Chronic bronchitis is not just about taking medicine and getting injections, it is also important to learn how to breathe!

Author: Xi Jianing, Chief Physician, Beijing Rehabilitation Hospital, Capital Medical University

Reviewer: Fang Baomin, Chief Physician, Beijing Hospital

Chronic bronchitis, commonly known as chronic bronchitis, is a pathological change caused by chronic inflammation of the trachea, bronchi and their mucosa.

In the early stage, chronic inflammation of small airways causes airway narrowing and affects the ventilation function of the lungs. As the disease gradually spreads, it progresses to the bronchioles and alveoli, which will affect the ventilation function of the lungs.

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Clinical treatment for chronic bronchitis is generally medication and injections, and the medications are mainly antiasthmatic, expectorant, and antitussive drugs. In fact, rehabilitation medicine is also very effective in treating lung dysfunction.

1. What is rehabilitation treatment for chronic bronchitis?

Rehabilitation medicine is a discipline that studies human functions, and it uses more physical means and methods. In the past, people did not know much about rehabilitation medicine, but in recent years, people's understanding of rehabilitation medicine has been continuously improving.

Rehabilitation treatment for chronic bronchitis has also become popular both domestically and internationally in recent years. In the late 1960s, some experts and scholars in North American countries had obtained evidence-based medicine in the rehabilitation treatment of chronic bronchitis, and rehabilitation treatment for chronic bronchitis has been generally recognized by experts and patients.

There are many rehabilitation methods for chronic bronchitis, such as manual therapy, breathing training, exercise training, environmental improvement, the use of respiratory physiotherapy, mechanical assistance and use, etc., which can greatly improve breathing or lung function. Under the training of rehabilitation therapists, mastering the methods and paying attention to them in daily life will reduce the onset of chronic bronchitis.

Chronic bronchitis requires intervention and treatment during acute attacks, but not necessarily during remission and protracted periods. Clinical medicine is about curing diseases and saving lives, while rehabilitation medicine is about maintaining, preserving, and improving respiratory function.

2. What principles should be mastered in respiratory training for chronic bronchitis?

Patients with chronic bronchitis should master a principle in breathing training. The first is to reduce the stimulation to the respiratory tract, and the second is to reduce the use of oxygen as much as possible. Therefore, when patients with chronic bronchitis are doing breathing training, they should first control the rhythm, and second reduce the work of the respiratory muscles.

In terms of rhythm control, rehabilitation therapists will guide patients on how to control breathing rhythm and train them to breathe smoothly. For example, inhaling is one step, exhaling is two steps, inhaling is slower, and exhaling is twice as fast as inhaling. When exercising or walking, take one step and inhale, then exhale slowly for two or three steps. It is recommended to proceed slowly.

In terms of reducing the work of breathing, it is important to slow down, reduce the stimulation of the airflow to the airway, and reduce the work of the respiratory muscles. If the speed is too fast, the respiratory muscles will do more work, the amount of oxygen absorbed by the body will be high, and chronic bronchitis patients will have symptoms of discomfort.

Patients with chronic bronchitis generally have shallow and rapid breathing. After breathing control training, the expiratory phase can be effectively prolonged, making breathing easier.

3. How do patients with chronic bronchitis conduct controlled breathing training?

Place your hands on your abdomen, feel your breathing first, then slowly slow down your breathing, allowing the air to be inhaled from the chest to the stomach as much as possible, gradually slowing down your breathing speed, and it is best to control your breathing to 15-18 times per minute.

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It is recommended that patients with chronic bronchitis practice abdominal breathing as much as possible, because the diaphragm plays a very important role in abdominal breathing. Every centimeter of movement of the diaphragm has a greater impact on the tidal volume of breathing, or the amount of air inhaled each time. Therefore, it is recommended to learn abdominal breathing as much as possible. Thoracic breathing is not recommended for patients with chronic bronchitis on a daily basis. It is recommended that all respiratory muscles be involved in exercise during exercise, which can exercise the respiratory muscles and prevent respiratory muscle atrophy.

How to do abdominal breathing training? When you first learn abdominal breathing, gently place your hands on your head to inhibit the movement of the upper thorax. When you do this, your breathing becomes abdominal breathing. You can also do this while lying on your back, in bed, to fully relax the upper thorax, that is, the respiratory muscles of our shoulders and neck, so that you can do abdominal breathing better.

After learning abdominal breathing, you can perform slightly more difficult breathing exercises. Raise your hands, stretch your upper limbs backwards when inhaling, and gently put them back when exhaling. Repeat this action. It can effectively inhibit the movement of the upper thorax and increase abdominal breathing. At the same time, it can better stretch the thorax and make inhalation more complete. Chronic bronchitis patients can do self-exercise at home when they have time.