The progression of chronic obstructive pulmonary disease (COPD) depends largely on the availability of effective pulmonary rehabilitation therapy. Pulmonary rehabilitation treatment mainly includes: exercise training, respiratory muscle exercise, long-term oxygen therapy, nutritional therapy, medication, health promotion and infection prevention, psychological and behavioral interventions, etc.
1.Exercise training
Exercise training includes endurance training of the whole body and muscle training of local muscles. You can first try the amount of whole-body exercise, observe the respiratory and cardiovascular response, and then also gradually increase to the degree of tolerance, to find out the intensity of whole-body exercise in line with the patient’s own conditions, limited to the appearance of slight shortness of breath and increased heart rate. If the intensity is too high, the patient refuses due to unbearable symptoms, and if it is too low, the effect is poor. Most patients are easy to accept low intensity, long time exercise, higher intensity, short time exercise, and safe and effective. Exercise methods are walking, jogging, ladder, bicycle, taijiquan, qigong, etc.
2.Respiratory muscle exercise
Respiratory muscle fatigue exercise is a very important content and method of COPD patients in the stable stage of treatment. Specific respiratory muscle exercise is mainly to enhance the muscle strength and endurance of respiratory muscles, its simple methods are: blowing balloons, blowing candles, lip – diaphragm breathing and whole body respiratory gymnastics. For patients with chronic pulmonary heart disease, it is mainly inspiratory fatigue, therefore, respiratory muscle exercise is mainly inspiratory muscle exercise. Training patients to shrink their lips – diaphragmatic breathing, 6 months for a course of treatment, can effectively carry out deep and slow breathing, slow down the respiratory rate, reduce the amount of residual air, improve the ventilation and ventilation function of the lungs.
3.Long-term oxygen therapy
Long-term oxygen therapy can improve dyspnea, but also can stop or delay the process and speed of the development of obstruction to lung disease, and improve the quality of life and survival rate of COPD patients. It is also recognized as one of the main factors that can affect the prognosis of COPD. The current primary indication for long-term oxygen therapy is more severe hypoxia, with one of the following conditions also indicated.
(1) secondary erythrocytosis (red blood cell pressure >0.55)
(2) manifestations of pulmonary heart disease;
(3) pulmonary arterial hypertension. The specific method is to administer nasal low-flow oxygen for at least 15 hours a day, especially at night with continuous oxygen intake.
4.Drug treatment
Bronchodilators (including β2 agonists, anticholinergic drugs and theophylline drugs) are the main measures to relieve symptoms during the stabilization period of COPD. At present, there are more clinical applications of Sulidex (salmeterol ticarbazone powder inhaler), Symbicort, Siliqua and Albuterol.
5.Nutritional therapy
COPD patients have higher energy consumption due to increased respiratory load and increased respiratory work. However, dietary intake cannot be increased or even decreased due to shortness of breath and hypoxia, heart failure, etc. Malnutrition often occurs. Malnutrition is an independent predictor of COPD and deteriorating health status.
6. Psychological and behavioral interventions
COPD patients often have anxiety and depression. The mechanisms that produce their deteriorating mental health status may be.
(1) recurrent episodes of shortness of breath, chest tightness, panic and exacerbation of dyspnea and other pain caused by the patient’s fear and anxiety about disease awareness;
(2) Depression and anxiety due to economic pressure, quality of life, increased family dependence, and limited social activities brought about by repeated medical visits;
(3) The indifference and even antipathy of family members and society make patients have low self-esteem, loneliness, and even anxiety;
(4) Long-term hypoxia, hypercapnia and adverse reactions caused by some drugs can easily produce psychological disorders. Therefore, for COPD patients, in addition to the diagnosis and treatment of physical diseases, clinical work should also pay attention to the diagnosis and treatment of psychological diseases.