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DOI: 10.1055/s-0033-1347042
Nicht-medikamentöse Therapie bei COPD – Ein wichtiger Bestandteil in der Langzeitbehandlung
Non-drug therapy for COPD – An important component of long-term treatmentPublication History
Publication Date:
13 May 2013 (online)
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Die Nicht-medikamentöse Therapie spielt eine immer größere Rolle in der Langzeitbehandlung von Patienten mit COPD. Die wichtigste Maßnahme stellt dabei die Beendigung des inhalativen Tabakkonsums dar, um den Verlauf der COPD positiv zu beeinflussen und den jährlichen Lungenfunktionsverlust signifikant zu vermindern. Regelmäßige körperliche Aktivität steht im Zusammenhang mit weniger Exazerbationen und geringer Mortalität bei COPD. Sie wird für alle Schweregrade empfohlen. Die pneumologische Rehabilitation kann insbesondere die Lebensqualität und Belastbarkeit steigern und die Hospitalisierungsrate reduzieren. Die jährliche Influenzaschutzimpfung sowie die Pneumokokkenschutzimpfung werden in Deutschland für alle COPD-Patienten empfohlen.
Non-drug therapy plays an ever increasing role in the long-term treatment of patients with COPD. The most important such measure is the cessation of inhaled tobacco consumption which has a positive effect on the course of COPD and significantly reduces the yearly loss of pulmonary function. Regular physical activity is associated with less exacerbations and reduces the mortality. In the meantime this is recommended for all grades of severity. Pneumological rehabilitation can above all improve the quality of life, increase performance and reduce the rate of hospitalization. On account of their high levels of evidence the yearly influenza as well as pneumococcal vaccinations are recommended for all COPD patients in Germany.
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Literatur
- 1 http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf
- 2 Vogelmeier C, Buhl R, Criee CP et al. Guidelines for the diagnosis and therapy of COPD issued by Deutsche Atemwegsliga and Deutsche Gesellschaft fur Pneumologie und Beatmungsmedizin. Pneumologie 2007; 61: 1-40
- 3 Scanlon PD, Connett JE, Waller LA et al. Smoking cessation and lung function in mild-to-moderate chronic obstructive pulmonary disease. The Lung Health Study. Am J Respir Crit Care Med 2000; 161: 381-390
- 4 Kanner RE, Anthonisen NR, Connett JE. Lower respiratory illnesses promote FEV(1) decline in current smokers but not ex-smokers with mild chronic obstructive pulmonary disease: results from the lung health study. Am J Respir Crit Care Med 2001; 164: 358-364
- 5 Au DH, Bryson CL, Chien JW et al. The effects of smoking cessation on the risk of chronic obstructive pulmonary disease exacerbations. J Gen Intern Med 2009; 24: 457-463
- 6 Anthonisen NR, Skeans MA, Wise RA et al. The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial. Ann Intern Med 2005; 142: 233-239
- 7 Andreas S, Batra A, Behr J et al. Guidelines for smoking cessation in patients with COPD issued by the Deutsche Gesellschaft fur Pneumologie und Beatmungsmedizin. Pneumologie 2008; 62: 255-272
- 8 Tonnesen P. Smoking cessation and COPD. Eur Respir Rev 2013; 22: 37-43
- 9 Magnussen H, Waschki B, Watz H. Measurement of physical activity in patients with chronic obstructive pulmonary disease. Med Klin (Munich) 2009; 104: 303-308
- 10 Waschki B, Kirsten A, Holz O, Muller KC, Meyer T, Watz H et al. Physical activity is the strongest predictor of all-cause mortality in patients with COPD: a prospective cohort study. Chest 2011; 140: 331-342
- 11 Wen CP, Wai JP, Tsai MK et al. Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. Lancet 2011; 378: 1244-1253
- 12 Kenn K, Heinzelmann I. Pulmonary rehabilitation. Dtsch Med Wochenschr 2012; 137: 1575-1578
- 13 Pitta F, Troosters T, Probst VS et al. Are patients with COPD more active after pulmonary rehabilitation?. Chest 2008; 134: 273-280
- 14 Puhan MA, Gimeno-Santos E, Scharplatz M et al. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev CD 005305 2011;