Chronical bronchitis. Treatment in the stage of exacerbation and remission

The basis for the treatment of chronic bronchitis is the exclusion of the etiological factor of the disease. If chronic bronchitis is diagnosed, treatment requires smoking cessation, excluding occupational hazards, sanation of foci of infection. Inpatient treatment of chronic bronchitis in adults and bed rest is prescribed for exacerbation of the disease with an increase in respiratory and heart failure, symptoms of intoxication, acute pneumonia or spontaneous pneumothorax, if necessary, diagnostic and therapeutic procedures. The therapeutic diet should be predominantly protein-vitamin, in the case of the addition of a decompensated pulmonary heart, limit table salt and liquid, and increase the potassium content.

All efforts in basic drug therapy should be directed to treatment of obstruction. In a constant, supporting bronchial patency of therapy the main role is given to cholinolytics in high doses. If there is a therapeutic effect, they can be prescribed for a long time in the form of monotherapy. If the effect is insufficient, short-acting beta-agonists can be added. In some patients, combined preparations containing a cholinolytic and beta-agonist are considered to be the most effective. Cholinolytics and beta-agonists are prescribed in inhalations.

With further progression of the disease, methylxanthines are added to the treatment regimen, which along with their bronchodilator action reduce fatigue of the respiratory muscles, but are more toxic, require monitoring of their concentration in blood serum.

The next stage in the long-term treatment of chronic bronchitis can be the appointment of glucocorticosteroids. The advantage is given to inhalation forms. The administration of systemic glucocorticosteroids is required only during the exacerbation of the disease.

When the clinical effect is achieved within three to four weeks, which is confirmed by the positive dynamics of the ventilating function of the lungs, a gradual dose reduction, a transition to inhalation forms of glucocorticosteroids, is recommended.

An important factor in improving bronchial patency is the restoration of the normal surfactant system, which also requires chronic obstructive bronchitis. Treatment is carried out by mucolytics and mukoregulyatorami, administered by inhalation, oral and parenteral. The most effective drugs from this group are ambroxol and acetylcysteine.

Chronic bronchitis treatment in the stage of exacerbation of infectious origin requires the appointment of antibiotics. Preferably, macrolides and semisynthetic ampicillins are prescribed. The course of antibiotic treatment is prescribed for one or two weeks. In addition to medication, other treatments are required to defeat chronic bronchitis. The treatment is carried out by individually selected respiratory gymnastics, the appointment of a diet to normalize the body weight.

Despite the fact that chronic bronchitis is a progressive disease, properly selected and timely therapy can significantly slow the development of bronchial obstruction, prevent the development of complications and improve the quality of life of patients.

Improvements in the drainage function of the bronchi are achieved by prescribing a chest massage, phytotherapy, postural drainage. Desintoxication therapy is necessary if acute in purulent chronic bronchitis. Treatment is necessary with the mandatory inclusion of antibiotic therapy.

When remission is achieved, patients are in most cases forced to continue treatment. Patients with non-obstructive bronchitis can manage without remedies in the remission stage. Patients with obstructive bronchitis almost always have to take broncho-spasmolytic and expectorant means.