Introduction
The ILD covers lung diseases with different causes but similar clinical, pathological and visual characteristics, with a gradual increase in the incidence of these diseases. Because of the complexity of ILD diagnosis and treatment, most patients tend to be first in primary care. It is therefore essential for primary health-care personnel to have access to appropriate ILD medicines and precision treatments, which not only facilitate early diagnosis and intervention, but also improve patients ‘ prognosis and quality of life.
II. Diagnosis points for IMTCT
(i) Clinical performance
Patients often suffer from sexual respiration difficulties, stem coughs, lack of strength, some of which can be accompanied by chest pain, heat, joint pain, etc. Medical examination can be seen on double lung base Velcro, with late signs of hair, toes, etc.
(ii) Visual inspection
High resolution CT (HRCT) of the chest is an important means of diagnosing ILD, which displays characteristic pathologies such as grids, beehive shadows and glass-blowing changes in the lungs, with different types of ILD having their own relatively distinctive visual manifestations.
(iii) Lung functional examination
The main manifestations are restricted aerobics, total lung (TLC), reduced lung activity (VC) and decreased dispersive function (DLCO).
(iv) Laboratory inspection
Examinations such as blood sank, C reaction proteins, and self-antibodies help to identify ILDs with different causes, and ILD patients such as connective tissues may have their own antibodies, such as rheumatism, anti-nucleus, etc.
III. Drug treatment programmes for common IMTPs
(i) Specific pulmonary fibrosis (IPF)
1. Anti-fibrosis drugs
– Nidanib: is a multi-target cheese aminoase inhibitor that inhibits the growth, transport and transformation of fibre cells, thus slowing the progress of lung fibrosis. The recommended dosage was 150 mg per dose, twice a day, for oral administration. Common adverse effects include diarrhoea, nausea, vomiting, hepatic enzymes, etc., and regular monitoring of liver function during drug use.
– uniphenone: anti-inflammation, antioxidation and anti-fibrosis. The initial dose was 200 mg per day, three times a day, increasing gradually to 600 mg per day, three times a day. The adverse effects are mainly gastrointestinal discomfort, rashes, photo-sensitization, etc. The patient should be careful to sunscreen during the use of the medication.
2. Treatment of illness
– In cases of visible coughing, coughing drugs, such as right-meal saphin, chords of licorice, etc., may be used on a case-by-case basis, but the use of central strong coughing should be avoided in order not to affect the discharge of sap.
– Oxygen treatment is available to patients with respiratory difficulties, and the oxygen flow is adjusted to the saturation of blood to improve their oxygen deficiency.
(ii) ILD relevance of the disease
1. Sugar cortex hormones
– For patients with a lighter condition, sugary cortex hormones, such as Poneysonron, are available, with an initial dose generally ranging from 0.5 to 1 mg/kg per day, with a morning shift, which is maintained for a period of time, depending on the reduction of the condition. However, the long-term use of sugar cortex hormones may cause adverse effects such as osteoporosis, haemo sugar rises and infections, which require close monitoring and prevention.
2. Immunosuppressants
– Often used in combination with sugary cortex hormones, such as cyclophosphate, sulfur, etc. cyclophosphorous amide can be injected with an intravenous drip of 0.4 – 0.6 g/m2 per month, with a daily dose of 2 – 3 mg/kg sulphate. Indicators such as blood regularity, liver and kidney function are regularly monitored during the use of immunosuppressants to prevent serious adverse effects such as bone marrow inhibition and liver and kidney impairment.
(iii) Allergies
1. Escaping allergy
– The immediate disengagement of patients from allergies once the allergies have been identified is a key measure for the treatment of allergic pneumonia. Such as stopping exposure to moldy hay, bird feathers, etc.
Sugar cortex hormones
For patients with apparent symptoms, sugar cortex hormonal treatment, such as Penesone, with an initial dose of 30 – 60 mg per day, a gradual reduction of the symptoms after abating, a course of treatment generally of 2 – 6 weeks, and a specific dose and course of treatment adjusted to the patient ‘ s severity and recovery.
IV. MEDICAL ATTENTION AT GROUND MEDIA
(i) Drug selection
Primary-level medical personnel should make a reasonable choice of medicines based on the patient ‘ s specific condition, physical condition, medical adaptation certificate and taboo certificate. In order to avoid the blind use of new or unfamiliar drugs, special groups such as the elderly, children, pregnant women, breastfeeding women and those who combine other basic diseases should be more cautious in their choice, with due regard for their safety and effectiveness.
(ii) Monitoring of adverse drug response
The possible adverse reactions of patients are closely monitored during the use of ILD treatment drugs. The patient is informed in detail of the common adverse effects of the drug and how to respond to it, and is instructed to return to the patient in a timely manner if he or she is unwell. Basic adverse response monitoring capabilities should be available in primary health-care institutions, and serious adverse effects, such as pharmaceutical liver damage, bone marrow suppression, should be identified and referred to higher-level hospitals in a timely manner for further treatment.
(iii) Drug interaction
ILD patients may be taking multiple drugs at the same time, and primary health-care personnel should be aware of the interaction between drugs. For example, certain anti-fibrosis drugs may interact with other drugs, affect their efficacy or increase the risk of adverse reactions. Before a prescription is made, the patient should be asked in detail about his or her medical history, and unreasonable joint use should be avoided.
(iv) Patient education
Increased drug education and increased patient dependence. Explain to the patient the role of the drug, its use, its use, the course of treatment and care to ensure its proper use. Patients are encouraged to cooperate actively in treatment, to take their medications on time and to retake them regularly, while at the same time informing them to maintain good living habits, such as smoking cessation, avoidance of inhalation of harmful gases and dust, and proper exercise, which contributes to the rehabilitation of the disease.
Integrated management measures
(i) Rehabilitation
Depending on the situation, primary health-care facilities can develop individualized rehabilitation programmes for ILD patients, including respiratory exercise, aerobics, etc. Respiratory activity, such as condensation, abdominal breathing, can enhance the respiratory muscles of the patient and improve the respiratory function. Appropriate aerobics, such as walking, Tai Chi, etc., contribute to the patient ‘ s resilience and mobility, but attention should be paid to the strength and duration of the exercise to avoid overwork.
(ii) Nutritional support
ILD patients often suffer from malnutrition due to respiratory difficulties and reduced appetite. Primary health-care personnel should monitor the nutritional status of patients, guide them to a reasonable diet and ensure adequate intake of calories, proteins, vitamins and minerals. Further nutritional support treatment may be considered for those suffering from severe malnutrition or referred to the Nutrition Unit.
(iii) Regular follow-up visits
Establishment of a follow-up file for ILD patients, and regular follow-up visits to check on changes in the patient ‘ s condition, the effectiveness of drug treatment and adverse reactions. Treatment programmes are adapted to follow-up results in a timely manner to ensure that patients receive continuous and effective treatment. At the same time, during follow-up visits, the psychological support and guidance of patients is being strengthened to build their confidence in overcoming the disease.
Conclusions
Primary health-care institutions play an important role in the treatment of IMTCT. Through accurate diagnosis, rational use of medicines, close adverse response monitoring and integrated management measures, primary health-care personnel are able to provide effective treatment for ILD patients, slow progress and improve their quality of life. However, ILD is still facing a number of challenges, and primary medical personnel need to continue to improve their learning and professionalism, as well as to strengthen collaboration and referral to higher-level hospitals to provide more comprehensive and accurate medical care for ILD patients.
