慢阻肺-COPD(Chronic Obstructive Pulmonary Disease)

What are the treatments for COPD?

Stop smoking
This is the most important treatment. No other treatment may be needed if symptoms are mild.

Short acting bronchodilator inhalers
An inhaler with a bronchodilator medicine is often prescribed. They relax the muscles in the airways (bronchi) to open them up (dilate) as wide as possible. They include:

• beta agonist inhalers. For example, salbutamol and terbutaline.
• anticholinergic inhalers. For example, ipratropium and oxitropium.

These inhalers work well for some people, but not so well in others. Some people with mild or intermittent symptoms only need an inhaler 'as required' for when breathlessness or wheeze occur. Some people need to use an inhaler regularly. The beta agonist and anticholinergic inhalers work in different ways. Using two, one of each type, may help some people better than one type alone.

Long acting bronchodilator inhalers
These include the beta agonists called formoterol and salmeterol, and the anticholinergic called tiotropium. They work in a similar way to the short acting inhalers, but each dose lasts at least 12 hours. They are an option if symptoms remain troublesome despite taking a short acting bronchodilator.

Steroid inhaler
A steroid inhaler may help in addition to a bronchodilator inhaler if you have more severe COPD. Steroids reduce inflammation. There are several brands of steroid inhaler. A steroid inhaler may not have much effect on your 'usual' symptoms, but may help to prevent flare-ups.

Bronchodilator tablets
These contain medicines such as theophylline that 'open the airways'. Side-effects are quite common and inhalers are usually better. However, some people find inhalers difficult to use, and tablets are an alternative. They may also be added in to the above treatments in severe cases.

Steroid tablets
A short course of steroid tablets is sometimes prescribed if you have a bad flare-up of wheeze and breathlessness (often during a chest infection). They help by reducing the extra inflammation in the airways caused by infections. Taking steroid tablets long-term is not advised due to the serious side-effects which can develop.

Mucolytic medicines
A mucolytic medicine such as carbocisteine makes the sputum less thick and easier to cough up. This may also have a knock-on effect of making it less easy for bacteria (bugs) to infect the mucus and cause chest infections. The number of flare-ups of symptoms (exacerbations) tends to be less in people who take a mucolytic. It needs to be taken regularly, and is most likely to help if you have moderate or severe COPD and have frequent or bad flare-ups.醫(yī).學(xué).全.在.線.網(wǎng).站.提供

Antibiotics
A short course is often prescribed if you have a chest infection.

Oxygen
This may help some people with severe symptoms. It does not help in all cases. A specialist usually does some breathing tests to assess whether oxygen will help. If found to help, oxygen needs to be taken for at least 15-20 hours a day to be of benefit.

Surgery
This is an option in a very small number of cases. For example, removing a section of lung that has become useless may improve symptoms. Lung transplantation is being studied, but is not a realistic option in most cases.

What can I do to help?

• Get immunised. Two immunisations are advised.
  • A yearly 'flu jab' each autumn protects against possible chest damage from influenza.
  • Immunisation against pneumococcus (a bug that can cause serious chest infections). This is a 'one off' injection and not yearly like the 'flu jab'.
• Keep fit. Studies have shown that people with COPD who exercise regularly tend to improve their breathing, ease symptoms, and have a better quality of life. Any regular exercise is good. A daily walk is a good start if you are not used to exercise.
• Lose weight if you are overweight. Carrying extra weight can make breathlessness worse.

In summary

• COPD is usually caused by smoking.
• Symptoms usually become worse if you continue to smoke.
• Symptoms are unlikely to get much worse if you stop smoking.
• Treatment with inhalers often eases symptoms, but no treatment can reverse the damage to the airways.
• A flare-up of symptoms, often during a chest infection, may be helped by a short course of steroid tablets and/or antibiotics.

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