vLFkek ¼nek½ 'olu ekxZ dk ,d vke th.

kZ lwtu
disease okyk jksx gS ftls pj o vkorhZ y{k.kksa]
çfrorhZ 'olu ck/kk vkSj 'oluh&vkd"kZls igpkuk tkrk
gSAvke y{k.kksa esa ?kj?kjkgV] [kkalh] lhus esa
tdM+u vkSj 'olu esa leL;k'kkfey gSaA

nek dks vkuqokaf'kd vkSj i;kZoj.kh; dkjdksa dk la;kstu

ekuk tkrk gSA bldk funku lkekU;r;k y{k.kksa ds çfr:i]
le; ds lkFk mipkj ds çfr çfrfØ;k vkSj LikbjksesVªhij
vk/kkfjr gksrk gSA ;g fpfdRlh; :i ls y{k.kksa dh
vko`fÙk] ,d lsdsUM esa cyiwoZd fu%'olu ek=k vkSj
f'k[kj fu%'okl çokg nj ds vk/kkj ij oxhZ—r gSA nes dks
vV‚fid ¼oká½ ;k xSj&vV‚fid ¼Hkhrjh½ dh rjg Hkh
oxhZ—r fd;k tkrk gS tgka ij vV‚ih dks Vkbi 1
vfrlaosnu'khyrk çfrfØ;kvksa ds fodkl dh vksj igys ls
vuqdwfyr :i esa lUnfHkZr fd;k x;k gSA

xaHkhj y{k.kksa dk mipkj vke rkSj ij ,d var%'olu okyh

y?kq vof/k es dke djs okyh chVk&2 ,xksfuLV ¼tSls fd
l‚YC;wVke‚y½ vkSj ekSf[kd d‚fVZdksLVj‚,M }kjk fd;k
tkrk gSA çR;sd xaHkhj ekeys esa var%f'kjk
d‚fVZdksLVj‚,M] eSXuhf'k;e lYQsV vkSj vLirky esa
HkrhZ djuk vko';d gks ldrk gSA y{k.kksa dks ,ythZ
dkjdksa vkSj rdyhQ dkjdksa tSls mRçsjdksa ls cpko
djds rFkk d‚fVZdksLVj‚,M ds mi;ksx ls jksdk tk ldrk
gSA ;fn vLFkek y{k.k vfu;af=r jgrs gSa rks yach vof/k
ls lfØ; gBh chVk ¼LABA½ ;k Y;wdksVªhu çfri{kh dks
'olu fd;s tkus okys d‚fVZdksLVj‚,M dks mi;ksx fd;k tk
ldrk gSA1970 ds ckn ls vLFkek ds y{k.k egRoiw.kZ :i
ls c<+ x;s gSaA 2011 rd] iwjs fo'o esa 235&300
fefy;u yksx blls çHkkfor Fks] ftuesa yxHkx 2]50]000
ekSrsa 'kkfey gSaA

fpà rFkk y{k.k

vLFkek dks ckj ckj gksus okyh ?kj?kjkgV] lkal ysus

esa gksus okyh rdyhQ] lhus esa tdM+u vkSj [kkalh ls
igpkuk tkrk gSA [kkalh ds dkj.k QsQM+s ls dQ mRiUu
gks ldrk gS ysfdu bldks ckgj ykuk dkQh dfBu gksrk
gSA fdlh nkSjs ls mcjus ds le; ;g eokn tSlk yx ldrk gS
tks fd 'osr jä df.kdkvksa ds mPp Lrj ds dkj.k gksrk gS
ftUgsa LuksfQYl dgk tkrk gSA vkerkSj ij jkr esa vkSj
lqcg&lqcg ;k O;k;ke vkSj BaM+h gok dh çfrfØ;k ds
dkj.k y{k.k dkQh [kjkc gksrs gSaA vLFkek ls ihfM+r
dqN yksxksa dks vkerkSj ij mRçsjdksa dh çfrfØ;k esa
'kk;n gh dHkh y{k.kksa dk vuqHko gks] tcfd nwljksa
esa y{k.k fn[krs gSa o cus jgrs gSaA

lacaf/kr fLFkfr;ka
vLFkek ls ihfM+r yksxksa esa dbZ lkjh vU; LokLF;
fLFkfr;ka vf/kd ckj gksrh gS ftuesa
%xSLVªks&blksQSft,y fj¶ysDl jksx ¼GERD½]
jkbuksflU;wlkbfVl vkSj v‚ClVªfDVo Lyhi ,iuh;k'kkfey
gSaA euksoSKkfud fodkj Hkh dkQh vke gSa ftlesa ls
fpark fodkj 16–52% yksxksa esa vkSj euksn'kk fodkj 14–
41% yksxksa esa gksrk gSA gkykafd ;g vHkh Kkr ugha
gS fd vLFkek] eukSoSKkfud leL;k,a iSnk djrk gS ;k
eukSoSKkfud leL;k,a vLFkek dk dkj.k gksrh gSaA

dkj.k

tfVy rFkk vi;kZIr :i ls le>h x;h i;kZoj.kh; vkSj thu

laca/kh ikjLifjd fØ;kvksa ds la;kstu ls vLFkek gksrk
gSA ;s dkjd bldh xaHkhjrk vkSj mipkj ds çfr çfrfØ;k
dks çHkkfor djrs gSaA ,slk fo'okl fd;k tkrk gS fd
vLFkek dh nj esa esa gky esa vk;h o`f) cnyrh
,fitsfufVd ¼os iSr`d dkjd tks Mh,u, vuqØe ls lacaf/kr
gksus ds vfrfjä gksrs gSa½ rFkk cnyrs i;kZoj.k ds
dkj.k gks jgh gSA

i;kZoj.kh;

vLFkek ds fodkl rFkk foLrkj ls dbZ i;kZoj.kh; dkjd

tqM+s gq;s gSa ftuesa ,ythZ dkjd rRo] ok;q çnw"k.k
rFkk vU; i;kZoj.kh; jlk;u 'kkfey gSaA xHkkZoLFkk ds
nkSjku /kweziku rFkk blds ckn fd;k x;k /kweziku
vLFkek tSls y{k.kksa ds xaHkhj tksf[ke ls tqM+k gSA
VªSfQd çnw"k.k ds dkj.k fuEu ok;q xq.koÙkk ;k mPp
vkstksu Lrj] vLFkek ds fodkl rFkk bldh c<+h gqbZ
xaHkhjrk ls tqM+k gSA ?kj ds Hkhrj ds vfLFkj dkcZfud
;kSfxdksa vLFkek ds mRçsjd gks ldrs gSa; mnkgj.k ds
fy;s Q‚eZ,fYMgkbM vukoj.k dk blls ,d ldkjkRed laca/k
gSA lkFk gh] ihohlh esa mifLFkr isFkQSysV~l cPpksa
rFkk o;Ldksa esa gksus okys vLFkek ls lacaf/kr gSa
blh rjg ls ,saMksV‚fDlu vukoj.k Hkh blls lacaf/kr gSA

vLFkek] ?kj ds Hkhrj mifLFkr ,ythZ dkjdksa ds lkFk

vukoj.k ls lacaf/kr gSA ?kj ds Hkhrj ds vke ,ythZ
dkjdksa esa /kwy okys ?kqu] d‚djksp] tkuojksa ds
ckyksa dh :lh rFkk QQwan lkfey gSaA /kwy ds ?
kquksa dks de djus ds ç;kl vçHkkoh ik;s x;s gSaA dqN
çdkj ds ok;jl tfur 'olu laØe.k vLFkek ds fodkl ds tksf[ke
dks c<+k ldrs gSa fo'ks"k :i ls rc tcfd mudks cpiu esa
'olu flfUl'k;y ok;jl rFkk jkbuksok;jlds :i esa gkfly fd;k
x;k gksA gkykafd dqN vU; çdkj ds laØe.k tksf[ke dks
de dj ldrs gSaA

 
LoPNrk ifjdYiuk

LoPNrk ifjdYiuk ,d fl)kar gS tks iwjh nqfu;k esa vLFkek

dh c<+h nj dks xSj&laØked cSDVhfj;k rFkk ok;jl ls
cpiu ds nkSjku ?kVs gq;s vukoj.k ds çR;{k rFkk vutkus
ifj.kke ds :i esa le>kus dk ç;kl djrk gSA/kkj.kk ;g gS fd
cSDVhfj;k vkSj ok;jl ds çfr vukoj.k esa deh dk dkj.k]
dqN gn rd vk/kqfud lektksa esa c<+h gqbZ LoPNrk
vkSj ifjokj ds ?kVs vkdkj gSaA LoPNrk ifjdYiuk dk
leFkZu djus okys lk{;ksa esa ?kjsyw o [ksrh laca/kh
i'kqvksa esa vLFkek dh ?kVh njsa 'kkfey gSaA

vkjafHkd thou esa ,aVhck;ksfVd dk mi;ksx vLFkek ds

fodkl ls tqM+k gqvk gSA lkFk gh] 'kY;fØ;k }kjk tUe
vLFkek ds c<+s gq;s tksf[ke ¼yxHkx 20 ls 80%½ ls
lacaf/kr gS – ;g c<+k gqvk tksf[ke LoLFk cSDVhfj;k ds
>qaM dh deh ds dkj.k gksrk gS ftls uotkr tUe uky ds
ekxZ ds ek/;e ls xzg.k djsxkA vLFkek rFkk le`f) dh nj
ds chp ds ,d laca/k gksrk gSA

vkuqokaf'kd

vLFkek ds fy, ikfjokfjd bfrgkl ,d tksf[ke dkjd gS ftlesa

fofHkUu thu 'kkfey fd;s x;s gSaA ;fn leku tqM+oka
esa ls ,d çHkkfor gksrk gS rks nwljs ds çHkkfor gksus
dh laHkkouk 25% rd gksrh gSA 2005 dh lekfIr rd] 6 ls
vf/kd i`Fkd tula[;kvksa esa 25 thUl dks vLFkek ls
lacaf/kr ik;k x;k gS ftuesa nwljks ds lkFk GSTM1]
IL10]CTLA&4] PINK5]LTC4] IL4R vkSj ADAM33 'kkfey gSaA

bu thUl esa ls vf/kla[; çfrj{kk ç.kkyh ;k fu;eu djus

okyh lwtu ls lacaf/kr gSaA vR;f/kd çfr:fir v/;;uksa ls
lefFkZr bu thUl dh lwph esa ls Hkh feyus okys ifj.kke
lHkh ijhf{kr tula[;kvksa ij ,d :i ugha gSaA 2006 esa
100 ls vf/kd thUl dks ,d vkuqokaf'kd laca/k v/;;u ls
lacaf/kr ik;k x;k Fkk; vkSj vf/kd thUl dk feyuk tkjh gSA

dqN vkuqokaf'kd fHkUu :i dsoy rc vLFkek iSnk djrs

gSa tc mudks fof'k"V i;kZoj.kh; vukoj.kksa ds lkFk
tksM+k tkrk gSA CD14 {ks= esa flaxy U;wfDy;ksVkbM
i‚yhe‚jfQt~e rFkk ,aMksV‚fDlu ¼,d cSDVhfj;k tfur
mRikn½ bldk ,d fof'k"V mnkgj.k gSA ,aMksV‚fDlu
vukoj.k dbZ i;kZoj.kh; lzksrksa ls gks ldrk gS ftlesa
/kweziku] dqÙks vkSj [ksr 'kkfey gSaA blfy;s vLFkek
dk tksf[ke O;fä dh vkuqokaf'kdrk vkSj ,aMksV‚fDlu
vukoj.k] nksuks ds ek/;e ls fu/kkZfjr fd;k tkrk gSA

fpfdRlh; ifjfLFkfr;ka

,V‚fid ,lst~ek] ,yftZd fjfufVl vkSj vLFkek ds f=dks.k

dks ,V‚ih dgrs gSaA vLFkek ds fodkl ds fy, lcls etcwr
dkjd ,V‚fid jksx dk bfrgkl gksrk gS ftlesa ,lst~ek ;k gs
cq[kkjihfM+r yksxksa dks vLFkek gksus dh vf/kd nj
gksrh gSA vLFkek Loçfrj{kh jksx dqxZ&LVª‚l flaMªkse
rFkk oSLD;qykbfVl ls lacaf/kr jgk gSA dqN fof'k"V çdkj
dh fiÙkh ls ihfM+r yksxksa esa vLFkek ds y{k.k fn[k
ldrs gSaA

eksVkis vkSj vLFkek gksus ds tksf[ke ds chp ,d

lglaca/k gksrk gS vktdy ;s nksuks dkQh c<+ x;s gSaA
blds fy;s dbZ dkj.k Hkwfedk fuHkk ldrs gSa ftuesa
pchZ ds ,d= gksus ds dkj.k 'olu fØ;k esa deha vkSj ;g
rF; fd ,fMiksl Ård lwtu c<+kus dh fLFkfr iSnk djrs gSa
'kkfey gSaA

chVk vojks/kd nok,a tSls fd çksçkuksyksy mu yksxksa

esa vLFkek dks 'kq# dj ldrk gS tks blds çfr
vfrlaosnu'khy gSaA gkykafdân; laca/kh chVk
vojks/kd] gYdh ;k e/;e chekjh ls ihfM+r yksxksa esa
lqjf{kr fn[krs gSaA vU; nok,a tks leL;k,a iSnk dj ldrh
gSa muesa vkSj ,aft;ksVsaflu& ifjorZd ,atkbe
vojks/kd'kkfey gSaA

rhozrk ¼çdksiu½
dqN yksxksa dks g¶rksa ;k eghuksa fLFkj vLFkek gks
ldrk gS vkSj fQj vpkud rhoz vLFkek dh fLFkfr iSnk gks
ldrh gSA fHkUu&fHkUu yksx fHkUu dkjdksa ij
vyx&vyx rjg ls çfrfØ;k djrs gSaA vf/kdrj yksxksa esa
dbZ lkjs mRçsjdksa ls xaHkhj rhozrk fodflr gks ldrh
gSA

os ?kjsyw dkjd tks vLFkek dh xaHkhj rhozrk dks c<+k

ldrs gSa /kwy] tkuoj :lh¼fo'ks"k :i ls fcYyh vkSj dqÙks
ds cky½] d‚djksp ,ythZ dkjd vkSj QQwanh'kkfey gSaA
lqxaf/k ¼ij¶;we½] efgykvksa o cPpksa esa xaHkhj
nkSjksa ds vke dkj.k gSaA Åijh 'oluekxZ ds ok;jl tfur
rFkk cSDVhfj;k tfur laØe.k jksx dh fLFkfr dks vkSj
xaHkhj dj nsrs gSaA ekufld ruko y{k.kksa dks vkSj
xaHkhj dj ldrs gSa – ,slk ekuk tkrk gS fd ruko çfrj{kk
ç.kkyh esa gsjQsj djrk gS vkSj bl çdkj ,ythZ vkSj
ijs'kku djus okys rRoksa dh ok;qekxZ dh Qqyko
çfrfØ;k dks c<+krk gSA

iSFkksfQft;ksy‚th ¼jksx ds dkj.k iSnk gq,

fØ;kRed ifjorZu½

vLFkek ok;qekxZ ds xaHkhj Qqyko ds dkj.k gksrk gS

ftlds ifj.kke Lo:i blds vklikl dh fpduh ekalisf'k;ksa esa
ladqpu c<+ tkrk gSA nwljs dkjdksa ds lkFk blds dkj.k
ok;qekxZ dks lhfer djus ds >Vds 'kq# gksrs gSa vkSj
blds lkFk lkal ysus esa rdyhQ ds y{k.kksa dh 'kq#vkr
gks tkrh gSA ladjs gksus dh çfØ;k mipkj }kjk ;k mlds
fcuk Hkh çfrorhZ gks ldrh gSAdHkh dHkkj ok;qekxZ
vius vki cny tkrs gSaA ok;qekxZ ds vke cnykoksa esa
LuksfQy esa c<+ksÙkjh rFkk ySfeuk dh vkarfjd lrg dk
eksVk gksuk 'kkfey gSA le; chrus ds lkFk ok;qekxZ dh
fpduh ekalisf'k;ka] 'ys"e xzafFk;ksa dh la[;k o`f) ds
lkFk viuk vkdkj c<+k ldrh gSaA vU; çdkj dh
dksf'kdkvksa esa fuEufyf[kr 'kkfey gSa% Vh
fyEQkslkbV~l] eSØksQst vkSjU;wVªksfQYlA çfrj{kk
ç.kkyh ds vU; ?kVd Hkh buesa 'kkfey gks ldrs gSa tSls
lkbVksfdUl] dseksfdUl] fgLVkekbu vkSjY;wdksfVªust
rFkk vU;A

funku

tcfd vLFkek ,d tkuh igpkuh ifjfLFkfr gS] ysfdu fQj Hkh

bldh dksbZ O;kid Loh—fr okyh dksbZ ifjHkk"kk ugha
gSA bls vLFkek ds fy;s oSf'od igy }kjk fuEu :i esa
fu/kkZfjr fd;k x;k gS ^^ok;qekxZ dk ,d th.kZ Qqyko
¼mÙkstd½ fodkj ftlesa dbZ dksf'kdkvksa rFkk
dksf'kdh; rRoksa dh Hkwfedk gksrh gSaA ;g th.kZ
Qqyko ¼mÙkstuk½ ok;q ekxZ dh vfr&çfrfØ;k ls
lacaf/kr gS ftlds dkj.k ckj&ckj ?kj?kjkgV] 'olu esa deh]
lhus esa tdM+u vkSj jkr esa ;k Hkksj esa [kkalh gksrh
gSA ;s fLFkfr;ka vke rkSj ij QsQM+ksa esa O;kid ysfdu
ifjorZu'khy ok;q çokg ck/kk ls lacaf/kr gS tks fd
rRdky ;k mipkj ds ckn vDlj lkekU; gks tkrh gSa^^A

bldk dksbZ lVhd ijh{k.k ugha gS rFkk funku vke rkSj ij

y{k.kksa ds Lo:i rFkk le; ds lkFk mipkj ds çfr çfrfØ;k ij
vk/kkfjr gSA vLFkek ds funku dh 'kadk rc dh tkuh
pkfg;s tc] fuEufyf[kr dk bfrgkl gks% ckj&ckj ?kj?kjkgV
gksuk] [kkalh ;k 'olu esa rdyhQ vkSj bu y{k.k O;k;ke
djus ls vkSj [kjkc gksrs gksa] ok;jl laØe.k] ,ythZ ;k
ok;q çnw"k.kA fLijksesVªh ¼QsQM+ksa dh 'olu {kerk
dk ekiu½ dks funku dh iqf"V ds fy;s mi;ksx fd;k tkrk
gSA N% lky ls de mez ds cPpksa esa funku dkQh dfBu
gks tkrk gS D;ksafd os fLijksesVªh ds fy;s dkQh NksVs
gksrs gSaA

fLijksesVªh ¼QsQM+ksa dh 'olu {kerk dk

ekiu½

funku rFkk çca/ku ds fy;s fLijksesVªh dh vuq'kalk dh

tkrh gSA vLFkek ds fy;s ;g vdsyk loZJs"B ijh{k.k gSA
;fn bl rduhd }kjk ekik x;k FEV1] lkyC;wVke‚y tSls
czksUdksMk;ysVj ds fn;s tkus ls 12% rd csgrj gks tkrk
gS rks ;g y{k.k dk leFkZd ekuk tkrk gSA gkykafd ;g
muesa lkekU; gks ldrk gS ftuesa gYds vLFkek dk
bfrgkl gks vkSj og orZeku esa çnf'kZr u gksrk gksA,dy
'olu Qqyko {kerk }kjk vLFkek o COPD esa varj djus
esa lgk;rk feyrh gSA çR;sd ,d ;k nks lky esa
fLijksesVªh djuk mi;qä gksrk gS ftlls fd ;g Kkr gks lds
fd fdlh O;fä dk vLFkek fdrus csgrj rjhds ls fu;af=r
gSaA

vU;

ehFksdksyhu pkSysat esa igys ls laosnu'khy yksxksa

esa 'olu ekxZ ladqpu ds fy;s ftEesnkj fdlh rRo dh
c<+rh ek=kvksa dk var%'olu 'kkfey gksrk gSA ;fn
_.kkRed gks rks bldk vFkZ gS fd O;fä dks vLFkek ugha
gS; gkykafd /kukRed gksuk bl jksx ds fy;s fof'k"V
ugha gksrk gSA

vU; lk{;ksa esa fuEufyf[kr 'kkfey gSa% de ls de nks

lIrkg rd çfr lIrkg rhu fnu esa ≥20% dk f'k[kj fu%'okl
çokg nj varj] l‚yC;wVke‚y }kjk mipkj ds lkFk f'k[kj fu
%'okl çokg nj esa ≥20% dk lq/kkj ;k fdlh mÙkstd ds
vukoj.k ds dkj.k f'k[kj çokg esa ≥20% dh dehA f'k[kj fu
%'okl çokg dk ijh{k.k fLijksesVªh ls vf/kd pj gS
gkykafd fu;fer funku ds fy;s vuq'kaflr gSA ;g mu
yksxksa ds nSfud Lo&fujh{k.k ds fy;s mi;ksxh gks
ldrk gS ftudks e/;e ;k xaHkhj jksx gks ldrk gS rFkk
ubZ nok dh tkap dh çHkko'khyrk ds fy;s Hkh ;g
mi;ksxh gks ldrk gSA;g xaHkhj rhozrkvksa okys
yksxksa esa mipkj ds ekxZn'kZu esa lgk;d gks ldrk
gSA

oxhZdj.k

y{k.kksa dh vko`fÙk;ksa] çfr lsdsaM cyiwoZd fu%'olu

ek=k ¼FEV1½] rFkk f'k[kj fu%'okl çokg nj }kjk vLFkek
dks fpfdRlh; :i ls oxhZ—r fd;k tkrk gSA vLFkek dks
,V‚fid ¼oká½ ;k xSj&vV‚fid ¼vkarfjd½ ds :i esa Hkh
oxhZ—r fd;k tk ldrk gS] tks bl vk/kkj ij fu/kkZfjr gksrk
gS fd y{k.k ,ythZ ¼vV‚fid½ }kjk mits gSa ;k ugha
¼xSj&vV‚fid½A tcfd vLFkek dks xaHkhjrk ds vk/kkj ij
oxhZ—r fd;k tkrk gS orZeku esa bl ckr dh dksbZ Li"V
fof/k ugha gS tks bl ç.kkyh ls vkxs vLFkek dks
fofHkUu mi lewgksa esa oxhZ—r dj ldsA mu mi
lewgksa dh igpku djus okys rjhdksa dh [kkst djuk] tks
fofHkUu çdkj ds mipkjksa ds lkFk lgh çfrfØ;k djsa]
vLFkek 'kks/k dk orZeku egRoiw.kZ y{; gSA

gkykafd vLFkek ,d th.kZ vojks/kd fLFkfr gS] fQj Hkh

bls th.kZ çfrjks/kh QsQM+s dh chekjh dk fgLlk ugha
ekuk tkrk gS D;ksafd ;g 'kCnkoyh fof'k"V :i ls jksx ds
la;kstuksa ls lUnfHkZr gS tks fd vifjorZuh; gksrs gSa
tSls fd 'oklufydkfoLQkj]th.kZ 'oluh'kksFk vkSj
okrLQhfrA bu jksxksa ds foijhr] vLFkek esa ok;qekxZ
vojks/k vke rkSj ij ifjorZuh; gksrk gS; gkykafd ;fn
mipkj u fd;k tk;s rks vLFkek ds dkj.k QsQM+ksa esa
gksus okyk th.kZ Qqyko vifjorZuh; :i ls çfrjks/kh gks
tkrk gS D;ksafd ok;qekxZ mlh ds vuq:i <+y tkrk
gSA ,aQhlsek ds foijhr] vLFkek 'oklufy;ksa dks
çHkkfor djrk gS u fd ok;qdksf"Bdk dksA
vLFkek dh rhozrk

th.kZ vLFkek Qqyko dks vke rkSj ij ,d ÞvLFkek nkSjkß

dgk tkrk gSA ges'kk ls çfrf"Br y{k.kksa esa 'olu esa
deh] ?kj?kjkgV vkSj lhus esa tdM+u 'kkfey gSA tcfd ;s
vLFkek ds çkFkfed y{k.k gSa] dqN yksxksa dks
'kq#vkr esa [kkalh gksrh gS vkSj xaHkhj ekeyks esa
ok;q xfr bruh vf/kd ckf/kr gks ldrh gS fd dksbZ Hkh ?
kj?kjkgV u lqukbZ nsA

,d vLFkek nkSjs ds le; fn[kus okys fpàksa esa 'olu dh

lgk;d ekalisf'k;ksa dk mi;ksx ¼xys dh
LVuksZdykbMksekLVj‚,M vkSj Ldsyhu ekalisf'k;ka½
'kkfey gSa] iSjkM‚fDldy ukM+h&Lian ¼,d ,slk
ukM+h&Lian tks var%'olu ds le; detksj rFkk fu%'olu
ds le; etcwr gksrk gS½] rFkk lhus dk vfrfjä Qqyko Hkh
gks ldrk gSA v‚Dlhtu dh deh ds dkj.k Ropk rFkk
uk[kwuksa esa uhyk jax fn[k ldrk gSA

,d gYds mHkkj esa f'k[kj fu%'okl çokg nj ¼ PEFR½ ≥200

L/min ;k loZJs"B Hkfo";ok.kh dk ≥50% gksrk gSA e/;e
mHkkj dks 80 vkSj 200 L/min ds chp ;k loZJs"B
Hkfo";ok.kh dk 25% vkSj 50% tcfd xaHkhj dks ≤ 80
L/min ;k loZJs"B Hkfo";ok.kh dk ≤25% ds :i esa fu/kkZfjr

fd;k tkrk gSA

th.kZ xaHkhj vLFkek] ftls igys vLFkesfVdl fLFkfr dgk
tkrk Fkk] vLFkek dh ,d ,slh xaHkhj n'kk gksrh gS tks
czksUdksMk;ysVlZ rFkk d‚fVZdksLVj‚,M ds ekud
mipkjksa ds çfr çfrfØ;k ugha djrs gSaA ekeyksa esa ls
vk/ks laØe.kksa ds dkj.k gksrs gSa tks ,ythZ] ok;q
çnw"k.k ;k vi;kZIr ;k vuqi;qä nokvksa ds mi;ksx ls
iSnk gksrs gSaA

Hkaxqj vLFkek] vLFkek dk ,d ,slk çdkj gS ftlesa

ckj&ckj o xaHkhj nkSjs gksrs gSaA Hkaxqj vLFkek dk
Vkbi 1 ,d ,slk jksx gS ftlesa xaHkhj nok mipkj ds
ckotwn foLr`r f'k[kj çokg ifjorZuh;rk gksrh gSA Hkaxqj
vLFkek dk Vkbi 2 ,d lqfu;af=r i`"BHkwfe vLFkek gksrk
gS ftlesa vpkud xaHkhj mHkkj gksrk gSA

O;k;ke çsfjr

O;k;ke ds dkj.k] vLFkek ls ihfM+r rFkk xSj&ihfM+r]

nksuks yksxksa esa czksUdksdUlfVªD'ku iSnk gks ldrk
gSA ;g vLFkek ls ihfM+r vf/kdka'k yksxksa esa rFkk
xSj&ihfM+r yksxksa esa 20% yksxksa dks gksrk gSA
,FkyhVksa esa ;g dqyhu ,FkyhVksa esa ;g dkQh vke
rkSj ij gksrk gS] ftldh nj c‚cLys; jsl okyksa esa 3% ls
ysdj lkbfdy /kkodksa esa 50% rFkk Ø‚l daVªh Ldhbax
djus okys ,FkyhVksa esa 60% rd gksrk gSA tcfd fdUgh
Hkh tyok;q ifjfLFkfr;ksa gks ldrk gS fQj Hkh ;g 'kq"d o
BaMh tyok;q ifjfLFkfr;ksa esa vf/kd vke gSA var%'olu
chVk2&,xksfuLV] vLFkek ls xSj&ihfM+r ,FkyhVksa ds
çn'kZu ij dksbZ lq/kkj ugha fn[krk gS gkykafd ekSf[kd
[kqjkd lgu'kfä vkSj rkdr c<+k ldrh gSA

is'ksoj

dk;ZLFky vukoj.k ds ifj.kkeLo:i gksus okyk ¼;k

fcxM+k gqvk½ vLFkek ,d vke rkSj ij crk;k x;k is'ksoj
jksx gSA gkykafd cgqr ls ekeys bl çdkj ls u rks fjiksVZ
fd;s x;s gSa vkSj u gh ntZ fd;s x;s gSaA ;g vuqekfur
gS fd vLFkek ds 5-25% ekeysa dk;Z ls lacaf/kr gSaA
dqN lkS fofHkUu ,tsUVksa dks blds lcls vke dkj.kksa
ds :i esa lafyIr ik;k x;k gS ftuesa fuEufyf[kr 'kkfey gSa
% vkblkslkbusV] vukt ;k ydM+h dk cqjknk]
dksyksQksuh] lksYMfjax ¶yDl] ysVsDl] tkuoj
vkSj,YMhgkbM~lA leL;kvksa ds mPpre tksf[keksa ls
tqM+s jkstxkj esa fuEufyf[kr 'kkfey gSa% os tks isaV
Lçs djrs gSa] csdjh okys vkSj tks [kk| çlaLdj.k ls
tqM+s gSa] ulsaZ] jklk;uksa ds lkFk dke djus okys]
tks tkuojksa ds lkFk dke djrs gSa] osfYMax djus okys]
cky yaokjus okys rFkk ydM+h dk dke djus okysA

foHksnd funku
cgqr lh vU; ifjfLFkfr;ka gSa] tks vLFkek tSls y{k.kksa
dks iSnk dj ldrh gSaA cPpksa esa] vU; Åijh ok;qekxZ
jksxksa tSls fd] ,yftZd fjuhfVlrFkk lkbu‚flfVl dks rFkk
ok;qekxZ çfrjks/k ds vU; dkj.kksa esa fuEu 'kkfey gSa
% ckgjh rRoksa dk var%'olu] VªSfd;y LVsuksfll ;k
ySfjaxksaVªSfd;kseykfl;k] oSLdqyj fjax] c<+s gq;s
fyaQuksM~l ;k xnZu dk ekalA o;Ldksa esa] COPD]
ladqyu tfur ân; foQyrk] 'oluiFk teko lkFk gh ACE
vojks/kdksa ds dkj.k nok&çsfjr [kkalh ij /;ku fn;k tkuk
pkfg;sA nksuks çdkj dh tula[;kvksa esa Loj jTtq esa
f'kfFkyrk leku :i ls mifLFkr gks ldrh gSA

th.kZ çfrjks/kh QsQM+s dk jksx vLFkek ds lkFk

ekStwn jgrk gS rFkk th.kZ vLFkek dh tfVyrkvksa ds :i
esa gks ldrk gSaA 65 dh mez ds ckn çfrjks/kh
ok;qekxZ jksx ls ihfM+r vf/kdrj yksxksa dks vLFkek
vkSj COPD gksxkA bl lsfVax esa] COPD dks c<+s gq,
ok;qekxZ] vlekU; :i ls c<+h gqbZ nhokj dh eksVkbZ
rFkk 'oklufy;ksa esa c<+h fpduh ekalisf'k;ksa }kjk
foHksfnr fd;k tk ldrk gSA gkykafd COPD vkSj vLFkek
ds çca/ku fl)kar ,d tSls gksus ds dkj.k bl Lrj dh tkap
ugha dh tkrh gS% d‚fVZd‚LVj‚,M] yacs le; rd dke djus
okys chVk ,fxuLV vkSj /kweziku lekfIrA ;s y{k.kksa
esa vLFkek ds dkQh leku gksrk gS vkSj ;g flxjsV ds
/kqa, ds vfrfjä vukoj.k ls] vf/kd mez] czksUdksMk;ysVj
nsus dk ckn Hkh y{k.kksa esa de ifjorZu rFkk vV‚ih ds
ikfjokfjd bfrgkl dh ?kVh laHkkoukvksa ls lacaf/kr gSA

jksdFkke

vLFkek ds fodkl dh jksdFkke ds mik;ksa dh

çHkko'khyrk ds lk{; detksj gSaA dqN ldkjkRed fn[krs
gSa tSls% xHkZ ds nkSjku vkSj çlo ds ckn nksuks gh
fLFkfr;ksa esa /kqa, ls vukoj.k lhfer djuk] Lruiku vkSj
fnu dh ns[kHkky esa c<+r rFkk cM+k ifjokj] ysfdu
buesa ls dksbZ Hkh lk{;ksa ls bruk vf/kd lefFkZr ugha
gS fd bl ç;kstu ds fy;s mldh vuq'kalk dh tk;sA ikyrw
tkuojksa ds lkFk igys ls vukoj.k mi;ksxh gks ldrk gSA
vU; le;ksa ij ikyrw tkuojks ls vukoj.k ds ifj.kke v/kwjs
gSa vkSj dsoy ;g vuq'kaflr gS fd ;fn fdlh O;fä dks fdlh
ikyrw tkuoj ls ,ythZ gS rks ml tkuoj dks ?kj ls gVk
nsuk pkfg;sA xHkkZoLFkk ;k Lruiku ds nkSjku [kkuiku
esa çfrca/kksa dks çHkkoh ugha ik;k x;k gS blfy;s
budh vuq'kalk ugha dh tkrh gSA laosnu'khy yksxksa
ds ds fy;s Kkr ;kSfxdksa dks dk;ZLFkyksa ls de djuk ;k
gVkuk çHkkoh gks ldrk gSA

çca/ku
gkykafd vLFkek dk dksbZ mipkj ugha gS ysfdu
vkerkSj ij y{k.kksa dks csgrj fd;k tk ldrk gSA y{k.kksa
dh vxzlfØ; :i ls fuxjkuh rFkk çca/ku ds fy;s ,d fof'k"V
rFkk vuqdwfyr ;kstuk cuk;h tkuh pkfg;sA bl ;kstuk esa
,ythZ ds vukoj.k dks djuk] y{k.kksa dh xaHkhjrk dk
vkadyu djus ds fy;s ijh{k.k rFkk nokvksa dk mi;ksx
'kkfey gksuk pkfg;sA mipkj ;kstuk dks fy[kk tkuk tkuk
pkfg;s vkSj y{k.kksa esa ifjorZu ds vk/kkj ij mipkj esa
lek;kstu dh lykg nh tkuh pkfg;sA

vLFkek ds lcls çHkkoh mipkj ds fy;s mRçsjdksa dh

igpku dh tkuh pkfg;s tSls fd flxjsV dk /kqavk] ikyrw
tkuoj ;k ,fLijhu vkSj muls vukoj.k dks lekIr fd;k tkuk
pkfg;sA ;fn mRçsjdksa ls cpko vi;kZIr gks rks nok dk
mi;ksx vuq'kaflr gSA fpfdRlh; nokvksa dk pquko] vU;
phtksa ds lkFk jksx dh xaHkhjrk rFkk y{k.kksa dh
vko`fÙk ij vk/kkfjr gSA vLFkek ds fy;s fof'k"V nokvksa
dks eksVs rkSj ij rhoz fØ;k rFkk nh?kZ vof/k esa fØ;k
djus okyh Jsf.k;ksa esa oxhZ—r fd;k tkrk gSA

czksUdksMk;ysVlZ dks y{k.kksa esa FkksM+h gh

vof/k esa vkjke nsus ds fy;s vuq'kaflr fd;k tkrk gSA
nkSjksa ds dHkh&dHkkj gksus dh n'kk esa fdlh vU;
nok dh vko';drk ugha iM+rh gSA ;fn jksx dh gYdh
fu;fer mifLFkfr ¼lIrkg esa nks ls vf/kd nkSjs½ gks rks
'olu }kjk yh tkus okyh d‚fVZd‚LVj‚,M dh gYdh [kqjkd ;k
oSdfYid :i ls ,d ekSf[kd Y;wdksVªkbZu ,UVkxksfuLV ;k
dksbZ ekLV lsy LVscykbtj vuq'kaflr gSA ftudks nSfud
nkSjs iM+rs gSa muds fy;s 'olu }kjk yh tkus okyh
d‚fVZd‚LVj‚,M dh csgrj [kqjkd dk mi;ksx fd;k tkrk gSA
e/;e ;k xaHkhj rsth dh fLFkfr esa] bu mipkjksa ds lkFk
ekSf[kd d‚fVZd‚LVj‚,M tksM+h tkrh gSA

thou 'kSyh esa la'kks/ku

fu;a=.k csgrj djus rFkk nkSjksa dh jksdFkke ds fy;s

mRçsjdksa ls cpko eq[; ?kVd gSA lcls vke mRçsjdksa
esa ,ythZ] /kqavk ¼rackdw rFkk vU;½] ok;q
çnw"k.k]xSj p;ukRed chVk Cy‚dlZ rFkk lYQkbV okys
[kk| 'kkfey gSaA /kweziku djuk vkSj f}rh;d /kweziku
¼vçR;{k /kqavk½ d‚fVZd‚LVj‚,M tSlh nokvksa dh
çHkko'khyrk de dj ldrk gSA /kwy dh ?kqu okys fu;a=.k
mik; ftuesa ok;q fuL;Unu] ?kquksa dks ekjus okys
jlk;u] pw"k.k] xís ds doj rFkk vU; fof/k;ksa ds vLFkek
y{k.kksa ij dksbZ çHkko ugha FksA

nok,a
vLFkek dk mipkj djus okyh nokvksa dks nks oxksaZ
esa ckaVk x;k gS% xaHkhj y{k.kksa dk mipkj djus
okyh rhoz fØ;k nok,a rFkk vfrfjä mHkkj dks jksdus
okyh nh?kZ vof/k esa fØ;k djus okyh nok,aA