How to effectively treat pulmonary tuberculosis? All the most modern and new methods of treating tuberculosis Modern treatment of tuberculosis

Infection with the tuberculosis bacillus most often leads to disorders in the pulmonary system. Timely detection of pathology and the prescription of a therapeutic course can stop the further development of the disease and increase the body's resistance to infection. Treatment of pulmonary tuberculosis in adults is often long-term and may require up to several months of persistent therapy.

Causes

The main reason for the development of tuberculosis is the penetration into the body and subsequent activation of acid-fast mycobacteria (Koch bacilli). These microbes have been known to mankind for centuries and are extremely resilient and resistant to drug therapy.

Tuberculosis can also be caused by other microorganisms, including Mycobacterium tuberculosis, Mycobacterium africanum, Mycobacterium bovis, Mycobacterium pinnipedii, Mycobacterium bovis BCG and others.

It is widely known that tuberculosis infection most often occurs through airborne droplets. Pathogens can also enter the human body through nutrition (by consuming products that have had contact with a patient with open form of tuberculosis), intrauterine (the fetus is affected by an infected mother), contact (in this case, the infectious agent enters the body of a healthy person through mucous membranes or microdamages on the skin).

Certain segments of the population are especially susceptible to infection with tuberculosis. These categories include the poor, the homeless, people in prison, people suffering from immune disorders, diabetes, and chronic diseases of the respiratory system. Mycobacterium infection also occurs in health care workers who do not take increased precautions when working with tuberculosis patients.

Symptoms of pulmonary tuberculosis in adults

The first signs of mycobacteria infection are in many ways similar to a common cold. The patient has symptoms such as:

1. Increased body temperature to subfebrile levels (from 37 to 37.5 °C).
2. Dry cough.
3. Body aches.
4. Runny nose, nasal congestion.
5. Chills.
6. Sleep disorders.
7. Increased sweating.
8. Increase in the size of lymph nodes.

Such symptoms can be present individually or combined in various variations.

The main clinical signs of tuberculosis appear as the disease progresses. The initial symptoms are supplemented by:

• a change in the patient’s appearance – the face becomes unhealthy thin and pale, the features become sharper, the cheeks become hollow, and a painful shine appears in the eyes;
• rapid weight loss while maintaining the usual appetite;
• an increase in hyperthermia in the evenings (t reaches 38 degrees or more, and subsides in the morning);
• constant cough, changing from dry to wet;
• pain in the chest, between the shoulder blades, intensifying with inspiration.

Coughing with sputum and bloody spots is observed when the disease passes into the infiltrative form. If blood is released in the form of a fountain, such a sign indicates a rupture of the cavity.

Diagnosis of the disease

The main methods for diagnosing a dangerous disease are:

• clinical examination, consisting of studying the condition of the lymph nodes, range of motion of the sternum, listening to the lungs and bronchi;
• chest x-ray;
• bacterioscopic examination of sputum for the presence of tuberculosis pathogens;
• blood analysis.

In some cases, the patient undergoing examination is prescribed a computed tomography (CT) scan and bronchoscopy.

The development of tuberculosis infection in children is indicated by a positive reaction to the Mantoux or Diaskintest test.

Treatment of pulmonary tuberculosis

Treatment of tuberculosis traditionally requires a considerable period of time - from 3 months to 2 years. The open form of the disease requires mandatory placement of the patient in a hospital. With a closed type of pathology, therapy is carried out on an outpatient basis.

The main method of treatment is taking special medications. If there are appropriate indications, surgery is prescribed.

The patient’s stay in a sanatorium allows the patient to stay in a sanatorium to consolidate the results of the treatment course. Treatment abroad based on the use of new medical technologies is considered highly effective.

Treatment in the early stages

The fight against the disease at an early stage consists of prescribing to the patient:

1. Antibiotics.
2. General strengthening drugs.
3. Immunomodulators.
4. Physiotherapy.

At the initial stage of pathology, aerosol antimicrobial therapy, which has a preventive effect and prevents further activation of pathogenic bacteria, becomes relevant. Taking vitamin complexes contributes to the overall strengthening of the body and increasing its resistance to infection. The administration of immunomodulators helps reduce the period of intoxication, increase the protective function, regression of the tuberculosis process, and reduce the frequency and severity of side effects of chemotherapy.

A significant improvement in the condition of lung damage can be achieved through electrophoresis and collapse therapy. It is allowed to begin such physical treatment only during the period of remission and while undergoing a rehabilitation course.

Traditional medicine methods help to enhance the effectiveness of basic therapy for tuberculosis at an early stage. A good addition to antimicrobial and supportive medications is the use of milk with rendered bear lard, a decoction of marshmallow roots, and badger fat with honey.

Medications

The selection of medications and determination of dosages is carried out on an individual basis. At the beginning of anti-tuberculosis therapy, drugs of first choice are used. The patient is prescribed a course:

• Ethambutol;
• Rifampicin;
• Streptomycin;
• Isoniazid;
• Pyrazinamide.

In case of an increased likelihood of the disease progressing to the next stage, it is planned to include Ofloxacin, Levofloxacin, Ethionamide, Lomefloxacin in the main regimen.

Among vitamin complexes, the choice is made in favor of drugs saturated with vitamins A, C, group B, E and D. Among the immunomodulators for tuberculosis, Leukinferon, Imunofan, Polyoxidonium, Glutoxim, Lykopid are effective.

The elevated temperature characteristic of the disease only goes down if it reaches 38.5-39 degrees. In such situations, ibuprofen drugs or Paracetamol are used.

Treatment in hospital

The length of stay of a patient with open form of tuberculosis in hospital is determined:

• severity and stage of the infectious process;
• the level of resistance of the body to the disease;
• existing complications such as emphysema, pulmonary hemorrhage, heart or pulmonary failure;
• the presence of contraindications to the medication course.

The degree of damage to the lungs or other organs is also taken into account (in the second case we are talking about secondary tuberculosis).

Placing a patient in a hospital is necessary to carry out the most accurate diagnosis, monitor all stages of the treatment course, and provide immediate medical care in case of complications. Keeping the patient under constant medical supervision makes it possible to take timely necessary measures in the event of the disease spreading beyond the lungs and to carry out urgent operations.

The course of treatment in a hospital setting takes at least 2 months. After the patient ceases to pose a danger to others, measures are taken to restore the body. To do this, the patient is sent to a tuberculosis dispensary or a specially equipped sanatorium. Also, consolidation of the course in an adult or child can be carried out at the place of residence (outpatient treatment).

A course of chemotherapy using anti-tuberculosis drugs becomes the basis for the treatment of a dangerous disease. The drugs used are often combined with each other - thanks to this, it is possible to avoid addiction to the active substances from the causative agent of the disease.

In the case of a correctly selected treatment regimen, on days 20-25 the process of abacillation of the patient is observed - the cessation of the release of pathogens into the sputum. At this stage, the decay of lung tissue stops, and the patient is no longer infectious.

The first course of therapy is completed after 2-3 months. During this period, the patient may be discontinued some medications. Basic antimicrobial agents, such as Rifampicin and Isoniazid, are taken for another 4-6 months. While in the hospital, the patient periodically takes blood and sputum tests, which are necessary to monitor his condition and the dynamics of the treatment.

Many anti-TB drugs are highly toxic and can cause severe side effects. To avoid deterioration of the patient's general condition, constant medical supervision is required. If medications are poorly tolerated, the doctor makes adjustments to the implemented therapeutic regimen.

Operation

Indications for surgery in a patient with tuberculosis are:

1. Low effectiveness of chemotherapy.
2. The presence of complications and critical consequences of the disease (bleeding in the lungs, spontaneous pneumothorax).
3. The presence of morphological changes, which cannot be avoided.

Surgical treatment helps restore the activity of the pulmonary parenchyma, remove accumulations of fluid and sputum, and eliminate congenital or acquired anatomical anomalies. More often, planned operations are performed for tuberculosis. Sometimes there is a need for emergency intervention (in cases of rapid development of pathology, a sharp deterioration in health, or risk of death of the patient).

The main types of surgical intervention are:

• lobectomy (resection of the pulmonary lobe);
• pneumectomy (complete removal of the lung);
• thoracoplasty (minimally invasive type of surgery).

Before and after surgical treatment, an intensive course of chemotherapy is required to ensure stabilization of the patient's condition.

Spa treatment

Sanatoriums for the recovery of patients who have suffered severe lung pathology are traditionally located in coastal, mountain, steppe, and forest-steppe zones. It provides for comprehensive treatment of tuberculosis in combination with climatic and physical factors.

Patients are prescribed:

1. Chemotherapy.
2. Inhalations.
3. Air baths.
4. Breathing exercises.
5. Heliotherapy.
6. Climatotherapy.
7. Treatment of concomitant diseases.

Treatment in sanatorium-resort conditions is especially indicated in the presence of focal, disseminated, infiltrative tuberculosis, which has passed into the resorption phase, scarring of the lung tissue. Also, postoperative patients, people who have completed the main course of treatment for tuberculoma, cavernous and fibrous-cavernous forms of the disease, and tuberculous pleurisy are sent to such institutions.

Treatment of tuberculosis abroad

Tuberculosis treatment abroad is carried out in accordance with all modern standards. Most often, the patient manages to completely get rid of the infection and undergo an effective recovery course.

Tuberculosis treatment is provided with high quality in Germany, Belgium, and Switzerland. The fight against the disease in these countries is based on the principle of an individual approach to each patient, the use of traditional and new drugs, and performing the safest surgical operations. A significant role is given to rehabilitation, including cryotherapy, massages, electrotherapy, iontophoresis, and the appointment of a special diet.

Although we live in a century of innovative technologies, the issue of curing some diseases still remains unresolved. One of them is pulmonary tuberculosis. The cause of the disease is Koch's bacillus, which turns a person into a carrier of infection: by coughing, the infection is thrown into the air, and this gives it the opportunity to move to the next victim.

There are many drugs and antibiotics that can significantly improve the patient’s condition, but, unfortunately, they cannot completely cure tuberculosis. Therefore, folk recipes can help in the fight against tuberculosis. Treatment of tuberculosis with folk remedies is a safe solution, because you can choose the medicine individually for yourself.

Let's look at the most effective ways that will contribute to your further recovery.

Treatment of tuberculosis with mole cricket

First of all, treatment of pulmonary tuberculosis with folk remedies cannot do without mole crickets. It is worth noting that mole cricket for tuberculosis is considered the most successful method for treating pulmonary tuberculosis.

The mole cricket is a large insect that lives underground and near rivers. The peoples of Africa and Asia often eat fried mole cricket and consider it a salvation from tuberculosis. All this is because the leukocytes that are in the blood of the insect dissolve the outer shell of the Koch bacillus. In order not to lose its beneficial properties, dried mole cricket is used to treat diseases and support the immune system. Traditional medicine says that you need to take 30-40 grams of mole crickets for one course and grind it in a mortar. You need to add honey or some kind of chilled porridge to the resulting mixture. The patient needs to take 2-3 spoons of the resulting product three times a day before meals. Just one course of using mole cricket is enough to treat tuberculosis at the initial stage.

Garlic and onion

Treatment of tuberculosis with garlic is a well-working folk remedy. How to cure tuberculosis with garlic? It's simple: the juice and special extract of garlic have a huge antibacterial property that prevents the Koch stick from growing and developing. That is why it will have an anti-tuberculosis and healing effect on your body and improve your health.

For example, you can make a simple garlic infusion: peel 2 cloves of garlic, chop it, add a glass of water and let it brew for a day. In the morning, drink garlic medicine and make a new one, continuing this procedure for 2-3 months.

Traditional methods of treatment offer another option - to increase the amount of garlic in the patient’s daily diet. This means that the daily norm should reach 30 grams. Gradually, over 1.5 months, it needs to be increased to 90-120 grams. Having reached the goal, you need to return to the original 30 grams per day. You can also get rid of pulmonary tuberculosis in adults using another remedy: mix 500 grams of horseradish and the same amount of garlic, 1 kilogram of butter and 5 kilograms of honey. While stirring this paste, leave it in a boiling water bath for 10 minutes. You need to take the medicine 50 grams every day before meals.

You can also nourish your body with onions, or rather, in pairs. It is believed that with this method it is possible to influence Koch's wand.

Badger fat

They say that you can and even need to use badger fat for pulmonary tuberculosis. It is believed that the huge number of beneficial properties and substances that it contains can help a person overcome pulmonary tuberculosis. How to take badger fat?

A fairly effective option is to drink badger fat in its pure form. To get rid of tuberculosis, you need to eat a teaspoon of fat every morning for a month.

Since badger fat has an unpleasant taste, you can prepare the following mixture: mix 1 tablespoon of badger fat, a spoonful of honey and 250 grams of milk. This drink will help you fight your cough and improve your well-being.

You can also use the following recipe: badger fat, 100 grams of dried apricots, 100 grams of raisins, the same amount of walnuts, pour honey and turn it into a homogeneous mass and take a tablespoon three times a day. Do not forget that treating a disease with folk remedies is an addition to the main medical treatment; taken together, these will be the most effective results.

Dog fat for tuberculosis

Unfortunately, tuberculosis cannot be completely cured with dog fat. However, you can take it if you want to help your body fight this disease. Its benefit is that the fat itself contains useful substances that can destroy Koch's bacillus. Moreover, a variety of vitamins, oils and acids, which dog fat is rich in, have a beneficial effect on the human body. To make your lungs say “thank you” to you, you need to take a tablespoon of warmed dog fat 2-3 times a day.

Fish fat

Fish oil, which treated us all in early childhood, can help with tuberculosis.

The benefit of fish oil in this situation is that it is rich in vitamin D and therefore can seriously help in the fight against the disease. American doctors conducted a study where it was noticed that the condition of the patient who drank fish oil along with antibiotics improved significantly. That is why they came to the conclusion that fish oil can significantly complement the standard treatment of this serious illness.

Aloe for tuberculosis

Unfortunately, aloe alone cannot defeat pulmonary tuberculosis. Aloe does not have a particularly strong healing effect, since its natural acids do not have a strong effect on Koch's bacillus. But we should not forget that the patient’s recovery lies not only in defeating the causative agent of the disease, but also in supporting and strengthening the immune system. That is why, when choosing folk remedies for pulmonary tuberculosis, the use of aloe is necessary.

A good option is aloe tincture with honey. You will need 250 grams of aloe, honey, vodka and butter. You need to mix the ingredients and put the mixture in a warm place for several days, and then put it in the refrigerator. After it has been infused for 10 days, squeeze out the juice and take one tablespoon before each meal.

You can also make a tincture of herbs, aloe and honey. First, you need to melt 1.5 kilograms of linden honey. Add a glass of chopped aloe leaves to the melted honey and boil the mixture for 10 minutes. Separately, take 25 grams of birch buds and 15 grams of linden blossom and boil them for three minutes. Add this decoction to the cooled aloe and honey, mix and pour into bottles (0.5 liters), adding another 50 grams of olive oil to each. Take the resulting decoction three times a day, one teaspoon.

Propolis for tuberculosis

One of the popular ways to combat tuberculosis is propolis. The bee glue contained in it is capable of destroying the microbacterium of tuberculosis. The right medicine can relieve the patient of illness, improve immunity and well-being.

The following recipe is universal: bring 1 kilogram of butter to a boil, and then add 150 grams of finely chopped propolis. After this, you need to stir the mixture and bring it to a homogeneous state and strain through cheesecloth. The mixture should be stored in the refrigerator in a container with a lid. You need to take the medicine for 4-10 months, 2 tablespoons three times before meals.

Treatment of tuberculosis with herbs

Folk remedies for tuberculosis would not be folk remedies if they were done without herbs. Herbs for tuberculosis will not replace specially selected medications for you, but will be a good addition to its treatment.

A mixture of agave, honey and red wine will be useful. You need to take a jar in which you put chopped agave (about a kilogram), add 2 kilograms of honey and 5 liters of red wine. After closing the jar with a lid, you need to store the tincture for 5 days in a cold place, after which, take a teaspoon of the medicine three times a day.

A drink made from the knotweed plant will be medicinal. You need to grind it, pour boiling water over it and then boil in a water bath for 10 minutes. Let it brew and strain. You need to consume a tablespoon of this herbal drink three times a day.

Coltsfoot leaves can also help with tuberculosis. You need to pour a tablespoon of leaves with a glass of boiling water and boil for 20 minutes. You need to take the decoction three times a day, 0.3 liters.

Another option is a decoction of wild rosemary herb. The recipe is very simple, because you just need to pour boiling water over a tablespoon of the herb and boil for 10 minutes. Use the decoction 3 times a day, 2 tablespoons each.

The working one is an infusion of a mixture of herbs. You need to mix: wormwood (4 parts), knotweed (2 parts), trifoliate (2 parts), shepherd's purse herbs (3 parts). To these herbs add rhizomes of wheatgrass (3 parts), snake knotweed (2 parts) and cinquefoil erect (2 parts). Pour boiling water over everything and let it brew. After that, strain and drink 0.3 cups three times a day.

Hydrogen peroxide and soda

There is a theory that hydrogen peroxide can improve your own condition during the treatment of tuberculosis.

You need to take 1 drop, mixing it with 3 tablespoons of water. You need to drink it for 10 days, 3 times a day, and at the same time, adding another drop every day. However, there is no exact guarantee that it will work as desired. Moreover, for greater effectiveness, you need to combine peroxide treatment with other folk remedies.

Also, the theory about the magical effects of soda in the fight against tuberculosis has not been confirmed. However, this theory does not have precise arguments and scientific confirmation, since soda itself, when it enters the human body, causes many chemical reactions. Therefore, you should still not experiment with treating tuberculosis with soda.

Tuberculosis is a terrible disease that can strike even the healthiest person. That is why, having identified signs of the disease, you need to immediately consult a doctor and begin treatment. In addition, there are a huge number of traditional methods against pulmonary tuberculosis. They are all good and useful in their own way. Moreover, in addition to their direct role in the fight against illness, they also improve your well-being and strengthen your immune system. But do not forget that treatment will be effective only with the combined use of special drugs and traditional medicine. It is worth carefully consulting with your doctor and choosing the methods and recipes that are right for you.

Don't get sick and always stay healthy!

The development of tuberculosis throughout the world today is becoming increasingly alarming. The Koch bacillus, which causes the disease, is in the process of constant mutation and successfully adapts to new conditions and medications, which significantly complicates the treatment of the disease.

General principles of tuberculosis treatment

Despite the progress of medicine, the treatment of pulmonary tuberculosis remains a non-trivial task with difficult to predict results. Here are several factors on which the effectiveness of therapy for tuberculosis depends:

Since the tuberculosis process itself, as well as restorative changes in the lungs, develop very slowly, the course of treatment lasts at least six months. If it is stopped prematurely, pulmonary tuberculosis will recur.

The effectiveness of therapy is judged not by how long it takes to treat pulmonary tuberculosis, but by the following criteria:

• bacterial excretion stops, which is confirmed by microscopic examinations and sputum culture (some foreign researchers believe that only this criterion is sufficient to confirm cured tuberculosis);
• signs of tuberculosis inflammation, both clinical and laboratory, disappear;
• the foci of the process, noticeable on the radiograph, regress, forming residual inactive tuberculous changes;
• The patient's functionality and ability to work are restored.

Modern methods of treating tuberculosis are always a set of measures that are effective only when used together. Principles of treatment of tuberculosis:

Treatment methods

Today there are many approaches to treating tuberculosis. The effectiveness of each varies and is often controversial in professional medical circles. It is worth saying that each of the methods described below makes its contribution to curing the disease, which ultimately leads the patient to recovery.

Hygienic regime

Modern principles of treating tuberculosis patients provide for a special diet and rest regimen. How important this detail of the treatment process is can be judged by the fact that in the era before the invention of antibiotics, doctors, in fact, had no choice but to treat pulmonary tuberculosis by changing climate, nutrition and daily routine, and in a third of cases it turned out that this A simple remedy helps.

In severely ill patients, physical activity is limited to bed rest. If the process is not widespread, use a gentle regime of relative rest.

To make the body feel comfortable, night sleep is extended, two hours of daytime sleep are added, or at least rest in bed. Walks in the fresh air are required, and if the patient’s physical condition does not allow this, you should at least take him out to sit or lie on the veranda or balcony. A training regimen is recommended for recovering patients. It includes moderate exercise, sports games, and occupational therapy.

Meals for pulmonary tuberculosis are divided, 4-5 times a day. It should be complete and high in calories. 15-20% of the diet should be proteins, mainly animals, 20-35% fats, the rest carbohydrates. With the development of tuberculosis, treatment involves increasing the calorie intake by 15-20%. You need at least 100 g of protein daily, with at least half of animal origin.

Fats should be at least 100 g, carbohydrates - 500-550 g. If tuberculosis progresses rapidly, or in patients with exacerbation of a chronic process, the amount of carbohydrates is reduced to 300-350 g, fats to 70-90 g per day. Multivitamins are very important as additional support for the body.

Recovering patients benefit from sanatorium-resort treatment: sunbathing, sea bathing. However, it is possible to dramatically change the climate zone only after the acute outbreak of the process has been stopped. Physiotherapy is also indicated at this stage.

Etiotropic therapy

This is the main direction in the treatment of tuberculosis. Mycobacterium tuberculosis is extremely resistant to both environmental influences and drugs. It is capable of penetrating inside human phagocytes (immune cells that absorb foreign agents), maintaining viability, or creating so-called persistent, dormant forms.

Those concentrations of medicinal substances that could quickly lead to its death are unattainable in the body of a living person. Therefore, when choosing how to treat tuberculosis, they always use from 2 to 6 medications simultaneously, and the duration of the course of treatment can reach a year.

Monotherapy (using only one anti-TB drug) is not only ineffective, but also leads to the development of resistance (drug resistance).

According to the spectrum of action, anti-tuberculosis drugs are divided into:

1. Broad-spectrum antibiotics(rifampicin derivatives, fluoroquinolones, aminoglycosides).
2. Synthetic chemotherapy drugs, which act only on Mycobacterium tuberculosis (thiamides, Ethambutol, etc.)

According to WHO recommendations, there are 4 standard treatment regimens (chemotherapy regimens) for tuberculosis, each of which is divided into an intensive therapy phase, which lasts from 2 to 6 months, and a continuation phase of treatment, from 4 to 12 months:

Various treatment regimens for tuberculosis are used depending on how long the disease lasts, how far the tuberculosis process has progressed, whether there have been relapses, and whether there are prerequisites for the development of drug resistance of the mycobacterium.

The first phase of therapy is usually carried out in a hospital; in the second phase, tuberculosis can be treated on an outpatient basis. Treatment with drugs that act on pathogens of pulmonary tuberculosis often causes undesirable reactions. For reasons of occurrence they can be:

In order to reduce the toxic effect of the drug on the body, vitamins, hepatoprotectors and the like are used in parallel with treatment. In addition, it is possible to replace one drug with another of the same group, split doses of the drug, or change the method of its administration.

Patients who do not tolerate anti-TB drugs are usually given supervised treatment: in a hospital, the medicine is taken in the presence of a health worker. If the patient is transferred to outpatient treatment for tuberculosis, it is necessary to monitor it by dispensing drugs for a short period of time and counting the tablets during the visit.

Pathogenetic therapy

Chemotherapy itself is not always enough to reduce decay cavities and stop bacterial excretion, since it is not possible to cure tuberculosis with its help alone in approximately 30% of cases. Therefore, together with etiotropic drugs, others are used:

• Glucocorticoids(Prednisolone, Dexamethasone);
• Immunomodulators(Likopid, Glutoxim);
• Antioxidants (sodium thiosulfate, A-Tocopherol acetate);
• Anabolics, including anabolic steroids (Methyluracil, Pentoxyl);
• Desensitizing agents(Calcium chloride, Diphenhydramine);
• Vitamins (groups B, C, A).

The use of these drugs in combination allows you to recover faster, optimizing the duration of therapy.

Collapse therapy methods

The basic principles of treatment using collapse therapy methods are the artificial injection of gas between the layers of the pleura (artificial pneumothorax) or peritoneum (pneumoperitoneum). The condition for this is a destructive form of tuberculosis, and the process must be fresh, without the formation of fibrous changes.

At the present stage, collapse therapy for the treatment of pulmonary tuberculosis is used quite rarely, as it is traumatic for the patient and burdensome for the doctor. Collapse therapy for tuberculosis is used in the following cases:

1. After the main course of antibacterial therapy, cavities in the lungs do not show a tendency to decrease.
2. Bleeding (“compression” artificial pneumothorax).

The principle of operation of collapse therapy methods is to create relative rest for the affected areas, which promotes the collapse of the cavity walls.

Over time, the gas dissolves and must be inflated. The period during which controlled pneumothorax or pneumoperitoneum is maintained ranges from 4 to 12 months.

Surgical methods

Pulmonary tuberculosis requires surgical treatment if destructive processes - cavities or large caseous formations - in the lungs do not decrease after 3-9 months of complex chemotherapy.

Also, surgical methods of treating tuberculosis are indicated for the development of complications - stenosis and deformation of the bronchi, chronic empyema (extensive purulent lesion), atelectasis (areas of collapse of lung tissue) and abscesses. Types of intervention:

High humidity, an asocial lifestyle, direct infection from a patient, insufficient or unbalanced nutrition - all this can lead to the development of tuberculosis. These are not all the conditions that contribute to the disease, because any disease can progress in an organism weakened by stress. If a decade ago tuberculosis was considered the plague of the 20th century, today there are many effective methods of treatment and prevention.

Drug treatment of tuberculosis

Doctors recommend treatment of this disease in two stages: intensive and prolonged. The first phase involves the cessation of bacterial secretions and lasts an average of two months. The goal of this phase is to stop the development of tuberculosis and eliminate the danger of the patient to others. Such treatment must be carried out under the close supervision of a pulmonologist in a hospital. For the second phase there is no need to be in the hospital constantly. Outpatient treatment is selected individually for each patient and a doctor’s visit schedule is calculated.

Three-component treatment

This was the very first treatment regimen that was used for quite a long time. Today it is called classical, although its use now practically does not bring the desired results. The main components of the first line are as follows:

• PAS (para-aminosalicylic acid);
• Streptomycin.

Four-component treatment

Due to the rapid adaptation of bacteria and increasing their resistance to chemicals, it is necessary to develop newer and stronger drugs. The result of many years of work was a diagram of their four components, including the following:

• Ethionamide or pyrazinamide;
• Ftivazid or isoniazid;
• Kanamycin or streptomycin;
• Rifabutin or rifampicin.

The developer of this scheme is the Dutch scientist Karel Stiblo. Since 1980, this regimen has been adopted for the treatment of tuberculosis in 120 countries. The medications used are called first-line drugs.

Treatment according to the five-component scheme

Modern medical centers prefer to use an even more powerful regimen for treatment than a three- or four-component regimen, adding a fifth - ciprofoclacin or another fluoroquinolone derivative. Drugs above the first generation are used in the fight against drug-resistant strains.

The use of drugs should be carried out daily without skipping for 20 months. Other supportive, enhancing effects or suppressing side effects of the medication are also added. This is a fairly expensive and complex treatment. If bacteria become resistant to the drugs used, the doctor may prescribe capreomycin, cycloserine, and others. These drugs are from the reserve second line due to the toxic effect on the human body.

In 2012, on December 28, bedaquiline, the newest drug for the treatment of forms of tuberculosis that are drug-resistant, was registered in the United States.

Treatment using new BPaL and BPaMZ regimens

In 2017, the TB Alliance announced the successful completion of trials of two more schemes.

The BPaL regimen is based on linezolid, pretomanid (PA-824) and bedaquiline. For 40 trial participants, out of 69 total respondents, the results were reported as successful.

The composition of BPaMZ includes the following drugs: pyrazinamide, moxifloxacin, pretomanid and bedaquiline. 240 patients took part in the trials.

Among scientists in the post-Soviet space, namely representatives of the Russian Federation and Ukraine, there was criticism towards new overseas developments. Our physicians are confident that the presence of a network of dispensaries for inpatient hospitalization of patients for tuberculosis is much more effective than chemical innovations.

Concomitant therapy

Due to the toxic effect of anti-tuberculosis drugs on humans, it is necessary to replenish the strength and support the immune system of patients. For these purposes, immunomodulatory drugs and detoxification compounds are used.

The first group supports the immune system, which is exposed to aggressive effects from first-line and higher medications. Detoxification occurs during or after taking major medications, helping to eliminate unwanted symptoms.

Alternative Therapies

Drug methods of eliminating tuberculosis are the basis of its treatment, which should be strengthened and supported by other non-scientific methods. Fresh, clean air, namely sea or forest air, has a very beneficial effect. Moreover, walks in the forest should take place in a pine forest. If sea therapy is useful exclusively for patients with a mild form of the disease, then phytoncides from pine essential oil are indicated for all types of disease.

In a modern city, it is difficult to find such pine oases, so pine pollen can be a good replacement. During the flowering period, trees secrete it on their microstrobilae - male flowers. Pollen must be collected at a certain period so that it has not yet scattered, but is already ripe. Mostly this is mid-May, although there are different types of trees and different climatic features that contribute to the shift of this period. To get about 2 liters of pollen, you need to collect a whole 10-liter bucket of pine flowers.

This natural medicine contains many trace elements: calcium, magnesium, phosphorus and choline. In a closed room, you need to pour pollen onto a spread oilcloth or newspaper and wait several days for it to free itself from the flowers. The use of pine pollen for the purpose of treatment can be different, for example, a mixture with honey, an alcohol tincture as a tea, or as a separate product without additives in its pure form.

Folk methods and remedies in the fight against tuberculosis

The most famous folk remedies are:

• Medvedka;
• Garlic;
• Aloe;
• Vinegar;
• Animal fat;
• Wax moth.

You need to prepare a honey mixture from dried mole crickets in the proportion of 100 ml of honey per 40 g of insect powder. The mole cricket is collected, thoroughly washed and dried, protected from light, ground into powder in a blender or pounded in a mortar. Over the course of a three-month period, you need to eat 3 tablespoons of the product three times a day before meals.

To treat tuberculosis using garlic, you can make jam from this vegetable or a water infusion. Due to the strong antibacterial properties of garlic, you should eat one clove every couple of hours.

Very effective treatment with animal fat, namely badger or bear fat. This product can be consumed either pure or mixed with honey. Siberian healers recommend carrying out such procedures in the morning and evening, a tablespoon at a time.

Conclusion

Tuberculosis is a dangerous and complex disease that today can be cured. The main method used for treatment today is still medication. In this case, you not only need to take the drugs in the regimens proposed by doctors, but also undergo concomitant treatment and enhance the effect with alternative methods and folk remedies. Since each case of the disease is unique, only a phthisiatrician can select the most successful treatment.

Pulmonary tuberculosis is an infectious pathology caused by the Koch bacillus, characterized by different clinical and morphological variants of damage to the lung tissue.

The variety of forms causes variability in symptoms. The most typical symptoms of pulmonary tuberculosis are respiratory disorders (cough, hemoptysis, shortness of breath) and symptoms of intoxication (prolonged low-grade fever, sweating, weakness).

Next, we will look at what pulmonary tuberculosis is, what forms of the disease there are and how a person becomes infected with them, as well as signs of the disease in the early stages and treatment methods in adults today.

What is pulmonary tuberculosis?

Pulmonary tuberculosis is an infectious disease. It develops due to the entry of a pathogen into the body - mycobacterium tuberculosis. Penetrating into the human body, bacteria cause local inflammation, manifested in the formation of minor epithelial granulomas.

Even if mycobacterium has entered the human body, it is not a fact that signs of pulmonary tuberculosis can be immediately noticed - the probability of the disease is not one hundred percent. As medical studies have shown, the Koch bacillus itself is present in the body of many modern people, among whom every tenth suffers from an unpleasant disease.

If the immune system is strong enough, it successfully resists the infectious agent, eventually developing strong immunity to it.

Because Koch's bacillus multiplies quickly in unsanitary conditions, there is an opinion that the disease occurs only in the poor, but anyone can get tuberculosis, regardless of age and position in society.

Forms of tuberculosis

According to WHO, 1/3 of the world's population is infected with mycobacteria. According to various sources, every year 8-9 million people become ill with tuberculosis and 2-3 million die from complications of this disease.

You should know that tuberculosis is transmitted exclusively from people who have an open form of the disease. The danger lies the fact that under some circumstances the patient himself may not know about the transition of the disease from a closed form to an open one.

Depending on the nature of the occurrence, the following types of disease are distinguished:

1. Primary. It develops when the patient makes first contact with Koch's bacillus. The human body to which the infection is first transmitted can easily become infected. The disease can take a latent form, remaining in the body for many years, and “waking up” only when the patient’s immunity is weakened;
2. Secondary pulmonary tuberculosis develops upon repeated contact with the office or as a result of reactivation of the infection in the primary focus. The main clinical forms of secondary tuberculosis are focal, infiltrative, disseminated, cavernous (fibrous-cavernous), cirrhotic, and tuberculoma.

Open form of pulmonary tuberculosis (contagious)

This form is the most dangerous. The lungs are most often affected, but other organs may also be involved. Infection occurs when the infectious agent is inhaled. A patient with an open form must be isolated. This term means that a person is infectious to others because he releases active mycobacteria into the environment. The presence of an open form can be determined by examining a sputum smear.

Mycobacteria can survive even on dust, so it is very easy to become infected with them when using the same objects. In addition, the use of public institutions and transport, even short-term, can lead to the transmission of an open form of tuberculosis from one person to many others.

Closed tuberculosis

The closed form of pulmonary tuberculosis does not involve the release of Koch bacilli into the environment by the patient. This form is called TB-, and this means that a person who has this disease will not be able to infect others.

Closed tuberculosis is associated with changes in the patient’s health status, which can take physical and internal forms. It should be noted that under the influence of CD on the lung area, an epidermal tuberculin test in infected patients guarantees a positive result in 80% of cases. Its confirmation is necessary through testing and instrumental examinations.

Other characteristics boil down to the fact that patients do not feel unwell - they do not develop any unpleasant symptoms indicating problematic functioning of the lungs or other body systems.

Signs of the early stage of pulmonary tuberculosis

Signs of tuberculosis in adults may not appear immediately. The length of the incubation period (the time from infection with the virus until the first noticeable symptoms appear) can vary depending on several factors. Very often, the signs of pulmonary tuberculosis in the early stages are mistakenly confused with ARVI, and the real cause of the disease can only be detected during routine fluorography.

The first signs of tuberculosis manifest themselves weakly, but then gradually increase. These include:

• cough with expectoration of sputum for 3 weeks;
• hemoptysis;
• constantly high temperature;
• fatigue, apathy, low performance;
• unexpected mood swings, irritability;
• sudden loss of kilograms;
• loss of appetite.

Symptoms do not necessarily appear immediately: as a rule, one or two appear first (and this is not necessarily a cough) or two, followed by others. If these symptoms collectively last longer than 3 weeks, there is a serious need to consult a doctor.

Pay attention to your appetite; in patients it decreases very quickly. The first characteristic sign of tuberculosis in children and adults is sudden weight loss and prolonged cough.

Causes

The causative agents of this disease in humans are bacteria of the genus Mycobacterium, or more precisely: Mycobacterium tuberculosis.

The main provoking factor is a decrease in the body's resistance. This may occur under the following circumstances:

• if a person has severe somatic diseases;
• chronic alcoholism;
• exhaustion of the body.

As it was revealed during research, the infectious agent is characterized by increased resistance to any aggressive influences; it is not afraid of alcohol, acid, or alkali. Tuberculosis can survive in soil, snow, and the methods of destruction identified by the German scientist assumed the direct influence of sunlight, heat, and antiseptic components containing chlorine.

The main predisposing factors for the development of pulmonary tuberculosis are:

• smoking;
• malnutrition (lack of vitamins and animal proteins);
• physical fatigue;
• neuropsychic overstrain (stress);
• drug use;
• substance abuse;
• hypothermia;
• frequent viral and bacterial infections;
• serving a sentence in prison;
• overcrowding of teams;
• staying in rooms with insufficient ventilation.

Transmission routes

1. Penetration of mycobacteria into our body usually occurs through the air, or aerogenous route. Contact, transplacental and nutritional (food) routes are much less common.
2. The respiratory system of a healthy person is protected from microbial penetration by special mechanisms, which are significantly weakened in acute or chronic diseases of the respiratory tract.
3. The alimentary route of infection is possible in case of chronic intestinal diseases that impair absorption functions in it.

Regardless of the route of entry, mycobacteria enter the lymph nodes. From there they spread through the lymphatic vessels throughout the body.

Symptoms of pulmonary tuberculosis in adults

The incubation period of the disease can range from one to three months. The danger is that in the early stages of the disease, the symptoms are similar to a simple respiratory infection. As soon as the stick enters the body, it begins to spread through the blood to all organs, and the first manifestations of infection appear.

With tuberculosis, a person feels weak, as at the beginning. Performance decreases, apathy appears, the patient constantly wants to sleep, and the patient gets tired quickly. Signs of intoxication do not go away for quite a long time.

Symptoms of pulmonary tuberculosis:

• persistent cough;
• shortness of breath, which gradually increases after infection with tuberculosis, occurs even with minor physical activity;
• wheezing, noted by the doctor when listening (dry or wet);
• hemoptysis;
• chest pain that occurs with deep breaths or at rest;
• elevated body temperature: up to 37 degrees or more;
• painful shine in the eyes, pallor, blush on the cheeks.

The temperature with tuberculosis usually rises at night. Fever occurs, the thermometer can show up to 38 degrees.

With greater bacterial activity, patients may complain of:

• sudden temperature rises up to 39° - especially towards the end of the day;
• girdle pain in the chest and shoulder area;
• spasms under the shoulder blades (if the disease has affected the pleura);
• dry persistent cough;
• heavy sweating during sleep.

Similar symptoms are characteristic of primary tuberculosis - this means that the person has not encountered this disease before.

Coughing up blood and the occurrence of acute painful sensations when inhaling are the most dangerous symptoms of pulmonary tuberculosis in adults. It is very difficult to treat the disease at this stage. The patient is recommended to be hospitalized. Foci of the disease rapidly affect various organ systems, and the musculoskeletal system may also be affected.

In severe cases, the patient experiences complications such as:

• pulmonary hemorrhage;
• pulmonary hypertension;
• cardiopulmonary failure;
• swelling of the limbs;
• abdominal ascites;
• fever;
• sudden weight loss;
• painful sensations in the cage;

To a greater extent, tuberculosis affects the lungs - in almost 90% of cases. However, mycobacteria can also be dangerous for other organs. The patient may be diagnosed with tuberculosis of the genitourinary system, bones, central nervous system, and digestive organs. The symptoms of the disease in this case are caused by a malfunction of the affected organs.

Stages of development

When the pathogen enters the lungs, the following occurs:

1. Mycobacterium tuberculosis settles in the bronchioles and alveoli, penetrates the lung tissue, and causes an inflammatory reaction (the focus of specific pneumonia).
2. Next, they are surrounded by macrophage defenders, which, having turned into epithelioid cells, stand around the pathogen in the form of a kind of capsule and form the primary tuberculosis focus.
3. Some mycobacteria manage to penetrate this defense, then they move through the bloodstream to the lymph nodes, where they come into contact with immune defense cells and cause a set of reactions that form specific cellular immunity.
4. Inflammation occurs and is replaced by a more advanced reaction, in which macrophages also participate; it is their activity that determines whether the body’s anti-tuberculosis defense will be effective.

Diagnostics

Diagnostics consists of several stages:

• Collection of anamnestic data (what complaints, whether there were contacts with tuberculosis patients, etc.).
• Clinical examination.
• Radiography.
• Laboratory tests (blood and urine tests).
• Three times microscopic and bacteriological examination of sputum.
• If necessary, a number of special examinations are carried out: bronchoscopy, biopsy of lung tissue, molecular biological diagnostics, etc.

If the possible presence of the disease is suspected, a Mantoux test is performed. In this case, an antigen of the causative agent of the disease is injected under the human skin, and after a few days the injection site and the body’s immune response are studied. If infection occurs, the reaction will be quite pronounced: the spot is large.

Based on the diagnostic results, pulmonary tuberculosis is differentiated from:

• pulmonary sarcoidosis,
• peripheral lung cancer,
• benign and metastatic tumors,
• pneumomycosis,
• lung cysts, abscess, silicosis, abnormal development of the lungs and blood vessels.

Additional diagnostic search methods may include bronchoscopy, pleural puncture, and lung biopsy.

The combination of tuberculosis is not uncommon in recent years. Recent studies show that people who have had tuberculosis have lung cancer occurs 10 times more often.

Treatment of pulmonary tuberculosis

Treatment of tuberculosis is a very long, systemic process. To get rid of the disease completely, you need to put in a lot of effort and patience. It is almost impossible to cure yourself at home, since Koch's wand gets used to many drugs over time and loses sensitivity.

Doctors prescribe to patients:

• physiotherapeutic procedures;
• breathing exercises at home;
• drugs to enhance immunity;
• special food for illness at home;
• surgical intervention.

Surgery for the treatment of adults is used if it is necessary to remove part of the lung due to its serious damage during illness.

Treatment of tuberculosis in the early stages in adults

• rifampicin;
• streptomycin;
• isoniazid;
• ethionamide and their analogues.

Pharmacotherapy takes place in two stages. At the initial stage, intensive treatment is prescribed to suppress bacteria with high metabolism, and at the final stage, blocking of the remaining microorganisms with low metabolic activity is prescribed. The main group of anti-tuberculosis drugs used include:

• Isoniazid
• Rifampicin
• Pyrazinamide
• Ethambutol
• Streptomycin

If bacteria are resistant to drugs of the main group, reserve drugs are prescribed:

• Kanamycin
• Amikacin
• Cycloserine
• Prothionamide
• Ethionamide.

Treatment of pulmonary tuberculosis should begin with first-line drugs; if they are ineffective, then others are prescribed. The best solution is to use several groups of drugs.

If the patient’s condition allows, he receives treatment on an outpatient basis, with a weekly appointment with a phthisiatrician.

Should be considered that outpatient treatment is possible only if a non-contagious form of pulmonary tuberculosis is diagnosed, in which it will not infect others.

The effectiveness of therapy is judged not by how long it takes to treat pulmonary tuberculosis, but by the following criteria:

1. bacterial excretion stops, which is confirmed by microscopic examinations and sputum culture (some foreign researchers believe that only this criterion is sufficient to confirm cured tuberculosis);
2. signs of tuberculosis inflammation, both clinical and laboratory, disappear;
3. the foci of the process, noticeable on the radiograph, regress, forming residual inactive changes;
4. The patient's functionality and ability to work are restored.

Spa treatment

This type is indicated for focal, infiltrative, disseminated forms of tuberculosis at the stage of scarring of lung tissue, resorption and compaction of changes in it, after surgical operations. Spa treatment includes:

• pharmacotherapy;
• dietary food;
• beneficial effects of climate;
• physiotherapy;
• physical therapy.

Operation

Pulmonary tuberculosis requires surgical treatment if destructive processes - cavities or large caseous formations - in the lungs do not decrease after 3-9 months of complex chemotherapy.

Surgical methods of treating tuberculosis are also indicated in case of complications:

• stenosis and deformations of the bronchi,
• chronic empyema (extensive purulent lesion),
• atelectasis (areas of collapse of lung tissue) and abscesses.

Prevention

1. Social prevention (carried out at the state level) is a set of measures to improve people’s lives and health, educational work regarding tuberculosis, etc.
2. Sanitary prevention includes various measures in foci of tuberculosis infection.
3. Specific – vaccination and revaccination with BCG.
4. Chemoprophylaxis is the administration of an anti-tuberculosis drug not for treatment purposes, but for prevention purposes to people who have been in contact with a patient with tuberculosis.

Pulmonary tuberculosis is a dangerous disease that needs to be treated under the supervision of a specialist and preferably at the earliest stages. Monitor your health, get diagnosed 1-2 times a year and follow preventive measures.