Physiotherapy in chronic bronchitis.
Chronic bronchitis is a common chronic nonspecific lung disease. In chronic bronchitis physiotherapy is applied both in the exacerbation and in remission with a view to their prevention.
When viscous and difficult detachable sputum it is advisable to use inhalation with 0.1% solution of potassium iodide or enzymatic preparations – himopaina (0.025 g of the substance diluted in 5 ml of 1% solution of sodium bicarbonate, inhalation is carried out from 1-2 times a day) and trypsin (0.005-0.01 g of drug is diluted in 5 ml of 1% solution of sodium bicarbonate, inhalation spend 1-2 times a day).
With purulent sputum, physical therapy, use inhalations of Pancreatin (0.5 g of drug is diluted in 5 ml of 1% sodium bicarbonate solution) or pancreatic deoxyribonuclease (6 mg of a substance dissolved in 3 ml of isotonic sodium chloride solution). To enhance the action of the drug in the solvent can be applied 0,036% solution of magnesium sulfate.
As a means of increasing the immunological reactivity and nonspecific resistance of the organism used prodigiozan solution (50 mg of the substance to the procedure) in the form of aerosols or electroaerosols, which is carried out 1 time in 3 to 5 days; in the course of treatment, 4-5 treatments. Inhalation of prodigiozan well to combine with the holding in the second stage, electrophoresis of calcium on the chest area daily;in the course of treatment of 10-12 procedures. Favorable action has and the total ultraviolet irradiation; start with 1/4 biodozy and gradually increased to 3-4 biodoses. Procedures performed in a day; in the course of treatment of 15-20 procedures (method No. 97: General individual UV irradiation; method No. 98: General Ultraviolet irradiation group).
Physical therapy should be combined with procedures that contribute to the hardening of the patient’s body: water – in the form of sponging of the chest and whole body with water, gradually reducing temperature, followed by douches and the use of soul, Aero – and heliotherapy, walks and sleep in the fresh air.
Patients with chronic bronchitis need to regularly engage in therapeutic exercises with an emphasis on breathing exercises.
In exacerbations of chronic bronchitis is recommended inductothermy on the area of the back at the level of projection of the roots of the lungs (inductor-ROM) labetalol in a dose of 10-15 min daily or every other day; in the course of treatment 12-20 procedures (method No. 83: the RF magnetic field to the region of the liver). In the presence of obstructive syndrome, in addition to the impact on the roots of the lungs, it is necessary to assign a consistently inductothermy on the area of projection of the adrenal glands (at the level h T 10 -L 3 ).
Inductotherm is contraindicated in patients with impaired hemodynamics in the pulmonary circulation, severe pulmonary and cardiac insufficiency, coronary heart disease. These patients appoint UHF-therapy.
UHF exposure is carried out sequentially on 2 fields: level 4 to 7 T h and on the level of T 10 h 10 min; the rate of 12-15 procedures (method No. 92: to the UHF region of the lungs).
The effectiveness of treatment is increased when conducting and one day, almost without time interval and UHF procedures described above and electrophoresis of calcium (2% solution). The current density of 0.03-0.05 mA/cm 2. duration: 20 min; in the course of treatment 10-12 procedures combined. This method of physiotherapy is contraindicated in patients with bronchiectasis. Instead of calcium can be applied electrophoresis other drugs.
In exacerbations of chronic obstructive bronchitis prescribed pulse EP UHF. The procedure is carried out successively on two fields: first field – T h 4-8 . second field – 9 T h-L 1 . Pulse duration 2 μs, average power output of 4.5-6 mo, duration of exposure 10 min on each field; in the course of treatment is 10-15 procedures.
Pulse E. p. with the success of UHF can be used in more severe patients, including those with significant hemodynamic disturbance of the pulmonary circulation, concomitant coronary heart disease, pulmonary heart disease 2B stage, and any time after suffering hemoptysis.
NRM is used in pulsed mode. Wherein the cylindrical inductors have on the posterolateral parts of the chest consistently at the level of T h 4-7 (first field) and T h 9-12 (second field) for 10 min on each field, using the magnetic induction of 35 MT. Treatments administered daily; in the course of treatment 12-18 procedures.
For the purpose of providing bronhodilatirutego action in patients in the subacute stage it is advisable to use CMT, with two electrodes 6×10 cm feature paravertebralna in the interscapular region, use the variable mode, the modulation frequency of 60-80 Hz, the depth of its 50%, PP III, and PP IV then for 3-5 min each. Procedures carried out daily; in the course of treatment of 10-12 procedures.
Patients with severe asthmatic or hypertension in the small circle used aminophylline-electrophoresis-ITC (in a similar way, the mode of operation rectified).
Simultaneously with the application of electrotherapy on the chest area you should use the spray – and electro-aerotriangulation bronchospasmolytic, antimicrobial, desensibiliziruyuschee and improves sputum production (including proteolytic enzymes) means. In obstructive bronchitis inhalation of bronchodilators should be preceded by (every 20-30 min) the inhalation of other drugs, for deeper penetration of the latter in the bronchopulmonary system.
When stihanii inflammatory manifestations, in the phase of incomplete remission can be applied turpentine baths (15-20 ml turpentine emulsion in the first bath to 50-60 ml at follow-up); water temperature 37-39°C. Use bath in a day or 2 consecutive days, followed by day break; in the course of treatment is 10 procedures (method No. 154: Turpentine baths).
Further, after remitting exacerbation, a phase of total remission, it is possible to employ other shared bath (water temperature to 36.5-37°C): radon (method No. 206: General radon baths), carbon dioxide (method No. 165: Carbon dioxide baths), coniferous (method No. 152: Coniferous baths), sage (method No. 153: Sage bath). It should be noted that the use of carbon dioxide baths on the method with decreasing water temperature 32-28°C the majority of patients with chronic bronchitis after acute and not shown can be applied individually for a long period of remission as a tempering agent.
In the warmer months shown patients treatment climate on the southern Crimean coast, in forest areas of middle belt of the country (predominantly in patients with poor wet) or in the medium – and high-altitude resort areas (predominantly in patients with copious sputum). Patients with chronic bronchitis with asthmatic component in remission shows the treatment in the microclimate of salt mines.