Abstract：
Chronic obstructive pulmonary disease (COPD) is characterized by airflow obstruction on spirometry and symptoms such as dyspnea on exertion and chronic cough with sputum production, thus making it a significant healthcare issue worldwide. Japanese patients with COPD have unique characteristics compared to patients in Western countries, including older age and lower exacerbation frequency. The Japanese Respiratory Society (JRS) published the 6th edition of the COPD guideline in June 2022. This article introduces the management goals of COPD and describes its management during the stable phase, as outlined in the guideline. Management goals include improving the current status, such as the symptoms, quality of life (QOL), exercise tolerance, and physical activity, and reducing future risks through prevention of exacerbation and suppression of disease progression to prevent shortening of healthy life expectancy. Management plans should include avoidance of causative substances, assessment of disease severity, and personalized treatment plans. Pharmacotherapy using inhalation bronchodilators is a key component of the treatment of stable COPD. Bronchodilators, including short- and long-acting dilators, are commonly used to relieve symptoms and improve QOL. Inhaled corticosteroids (ICSs) are used in combination with long-acting bronchodilators, especially in patients with asthma and COPD overlap, or those experiencing frequent exacerbation of eosinophilia. Combination therapy with a long-acting muscarinic antagonist (LAMA), a long-acting beta 2 agonist (LABA), and ICS is expected to improve QOL and respiratory function and reduce mortality and exacerbation compared to the LAMA + LABA combination. Non-pharmacological therapies, including smoking cessation and pulmonary rehabilitation, should also be considered.
摘要：
慢性阻塞性肺疾病（COPD）的特征是肺活量测定中的气流阻塞和症状，例如劳累时呼吸困难和痰产生的慢性咳嗽，从而使其成为全球范围内的重大医疗保健问题。与西方国家的患者相比，日本的COPD患者具有独特的特征，包括年龄较大和恶化频率较低。日本呼吸学会（JRS）于2022年6月发布了第6版COPD指南。本文介绍了COPD的管理目标,阐述了COPD稳定期的管理,如指南所述。管理目标包括改善现状，如症状，生活质量（QOL），运动耐受力,和身体活动，并通过预防恶化和抑制疾病进展来减少未来的风险，以防止缩短健康预期寿命。管理计划应包括避免致病物质，疾病严重程度的评估，个性化的治疗方案。使用吸入支气管扩张剂的药物治疗是治疗稳定COPD的关键组成部分。支气管扩张器,包括短效和长效扩张器，通常用于缓解症状和改善生活质量。吸入皮质类固醇（ICSs）与长效支气管扩张剂联合使用，特别是在哮喘和COPD重叠的患者中，或经常加重嗜酸性粒细胞增多症的患者。长效毒蕈碱拮抗剂（LAMA）的联合治疗，长效β2激动剂（LABA），与LAMA+LABA组合相比，ICS有望改善生活质量和呼吸功能，并降低死亡率和恶化。非药物治疗,包括戒烟和肺部康复，也应该考虑。
