Do you know what is airway mucus hypersecretion? It is an important risk factor of chronic airway inflammatory disease!
Airway mucus hypersecretion refers to the pathophysiological process in which various pathogenic factors cause airway mucosa to produce excessive mucus. It will lead to airway obstruction, and then lead to such pathophysiological abnormalities as gas exchange dysfunction, imbalance of ventilation and perfusion ratio, which will significantly reduce the pulmonary function and quality of life of patients. It is an important risk factor affecting the onset and progress of chronic airway inflammatory diseases.
In recent years, many studies have shown that airway mucus hypersecretion is a common clinical pathological change of the respiratory tract, which plays an important role in the progress and prognosis of chronic obstructive pulmonary disease (COPD), bronchial asthma (asthma), bronchiectasis, pulmonary cystic fibrosis and other chronic airway inflammatory diseases.
With regard to the respiratory rehabilitation treatment for common diseases of airway mucus hypersecretion, the Chinese Expert Consensus on Respiratory Rehabilitation Treatment for Airway mucus hypersecretion mentions some treatment points and methods:
01 Chronic obstructive pulmonary disease
Hypersecretion of airway mucus is one of the most important pathophysiological and clinical features of COPD.
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Treatment of chronic obstructive pulmonary disease (COPD) with mucus hypersecretion includes reducing mucus formation and promoting mucus excretion.
Reduce mucus formation: smoking is one of the important factors that cause chronic airway mucus hypersecretion of COPD. Therefore, quitting smoking as soon as possible and avoiding continuous inhalation of toxic particles are the simplest and most effective respiratory rehabilitation methods to reduce mucus formation.
Promote mucus discharge: airway clearance technology, enhance cough ability and exercise. In addition, about 20%~60% of patients with chronic obstructive pulmonary disease (COPD) have anxiety and/or depression. With the joint assistance of medical staff and family members, psychological rehabilitation can help improve the compliance of patients with drug treatment and respiratory rehabilitation treatment, so as to improve the respiratory rehabilitation effect of patients with COPD.
02 Bronchial asthma
Airway mucus hypersecretion is one of the important pathophysiological characteristics of severe asthma. The degree of mucus hypersecretion is positively related to the level of airway inflammation. At the same time, the mucociliary clearance function of chronic persistent asthma patients is significantly reduced, which can cause bacterial colonization and airflow restriction in the airways of asthma patients, thus making the symptoms of patients difficult to control.
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Good asthma control is the simplest and most effective respiratory rehabilitation method for patients with chronic persistent asthma. Patients with definite allergens should be separated from allergens as much as possible, and strictly follow the asthma prevention and treatment plan to maintain asthma control, and at the same time, conduct airway clearance, which can wet the airway, dilute sputum, and prevent the formation of sputum scabs.
Airway clearance in the morning and evening and before inhalation of drugs: Patients with asthma who are not fully controlled have mucus retention in their airways. Active airway clearance in the morning is conducive to reducing patients' morning symptoms; Active airway clearance before sleep can reduce night symptoms, improve sleep quality and improve health status; Before inhalation of drugs, airway clearance is conducive to the inhalation of drugs to small airways to play a better role.
03 Bronchiectasis
Bronchiectasis is often accompanied by hypersecretion of airway mucus. Its main symptoms are repeated expectoration, hemoptysis, frequent lower respiratory tract infection and gradually increasing dyspnea. Therefore, the respiratory rehabilitation treatment of patients with bronchiectasis mainly focuses on the clearance of airway secretions, which helps to reduce symptoms and reduce the risk of acute exacerbation.
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Because of repeated suppurative inflammation and repair of the airway wall in bronchiectasis, the remodeling and poor compliance of the airway wall make the narrow airway difficult to be expanded by positive expiratory pressure; The sputum is mostly yellow purulent sputum with high viscosity and is not easy to be drained. Therefore, the treatment of airway clearance in patients with bronchiectasis must fully humidify airway secretions and improve the fluidity of airway secretions.
In addition, cystic fibrosis pulmonary disease, similar to bronchiectasis, is a congenital disease with autosomal recessive inheritance in the family. Excessive secretion of airway mucus is easy to cause airway obstruction and chronic infection. Clearing airway mucus is one of the important contents in the treatment of cystic fibrosis pulmonary disease.
It can be seen from the Expert Consensus that the respiratory rehabilitation treatment of common diseases such as COPD, asthma, bronchiectasis and other airway mucus hypersecretion cannot be separated from airway clearance and expectorant treatment.
Expert Consensus on Airway Clearance Technology for Severe Patients
The Expert Consensus on Airway Clearance Technology for Severe Patients pointed out that hypertonic saline is a common means of airway clearance: saline atomization can increase the clearance rate of secretions and sputum production, and cause cough. The mechanism of action includes that the water sample layer around cilia is rehydrated by 'absorbing water' from epithelial cells through high osmotic pressure; Other mechanisms include promoting cough and direct effects on mucus elasticity. Hypertonic saline can also be used for patients with no or little sputum, and induce sputum production for specimen collection. The role of hypertonic saline in airway clearance was confirmed.
Chinese Expert Consensus on the Clinical Application of Aerosol Expectoration
In the Chinese Expert Consensus on the Clinical Application of Aerosol Expectoration, when referring to the 'physical expectoration' of 'expectoration management', it was proposed that humidification therapy is one of the physical expectoration methods, which can reduce the viscosity of secretions to promote excretion. It is reported that the aerosol particles of rock salt saturated in the air (diameter 1-5 µ m, concentration 3 mg/m) are inhaled ³ (above) can improve the rheology of bronchial contents, thus promoting mucus clearance.
The Sinashu Salsol Therapeutic Apparatus independently developed by Nanjing Kuancheng Technology simulates the microenvironment of natural salt mines through a patented dry salt generator, releasing dry salt aerosol particles no more than 5 microns into the air, directly reaching the deep respiratory tract, thus helping to clear the airway, promote sputum excretion, and effectively treat and improve respiratory diseases.
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Antibacterial, anti-inflammatory and edema relieving
By increasing the concentration of ions in the respiratory tract, changing the osmotic pressure of mucus, improving the internal environment of the respiratory tract, inhibiting the growth of bacteria, and achieving the goal of diminishing inflammation and relieving edema.
Enhance the clearance of phlegm and expel phlegm
Improve the rheology of respiratory mucus, enhance the vitality of cilia swing, dilute sputum, and promote sputum excretion.
Enhance immunity and resistance
Activate the innate immunity of lung tissue, enhance the activity of pulmonary macrophages, and regulate the immune function of the body.
It can eliminate inflammation, relieve edema, improve the rheology of respiratory mucus, promote the clearance and elimination of phlegm, and promote the rehabilitation treatment of airway clearance and respiration. It is recommended to use the Sinashu Salsol Therapeutic Apparatus!
[1] China Medical Equipment Association Respiratory Equipment Professional Committee, China Disabled Persons' Rehabilitation Association Lung Rehabilitation Professional Committee Young and Middle aged Lung Rehabilitation Professional Group. Chinese Expert Consensus on Respiratory Rehabilitation Therapy for Airway Mucus Hypersecretion [J]. International Journal of Respiratory Science, 2021,41 (22): 1686-1696
[2] Expert consensus on diagnosis and treatment of adult bronchiectasis in China [J]. Chinese Journal of Tuberculosis and Respiratory Sciences, 2021,44 (04): 311-321
[3] Ge Huiqing, Sun Bing, Wang Bo, Xu Peifeng, He Guojun, Liang Guopeng, Duan Kailiang, Wang Jimei, Ding Jie, Chu Huiwen, Li Haichao, Zhao Yu, Yuan Xue, Zhou Yongfang, Ni Zhong, Liu Tingting, Wang Zhen, Han Yijiao, Wei Bilin, Liu Kai. Common knowledge of airway clearance technology experts in severe patients [J]. Chinese Journal of Critical Care Medicine (Online Edition), 2020,6 (03): 272-282
[4] Chinese expert consensus on the clinical application of aerosol expectoration [J]. Chinese Journal of Tuberculosis and Respiratory Sciences, 2021,44 (04): 340-348