Main indications for prescribing inhalation therapy. Advantages of modern inhalation therapy. Interesting facts about inhalation therapy

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Aerosol therapy is a method of physiotherapy that involves the use of medicinal and biologically active substances in the form of aerosols for therapeutic purposes. Based on the possibility of quick and painless application medicinal substances on wound surfaces, mucous membranes and respiratory tracts of the lungs, from where these substances enter the blood.

During aerosol therapy, aerosols from the mucous membrane of the nose, nasopharynx, and trachea, where particles initially settle, are absorbed into the developed capillary and lymphatic vascular network in the submucosal layer. In the bronchi, absorption occurs more intensely than in the trachea, and absorption is most pronounced in the alveoli. Substances entering the lymph during aerosol therapy circulate for some time in the pulmonary lymph circulation and enter through the thoracic flow into the pulmonary circulation system, entering directly into the arterial blood. In this case, the medicinal substances bypass the liver barrier and penetrate into all tissues. In addition, the dense network of lymphatic vessels during aerosol therapy creates conditions for the concentration of aerosols in the lung tissue, prolonging the effect of the drug while slowly entering the pulmonary bloodstream.

The administration of drugs by aerosol therapy eliminates trauma to the skin and irritation to the mucous membrane of the esophagus and stomach. At the same time, a physiological natural supply of the medicinal substance and an active local and general resorptive effect on the pathological process, both in the respiratory system and on other systems of the human body, are ensured.

Aerosol therapy is divided into natural and artificial.

Natural aerosol therapy is inhalation into natural conditions clean air containing useful impurities in the form of element ions sea ​​water, medicinal mineral water, substances secreted by plants (conifers, camphor trees, linden, laurel, various herbs and phytoncides.

Artificial aerosol therapy can be performed by fumigating open wounds and diseased areas of the skin (fumigation), inhaling the smoke of medicinal herbs (smoking), as well as pure or hot steam with medicinal substances (inhalation).

Artificial aerosol therapy is carried out using inhalers, devices that generate aerosols. With the help of these devices, artificial aerosols containing various medicinal substances are introduced into the respiratory tract. Aerosol inhalers can be individual or chamber (a group of patients during aerosol therapy inhales medicinal substances sprayed in the inhalation room).

For treatment, aerosols of dry, wet, oily local and general action are used. It is possible to spray sea and mineral water, various salt solutions, infusions of medicinal herbs, phytoncides, enzymes, hormones, vitamins, antiseptic drugs, antibiotics.

The aerosols used are systems consisting of solid or liquid particles suspended in a gaseous medium. As a result of grinding the medicinal substance, its active surface area significantly increases and aerosol therapy provides biological effect of this substance on the mucous membrane of the respiratory tract, as well as on the entire body in relatively small quantities of the drug.

The degree of dispersion (particle diameter) of the aerosol determines the localization of its deposition in the bronchopulmonary apparatus and maximum concentration. If necessary, act on the mucous membrane oral cavity, nose and pharynx, larynx, aerosol therapy is carried out using large aerosols, the particle size of which is at least 30 microns. With average dispersion, the size of aerosol particles reaches 10-30 microns, and their maximum deposition occurs in the trachea and large bronchi. With fine dispersion, the particle size of aerosols does not exceed 0.5-10 microns. In this case, particles with a size of 10 microns penetrate into the bronchioles during aerosol therapy, and particles with a size of 0.5-3 microns penetrate into the alveoli. The epithelium of bronchioles and alveoli has the greatest absorption capacity.

Main groups of drugs used in aerosol therapy (in all groups, doses are indicated for one inhalation)

  • 1. Mucus-dissolving and mucus-liquefying substances. They are used in the form of coarse and medium-disperse aerosols. Reducing the viscosity of mucus during aerosol therapy is achieved using substances with mucolytic, proteolytic effects or by reducing the concentration mineral salts on a surface mucous membranes. These substances include: 1-2% sodium bicarbonate solution (100 ml), trypsin (5 mg), bisolvon (1-2 ml), heparin (5,000 - 10,000 units), deoxyribonuclease (2 mg), glycerin (5 g per 200 ml distilled water).
  • 2. Astringent and weakly cauterizing substances. They are used in the form of coarse aerosols. This group includes: infusion of chamomile flowers (6 g per 200 ml of distilled water), infusion of sage leaves (6 g per 200 ml of distilled water), 0.5% tannin solution.
  • 3. Bactericidal and bacteriostatic substances. They are used in the form of fine aerosols. Antibiotics of the aminoglycoside series (garamycin, gentamicin) prescribed for the treatment of acute pneumonia, lung abscess, and destructive bronchitis at a dose of 40 mg per inhalation are of practical value. Aerosol therapy is carried out in the form of procedures three times a day for 6-7 days. Other medicinal substances are also used for bacteriostatic purposes, for example furacillin (1 g per 5,000 ml of distilled water), interferon.
  • 4. Local anesthetics. Used in the form of coarse and medium-disperse aerosols before examining the respiratory tract instrumental methods, with a pronounced cough reflex, with burns of the respiratory tract. The use of a 1-2% lidocaine solution (1-2 ml per procedure) has practical value. Due to the pronounced allergenic ability of novocaine, aerosol therapy using this substance for inhalation is not recommended.
  • 5. Decongestant and antispasmodic substances. They are used in the form of medium and fine aerosols. In everyday practice, the following are widely used: 0.1% solution of atropine sulfate (1 ml), 0.1% solution of adrenaline hydrochloride (0.5-1 ml), 2% solution of aminophylline (3-5 ml), 2% solution of ephedrine hydrochloride ( 3-5 ml), 1% diphenhydramine solution (1 ml), hydrocortisone (25 mg). According to indications, drugs are prescribed separately or in combination.
  • 6. Protective and coating agents. They are used in the form of medium-disperse aerosols. This group includes vegetable oils (peach, olive, apricot, rose oil, rosehip and sea buckthorn oil), the aerosols of which cover the mucous membrane of the respiratory tract with a thin layer, protecting it from drying out. In addition, they have anti-inflammatory and bacteriological effects.

One of the types artificial aerosol therapy is electroaerosol therapy, which consists in giving aerosols a positive or negative electrical charge. This aerosol therapy is carried out using special devices - electric aerosol generators.

Indications.

  • Acute and chronic diseases of the upper respiratory tract, bronchi and lungs,
  • tuberculosis of the upper respiratory tract and lungs,
  • acute and chronic diseases of the oral cavity,
  • acute respiratory viral diseases,
  • · damage skin and mucous membranes,
  • · burns,
  • · trophic ulcers.

Contraindications.

Based on temperature, aerosols are divided into cold (25-28°C and below), warm (28-35°C), indifferent (35-40°C) and hot (40°C and above).

Based on the type of dispersed phase, aerosols of thermal steam and oils are distinguished. Medicinal substances used for aerosol therapy should not have an unpleasant odor or taste. Their concentration, as a rule, does not exceed 2%.

Medicinal substances and their mixtures most often used for aerosol therapy

Medicinal substances (mixtures), their quantity in solution

Quantity of solution per 1 procedure

Steam individual inhalations of menthol - 1g

Eucalyptus peach oil - 10g

10 drops per 100 ml of water

Glycerin 35 ml, eucalyptus tincture 35 ml,

Menthol 0.7 g, ethyl alcohol 30 ml

Warm-moist individual inhalations

Sodium bicarbonate - 2g, distilled water - 100 ml

Sodium bicarbonate - 2g, sodium chloride - 1g,

Distilled water 100 ml

Sodium bicarbonate - 1g, sodium tetraborate - 1g,

potassium iodide - 0.25g, distilled water - 100 ml

Infusion of chamomile flowers - 10g per 100 ml of water,

Menthol oil - 5 drops

Oletetrina 0.5 g (500,000 units), ascorbic acid - 2 g,

Distilled water - 100 ml

Mineral medicinal and medicinal table waters bottled: Essentuki No. 4, 17, Narzan, etc.

Wet individual inhalations

Acetylcysteine ​​solution 10% 4ml,

sodium chloride solution 0.9% - 5 ml

Novoimanin solution 1% - 0.5 ml,

Glucose solution 5% - 5 ml

Dioxidine solution 1% - 1 ml, glucose solution 5% - 5 ml

Aloe extract - 1 ml, novocaine solution 0.5% - 3 ml

Humisol solution - 5 ml

Aminophylline solution 2% - 2 ml, distilled water 3 ml

Crystalline trypsin 0.01 g sodium bicarbonate solution 1% - 5 ml (dilute before inhalation)

Oil individual inhalations

Menthol 0.1g, eucalyptus oil 1g, castor oil 1g,

peach oil 1g

Anise oil 10g, eucalyptus oil 10g

Menthol 0.1g, vaseline oil 10 ml, fish oil 0.8g,

eucalyptus oil 1g

Menthol 0.8g, eucalyptus oil 3g, purified turpentine oil 10 ml, vaseline oil - 87 ml

Chamber group inhalations of aminophylline solution 2%-20ml, distilled water 10 ml

Atropine sulfate solution 0.1% - 1 ml, diphenhydramine solution 1% - 2 ml, distilled water - 20 ml

Euphylline solution 2% - 20 ml, ephedrine solution 3% - 5 ml, ascorbic acid solution -5% 5 ml

Papaverine hydrochloric acid solution 2% - 4 ml, diphenhydramine solution 1% - 2 ml, ephedrine hydrochloric acid solution 5% - 2 ml, distilled water 30 ml

Novocaine solution 0.5% - 5 ml, hydrocortisone suspension - 2 ml, distilled water - 30 ml

Novocaine solution 0.5% - 5 ml, papaverine solution 2% - 4 ml, distilled water 30 ml

For inhalation therapy, steam, wet and oil inhalations are used.

Steam inhalations. They use water vapor, which captures medicinal substances that are in a dissolved state in the inhaler reservoir (alkalis, sulfonamides, decoctions of sage leaves, chamomile, eucalyptus tincture, etc.). The temperature of the inhaled steam is 40-45°C, which leads to the sublimation of the herbs, leaves, cones and buds contained in the decoction. Such inhalations are used during the prodromal period, as well as during the resolution phase of the inflammatory process. They are contraindicated: in acute pneumonia, severe edema, hypertrophy or polyposis of the mucous membranes, purulent inflammation, hypertension, coronary heart disease.

Warm-moist inhalations. Aerosols of solutions of salts and alkalis, which have mucolytic and bronchiolytic effects, heated to 38-42°C are used. They are carried out to liquefy and evacuate mucus, suppress persistent cough, and improve the drainage function of the bronchi. After it is carried out, the patient must cough in a drainage position (in which the paths for the outflow of sputum are below the place of its accumulation), do breathing exercises or vibration massage of the back and chest. Contraindications for warm-moist inhalations are similar to steam inhalations.

Wet inhalations. Medicinal substances are administered into the respiratory tract without preheating. Due to the low load on the respiratory tract, such inhalations can be performed by patients in the early postoperative period, for anesthesia of the nasopharyngeal mucosa. They can be prescribed to patients for whom steam and warm-moist inhalations are contraindicated.

Oil inhalations. When they are carried out, heated aerosols are injected into the tracheo-bronchial tract various oils, which have trophic, reparative-regenerative and bronchoprotective effects. In this regard, they are used for acute inflammation and severe atrophy of the mucous membranes of the respiratory tract. When combined with warm-moist inhalations, it is necessary to first remove sputum to prevent the formation of oil-mucus plugs in the small bronchi.

To obtain aerosols in medical practice, the following methods are used:

  • - pneumatic (using compressed air that disperses the medicine);
  • - ultrasonic (mechanical vibrations of ultrasonic frequency cause liquid cavitation and the formation of small particles);
  • - propellant (dispersion of particles of a medicinal substance using the sublimation of propellants);
  • - steam (steam, when moving, captures medicinal substances dissolved in the tank).

To produce aerosols, devices that disperse liquid in the air are more often used - aerosol generators of closed (individual) and open (group) types. The first of them include portable inhalers: Breeze, IP-2, Dissonic, Monsoon, IN-6, IN-7, IP-1, PAI, as well as stationary universal inhalers “Arsa”, Aerosol, “Vulcan-1”, “ Fog-1", Paros, PulmoAide, USI and others. Electroaerosols are obtained using the devices “Electroaerosol-1” and “TEI-1”. Aerosols for external use are obtained using open-type inhalers “Albedo”, Vapazon, Vaporisator, and to obtain electric aerosols the devices GEK-1 (chamber electric aerosol generator) and GEG-2 (group electric aerosol generator) are used. They are placed in special rooms - inhalators, with an area of ​​at least 12 m2. The inhalation room requires supply and exhaust ventilation with a 4-fold air exchange.

Methodology. Inhalations are carried out no earlier than 1.5 hours after eating in a calm state of the patient, without difficulty breathing. For diseases of the nasopharynx, during inhalation the patient inhales and exhales evenly. For diseases of the larynx, trachea and bronchi, the patient should take a deep breath, hold his breath and exhale through the nose. To increase the penetrating ability of aerosols, drugs that improve bronchial patency (bronchodilators) should be taken before inhalation. After inhalation, rest for 10-15 minutes is necessary. Eating, talking and smoking are not recommended for an hour.

During group inhalations, patients are placed at a distance of 75-120 cm from the aerosol generator. Inhalation of electric aerosols is carried out through a respiratory mask.

External aerosol therapy is performed by spraying aerosols on the surface of the skin, surgical field, wounds and burns. The aerosol generator nozzle is installed at a distance of 10-20 cm from the irrigated surface. After the procedure, a sterile bandage moistened with a solution of the sprayed substance is applied to the treatment area. In addition to aeroion therapy, aerosol therapy is combined with electrotherapy and heat therapy.

Dosing of aerosol therapy procedures is carried out according to the degree of particle dispersion (which is determined by the pressure, air flow and sprayed solutions in inhalers), inhalation depth, drug concentration and duration of the procedure.

The duration of daily procedures is 5-15 minutes. The course of treatment is 10-20 procedures. If necessary, a repeat course of aerosol therapy is carried out after 10-20 days.

Inhalation therapy is one of the best views treatment of inflammatory diseases of the respiratory tract, practiced by humanity for 6 thousand years. And today inhalations remain one of the most popular methods of treatment and prevention. colds. Inhalation is accompanied by a decrease in the viscosity of sputum, which improves its removal from the respiratory tract. Essential oils penetrate deep into the mucous membrane and change the functional properties of the free nerve endings of the submucosal layer. At the same time, the respiratory reserve of the lungs increases, gas exchange and the rate of transport of essential oil molecules into the pulmonary circulation, their accumulation in the blood and the formation of generalized reactions increase.

Therapeutic effects: antimicrobial, anti-inflammatory, expectorant, bronchodilator. Indications: acute and chronic diseases of the upper respiratory tract, bronchi and lungs, occupational diseases of the larynx; acute and chronic diseases of the middle ear and paranasal sinuses; respiratory, adenoviral infections in the acute and subacute period; obstructive syndromes, laryngospasms, bronchial asthma, prevention of complications in the postoperative period.

Inhalations are... Possibility of direct and rapid impact on the area of ​​inflammation in the mucous membranes. The inhaled substance is practically not absorbed into the blood and does not have side effects on other organs and systems, as happens when taking tablets or injections. This is a cheaper way to achieve rapid relief of symptoms and recovery.

Inhalation through a nebulizer is one of the methods of aerosol therapy in children under 5 years of age, as well as in many elderly patients. It is possible to combine medications. One of effective ways Treatment of diseases of the upper respiratory tract and colds is inhalation, that is, inhalation of medicinal substances.

The advantage of inhalation therapy over other methods is faster absorption of drugs, an increase in the active surface of the drug substance, its deposition in the submucosal layer (rich in blood and lymphatic vessels), creation high concentrations medicinal substances directly at the site of the lesion. In addition, bypassing the liver, drugs in unchanged form act more effectively in diseases of the upper respiratory tract and lungs than when administered orally.

In medicine, aerosols are divided according to particle size into high-, medium- and low-disperse. The smaller the aerosol particles, the longer they remain in the flow of inhaled air and the deeper they penetrate into the respiratory tract. Particles with a diameter of 8-10 microns usually settle in the oral cavity, 5-8 microns - in the pharynx and larynx, 3-5 microns - in the trachea and bronchi, 1-3 microns - in the bronchioles, 0.5-2 microns - in the alveoli.

The mechanism of aerosol propagation in the respiratory tract is as follows. During the spraying process, the particles gain speed. Large particles simultaneously move and quickly settle under the influence of gravity on the walls of the upper respiratory tract. Small particles are slowed down much faster by air resistance, their speed of movement decreases, they seem to hang in the flow of inhaled air and move with this flow, slowly settling under the influence of gravity. The speed of air movement in the upper respiratory tract is higher, which prevents the settling of small particles. Only once it reaches the lower sections of the bronchi does the air flow slow down and become laminar, which facilitates the settling of small particles. A slow deep breath and holding your breath at the end of the inhalation increase the mass of aerosol that settles on the walls of the small bronchi and alveoli.

In diseases of the upper respiratory tract, the inflammatory process develops in the mucous membrane. This is where adhesion (sticking) occurs pathogenic microorganisms, their reproduction, which is the trigger for development inflammatory reaction. Initially, an acute process occurs, which lasts on average about 1-2 weeks. If treatment is not effective enough, the inflammatory process goes into the subacute period, and may develop in the future. chronic form inflammation. Depending on the organ where the inflammatory changes in the mucous membrane are most pronounced and the duration of the disease, it occurs in the form of acute or chronic rhinitis, pharyngitis, laryngitis, tracheitis, sometimes spreading to 2-3 departments.

IN clinical otorhinolaryngology aerosols as highly effective agents can be used both as monotherapy and in combination with other therapeutic methods. To reduce the treatment time for acute and chronic rhinitis, pharyngitis, tonsillitis, laryngitis, acute respiratory diseases and acute respiratory viral infections of the upper respiratory tract, inhalation therapy is increasingly prescribed in combination with other methods. Local use of drugs in the form of inhalations is widely used in phoniatric practice for the treatment of various diseases voice apparatus, drug therapy after surgical interventions on the larynx and upper sections trachea. In this case, the drug affects not only the larynx and vocal folds, but also other parts of the upper and lower respiratory tract. This allows for making the right choice carry out medications complex treatment not only disorders of the vocal apparatus, but also the entire respiratory tract.

Using inhalers, you can administer antibiotics, antihistamines, bronchodilators and anti-inflammatory drugs, and biostimulants. Antiseptics are also used,

Inhalation of antibiotics is recommended after determining the sensitivity of the microflora to them and the absence of individual hypersensitivity. However, a clinic doctor often does not have the ability to quickly carry out laboratory diagnostics and correctly determine the nature of the infection: viral, bacterial or mixed. Therefore, they are more often carried out empirical therapy, given that rhinitis, pharyngitis, tonsillitis, laryngitis have viral etiology, and sinusitis is of a bacterial nature. However, there are exceptions. In particular, tonsillitis can be caused by pathogenic streptococcus. In addition, one should remember about the dramatically changing structure of pathogens of upper respiratory tract infections and their increasing resistance to many antibiotics and chemotherapy drugs that have long been used in medical practice.

Inhalation is a method of introducing various medicinal substances into the patient’s body in the form of aerosols through the respiratory tract.

Aerosol is the smallest solid and liquid particles dispersed in. air. In the form of aerosols, solutions of medicinal substances, mineral waters, herbal remedies, oils, and sometimes powdered medicines can be used in physiotherapy. As a result of grinding (dispersing), medicinal substances acquire new properties that increase their pharmacological activity: a) an increase in the total volume of the medicinal suspension and b) the contact surface of the medicinal substance, c) the presence of a charge, d) rapid absorption and delivery to tissues. Other advantages of inhalation therapy are: absolute painlessness of drug administration, elimination of their destruction in the gastrointestinal tract, reduction in frequency and severity side effects medications.

According to the degree of dispersion, five groups of aerosols are distinguished:

1) highly dispersed(0.5-5.0 microns) - practically do not settle on the mucous membrane of the respiratory tract, they are freely inhaled and settle mainly on the walls of the alveoli and bronchioles;

2) medium-dispersed(5-25 µm) - settle mainly in the bronchi of the 1st and 2nd order, large bronchi, trachea;

3) low-disperse(25-100 microns) - very unstable (especially droplets), settling on the surface, quickly connecting with each other and eventually returning to the original state of a regular solution;

4) small-droplet(100-250 microns) - almost completely settle in the nose and oral cavity;

5) large-panel(250-400 microns).

These features of aerosols are taken into account when choosing the degree of dispersion of aerosols for the treatment of diseases of various localizations. For the deposition of aerosols in the respiratory tract, the speed of their movement is important. The higher the speed, the fewer aerosol particles settle in the nasopharynx and oral cavity. It is believed that on average 70-75% of the medicine used is retained in the body.

To increase the stability of aerosols in the air and increase their biological effect, a method of forced recharging with an electric charge has been developed. Such aerosols are called electroaerosols. Electric aerosol particles have a free positive or negative charge, and the presence of a free electric charge brings their action closer to the action of air ions.

Routes of administration of aerosols in medicine:

intrapulmonary(intrapulmonary) - for their effect on the mucous membrane of the respiratory tract and the ciliated epithelium of the lungs (for diseases of the paranasal sinuses, pharynx, larynx, bronchi and lungs);

transpulmonary - absorption of a drug from the surface of the mucous membrane of the respiratory tract, especially through the alveoli, for a systemic effect on the body, while the rate of absorption is second only to intravenous infusion of drugs (for the administration of cardiotonic drugs, antispasmodics, diuretics, hormones, antibiotics, salicylates, etc. );

extrapulmonary(extrapulmonary) - application on the surface of the skin (for wounds, burns, infectious and fungal infections of the skin and mucous membranes);

parapulmonary(parapulmonary) - exposure to air and objects, animals and insects for disinfection and disinfestation. In clinical practice highest value have intrapulmonary and transpulmonary methods of administering aerosols.

Physiological and therapeutic effects of aerosols. The effect on the body is determined by the drug used, the choice of which determines the nature of the pathological process and the purpose of the effect. Most commonly used are alkalis or alkaline mineral water, oils (eucalyptus, peach, almond, etc.), menthol, antibiotics, proteolytic enzymes, bronchodilators, glucocorticoids, phytoncides, vitamins, decoctions and infusions of medicinal herbs, etc. Aerosols act primarily on the mucous membrane of the respiratory tract throughout their throughout, on the microorganisms located here, as well as on the production of mucus. Their most pronounced absorption occurs in the alveoli, less intense - in the nasal cavity and paranasal sinuses. When absorbed, aerosols have not only a local, but also a reflex effect through the receptors of the o6oHHfelenic nerve, receptors of the bronchial mucosa and bronchioles.

As a result of exposure to aerosols, the permeability of the boonchoalveolar tree improves. This occurs due to the use of mucolytic drugs and cough reflex stimulants, as well as due to the action of a moistened and warmed inhaled mixture. Gas exchange and vital capacity of the lungs increase, as well as the rate and volume of drugs entering the blood. At the same time, tissue blood supply and metabolism are improved.

Electrical aerosols (compared to aerosols) have a more pronounced local and general action, since an electric charge enhances the pharmacological activity of substances and changes the electrical potential of tissues. Preference is given to negatively charged aerosols.

The temperature of the aerosol is important. Hot solutions (above 40°C) suppress the function of the ciliated epithelium. Cold solutions (25-28°C and below) cool the mucous membrane of the respiratory tract and can cause an attack of suffocation in patients with bronchial asthma. The optimal temperature of aerosols and electric aerosols is 37-38°C. The pH of the inhaled solution (optimal 6.0-7.0) and the concentration (not higher than 4%) of the drug in it are also essential.

When aerosols are used externally, the area of ​​active contact of the medicinal substance with the pathological focus increases, which accelerates its absorption and the onset of the therapeutic effect.

Features of the technique. For clinical purposes, an aerosol is obtained by dispersion - grinding the drug using mechanical and pneumatic methods. The most promising method for preparing aerosols is using ultrasound.

Portable devices (individual) - ultrasonic inhalers (“Fog”, “Breeze”, “Monsoon”, “Diso-nik”, “Taiga”, UP-3.5, “Thomex”, “Nebatur”, “UltraNeb-2000” ), steam (IP-1, IP-2, "Boreal") and pneumatic (IS-101, IS-101P, "Inga", "PulmoAide", "Thomex-L2"). Stationary devices - "UI-2, "Aerosol U-2", "Aerosol K-1", TUR USI-70, "Vapozone" are intended for group aerosol therapy.

To obtain electroaerosols - portable devices “Electroaerosol-1” and EI-1, stationary devices for group inhalations GEK-1 and GEG-2.

Group inhalations are based on the creation of a uniform fog in the air of a limited room and are intended for simultaneous exposure to a group of patients; individual - for direct administration of an aerosol into the respiratory tract of one patient. Inhalation therapy is carried out in a specially designated room (inhalation room) with an area of ​​at least 12 m2, which must be equipped with a supply and exhaust ventilation system that provides 4-10 times air exchange.

Types of inhalations: steam, heat-moist, moist (aerosols at room temperature), oil and powder inhalations.

Steam inhalations are carried out using a steam inhaler (type IP-2), but they can also be carried out at home without a special device. Inhalations are prepared by obtaining steam from a mixture of easily evaporating medications (menthol, eucalyptus, thymol) with water, as well as from a decoction of sage and chamomile leaves. The vapor temperature is 57-63°C, but when inhaled it decreases by 5-8°C. The inhaled steam causes an increased flow of blood to the mucous membrane of the upper respiratory tract, helps restore its function and has an analgesic effect.

Steam inhalations are used for diseases of the upper respiratory tract. Due to the high temperature of the steam, these inhalations contraindicated in severe forms of tuberculosis, acute pneumonia, pleurisy, hemoptysis, arterial hypertension, coronary heart disease.

Warm-moist inhalations carried out at an inhaled air temperature of 38-42°C. They cause hyperemia of the mucous membrane of the respiratory tract, thin out viscous mucus, improve the function of the ciliated epithelium, accelerate the evacuation of mucus, suppress persistent cough, and lead to free expectoration. They use aerosols of salts and alkalis (sodium chloride and bicarbonate), mineral waters, anesthetics, antiseptics, hormones, etc. After using them, the patient must cough in a drainage position, do breathing exercises or vibration massage of the chest. Contraindications requirements for heat-moisture inhalations are the same as for steam inhalations.

Wet inhalations - the medicinal substance is sprayed using a portable inhaler and introduced into the respiratory tract without preheating; its concentration in the solution is higher and the volume is smaller than with warm-moist inhalations. Anesthetics are used and antihistamines, antibiotics, hormones, phytoncides.

Oil inhalations - spraying heated aerosols of various oils. Oils of plant origin (eucalyptus, peach, almond, etc.) and animal origin (fish oil) are used. The use of mineral oils (vaseline) is prohibited. When inhaled, the oil is sprayed, covering the mucous membrane of the respiratory tract with a thin layer that protects it from various irritations and prevents absorption harmful substances into the body. Oil inhalations have a beneficial effect in inflammatory processes of a hypertrophic nature, reduce the feeling of dryness, promote the rejection of crusts in the nose and throat, and have a beneficial effect in acute inflammation of the mucous membrane of the respiratory tract, especially in combination with antibiotics.

Inhalation of powders(dry inhalations, or insufflations) are used mainly for acute inflammatory diseases of the upper respiratory tract; for this, the sprayed drug is mixed with dry hot air. Powdered antibiotics, sulfonamides, vasoconstrictors, antiallergic, and anti-influenza drugs are used. For spraying, a powder blower (insuflator), sprayers with a balloon or special sprayers (spinhaler, turbohaler, rotahaler, dischaler, isihan ler, cyclohaler, etc.) are used.

Ultrasonic inhalations are based on obtaining medicinal solutions using ultrasound. Ultrasonic aerosols are characterized by a narrow spectrum of particles, high density and stability, low oxygen concentration, and deep penetration into the respiratory tract.

All types of hardware inhalations are carried out daily, only some - every other day. Duration of inhalation - from 5-7 to 10-15 minutes. The course of treatment is prescribed from 5 (for acute processes) to 20 procedures. If necessary, repeat the course after 10-20 days.

Children can be prescribed inhalations from the first days of life to prevent and treat respiratory diseases.

Inhalation therapy has long been one of the main components in the prevention and treatment of acute and chronic diseases of the upper respiratory tract.

Devices intended for aerosol therapy are divided into portable (usually used at home) and stationary - for inhalation in medical institutions. The choice of inhaler depends on the purpose for which inhalation therapy is prescribed.

If medicinal product must be delivered to the upper respiratory tract, use a compressor-type inhaler. The medicine is supplied in it along with the escaping air stream. The aerosol that is formed when using such inhalers contains drug particles that are easily deposited in the upper respiratory tract. A compressor type of medication supply is used for oil, moist, heat-moisture and steam inhalations.

Nebulizers are highly effective devices for treating the central and upper respiratory tract. This is essentially a compressor-type inhaler. He delivers the inhaled mixture through a special nozzle, which allows you to obtain an aerosol or “cloud” with a high content of fir oil particles. Nebulizers are used to deliver antibiotics, mucolytics and other drugs into the respiratory tract.

Ultrasonic inhalers are used if it is necessary for the medication to penetrate small bronchi (this is required for acute and chronic bronchitis, pneumonia, bronchial asthma). The aerosol produced by such inhalers contains very small particles of the drug. However, it should be noted that the structure of some substances is completely or partially destroyed when finely sprayed, which leads to a loss or reduction in the therapeutic effect of inhalation.

Types of inhalations

1. Steam inhalations can be performed without a special device (steam inhaler). Such inhalations are prepared from easily evaporating medications (fir oil, menthol, eucalyptus and others) with water. The temperature of the vapor should be 57-63 degrees, but when inhaled it decreases. Such inhalations are contraindicated in case of pleurisy, acute pneumonia, severe forms of tuberculosis, arterial hypertension, and hemoptysis due to the high temperature of the steam.

2. Warm-moist inhalations thin out viscous mucus, improve blood flow to the mucous membrane of the respiratory tract, and improve the function of cilia, which push mucus out of the bronchi. For this type of inhalation, solutions of alkalis and salts (soda, saline and others), hormones, mucolytics, and antibiotics are used. The temperature of inhaled air is from 38 to 42 degrees. Contraindications are the same as for steam.

3. For wet inhalations, anesthetics and antihistamines, phytoncides, hormones, and antibiotics are used. The concentration of the drug in the solution is greater than with warm-moist inhalations. Such inhalations are tolerated quite easily, so they are prescribed to those patients for whom heat-moist and steam inhalations are contraindicated.

4. Oil inhalations are carried out using heated air. Fir oil, eucalyptus, almond, peach and other oils are used. The use of mineral oils is prohibited! Oil inhalations promote the rejection of crusts in the throat and nose and reduce the feeling of dryness. However, such inhalations are prohibited for people in contact with large amounts of dust (including tobacco). Since dust, mixing with oil, forms plugs, which, in turn, clog the lumen of the bronchi.

5. The peculiarity of ultrasonic inhalations is that thanks to ultrasound, aerosols with smaller particle sizes are formed. A small medicinal substance is delivered to the respiratory tract, which significantly increases the effectiveness of inhalation. The attending physician will select an individual treatment regimen for you: determine the duration and number of sessions, taking into account the type of disease and its severity.

Inhalation therapy allows you to deliver the drug directly to the pathological focus and avoid the occurrence of side effects that are typical for other methods of drug administration.

The use of fir oil as one of the components in inhalations, clinics, and hospitals will significantly increase the effectiveness of treatment for various diseases of the upper respiratory tract. One thing to remember: filling your inhaler with fir oil for several days is not recommended. Only for a day, maximum two. A rapid oxidation process occurs in the inhaler, light fractions evaporate, and hence the therapeutic effect abruptly disappears, fir oil loses its softness and becomes an irritant.

Inhalation therapy (lat.inhalare– inhale) – treatment and prevention of diseases by inhaling artificially sprayed medicinal substances or air saturated with salts, essential oils, etc. The main goal of inhalation therapy is to achieve maximum local therapeutic effect in the respiratory tract with minor manifestations of systemic action. The main objectives of inhalation therapy are: improving the drainage function of the respiratory tract; sanitation of the upper respiratory tract and bronchial tree; reducing swelling and stimulating regeneration; decreased activity of the inflammatory process; relief of bronchospasm; impact on local immune responses of the respiratory tract; improvement of microcirculation of the mucous membrane of the respiratory tract; protection of the mucous membrane from the action of industrial aerosols and pollutants.

Inhalation therapy has a number of advantages over other methods of using medicinal substances: increased physical and chemical activity of substances, minimal systemic effect, absence side effect, the possibility of creating high local concentrations of the drug, etc., which served as the basis for its widespread therapeutic and prophylactic use. The main procedure in inhalation therapy is inhalation (see), carried out using various devices and devices (see Inhalers). Inhalation therapy can be used alone or in combination with other physiotherapeutic methods. It is compatible on the same day with electro- and light therapy, ultrasound, water-heat therapy, which, as a rule, precede inhalations.

Inhalation therapy is mainly used in the treatment and prevention of acute and chronic respiratory diseases, however, each of its methods has its own indications, contraindications, techniques and methods of implementation, which requires their independent consideration.

The following methods can be classified as inhalation therapy: aerosol therapy, electroaerosol therapy, halotherapy, aerophytotherapy.

Aerosoltherapy

Aerosoltherapy– a physiotherapeutic method based on the use of aerosols of medicinal substances (medical aerosol) for therapeutic, prophylactic and rehabilitation purposes. They are most often used by inhalation (by inhalation), therefore aerosol therapy is often identified with inhalation therapy. Inhalation of aerosols is one of the oldest methods of treatment. ethnoscience widely used aerosols (in the form of vapors of various balsamic substances and aromatic plants, as well as smoke when burning them - the so-called smoking, fumigation) to treat many diseases. Thus, fumigation with sulfur against miasma and infection is mentioned in Homer. Hippocrates recommended fumigation and inhalation of hot water vapor for the treatment of lung diseases, and also proposed a number of recipes for inhalation. Celsus advised inhaling hot vapors of herbal infusions for ulcers of the pharynx, and Plinius recommended smoke from pine needles as an expectorant. For pulmonary consumption, for ulcers of the pharynx and larynx, and for the treatment of lung diseases, Galen recommended staying on the seashore or near sulfurous volcanoes.

The use of artificial aerosols in medicine began in the mid-19th century, when medical practice ether anesthesia was administered. Active study and use of medicinal aerosols began after the invention of aerosol devices.

In 1908 Ya.M. Kopylov developed a number of devices for inhalation, recommended the inhalation of vapors with medications, proposed a recipe for inhalation, and gave a classification of the most used drugs. In 1932, the Norwegian chemist E. Rotheim received a patent for the first aerosol apparatus. The foundations of the scientific and practical study of aerosols were laid by L. Dotreband (1951), which were later developed in the research of M.Ya. Polunova, SI. Eidelshteina, F.G. Portnova and others. All-Union conferences (1967, 1972, 1977) contributed to the improvement and spread of aerosol therapy International congresses(1973, 1977) on the use of aerosols in medicine. Thanks largely to them, aerosol therapy has taken a strong place in the complex of therapeutic agents for various sections of modern medicine.

Aerosol therapy has obvious advantages over other treatment methods, due to a number of reasons:

1) the drug enters the body physiologically while breathing:

2) aerosols of medicinal substances have higher chemical and physical activity than conventional liquid drugs, due to an increase in the total surface of the dispersed phase during spraying;

3) medicinal aerosols have a pronounced local effect on the mucous membrane of the respiratory tract, which is more difficult to achieve with other methods of drug therapy;

4) the medicinal substance in the form of aerosols is absorbed more quickly by the lungs, the absorption surface of which (100-120 m2) is many tens of times larger than the entire surface of the body (1-1.5 m2);

5) aerosols of medicinal substances, absorbed through the respiratory tract, immediately enter the lymphatic system lungs (where they are partially deposited), into the blood of the pulmonary circulation, i.e. bypassing the liver and systemic circulation, which means they have a therapeutic effect almost unchanged;

6) inhalation aerosol therapy is also a good breathing exercise that improves lung ventilation, eliminates blood stagnation in the lungs and improves heart function;

7) the introduction of drugs into the body by this method is painless, which contributes to its widespread use in micropediatrics and pediatrics;

8) medications can be used in aerosol form, the use of which in any other form causes undesirable reactions;

9) As a rule, a significant amount of money is spent on aerosol therapy less drug than with injections and oral administration, which determines some of its economic advantages.

There are four known ways to use aerosols in medical practice: intrapulmonary (intrapulmonary), transpulmonary , extrapulmonary(extrapulmonary) and parapulmonary(parapulmonary). IN clinical practice Intrapulmonary and transpulmonary methods of administering aerosols are of greatest importance.

For the main type of aerosol therapy, inhalation aerosol therapy, aerosol particles of a medicinal substance of various linear sizes are used. In descending order, the following types of inhalations are distinguished: powder, steam, heat-moist, wet, oil, air and ultrasonic.

Powder inhalation (insufflation) is used primarily for inflammatory diseases of the upper respiratory tract. When using special nebulizers (spithallers), insufflations are used for acute and chronic bronchitis. For them, finely ground homogeneous powder of the medicinal substance is used. For insufflations, vaccines, serums, dry powders of interferon, etazol, sulfadimezine, and anti-tuberculosis drugs are used.

Steam inhalations – simplest form inhalations, easily carried out at home. In addition to drug aerosols, the active factor in them is water vapor, which captures medicinal substances. For these inhalations, easily evaporating drugs are used (menthol, thymol, eucalyptus and anise oil and etc.). Steam inhalations are indicated for acute and chronic inflammatory diseases of the nose, middle ear, trachea and bronchi, pneumonia, influenza, occupational diseases upper respiratory tract, etc.

Warm-moist inhalations one of the most common types of inhalations, for which aerosols of medicinal substances with mucolytic and bronchodilator effects are used heated to 38-42 ° C. Such inhalations are indicated for subacute and chronic diseases of the nasal cavity, paranasal sinuses, middle ear, throat, acute and chronic diseases of the trachea and bronchi, lung abscess, pneumosclerosis, bronchial asthma, pneumonia, influenza and acute respiratory diseases, occupational respiratory diseases, etc. .

Wet (moisturizing) inhalations prescribed to patients for whom steam and heat-moisture inhalations are contraindicated. For this type of inhalation, carried out without heating the solution, anesthetics, hormones, antibiotics, enzymes, bronchodilators, mineral waters, sodium chloride solutions, etc. are used. Wet inhalations are prescribed for sluggish and recurrent inflammatory diseases of the pharynx, larynx, trachea and large bronchi.

Oil inhalations – introduction of heated aerosols of various oils, which have trophic, respiratory-regenerative and bronchoprotective effects. They are used for acute inflammation and severe atrophy of the mucous membranes of the respiratory tract. For preventive purposes, oil inhalations are used in industries where there are particles of mercury, lead, chlorine compounds, zinc vapors, phosphorus, fluorine and its compounds, ammonia, hydrogen sulfide, carbon monoxide, benzene, etc. in the air. However, they are contraindicated for workers. industries where the air contains a lot of dry dust (flour, tobacco, cement, asbestos, etc.).

Ultrasonic inhalations use of aerosols obtained using ultrasonic vibrations for therapeutic and prophylactic purposes. Ultrasonic aerosols are characterized by a narrow spectrum of particles, high density and great stability, and deep penetration into the respiratory tract. A wide variety of medicinal substances can be used for ultrasonic spraying (except for those that are viscous and unstable to ultrasound). Ultrasound inhalations are indicated for lung abscess, pneumosclerosis, pneumonia, and occupational lung diseases.

For aerosol therapy, pharmaceutical aerosols are also used, which are ready-made dosage form, obtained using a special cylinder with a valve spray system (pharmaceutical aerosols). In the mechanism of action of aerosol therapy (and electroaerosol therapy), the following factors are of greatest importance: pharmacotherapeutic properties of the drug substance, electrical charge, pH and temperature of aerosols.

The main role in the action of aerosol therapy is played by the pharmacological activity of the drug used, the choice of which is dictated by the nature of the pathological process and the purpose of treatment. Most often, alkalis or alkaline mineral waters, vegetable oils, menthol, antibiotics, proteolytic enzymes, phytoncides, antiseptics, adrenomimetics, anticholinergics, antihistamines, vitamins, biogenic amines, etc. are used for aerosol therapy. When inhaled, aerosols have an effect on the mucous membrane of the respiratory tract , especially in the area of ​​their predominant deposition. When absorbed, aerosols have a local and reflex effect through the receptors of the olfactory nerve, interoreceptors of the bronchial mucosa and bronchioles. Their most pronounced absorption occurs in the alveoli; this process occurs less intensely in the nasal cavity and paranasal sinuses. There is also humoral influence pharmacological agents after they enter the blood.

Giving aerosols a forced charge (with electroaerosol therapy) enhances the pharmacological activity of drugs and changes electrical processes in tissues. The most pronounced and adequate reactions in the body are caused by negatively charged aerosols (electric aerosols). They stimulate the function of the ciliated epithelium, improve blood circulation in the bronchial mucosa and its regeneration, and have a bronchodilator and desensitizing effect.

The effect of aerosols depends on the temperature of the inhaled solutions. The optimal temperature of aerosols is 37-38 °C. Solutions at this temperature cause moderate hyperemia of the mucous membrane, thin out viscous mucus, improve the function of the ciliated epithelium, and weaken bronchospasm. Hot solutions with temperatures above 40 °C suppress the function of the ciliated epithelium, and cold solutions can cause or intensify bronchospasm.

The pH and concentration of the working solution also play an important role. According to existing recommendations, a pH of 6.0-7.0 is considered optimal, and the concentration of the inhaled solution should not be higher than 4%. Highly concentrated solutions with suboptimal pH negatively affect the ciliated epithelium and the air-hematic barrier of the lungs.

With external aerosol therapy, the area of ​​contact of damaged areas of the body with active particles of medicinal substances increases. This leads to an acceleration of their absorption and a decrease in the latent period of therapeutic action for burns, wounds, frostbite, infectious and fungal lesions of the skin and mucous membranes. The use of aerosol therapy is primarily designed to enhance and accelerate the specific pharmacological (vasoactive, anti-inflammatory, bronchodrainage, etc.) effects of the medicinal substances used.

Aerosols are prepared directly at the time of use using aerosol generators. They can be dispersing (crushing, spraying) and condensing (or coagulating).

In medical practice, dispersive aerosol generators are usually used for aerosol therapy. According to the method of generating aerosols, they are divided into:

1) mechanical (centrifugal, in which the liquid breaks off from the rotating disk and breaks up into small particles);

2) pneumatic (nozzle) – the spray source is compressed gas (from a compressor, cylinder, bulb) or steam pressure;

3) ultrasonic, in which the formation of aerosols occurs under the influence of high-frequency mechanical vibrations (ultrasound);

4) propellant, in which the dispersion of particles of the medicinal substance is carried out due to the sublimation of propellants.

By mobility aerosol inhalers are divided into portable and stationary. The first are aerosol generators of a closed (individual) type. These include ultrasonic inhalers (“Fog”, “Breeze”, “Monsoon”, “Taiga”, Nebatur), steam inhalers (IP-1, IP-2, “Boreal”), compressor inhalers (Heyr, Medel, Pari, etc. ) and pneumatic (IS-101, IS-101P, “Inga”). Stationary devices (UI-2, Aerosol U-2, TUR USI-70) are intended for group (chamber) aerosol therapy and are open-type generators. At home, they use the simplest pocket inhalers (IKP-M, IKP-M-2, IKP -M-3, Machold inhaler, etc.).

Aerosol therapy is carried out 1-1.5 hours after eating, when the patient is in a calm state, without difficulty breathing due to clothes or a tie. During the procedure, the patient should not be distracted by talking or reading. Immediately after inhalation, you should not talk, sing, smoke, or eat food for 60 minutes. During the course of inhalation therapy, limit fluid intake, it is not recommended to smoke, take heavy metal salts, expectorants, rinse your mouth before inhalation with solutions of hydrogen peroxide, potassium permanganate and boric acid. Aerosol therapy can be combined with many physiotherapeutic procedures. It is prescribed after light therapy, heat therapy and electrotherapy. After steam, thermal and oil inhalations Local and general cooling procedures should not be performed. For diseases of the nose and paranasal sinuses, inhalation and exhalation should be done through the nose, without straining. For diseases of the pharynx, larynx, trachea and large bronchi, after inhaling, you must hold your breath for 1-2 seconds, and then exhale as much as possible (preferably through the nose). To increase the penetrating ability of aerosols, before the procedure, you should take drugs (bronchodilators) or procedures (breathing exercises) that improve bronchial patency. After the procedure, rest for 10-20 minutes is necessary. When prescribing antibiotic inhalations, the sensitivity of the microflora to them should be determined and an allergy history should be collected. Bronchodilators for aerosol therapy are selected individually based on pharmacological tests.

When using several drugs for inhalation, it is necessary to take into account not only pharmacological, but also physical and chemical compatibility. Incompatible medications should not be used in one inhalation.

During group inhalations, patients are placed at a distance of 70-120 cm from the aerosol generator. External aerosol therapy is performed by spraying aerosols onto the surface of the skin or mucous membranes. The nozzle of the aerosol generator is installed at a distance of 10-20 cm from the irrigated surface. After the procedure, a sterile bandage moistened with a solution of sprayed medication is applied to the treatment area. Aerosol therapy can be performed on children from the first days of life. In this case, inhalations are carried out using special devices (“house”, cap or box) for one child or a group of children.

Aerosol therapy is carried out daily or every other day. The duration of inhalation ranges from 5-7 to 10-15 minutes. The course of treatment includes 5 to 20 procedures. If necessary, the course of treatment can be repeated after 2-3 weeks. Aerosol therapy is carried out in specially equipped rooms with an area of ​​at least 12 m2 with effective system ventilation.

Shown aerosol therapy for acute, subacute and chronic inflammatory diseases of the upper respiratory tract, bronchi and lungs, occupational respiratory diseases, tuberculosis of the upper respiratory tract and lungs, bronchial asthma, acute and chronic diseases of the middle ear and paranasal sinuses, influenza and other respiratory diseases viral infections, arterial hypertension, wounds, burns, trophic ulcers, some skin diseases.

Contraindications for aerosol therapy are: spontaneous pneumothorax, giant cavities in the lungs, widespread and bullous forms of emphysema, bronchial asthma with frequent attacks, pulmonary heart failure stage III, pulmonary hemorrhage, arterial hypertension stage III, widespread and severe atherosclerosis, diseases of the inner ear, tubotitis, vestibular disorders, epilepsy, individual intolerance to the inhaled drug.

Halotherapy


Halotherapy (Greekhals– salt + therapy- treatment) – use of dry aerosol of table salt (sodium chloride) for therapeutic purposes. The method is also called haloaerosol therapy. It was born from attempts to artificially reproduce the microclimate salt caves, successfully used in the treatment of patients in many countries (see Speleotherapy). The main contribution to its development was made by domestic scientists M.D. Torokhtin and V.V. Zheltvoy (1980), V.F. Slesarenko, P.P. Gorbenko (1984), A.V. Chervinskaya et al. (1995-1999), etc. In practical healthcare in the countries of the former USSR, halotherapy began to be used in the late 1980s.

Aerosols of sodium chloride, classified as highly dispersed aerosols, are capable of penetrating deeply into the respiratory tract and stimulating motor activity cilia of the ciliated epithelium and change its permeability to the level of bronchioles. At the same time, due to the restoration of normal osmolarity, the production of bronchial mucous secretions is reduced and its rheological properties are improved. Halotherapy enhances passive transport in epithelial cells, improves mucociliary clearance, and helps restore intracellular pH. It stimulates reparative processes in the bronchi, reduces their increased tone, and provides mucolytic and anti-inflammatory effects. Halotherapy is characterized by a pronounced immunosuppressive effect, which manifests itself in a decrease in the content of circulating immune complexes, immunoglobulins of classes A, E and G, and eosinophils in the blood. Against the background of its implementation, patients improve respiratory function, gas exchange and general condition, the course of respiratory diseases noticeably improves.

Halotherapy is carried out using a group or individual method. With the group method, 8-10 patients simultaneously undergo the procedure in specially equipped rooms - halochambers, the ceilings and walls of which are lined with sodium chloride slabs or treated with a dry sodium chloride aerosol. Aerosol spraying during halotherapy procedures is carried out using halogenerators, among which the most common are ASA-01.3 and various models of halocomplexes (Ariel, Breeze, Spectrum, etc.). Inside such devices, a chaotic movement of sodium chloride crystals in the air flow is created (the so-called “fluidized bed”).

When conducting halotherapy, other principles for obtaining a dry aerosol of sodium chloride are used. During the procedure in halochambers, patients are in comfortable chairs; their clothing should be loose, not making it difficult to inhale and exhale. They use 4 halotherapy modes, differing in the concentration of aerosol in the air: 0.5; 1-3; 3-5 and 7-9 mg/m3. Their choice is determined by the nature of the pathological process and the degree of bronchial obstruction. The first mode is used in patients with emphysema and bronchial asthma, the second - for chronic nonspecific lung diseases with a reduced forced expiratory volume of up to 60%, the third - when it is reduced above 60%, the fourth - for bronchiectasis and cystic fibrosis. The procedure may be accompanied by the broadcast of calm music. Individual halotherapy is carried out using the AGT-01 halotherapy devices or the GISA-01 “Haloneb” dry salt aerosol therapy inhaler. The latter provides 6 modes therapeutic effects: duration 5, 10 and 15 minutes and dry aerosol productivity 0.4-0.6 mg/min and 0.8-1.2 mg/min. Halotherapy is dosed according to the countable concentration of the aerosol, the performance of the halogenerator and the exposure time. A course of haloaerosol therapy usually consists of 12-25 daily procedures lasting up to 30 minutes (for children) and up to 60 minutes (for adults). Patients with chronic pathology It is recommended to conduct 2 courses of halotherapy within a year.

Halotherapy can be used either independently or in combination with drug therapy. It is combined with almost all drugs used in pulmonology. It is also combined with various methods physiotherapy, massage, exercise therapy and reflexology.

Indications for halotherapy are: chronic nonspecific diseases of the lungs (pneumonia, cystic fibrosis, bronchiectasis, bronchial asthma, bronchitis, etc.), ENT organs (rhinitis, sinusitis, adenoiditis, pharyngitis), skin (eczema, allergic dermatoses, alopecia areata, etc.) . As a preventive measure, halotherapy is prescribed to persons most at risk of developing chronic bronchial pathology, as well as for hay fever.

Contraindications for the purpose of haloaerosol therapy are: severe exacerbation of diseases bronchopulmonary system, flu, ARVI with high fever and intoxication, hemoptysis and a tendency to it, previous pulmonary tuberculosis with residual morphofunctional changes, previous lung abscess with residual changes, emphysema, diffuse pneumosclerosis with signs of chronic pulmonary insufficiency III degree, arterial hypertension II-III degree, chronic coronary insufficiency, acute and chronic kidney diseases, presence or suspicion of a neoplasm, severe pathology of other organs and systems.


Aerophytotherapy (aromatherapy) one of the methods of aerotherapy, based on the therapeutic and prophylactic use of air saturated with volatile aromatic substances.

First information about medicinal properties plant odors and essential oils were found on cuneiform tablets found in Sumer (Northern Iraq, about 5000 years ago). They mention myrtle, thyme, buds and tree resin. Hippocrates (about 2500 years ago) and his disciples used, for example, rose oil to treat many gynecological diseases and digestive disorders. Due to their antimicrobial effects, essential oils have long been used to combat infections and epidemics. A clear example This may be due to the fact that in the 18th century. residents of the English town of Booklesbury escaped from the pestilence, since the village was a center for the production and trade of lavender. The air saturated with this oil had disinfectant properties. It is also known that medieval perfumers from the essential oil center in Grosse (France) were rarely exposed to danger in cases of epidemics of cholera and other infectious diseases. ABOUT therapeutic effect essential oils of plants were written by the French surgeon Ambroise Pare, the founder of homeopathy S. Hahnemann, the outstanding Russian therapist V. Manassein and others. By the beginning of the 18th century. About 120 plant aromatic substances used in medicine were known. The term "aromatherapy" was coined by the Frenchman Rene Gatefosse, who used lavender oil due to the lack of disinfectants when dressing the wounded during the First World War. It turned out that this oil not only has an antimicrobial effect, but also accelerates the healing of wounds and organs. A follower of Gatefoss in France and the founder of clinical aromatherapy was the French scientist Jean Valnet, who successfully used essential oil in the treatment of wounds, ulcers, injuries, diabetes and other diseases. Since then, the widespread development of modern aromatherapy began in France, later in England, and then throughout the world. Doctors, chemists and biologists have accumulated a large amount of experimental and clinical material, which made it possible to draw conclusions about the pronounced physiological and therapeutic effect essential oils of plants on the human body.

In world practice, 170-200 essential oils are used for medicinal purposes. They have a complex composition: one essential oil can contain up to 500 components, presented various types hydrocarbons, alcohols, ketones, esters, lactones, etc. Due to such a complex composition, most essential oils are multifunctional, have a diverse effect, among which 2-3 main ones stand out, which determine the direction of their use for therapeutic and preventive purposes.

Today, essential oils and plant odors are most widely used by inhalation. This type of aromatherapy is most often called aerophytotherapy. But essential oils can be used for massage, baths, compresses, i.e. The concept of “aromatherapy” is somewhat broader than the concept of “aerophytotherapy”.

Most essential oils contain mono- and sesquiterpenes, and therefore most of them have antiseptic properties, especially against pathogens of airborne infections. Essential oils with a predominance of monoterpenes also provide analgesic, sedative, mucolytic effect. Some essential oils relax the eye muscles, relieve muscle spasm, have a pronounced hypotensive, relaxing, sedative and immunomodulatory effect. Essential oils of clary sage, containing diterpene alkaloids, affect the hormonal system of the body, and essential oils of sandalwood stimulate the heart and tissue circulation, eliminate congestion, stimulate the liver, and tone the central nervous system. Phenols, which are part of many essential oils of plants, provide pronounced antispastic, anti-inflammatory, analgesic, mucolytic, diuretic, immuno- and hormone-stimulating, sedative and antispasmodic effects. Aldehydes of essential oils are distinguished by antiviral and fungicidal activity, and give a sedative and hypotensive effect. Some plants contain ketones, which can cause analgesic, anti-inflammatory, lipolytic and hypocoagulant effects. Aerophytotherapy also has muscle relaxant, antioxidant and healing effects.

Distinguish natural and artificial aerophytotherapy . Natural aerophytotherapy is carried out in park areas planted with plants that release volatile substances that have a beneficial effect on the body. The latter predominantly have bactericidal, antispasmodic, hypotensive and sedative effects. In these areas, patients are recommended to relax in a sun lounger, sit on a bench, take a walk, play Board games, do breathing exercises and breathe in the aroma of plants. For a phytoaerarium (phytodesign corner) at home, it is best to use plants that are used to treat the most common diseases (noble laurel, geranium, cypress santolin, rosemary, etc.). When carrying out procedures, you must adhere to some rules:

1) before the procedure, you need to spray the plants with degassed water at room temperature;

2) you should sit in front of the plants in a comfortable position at a distance of 50-60 cm from them;

3) at the beginning and end of the procedure, it is advisable to take several deep breaths and exhalations, and for the rest of the time (8-12 minutes) breathe evenly;

4) It is better to carry out procedures 1-2 hours after eating;

5) the course includes from 15 to 30 daily procedures.

To carry out artificial aerophytotherapy, a special room is equipped, in which, in addition to simulating natural air, saturated with the corresponding volatile substances of plants, suitable aesthetic conditions are created (stained glass windows, slides, music, etc.). At the same time, they strive to artificial conditions create close to natural concentrations of volatile plant components (from 0.1 to 1.5 mg/m3). Procedures are performed in groups in chairs. Spraying is carried out using special devices - aerophytogenerators (for example, Aerofit, Fiton-1, etc.). In the spring and summer, freshly harvested plants are used as raw materials, and in the autumn and winter, decoctions of dried plants are used. The duration of the procedure is from 15 to 30 minutes.

Recently, essential oils of plants have been widely used for aerophytotherapy, especially for lung diseases. Phytogenerators of the AF-01 or AGED-01 type are suitable for their spraying. They ensure the saturation of the room with volatile components of essential oils in a concentration of 0.4-0.6 mg/m3. For aerophytotherapy, you can use both individual oils and their compositions. Compositions of essential oils can be created either by sequentially saturating the air with them or by using different oils simultaneously. When choosing them, they are guided by the main effects of specific essential oils. The procedures are carried out daily, duration – 20-30 minutes, per course – 10-12 procedures. Preventive courses are carried out 2 times a year (more often in the autumn-winter and spring periods).

Basic readings for aerophytotherapy: acute diseases respiratory organs during a prolonged course or in the convalescence stage (acute bronchitis, acute pneumonia, recurrent bronchitis); chronic nonspecific lung diseases in the phase of fading, sluggish exacerbation and remission ( Chronical bronchitis, bronchial asthma, bronchiectasis); some infectious diseases, dermatitis, inflammatory diseases genitourinary system and etc.; primary prevention of chronic nonspecific diseases in people suffering from frequent acute respiratory diseases, flu, repeated acute bronchitis and pneumonia, chronic diseases upper respiratory tract.

Contraindications: increased individual sensitivity to odors, severe respiratory and heart failure.

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