This article is from "Nankai Sun Pharmacist", which is used for medical science popularization for reference. Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease characterized by persistent airflow limitation, which develops progressively, has a slow onset and a long course of disease, and common clinical manifestations such as chronic cough, sputum production, dyspnea, chest tightness, wheezing, etc., and often occurs acute exacerbation. Harmful gases or particles such as cigarette smoke infect the airways and lung tissue, causing chronic inflammation, which is a common cause of COPD**. Chronic obstructive pulmonary disease (COPD) is a common and frequent disease of the respiratory system, which has the characteristics of high morbidity, high disability rate and high mortality rate, and with the progressive decline of lung function, it seriously affects the labor force and quality of life of patients, causing a huge social and economic burden.
COPD cannot be reversed, the purpose of ** is to delay the development of the disease, improve lung function, and improve the quality of life of patients
Antibiotics: respiratory tract infections are the main cause of acute exacerbations of COPD, and patients present with cough, sputum production, worse-than-usual dyspnea or increased sputum volume, or purulent sputum requiring a change in medication regimen. At this time, antibiotics such as amoxicillin, clavulanate, cefuroxime, cefixime, levofloxacin, moxifloxacin, and ceftriaxone can be given empirically**. If the exact pathogen is found, antibiotics can be selected based on susceptibility results.
Glucocorticoids: Patients in the stable phase of COPD can take long-term inhaled corticosteroids, such as budesonide and fluticasone, to help reduce the frequency of exacerbations and delay the progression of the disease. Patients in the acute exacerbation of COPD can be given oral prednisone or intravenous methylprednisolone to smooth the patient through the risk period, usually for 5 to 7 days.
Bronchodilators: including short-acting preparations such as albuterol, terbutaline, ipratropium, etc., these drugs have a rapid onset of action, can quickly control shortness of breath, dyspnea and other clinical symptoms, suitable for the acute phase of COPD**. Long-acting preparations such as salmeterol, formoterol, tiotropium, etc., these drugs have a slower onset of action but a long time of action, which is suitable for long-term COPD stabilization**, which helps to protect lung function, reduce the frequency of acute attacks, increase patients' exercise tolerance, and improve quality of life.
Expectorant: It can be used for those who are not easy to cough up sputum. Commonly used drugs include bromhexine, ambroxol hydrochloride, acetylcysteine, carbocisteine, etc., which can reduce the viscosity of sputum, make it easy to cough up, and avoid sputum blocking the airway and causing or aggravating infection.
According to the theory of traditional Chinese medicine, in the acute exacerbation period of COPD, it is common to have symptoms such as wind and cold attacking the lungs, external cold and internal drinking, phlegm and heat to suppress the lungs, phlegm turbidity obstruction of the lungs, phlegm and other syndromes, and in the stable period, lung qi deficiency, lung and spleen qi deficiency, lung and kidney qi deficiency and yin deficiency are common, blood stasis is the main pathological mechanism, often coexisting with the above symptoms, acute exacerbation stage ** to clear heat, activate blood, promote lung qi and reduce qi, Chinese patent medicine is often combined with conventional Western medicine**, enhance efficacy, reduce inflammatory reaction, protect lung function, the main drugs include:
Phlegm Reqing Injection: The formula is skullcap, bear bile powder, goat horn, honeysuckle, forsythia, which has the effects of clearing heat, dissolving phlegm and detoxifying, and is used for phlegm and heat obstruction syndrome of wind-temperature pulmonary fever, such as fever, cough, phlegm unpleasantness, sore throat, thirst, red tongue and yellow moss.
Qingkailing Injection: The formula is bile acid, hyodeoxycholic acid, buffalo horn (powder), baicalin, mother-of-pearl (powder), gardenia, indigo root, honeysuckle, which has the effect of clearing heat and detoxifying, dissolving phlegm and channeling, awakening and opening the mind, and is suitable for phlegm and mental disorders, such as wheezing, phlegm in the throat, and abnormal mental status.
Awakening Brain Jing Injection: The formula is musk, tulip, borneol, gardenia, which has the effect of clearing heat and detoxifying, cooling blood and activating blood, opening the body and awakening the brain.
Tongxuanli Lung Pills: The formula is perilla leaves, front hu, bellflower, bitter almond, ephedra, liquerice, tangerine peel, Fabanxia, Poria cocos, citrus aurantium (fried), skullcap, which has the effect of dissolving the cold and relieving the lungs, and is suitable for wind and cold attacking the lungs, such as cough, wheezing, and fever.
Suzi Qi Lowering Pills: The formula is fried perilla seeds, magnolia bark, Qianhu, licorice, ginger banxia, tangerine peel, agarwood, angelica, which has the effect of reducing qi and dissolving phlegm, warming the kidneys and absorbing qi, and is suitable for phlegm turbidity and obstruction of the lungs, such as the upper and lower deficiency, cough and wheezing caused by qi reversal and phlegm, and chest and diaphragm congestion.
Xingsu cough granules: The formula is bitter almond, tangerine peel, perilla leaves, front hu, bellflower, licorice, which has the effect of dissipating cold in the lungs, relieving cough and removing phlegm, and is suitable for wind and cold attack on the lungs, such as cough and qi reversal.
Xiaoqinglong Granules: The formula is ephedra, cinnamon branch, white peony, dry ginger, fine pungent root, boiled licorice, French banxia, and schisandra, which has the effect of relieving the surface of drinking, relieving cough and asthma, and is suitable for external cold and internal drinking, such as cold and fever, no sweating, wheezing and coughing and thin phlegm.
In the stable stage of COPD**, it is mainly based on invigorating qi, nourishing yin, expelling phlegm, and invigorating blood, and on the basis of conventional Western medicine**, combined with Chinese patent medicine, it can further improve clinical symptoms and lung function, and prevent acute exacerbation, the main drugs include:
Lung and blood capsule: The formula is astragalus, red peony and psoralen, which have the effect of invigorating qi and invigorating blood, invigorating the lungs and strengthening the kidneys, and is suitable for lung and kidney qi deficiency, such as cough and shortness of breath, or coughing and wheezing, chest tightness, palpitations and shortness of breath, cold and weak limbs, soreness and weakness of the waist and knees, cyanosis of the lips, pale tongue or purple tongue, etc.
Jade Screen Granules: The formula is Astragalus, Atractylodes macrocephalus (stir-fried), and fengfeng, which has the effect of invigorating qi, fixing the surface, and stopping perspiration, and is suitable for lung qi deficiency syndrome and lung and spleen qi deficiency syndrome, which can replenish the lungs and strengthen the spleen, reduce qi and dissolve phlegm.
Shengmai Drink Oral Liquid: The formula is red ginseng, wheat dong and schisandra, which has the effect of invigorating qi and nourishing yin and rejuvenating Jin, and is suitable for both lung and kidney qi and yin loss, such as palpitations, shortness of breath, and self-sweating. Drugs with similar efficacy also include Clam Dingqi Pill and Lily Gujin Pill.