Toyoshima Hideo, Yoshida Minoru
Department of Respiratory Medicine, School of Medicine, Fukuoka University.
Nihon Rinsho. 2003 Dec;61(12):2163-9.
Management of patients with stable COPD is consisted with education for smoking cessation, pharmacologic therapy and non-pharmacologic therapy. Smoking cessation is a basic standing point for management of COPD. Prognosis of COPD with less economical cost is improved by smoking cessation. Pharmacotherapy should be arranged according to the severity of disease. beta 2 agonists, anticholinergic agents, theophylline and a combination of one or more of these drugs are available to improve obstructive ventilatory impairment. Inhaled steroid is used for patients with asthmatic symptom and with documented spirometric response to steroid. Pulmonary rehabilitation is useful for patients with all severity to reduce symptoms and to improve quality of life. Selected patients can take beneficial effect by long-term oxygen therapy, ventilatory support and surgical treatment.
稳定期慢性阻塞性肺疾病(COPD)患者的管理包括戒烟教育、药物治疗和非药物治疗。戒烟是COPD管理的基本出发点。通过戒烟可改善COPD的预后且成本较低。应根据疾病严重程度安排药物治疗。β2受体激动剂、抗胆碱能药物、茶碱以及这些药物中的一种或多种联合使用,可用于改善阻塞性通气功能障碍。吸入性糖皮质激素用于有哮喘症状且肺功能测定显示对糖皮质激素有反应的患者。肺康复对所有严重程度的患者均有益,可减轻症状并提高生活质量。部分患者可通过长期氧疗、通气支持和手术治疗获益。