BIOCHEMICAL AND PHYSIOLOGICAL MECHANISMS OF CHEST PERCUSSION IN ENHANCING SPUTUM CLEARANCE IN PULMONORY TUBERCULOSIS PATIENTS
DOI:
https://doi.org/10.55197/qjmhs.v4i4.166Keywords:
pulmonary tuberculosis, chest percussion, sputum clearance, biochemical mechanism, ciliary activity, nitric oxideAbstract
Pulmonary tuberculosis (TB) is characterized by chronic inflammation and excessive mucus production. Chest percussion is widely used to facilitate sputum clearance, but the underlying biochemical and physiological mechanisms remain underexplored. The objective is to examine the biochemical and physiological impact of chest percussion therapy on sputum clearance in TB patients. An experimental study was conducted from June 2024 to May 2025 across four hospitals in Palopo, Pinrang, Rappang, and Enrekang. A total of 200 pulmonary TB patients were randomly assigned to intervention and control groups. The intervention group received standardized chest percussion therapy twice daily, while the control group received standard care only. Outcome measures included sputum volume, ciliary activity (measured via nasal brushing and electron microscopy), and levels of nitric oxide (NO) and surfactant proteins in sputum. Data were analyzed using paired t-tests and ANOVA with a significance level set at p<0.05. Ethical clearance was obtained from Poltekkes Kemenkes Makassar (No. EC/87023/05/2024). Chest percussion significantly increased daily sputum volume (p<0.001), elevated sputum NO levels (p=0.002), and improved ciliary beat frequency (p<0.001) compared to controls. Surfactant protein SP-A and SP-D concentrations were significantly higher in the intervention group. These biochemical markers correlated with improved mucus rheology and easier expectoration. Chest percussion enhances sputum clearance in TB patients through stimulation of autonomic pathways, increased NO production, ciliary activation, and surfactant modulation. Integrating this technique into TB nursing protocols may accelerate recovery and improve respiratory outcomes.
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