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Immunosuppressants in the treatment of bronchial asthma
Jan 26,2020 Leave a comment By Admin
Immunosuppressants in the treatment of bronchial asthma began to be used in connection with the notion of autoimmune pathology in bronchial asthma. Currently, they are used in a limited way: they are prescribed in certain cases with a very severe, progressive course of bronchial asthma with a pronounced immunopathological component in the absence of the effect of all other treatment methods, including glucocorticosteroid drugs, and pronounced steroid-induced complications. Treatment is carried out only in a hospital. Immunosuppressants should be used very carefully. In recent years, a selective effect of these agents on subpopulations of immunoregulatory cells has been identified, which can lead to irreversible changes in the regulatory link of immunity. Long-term use of immunosuppressants increases the risk of viral and bacterial diseases. A number of experts consider the use of immunosuppressants in bronchial asthma pathogenetically unjustified and note that the long-term results of treatment are significantly worse than the nearest ones. Aminoquinoline drugs (delagil, plaquenil) are sometimes used to treat bronchial asthma: in the first month, take a tablet at night, several months – half a tablet.
Immunocorrective agents for treatment. The feasibility of using immunocorrective agents is justified by the presence of secondary immunological deficiency in bronchial asthma, therefore, when prescribing immunomodulators, the severity of the clinical symptoms of the disease and the state of immunity must be assessed. For the purpose of immunomodulation in bronchial asthma, decaris, diutsifon, sodium nucleinate, transfer factor, thymosin are used. However, these drugs pass the stage of clinical trials, so the indications and treatment regimens need to be studied. There are several treatment regimens for decaris: 100 mg once after eating four days in a row, two days off; 150 mg every other day, course dose of 900 mg or more; 150 mg for three consecutive days, four days off; 150 mg twice a week, course dose of 1200 mg. It is believed that decaris is indicated for patients with asthma with T-cell deficiency and functional deficiency of T lymphocytes. A positive effect was noted with exacerbations of bronchial asthma caused by respiratory diseases, influenza; in patients with moderate course of bronchial asthma, severe T lymphocyte deficiency and insufficient cvpressor activity. There is an opinion that decaris with bronchial asthma favorably affects the course of concomitant infections and does not affect allergy mechanisms. The effect of decaris is observed less frequently and is not sufficient in steroid-dependent patients (perhaps, in this case, other treatment regimens are necessary). In the process of therapy, hemogram and immunity are monitored. In case of infectious bronchial asthma with leukemia lymphopenia, a decrease in the number of B and T lymphocytes and inhibition of their function, it is advisable to use sodium nucleinate: inside 0.8 g per day (three days taken, three days off), course dose 1018 g. Long-term remissions were noted in some sick. There is evidence of a positive effect of the transfer factor with a decrease in the frequency and severity of respiratory infections.
In the treatment of bronchial asthma, uglobulin preparations and native plasma transfusions (100-120 ml once a week, five to six transfusions per course) are used with a favorable effect. Splenin also possesses certain immunocorrective sva, which is thought to act on target cells of an allergic reaction like the anti-allergic drug ketotifen. Along with this, splenin has a desensitizing, detoxifying effect, has a positive effect on liver function, adrenal cortex, and vascular permeability. Assigned to 2.0 ml twice a day intramuscularly for three weeks. Included in complex therapy, including steroid-dependent patients.
Sedatives in the treatment of asthma
Normalization of the functional state of the central nervous system is of great importance in the treatment of bronchial asthma, especially in cases of severe neuropsychiatric disorders. As sedatives, bromides, valerian, motherwort, antihistamines are used. If necessary (stressful situations), Elenium, Seduxen are briefly prescribed. The appointment of "large" tranquilizers to patients with asthma is undesirable.
There are general rules for using sedatives: they cannot be overdosed and prescribed for respiratory failure; courses during a period of situational stress should be short. Treatment of patients with bronchial asthma with a predominance of the neurogenic component in the pathogenesis has features.
Detoxification hemosorption during treatment. There is evidence of the use of this method in infectious-allergic bronchial asthma of moderate and severe course. The best results were obtained in individuals with an initial increase in the level of circulating immune complexes – remission was observed from two months to a year. With a normal content of immune complexes, treatment results are worse.
Diet for the treatment of bronchial asthma
A general hypoallergenic diet is recommended, as certain types of food can be an additional provoking factor in some patients.
In patients with bronchial asthma with metabolic disorders (obesity), concomitant pathology of the cardiovascular system (stage I-II hypertension, atherosclerosis), gastrointestinal tract, metabolic-dystrophic joint lesions, the choice of choice may be unloading and dietary therapy. A good effect of this method is described for infectious-allergic bronchial asthma (carried out according to the method of Yu. S. Nikolaev). Contraindications: deep degree of exhaustion, active pulmonary tuberculosis, malignant neoplasms, cirrhosis, organic diseases of the central nervous system, pregnancy and lactation, helminth infections.
Physiotherapeutic methods in the treatment of bronchial asthma
Physiotherapeutic methods in the treatment of bronchial asthma are used very widely. They are used differentially depending on the characteristics of the course of bronchial asthma and the biological effects of physiotherapy. At the stage of exacerbation, electrophoresis of various drugs (adrenaline, magnesium, bromine, calcium iodine) is carried out, as well as aeroinotherapy. During the period of exacerbation, the use of ultraviolet radiation of certain reflexogenic zones (contraindicated in case of hypersensitivity to ultraviolet rays); ultrasound therapy; high-frequency inductothermy and electromagnetic field of microwave frequency on the projection area of ​​the adrenal glands (stimulates their function). In the presence of a concomitant inflammatory process in the lungs, high-frequency electrotherapy is performed. The positive effect of barotherapy is described under conditions of reduced or increased barometric pressure.
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