Allergic cough (cough variant asthma) in children is prone to recurrent attacks and is easily misdiagnosed as bronchitis. 5% of asthma is refractory asthma, and the essence of asthma is chronic inflammation of the airways, and inappropriate use of bronchodilators can significantly increase the death rate of asthma.
The goals of asthma management proposed by the World Health Organization are
a. Minimal (ideally no) chronic symptoms, including nocturnal symptoms.
b. Minimal (rare) asthma attacks.
c. No emergency medical conditions.
d. Minimal use of beta2 agonists as needed.
e. No restriction in activity (including exercise).
f. Minimal (or no) medication side effects.
Prevention steps for long-term control.
1. Avoid exposure to risk factors
a. House dust mite allergens, wash sheets and blankets weekly in hot water and dry them in a dryer or in the sun. Wrap pillows and mattress pads with an airtight cover. Remove carpets and replace them with faux linoleum carpets or wood floors. Use plastic, leather or simple wood furniture instead of fiber-filled furniture. If possible, use a vacuum cleaner with a filter.
b. Tobacco smoke, stay away from tobacco smoke.
c. Allergens from fur-bearing animals, remove animals from the home.
d. Cockroach allergens, clean the house thoroughly and often and use spray insecticide, but make sure the affected person is not indoors during the spraying process.
e, outdoor pollen and mold, in the peak of pollen and mold number, should close the windows and doors to stay indoors. Indoor molds reduce indoor humidity and clean all wet areas frequently.
f. Physical activity: It is best to avoid strenuous physical activity. Using a fast-acting beta2 agonist or sodium cromoglycate before exercise can prevent or eliminate asthma symptoms. Light physical exercise such as walking is good for the body; continuous inhaled corticosteroid treatment can significantly reduce the occurrence of asthma after exercise.
g. Medications: If taking aspirin or beta-blockers or NSAIDs causes asthma symptoms to occur, do not use such medications again.
h. Do not eat allergy-prone foods (such as eggs, beef, milk, wheat, pineapple, grapes, grapefruit, mango, etc.), but there are individual differences; if cough, itchy throat, abdominal pain, diarrhea, rash, itchy skin occurs about 40 minutes after consuming these foods, you should not eat them again; do not drink frozen drinks, stimulating foods (such as chili peppers, strong tea, coffee, etc.).
2. Daily use of drugs:
Inhaled glucocorticoids are currently the strongest anti-airway inflammatory drugs . The drug is inhaled directly into the airway, which can play the most powerful anti-inflammatory effect, and the regular dose of inhaled hormone is only 1/50 of the oral dose, and the amount of inhaled drug is only 1/300 to 1/400 of the oral or intravenous dose into the body. Because asthma is a chronic airway inflammation, although the asthma symptoms disappear, but not the airway inflammation is completely eliminated, sometimes this airway inflammation can last for a long time, it is necessary to gradually reduce the drug to the maintenance amount when the asthma control is better, and continue for 3 to 5 years or more to achieve stable results.
Professor Soroped-erson from Denmark followed asthmatic children with corticosteroids for 5 to 20 years until they reached adulthood and found that the growth and development of these individuals in childhood were not affected in any way and their height in adulthood reached normal human standards. Pediatricians at the First Hospital of Hubei Medical University have also studied the long-term inhalation of surface corticosteroids without adverse effects on children; the most widely used and effective ones are Sulidex, Cymbalta, Co-corticosterone, and Budesonide.