increased sputum, antibiotics are used.

Their use is relevant for intoxication. Amoxiclav, augmentin, azithromycin, cefuroxime, avelox, lefofloxacin, cyprom are mainly prescribed.

The patient is shown the use of expectorant drugs, such as flavamed, ACC, bromhexine, lazolvan and analogues.

Bronchodilators used to improve airway clearance: neophyllin, eufillin, atrovent, berodual. Preparations in the form of mini-inhalers instantly convey the active substance to the site of infection, relieve inflammation and improve breathing.

Immunomodulators help to increase resistance to infections.

How to cure folk methods

Alternative treatment knows many remedies that relieve the symptoms of chronic bronchitis. From distraction therapy, mustard plasters and cans are used on the back. To strengthen the immune system, honey, dried fruits, herbal teas are used.

Important. Traditional medicine helps patients for whom antibiotics are contraindicated, such as pregnant women and people whose body has been weakened by previous antibiotic therapy.

In the treatment, recipes with lemon, viburnum berries, and garlic are used. Useful collection of chamomile, coltsfoot, oregano, infused in boiling water for 6 hours.

Additionally, classical and honey massage, breathing exercises, warming compresses, fortified drinks (freshly squeezed juices, cocktails) are useful. Take the drug in a glass every 2 hours.

Traditional medicine is a more gentle therapy compared to traditional treatment. However, before using folk remedies, you should be aware of the allergic characteristics of your body.

Honey massages during treatment alternate with honey-water and potato compresses.

Grain decoction of wheat, barley and wheat is taken as a drink. The grains in equal proportions are boiled in a saucepan over low heat for 1 hour, then filtered, the grains are crushed and sent to the broth.

Measures during remission

In the stage of remission, anti-relapse treatment is advisable:

• the use of garlic, onions,
• inclusion in the diet of honey,
• inhalations with furacilin, aloe,
• with bronchospasm, bronchodilators are administered,
• appointment of physical therapy,
• vitamin complexes.

All groups of patients should observe the regime of work and rest, master breathing exercises to strengthen muscle tissue.

Actions during an exacerbation

During the period of exacerbation, wheezing may appear in the chest, sometimes the temperature rises, weakness is observed.

In the acute phase, it is necessary to use antibiotics, inhalations. Complex drug treatment is combined with folk recipes.

Antipyretic drugs are prescribed when the temperature rises above 38 ° C.

Important. Patients with diabetes are contraindicated in licorice root syrup. With atherosclerosis, steam inhalations are prohibited.

Inhalations at home are carried out using a purchased inhaler, a kettle with hot infusion, a pot of water.

For inhalation use:

• pine buds and needles,
• dog-rose fruit,
• essential oils of eucalyptus, fir, cedar, camphor, rosemary,
• sea ​​salt,
• elderberry color,
• fennel seeds,
• raspberry leaves.

Halotherapy also has a therapeutic effect.. Its simplest imitation at home is a salt lamp made from salts mined in caves. With the help of a lamp at home, a microclimate favorable for treatment is created.

Nutrition

Eat foods rich in antioxidants and vitamins. The patient is useful year-round eating fresh herbs, fruits, vegetables, dairy products, fish, lean meat.

You should not eat less high-calorie food, the patient's diet should be varied and rich. It is necessary to give up fried foods for a while (during an exacerbation).

Important. With bronchitis, patients often experience protein deficiency. Therefore, it is important to include protein foods in the diet.

Mineral water, kissels and fruit drinks, as well as purified water should be consumed in an amount at least 3 liters per day.

Prevention procedures

Timely cured acute bronchitis reduces the risk of developing a chronic form. Strengthening immunity and general hardening of the body help to avoid re-infection in the initial stages of the disease. Patients with a long experience are shown annual trips to sanatoriums in a pine forest, mountains, steppe, resort treatment in the Crimea (Kislovodsk) is useful.

Important Vkontakte

Cough, shortness of breath, chest pain, feeling short of breath and general weakness, a temperature that stays at or above 37 ° C for a long time are symptoms of chronic bronchitis, a serious disease that is often diagnosed in adults, especially in the second half of life. Fortunately, there is a cure for it, and if it is taken on time, it is possible to completely get rid of the disease.

According to the WHO (World Health Organization), chronic bronchitis is the second most common, after bronchial asthma, non-specific disease of the bronchopulmonary system in adults, with which they go to medical institutions.

Chronic bronchitis and its symptoms appear if progressive diffuse inflammation is present in the bronchi. The disease is characterized by a sluggish course and occurs as a result of prolonged exposure to aggressive agents on the mucous membrane of the bronchial tree. In this case, changes occur in the mechanism of sputum production, there is a violation in the mechanism of self-purification of the bronchi.

There are WHO criteria, according to which the diagnosis of a chronic form of the inflammatory process in the bronchi is possible if sputum is coughed up by patients for three months (in a row or in total for a year).

Chronic inflammation of the bronchi is:

• primary (independent disease);
• secondary (due to bronchiectasis, tuberculosis, other diseases).

According to the type of flow, non-obstructive and obstructive bronchitis are distinguished in a chronic form. Obstructive is diagnosed if supersecreted sputum clogged the bronchial lumen, disrupted its patency. Treatment of this type of disease is more complex.

The causes of the disease are:

1. Infections. The anamnesis of adults with chronic bronchitis consists of frequent acute respiratory viral infections, influenza, and other infectious diseases of the respiratory system. Viruses and bacteria also become provocateurs of exacerbations of the disease.
2. Colds and hypothermia. Signs of chronic bronchitis in patients become aggravated in late autumn or early spring against the background of a sharp change in weather conditions.
3. Smoking. Tobacco smoke has a destructive effect on the mucous membrane of the bronchial tree, the normal mechanism for the production of sputum by it. The clinical picture of smoker's bronchitis in adults is the same as if the disease had another cause. But its treatment is impossible without giving up a bad habit.
4. Industrial-production pollutants (pollutants). A protracted inflammatory process in the bronchi occurs in people who work in industrial enterprises or live in polluted areas.

Symptoms of chronic inflammation in the bronchi

According to WHO, the symptoms of chronic bronchitis are:

• cough with sputum;
• pain in the chest;
• dyspnea;
• hemoptysis;
• body temperature is about 37 o C.

In addition, adults with this disease may have complaints of general weakness, loss of appetite, poor sleep, lack of air, cyanosis.

1. WHO identifies an obligatory sign of sluggish inflammation of the bronchi - a prolonged cough with sputum. Cough occurs reflexively in response to irritation of the mucous membrane of the bronchial tree. With it, the body tries to clear the respiratory tract from sputum. Once the illness worsens, the cough is usually dry. The secret secreted by the bronchial mucosa is still viscous, it is impossible to expectorate it. Therefore, an unproductive paroxysmal cough literally exhausts the patient, during his attacks pain in the chest and throat can be felt. If the diagnosis of the disease in adults is correct, treatment begins with the onset of exacerbation, already on the 3rd day the sputum liquefies, the cough becomes productive and not so painful.
2. If the inflammation of the bronchi is obstructive, the cough is accompanied by a meager sputum, mainly in the morning. By itself, sputum is not the main symptom of a chronic form of bronchial inflammation. It is not a sign of disease at all. By this term, WHO understands the secret produced by goblet cells, which form the ciliated epithelium of the bronchi. They provide local immunity to the respiratory organ. If the mucous membrane is exposed to dust, harmful substances, viruses, bacteria for a long time, and this effect is of a protracted nature, the number of goblet cells increases, respectively, and the amount of secretion they produce increases. At the same time, it is viscous, difficult to separate. When the sputum is too thick, it can completely clog the small bronchioles and larger bronchi, and an obstructive process will begin in the organ. In addition, due to its chemical composition, bronchial secretions are a favorable environment for the reproduction of pathogens. Therefore, it often happens that acute inflammation of a viral nature develops into a chronic bacterial one, the treatment of which will be mandatory with antibiotics. If the chronic inflammatory process in the bronchi is obstructive, the sputum may be purulent.
   
3. Shortness of breath, as a symptom of a chronic form of inflammation in the bronchi, designated by WHO, especially if it is obstructive, occurs due to narrowing of the respiratory lumen and spasm of smooth muscles. A sufficient amount of air ceases to flow into the lungs, the body is forced to turn on the compensatory mechanism.
4. Hemoptysis is a very bad sign of many serious diseases of the bronchopulmonary system, such as tuberculosis or lung cancer. If blood is present in the sputum, the WHO recommends a differential diagnosis. In adults in the first half of life, it is necessary, first of all, to exclude tuberculosis, in the elderly - oncology. As a rule, hemoptysis in the chronic form of bronchitis is poor, in the expectorant mucus or purulent secretion, blood is present in the form of small streaks. The reason for this is a strong cough, during which small blood vessels can burst. At the same time, blood loss is insignificant, in adults it is up to 50 ml per day, as a result of which anemia does not occur. A more significant loss of blood, from 100 ml per day, according to WHO, is no longer hemoptysis, but pulmonary bleeding. This rarely happens with an inflammatory process in the bronchi, even if it is running.
5. Chest pain can be of various origins, but, as a rule, they are signs of diseases of the bronchopulmonary, cardiovascular or musculoskeletal systems. Pain in the lungs and bronchi, radiating to the back, collarbone, diaphragm in adults occurs with pneumonia, COPD, emphysema and lung cancer, pneumothorax, pleurisy. Usually, it is intense, affecting the quality of life. It becomes necessary to treat with analgesics or stronger painkillers. With chronic inflammation of the bronchial mucosa, the occurrence of pain is more of an unpleasant sensation. More often, pain accompanies a cough at the start of an exacerbation, when it is dry and unproductive. If sluggish bronchitis is obstructive, chest pain may be present all the time.
   
6. The temperature in chronic inflammation of the bronchi rises to 37 ° C or slightly higher, but always remains within the low-grade. WHO believes that this is due to the general intoxication of the body, when the waste products of pathogens enter the bloodstream. Since the inflammatory process caused by them is sluggish, the clinical picture is characterized by the fact that the temperature rises to 37 ° C and stays at this mark for a long period of time, up to several months. The temperature is accompanied by other manifestations of intoxication: lethargy, loss of appetite, decreased ability to work.

How is chronic bronchitis diagnosed?

Since some manifestations of chronic bronchitis in adults, such as subfebrile temperature, shortness of breath, chest pain, cough, blood present in sputum, can occur with more severe, sometimes irreversible bronchopulmonary diseases (bronchial asthma, tuberculosis, emphysema, COPD, oncological neoplasms of the lungs ), its diagnosis is quite complex and multi-stage.

According to WHO recommendations, the diagnosis of chronic inflammation of the bronchi includes:

Methods of treatment of chronic bronchitis

Treatment of chronic inflammation of the bronchial mucosa is long-term. It consists in taking etiotropic and symptomatic drugs.

Etiotropic treatment is aimed at eliminating the cause of the disease, which was identified when the history was taken. In the case of sluggish bronchitis, it comes down to taking antibiotics from the groups of penicillins (Flemoxin), cephalosporins (Augmentin) and macrolides (Sumamed). The course of taking the drug is at least 7 days, and sometimes 2 weeks. Do not stop taking the antibiotic if the patient's temperature normalizes or the cough becomes moist. If the cause of chronic inflammation is not completely eliminated, it will soon worsen again.

To relieve swelling and reduce swelling of the bronchial mucosa, treatment with antihistamines is used. It is advisable for adults to take Suprastin, Cetrin, L-cet, Claritin.

If sluggish bronchitis is obstructive, so that the patient has shortness of breath, he is prescribed bronchodilator drugs, for example, Ventolin by inhalation.

Symptomatically in chronic bronchitis, cough is treated. At the first stage of the disease, when it is dry and literally interferes with life, antitussive drugs are prescribed. For adults, they may be codeine-containing, such as Cofex or Codterpin.

To reduce the viscosity of bronchial secretion, mucolytics are prescribed: Ambrocol, ACC, Inspiron.

There is no need to bring down the temperature below 38.5 ° C, therefore, anti-inflammatory drugs such as Ibuprofen or Nimesil are taken only to relieve pain.

In chronic bronchitis, physiotherapy is effective. According to WHO, it is recommended to carry it out for another month after the patient's temperature returns to normal and other symptoms of exacerbation disappear. Methods of inhalation, UHF, electrophoresis, as well as gymnastics, exercise therapy and massage are used.

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