Patient: I have been suffering from bronchitis for more than 20 years, but in the past few years, it became emphysema, and in the past two years, it has turned into pulmonary heart disease.
I was hospitalized every winter for the first two or three years, and was diagnosed with pulmonary heart disease by my county hospital the year before last, and was slightly relieved after being discharged, but my health has been poor. Furthermore, how should pulmonary heart disease be treated and what should I pay attention to in terms of diet?
Doctor: Hello, insomnia in patients with pulmonary heart disease is mainly related to hypoxia, which is directly related to the disease itself. The treatment of pulmonary heart disease in remission can be combined with Chinese and Western medicine to enhance the patient’s immune function, remove the triggering factors, reduce or avoid the birth of acute exacerbation, and hopefully gradually make the lung and heart function partially or fully recovered. In case of acute exacerbation, it is necessary to actively control infection; ventilate the airway and improve respiratory function; correct hypoxia and carbon dioxide retention; and control respiratory and cardiac failure.
Regarding diet, you can refer to the diet therapy for emphysema patients, which can be found in my list of articles. I wish you a speedy recovery.
I. Overview of pulmonary heart disease.
Chronic pulmonary heart disease most commonly known as chronic hypoxemic pulmonary heart disease, also known as obstructive emphysematous heart disease, referred to as pulmonary heart disease, refers to a class of heart disease caused by chronic lesions of the pulmonary thorax or pulmonary arteries that increase the resistance of the pulmonary circulation, resulting in pulmonary hypertension and right ventricular hypertrophy, with or without right heart failure. Pulmonary heart disease is a common and frequent disease in China. Ten years ago, according to a nationwide survey of more than 20 million people, the average prevalence of pulmonary heart disease was 0.4%. 1992 in Beijing, Hubei, Liaoning, certain areas of farmers surveyed more than 100,000 people, the average prevalence of pulmonary heart disease was 0.47%, basically similar to the former.
The prevalence was higher in people living in highlands (such as northeast, north and northwest China), southwest areas with insufficient sunlight and excessive humidity, and in people who smoked, and increased with age, with more than 91.2% of patients being over 41 years old.
There was no significant difference between male and female. The prevalence rate varies by occupation, with workers, farmers and city dwellers in descending order. The highest prevalence rate can be 15.7%-49.8%. The prevalence of this disease accounted for 46% to 38.5% of the composition of hospitalized heart disease. In most areas, it is the third or fourth most common cause of heart disease, but from 1980 to 1989, it was only 2.49% and the eighth most common cause of heart disease, which is related to the increase in the incidence of coronary artery disease and myocarditis and the number of admissions. This is related to the increase in the incidence of coronary heart disease and myocarditis and the number of admissions.
II. Clinical manifestations.
1. Pulmonary heart function compensation period: mainly cough, sputum, palpitation after activity, shortness of breath, cyanosis, weakness and other symptoms, i.e., the manifestations of primary chest disease and signs of pulmonary hypertension and right ventricular hypertrophy are predominant. In this case, the second heart sound in the pulmonary valve area is hyperactive and there is a systolic beat under the saber.
2. Pulmonary heart failure: respiratory acidosis and respiratory failure, palpitations, shortness of breath, nausea and vomiting, abdominal distension, lower limb edema, increased heart rate, etc. often appear. In severe cases, there may be obvious cyanosis, dyspnea and other symptoms, and even drowsiness, delirium, convulsions, coma and other manifestations of pulmonary encephalopathy.
Third, the treatment of pulmonary heart disease.
1.Western medicine treatment
(1) control respiratory tract infection: generally preferred penicillin, 2-4 million u daily, intravenous drip in several doses, and add streptomycin, 0.5g each time, twice daily, intramuscular injection. Ampicillin, carbenicillin, cephalosporin, etc. can also be selected according to the condition. When available, it is more reasonable to choose drugs according to sputum culture and drug sensitivity test.
(2) Keep the respiratory tract unobstructed: including measures to calm asthma, sputum, oxygen and appropriate application of respiratory stimulants. For asthma, use aminophylline 0.25g diluted intravenous drip. To reduce sputum, use Bixupine, 16mg each time, 3 times a day.
(3) Control of heart failure: according to the condition, use small doses, short courses of diuretics and cardiac glycosides with moderate effects as appropriate. For example, dihydrocortisone, 25mg each time, 3 times a day. Tachyphylaxis 20-40mg 3 times a day. If the heart failure is not corrected after the above measures are appropriately applied, then fast-acting short-acting cardiac glycosides like digitalis 0.2~O.4mg diluted and injected intravenously can be considered.
2, Chinese medicine treatment of acute exacerbation of pulmonary heart disease, the performance of this deficiency is confirmed, the condition is variable, treatment should be in accordance with the principle of treating the symptoms and both the symptoms and the root cause of the emergency.
(1) Lung and kidney qi deficiency external sensation type (pulmonary insufficiency combined with respiratory tract infection), the cold side of the lung is recommended to promote cold, dispel phlegm and calm asthma, available Xiao Qing Long Tang, Zhen Wu Tang and other additions and reductions. For those with heat, it is recommended to clear heat, resolve phlegm, and calm asthma with the addition and subtraction of Ma Heng Shi Gan Tang, combined with Seeping Su Drink and Di Bai San.
(2) Heart, lung, kidney and yang deficiency and water flooding type (mainly cardiac insufficiency), it is recommended to warm the kidney and strengthen the spleen, promote water and benefit qi, calm the heart, and adjuvantly activate blood circulation and eliminate blood stasis. For Qi and Yin deficiency (heart failure with hyponatremia, hypokalemia and hypotonicity), nourishing Qi and nourishing Yin is recommended.
(3) Phlegm clouding the orifice (pulmonary lung disease), it is advisable to clear heat and expel phlegm, open the orifice and awaken the mind, using Qing Ying Tang, Dan Xi Dushu Tang, and Purging Phlegm Tang with addition and subtraction.
(4) Yang-free type (shock), with addition of Yang rescue soup and Dushan Tang.
(5) For the type of heat and silt injury (with bleeding tendency), it is advisable to clear heat and cool the blood, activate the blood and stop bleeding, using Rhizoma Dihuang Tang with Ten Ash San, Ji Sheng Hui Sheng Wan, and Huang Tu Tang with addition or reduction. In addition, for Qi deficiency and fluid injury (late treatment with hormones, antibiotics and diuretics), it is advisable to benefit Qi and nourish Yin, moisten the lung and resolve phlegm, and Sha Shen Mai Dong Tang with addition and subtraction. The combination of traditional Chinese and Western medicine is a good way of treatment.