Bronchial asthma (hereafter referred to as “asthma”) is a common respiratory disease, the incidence and prevalence of which is increasing. Asthma is an ancient disease that has been known for more than 2,000 years in both Western and Chinese medicine. However, it was not until the late 1970s of this century that airway inflammation was recognized as the main pathogenesis of asthma and emphasis on anti-inflammatory therapy began. Since the release of the Global Initiative for Asthma Control (GINA) in 1995, there has been considerable progress in the diagnosis and treatment of asthma. However, the treatment of chronic persistent asthma is not yet widespread in China. In fact, the treatment of chronic persistent asthma is available at all levels of hospitals. In 2003, the Asthma Group of the Society of Respiratory Diseases of the Chinese Medical Association divided asthma into acute exacerbation, chronic persistence and remission according to China’s “Guidelines for the Prevention and Treatment of Bronchial Asthma” developed by GINA. The chronic persistent phase is defined as the onset of symptoms (wheezing, shortness of breath, chest tightness, cough, etc.) at varying frequencies and/or degrees each week for a considerable period of time.In 2006, the GINA Executive Committee revised the Global Strategy for Asthma Management and Prevention based on the original guidelines, clearly stating that the goal of asthma treatment is to achieve and maintain clinical control of asthma and that most patients can achieve this goal with pharmacologic therapy. Clinical control of asthma is defined as (1) no (or ≤2/week) daytime symptoms; (2) no limitation of daily activities and exercise; (3) no nocturnal symptoms or nocturnal awakening due to asthma attacks; (4) no need (or ≤2/week) to receive relieving medication; (5) normal or near-normal lung function; and (6) no acute exacerbation of asthma. At present, the number of patients who meet the criteria for complete asthma control is quite small in China, and most of them have their normal life seriously affected by asthma. In most areas, especially in primary medical institutions, the level of diagnosis and treatment of asthma is still stuck in the treatment of acute exacerbations, while the diagnosis and treatment of chronic persistent asthma are not sufficiently understood and cannot be applied in clinical work. To master the diagnosis and treatment of chronic persistent asthma, we should first fully understand that asthma is a chronic inflammatory disease of the airways with airway hyperresponsiveness and airway remodeling on this basis. For this chronic inflammation, inhaled glucocorticoid therapy is currently preferred, while β2 agonists, slow-release theophylline, and leukotriene modulators are used according to the condition. The late Australian asthma expert Wooclcock proposed at the European Respiratory Conference in 2000 the time required to achieve asthma control that daytime and nocturnal symptoms would be relieved after a few days of treatment, FEV1 (first second expiratory volume) would improve after a few weeks, PEF (expiratory airflow velocity) would improve after a few months and short-acting β2 agonists would not be required, whereas it would take several years to eliminate airway hyperreactivity and improve It takes several years to eliminate airway hyperresponsiveness and improve airway remodeling. It is clear that asthma treatment is a slow and long process, and only by paying attention to the diagnosis and treatment of chronic persistent asthma can symptoms be controlled to avoid acute exacerbations. Once the classification of the asthma patient’s condition is determined, a graded stepwise treatment plan can be chosen. (1) Intermittent attacks of asthma: daily prophylactic medication is not necessary except for the administration of rapid-acting beta2 agonists by inhalation as needed (no more than once a week). (2) Mild persistent asthma: In addition to rapid-acting β2 agonist inhalation as needed (no more than 3-4 times per day), low-dose glucocorticoids ≤500 μg BDP (beclomethasone propionate) or equivalent doses of other inhaled hormones are required for long-term daily inhalation. (3) Moderate persistent asthma: In addition to inhaling rapid-acting β2 agonists as needed (no more than 3~4 times a day), long-term inhaled low~moderate doses of glucocorticoids 200μg~1000μg BDP or equivalent doses of other hormones, combined with inhaled long-acting β2 agonists. (4) Severe persistent asthma: In addition to inhaling fast-acting β2 agonists as needed, long-term daily inhalation of medium~high dose glucocorticoids, >1000μg BDP or equivalent dose of other inhaled hormones, combined with inhaled long-acting β2 agonists is required, and one or more of the following drugs can be added when needed, such as leukotriene modulators, slow-release theophylline, oral long-acting β2 agonists, and oral hormones. Review the treatment regimen every 3-6 months and if asthma is controlled and maintained for at least 3 months, treatment can be downgraded to eventually achieve maintenance of symptom control with minimal medication. If asthma is not controlled, escalation of therapy is considered, but the patient’s medication technique, adherence to the medication regimen, and avoidance of allergens and triggers should be reviewed first. The main drugs used to treat chronic persistent asthma are: 1. inhaled glucocorticoids and inhalation therapy There are three commonly used ICS in China, BDP, budesonide (BUD) and fluticasone propionate (FP). the anti-inflammatory activity of BDP and BUD is roughly similar, and the anti-inflammatory activity of FP is stronger, more than two times that of BDP and BUD. Clinical applications have demonstrated that the efficacy of BDP and BUD can be achieved and exceeded with 1/2 dose of FP. Inhalation devices are mainly the following three types (1) pressure-type quantitative hand-controlled aerosol (pMDI): it is the most widely used inhalation device in clinical application; (2) dry powder inhaler: by the quasi-napper, DuPao, automatic inhaler, etc., the inhalation effect is better than pMDI, but the price is higher, (3) jet nebulizer: for acute asthma attack is recommended to use jet nebulizer to inhale the solution of asthma calming drugs, jet nebulizer is the use of compressed air or oxygen for power, the use of this solution inhalation form of asthma medication include β2 agonists (allantoin nebulizer solution), anticholinergics (ipratropium nebulizer solution) and glucocorticoids (pramipexole, lindenosol nebulizer solution). 2.β2 agonists According to the onset of action and maintenance time of β2 agonists, they are divided into 4 categories: (1) fast-acting-short-acting category: represented by salbutamol and terbutaline, which are clinically used for acute asthma attacks; (2) slow-acting-long-acting category: represented by salmeterol, which is used as an asthma control agent, especially for preventing nocturnal attacks; (3) fast-acting-long-acting category: represented by formoterol It can be used for acute asthma attacks and also for prevention of nocturnal asthma attacks; (4) slow-acting-short-acting class: represented by oral salbutamol and salbutamol. In recent years, the combination of inhaled hormone and long-acting β2 agonist is recommended for the treatment of asthma, both of which have synergistic anti-inflammatory and asthma calming effects, which can obtain the same efficacy as when double the dose of inhaled hormone is applied, thus reducing the adverse effects caused by larger doses of hormone, and is especially suitable for the long-term treatment of patients with moderate to severe persistent asthma. At present, there are two kinds of preparations, namely, Sulidexin quasi-nasal (fluticasone propionate and salmeterol dry powder) and Symbicort (budesonide and formoterol dry powder). Leukotriene receptor antagonists are a new class of non-steroidal anti-inflammatory drugs developed in recent years, which can reduce asthma symptoms and improve lung function, but their effects are not as good as those of ICS, and they cannot replace hormones. Leukotriene receptor antagonist as a drug in the combination therapy can reduce the dose of inhaled hormone in patients with moderate to severe asthma, especially suitable for asthma patients with both allergic rhinitis and aspirin asthma, sports asthma, childhood asthma, commonly used are montelukast (cisplatin) l0mg once a day, the advantage of this product is less side effects. 4, long-acting theophylline Theophylline had been the main asthma medication in China, and some studies have shown that low concentration theophylline also has anti-inflammatory and immunomodulatory effects. In recent years, the application of theophylline controlled release tablets or extended release tablets, i.e., long-acting theophylline, both of which can be slowly disintegrated and absorbed to maintain a more stable blood concentration, the asthma effect can be maintained for 12 to 24 h. Long-acting theophylline combined with ICS is one of the better long-term asthma treatment programs, used for mild to moderate asthma maintenance treatment and nighttime asthma control, the general dose of 6 to 10 mg/kg per day. The theophylline extended-release tablets and the theophylline wheezing tablets are available in 12-hour duration of action, while the theophylline extended-release tablets and the theophylline wheezing tablets are available in 24-hour duration of action. Theophylline has synergistic effects when combined with hormones and anticholinergic drugs. When combined with β2 agonists, it is easy to have increased heart rate and arrhythmia, so it should be used with caution and the dose should be reduced appropriately.