Long-term cough, phlegm, and wheezing may indicate chronic obstructive pulmonary disease

Author: Yuan Congcong Department of Respiratory Critical Care, The First Affiliated Hospital of Zhengzhou University

Reviewer: Yao Mengying, Chief Physician of Respiratory Critical Care Department, The First Affiliated Hospital of Zhengzhou University

1. What is chronic obstructive pulmonary disease?

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Chronic obstructive pulmonary disease, or COPD, is a chronic, progressive lung disease characterized by airway obstruction leading to difficulty breathing. The two most common types of COPD are chronic bronchitis and emphysema. Chronic bronchitis is an inflammatory response to the airways that causes airway constriction, excess mucus, and thickening of the airway walls, which leads to airway narrowing. Emphysema is caused by airway inflammation and damage that causes a decrease in lung tissue elasticity, resulting in gas retention in the lungs and an increase in lung volume.

2. What factors are likely to cause chronic obstructive pulmonary disease?

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1. Smoking: Smoking is one of the main factors leading to COPD. Long-term smoking can damage lung tissue, leading to airway inflammation and airway obstruction.

2. Exposure to the work environment: People who are exposed to air pollutants, chemicals, dust and other harmful substances in the workplace for a long time, such as miners, construction workers, farmers, welders, etc., are more likely to suffer from COPD.

3. Household exposure: Harmful gases and particulate matter present in the home environment, such as smoke from burning wood, coal or biomass fuels, can also increase the risk of COPD if exposed for a long time.

4. Genetic factors: Some people may have a genetic susceptibility and may develop COPD even without an obvious history of smoking or exposure to harmful environments.

5. Elderly people: As age increases, lung function will gradually decline, and the elderly are more likely to develop COPD.

6. Suffering from chronic bronchitis: People who suffer from bronchitis for a long time, especially smokers, are more likely to further develop COPD.

7. Early respiratory infections: Experiencing severe respiratory infections in childhood, especially pneumonia or bronchitis, may also increase the risk of COPD.

If you belong to the above risk factors, you should pay special attention to protecting your lung health and take measures to prevent the occurrence of COPD. Quitting smoking, avoiding exposure to harmful environments, regular health checks and maintaining a healthy lifestyle are all important preventive measures. Early identification of COPD risk factors and taking appropriate preventive measures are of great significance in reducing the occurrence of the disease.

3. How to diagnose and treat chronic obstructive pulmonary disease?

COPD is a chronic, progressive lung disease that has a serious impact on a person's quality of life and health. Therefore, early diagnosis and treatment, as well as ongoing management, are critical. Early diagnosis can help us take steps earlier to slow the progression of the disease and provide better treatment outcomes. By performing tests such as lung function tests, chest X-rays, or CT scans, your doctor can determine if there are signs of airway obstruction and decreased lung function, thus confirming COPD. If you have trouble breathing , a persistent cough , or other symptoms associated with COPD, see your doctor for evaluation as soon as possible.

4. How do patients with chronic obstructive pulmonary disease manage themselves at home?

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1. Maintain a positive attitude : A positive and optimistic attitude is very important. Anxiety and pessimism may cause autonomic nervous system dysfunction, thereby affecting the endocrine system and immune system, and leading to a decrease in human immunity. An optimistic mood is conducive to recovery from illness.

2. Quit smoking : Common risk factors for COPD include smoking, air pollution, respiratory tract infection, immune dysfunction, climate, etc. Smoking can cause COPD and aggravate the condition of COPD. Therefore, quitting smoking and preventing the inhalation of secondhand smoke are very important for COPD patients.

3. Improve nutrition : COPD patients should eat a high-calorie, high-protein, high-vitamin diet. Do not eat too much sugar or other foods that easily produce gas, such as soda, beer, and beans, to avoid producing a large amount of CO2 and increasing the burden of ventilation. People with abdominal distension should eat small meals frequently, eat soft food, and chew slowly.

4. Home oxygen therapy **: **Long-term oxygen therapy can improve the quality of life and survival rate of patients with COPD and chronic respiratory failure.

(1) PaO2≤55 mmHg or SaO2≤88%.

(2) PaO2 55-60 mmHg or SaO2 <89%, and one of the following conditions: pulmonary hypertension, right heart failure, secondary erythrocytosis (hematocrit >55%).

Anyone who meets any of the above two conditions can receive long-term home oxygen therapy.

Oxygen therapy time: 10 to 15 hours per day.

Oxygen therapy method: generally use nasal cannula, with a flow rate of 1 to 2L per minute.

Oxygen therapy target: SaO2≧90%, PaO2≧60mmHg.

5. Prevent respiratory tract infections : Pay attention to adding or removing clothes when the climate changes, keep warm, avoid getting cold, and prevent colds. Timely vaccination of influenza vaccine, pneumococcal vaccine, bacterial lysate, BCG polysaccharide nucleic acid, etc. may be helpful in preventing repeated infections.

6. Exercise : Exercise should be done according to the cardiopulmonary function. Do not force yourself to exercise. Walking is a good way to exercise. Walk for at least 15 minutes every morning and evening. You can calculate the 6-minute walking distance every day. If it is greater than 550 meters, it means that the cardiopulmonary function is normal. This is an internationally unified judgment indicator. If the 6-minute walking distance decreases, it indicates that the condition may be aggravated.

7. Pulmonary rehabilitation training : Broadly speaking, respiratory physiology therapy, muscle training, nutritional support, mental therapy and education all belong to pulmonary rehabilitation therapy. After discharge, COPD patients can actively carry out respiratory function exercises such as abdominal breathing, pursed lip breathing, and breathing gymnastics.

8. Standardized medication : Each patient’s condition is different, so it is advisable to standardize medication according to the doctor’s discharge instructions.

9. Outpatient follow-up : It is recommended to have an outpatient follow-up every 3 months. If fever, coughing up purulent sputum, chest pain, worsening dyspnea, hemoptysis, pain in both lower limbs, edema in both lower limbs or worsening of existing edema, excessive sleep, and decreased reaction ability occur, it indicates that the condition has worsened and you should seek medical attention immediately.