Treatment of pneumosclerosis: basic principles

In modern pulmonology, the treatment of pneumosclerosis is associated with certain difficulties, since, despite the commonality of symptoms, pneumosclerosis is a polyetiological disease. However, it is not possible to focus efforts on eliminating the causal factor of this pathology due to the almost complete irreversibility of fibrous changes in the lungs.

Therefore, the treatment of pneumosclerosis is mainly symptomatic, aimed at eliminating foci of inflammation and maintaining the function of the respiratory system of patients with this diagnosis.

Treatment of pneumosclerosis: pharmacological agents and non-drug methods

Treatment of pneumosclerosis with pharmacological drugs is aimed at combating its manifestations. And the symptoms of pneumosclerosis are often the same as those of the diseases that most often cause it - bronchitis, pneumonia, pleurisy, etc.

The occurrence of bacterial inflammations fully justifies the use of antibiotics, among which doctors prefer to prescribe Oletetrin in combination with sulfonamide drugs (Sulfapyridazine) in standard doses; Amoxicillin (Augmentin) - three times a day, 500 mg (after meals) for five days; Azithromycin (Sumamed) - on the first day 0.5 g (once, an hour before meals) and for another four days 0.25 g. Ciprofloxacin (Tsifran, Ciprinol, etc.) is also effective in such cases; it is recommended to take 0.25-0.5 g twice a day for at least five days.

For coughs associated with exacerbation of bronchitis or pneumonia, expectorants such as Acetylcysteine (Fluimucil, ACC) are used - 0.2 g three times a day; Bromhexine (8-16 mg 3-4 times a day) or Ambroxol (Ambroxol, Lazolvan, etc.) - one tablet 2-3 times a day (after meals).

In case of exacerbation of inflammation, treatment of root pneumosclerosis, when the growth of fibrous tissue occurs in the root sections of the lungs, is carried out in a similar manner.

Reduced elasticity of lung tissue in focal pneumosclerosis often results in problems with blood circulation and heart failure. Then the treatment of pneumosclerosis should include cardiac glycosides and potassium preparations. Hawthorn or lily of the valley tincture or Corvalol drops are used 20-25 drops orally (before meals) three times a day. Digoxin or Celanide preparations are prescribed one tablet (0.25 g) three times a day. To reduce the load on the heart and expand the lumen of blood vessels, you can use Nitroglycerin - a 0.5 mg tablet under the tongue. And among potassium preparations, doctors most often recommend Asparkam (Potassium and magnesium aspartate, Panangin ) - one tablet three times a day (after meals).

If patients with pneumosclerosis have an allergic component, antihistamines should be prescribed, for example, Suprastin or Tavegil - one tablet (0.25 g) 2-3 times a day, after meals.

Physiotherapeutic procedures such as UHF chest, iontophoresis (with calcium chloride), ultrasound, diadynamic currents (in the absence of acute inflammation), as well as oxygen and aeroionotherapy sessions (30 minutes a day) help improve the condition and well-being of patients with this pathology. In addition, special breathing exercises are very useful for improving respiratory function.

Treatment of diffuse pneumosclerosis

Diffuse pneumosclerosis, in which fibrous changes in the lung tissue affect large areas, the lungs become denser and decrease in volume, and their blood supply deteriorates, is more difficult to treat than regional pneumosclerosis.

The main principle on which the treatment of diffuse pneumosclerosis is based is to maintain the functioning of the respiratory system at a level as close as possible to the physiological one, and thereby preserve the patient’s ability to breathe.

Patients with diffuse pneumosclerosis are required to be prescribed glucocorticosteroids, most often Prednisolone in tablet form: during the first three months, 1 mg per kilogram of body weight (but not more than 100 mg per day), another three months - 0.5 mg per kilogram of weight, the next six months - 0.25 mg. The total duration of treatment of diffuse pneumosclerosis with Prednisolone is 12 months, but may be longer.

Treatment of diffuse pneumosclerosis can also be carried out using such a drug - an immunosuppressant with a cytostatic effect as Azathioprine (Azanin, Azamun, Imuran), which is usually taken in parallel with glucocorticosteroids. The standard daily dosage of Azathioprine is 1-1.5 mg per kilogram of body weight, the individual dose is determined by the doctor depending on the condition; systematic monitoring of blood composition is mandatory. It is not yet clear whether this method of treatment can slow down the transformation of normal lung tissue cells into fibroblasts.

Only under constant supervision of the attending physician and with control of the blood and urine composition is a drug prescribed that disrupts collagen synthesis in the body - Penicillamine. The dosage is determined depending on the degree of lung damage: 125-250 mg per day (in four doses), one hour before or two hours after meals. The use of this drug should be accompanied by additional intake of vitamin B6.

The softening of fibrinous formations and the liquefaction of viscous exudates are facilitated by proteolytic enzyme preparations Trypsin, Lidase, Fibrinolysin, which are used by inhalation.

In diffuse pneumosclerosis, the pressure in the pulmonary artery often increases, which leads to an enlargement of the right ventricle of the heart and its failure. And this, in turn, causes blood stagnation in the systemic circulation with inevitable negative consequences. Therefore, the so-called calcium ion antagonists are used in therapy - drugs that adapt the work of the myocardium in conditions of oxygen deficiency, help relieve spasms of the vessels of the pulmonary circulation, and promote relaxation of the muscles of the respiratory system. Amlodipine (Normodipine, Norvax, Corvadil, etc.) is usually prescribed at 2.5-5 mg once a day. The drug Nifedipine (Cordipine, Corinfar, Nifekard, etc.) - 0.01-0.02 g 1-2 times a day (after meals).

Captopril and Pentoxifylline (Trental) improve microcirculation and myocardial oxygen supply, and also increase overall blood oxygenation. Thus, Captopril in tablet form is prescribed at 25 mg twice a day (approximately an hour before meals).

Also, for diffuse pneumosclerosis, you need to take vitamins C, B1, B6, E, P, PP.

In case of lung tissue necrosis, treatment of pneumosclerosis requires surgical intervention - removal of the affected part of the organ.

According to the American medical journal Journal of Respiratory and Critical Care Medicine (2013), research and clinical trials are ongoing to treat pneumosclerosis using mesenchymal stem cells, which promote the restoration of lung tissue.

Treatment of pneumosclerosis with folk remedies

Symptomatic treatment of pneumosclerosis with folk remedies uses such medicinal plants with an expectorant effect as thyme, coltsfoot, oregano, sweet clover, wild pansy, plantain, elecampane, black elderberry (flowers), licorice root and marshmallow. Decoctions or infusions are prepared from them (the usual proportion is a tablespoon of dry raw materials per glass of water), which I drink 50-100 ml three times a day. A decoction for steam inhalations is made from eucalyptus leaves and pine buds.

There is a recipe for an oat decoction that herbalists recommend taking for this disease. To prepare it, whole oat grains (two tablespoons) should be washed and boiled in a liter of water for 40-50 minutes (over low heat, under a lid); strain the decoction, cool and drink 150 ml three times a day.

A wine and honey tincture with aloe is also recommended: for 250 ml of dry red wine, take a tablespoon of liquid buckwheat or May honey and 80-100 ml of aloe juice. Before squeezing the juice out of the aloe leaves, they must be kept on the bottom shelf of the refrigerator for at least 10 days. The tincture will be ready for use 7-10 days after combining all the ingredients, and take this remedy in a tablespoon 2-3 times a day.

Treatment of diffuse pneumosclerosis with folk remedies is recommended to be carried out with tincture of stinging nettle: for half a liter of vodka you need about 250 g of fresh nettle leaves. Finely chop the leaves and pour vodka, insist in a dark place for a week; drink a teaspoon before meals three times a day.

Heather, sweet clover, St. John's wort, nettle, and couch grass are good for relieving pulmonary edema. These medicinal plants can be combined with plantain leaves, wild strawberries, black currants, and rose hips.

An infusion of a mixture of chamomile, sweet clover, stinging nettle, horsetail and birch buds (in equal quantities) helps improve blood microcirculation in the lung tissues. A tablespoon of the mixture is poured with a glass of boiling water, the container is tightly closed and wrapped for 1.5-2 hours. After straining, the infusion is taken two tablespoons 3-4 times a day.

Treatment of diffuse pneumosclerosis is further complicated by the fact that pathological replacement of lung tissue with fibrous tissue - with a gradual increase in shortness of breath, accompanied by attacks of irritating dry cough, wheezing, chest pain - can be a consequence of tuberculosis, syphilis, pneumoconiosis (lung damage from inhaled industrial dust), radiation exposure, granulomatous lung diseases, collagenoses, systemic scleroderma and other autoimmune diseases. So only pulmonologists can prescribe the correct treatment for pneumosclerosis.