8.What are the clinical manifestations of asthma? In typical bronchial asthma, there are aura symptoms such as sneezing, runny nose, cough, chest tightness, etc. before the attack. In some patients, it can reappear after a few hours of remission and even lead to a persistent state of asthma. In addition, there are also clinically atypical asthma manifestations, such as cough variant asthma, in which the patient has had cough without obvious triggers for more than 2 months, with frequent attacks at night and in the early morning, exacerbated by exercise, cold air, etc. The airway reactivity is determined to be hyperreactive, and antibiotics or cough suppressants and expectorants are ineffective, while bronchial antispasmodics or corticosteroids are effective, but other diseases causing the cough need to be excluded. 9.How is asthma diagnosed? Asthma can be diagnosed only if 1 to 4 or 4 or 5 of the following are met ① Recurrent attacks of wheezing, shortness of breath, chest tightness or cough are mostly related to exposure to allergens, cold air, physical and chemical stimuli, as well as viral upper respiratory tract infections and exercise. ②Dispersive or diffuse, expiratory phase dominated croup with prolonged expiratory phase can be heard in both lungs during the attack. ③The above symptoms and signs may be relieved by treatment or may resolve on their own. ④Except wheezing, shortness of breath, chest tightness and cough caused by other diseases. ⑤ For atypical clinical manifestations (such as no obvious wheezing or signs), at least 1 of the following pulmonary function tests should be positive: a. positive bronchial excitation test or exercise excitation test; b. positive bronchial diastolic test with ≥ 12% increase in FEV1 and absolute FEV1 increase ≥ 200 ml; c. peak expiratory flow (PEF) intra-day (or 2-week) variability ≥ 20%. 10. How is asthma diagnosed when it is only a cough? One type of asthma that presents only with cough is cough variant asthma, a specific type of asthma with chronic cough as the main or only clinical manifestation. In the early stages of asthma, about 5-6% have a persistent cough, mostly at night or in the early hours of the morning, often irritating, which is often misdiagnosed as bronchitis. cough variant asthma is clearly recognized as a form of asthma in GINA and has the same pathophysiological changes as asthma, namely a persistent airway inflammatory response and airway hyperresponsiveness. Its prevalence in children is approximately 0.77% to 5.0%. Approximately 13% of patients are older than 50 years of age, and it is more common in middle-aged women. Seizures are somewhat seasonal, with spring and fall being the most common. 11.Can a film or CT detect whether I have asthma or not? Generally, asthma patients have no special abnormalities on the chest image. If there are complications of respiratory tract infection, increased lung texture and inflammatory infiltrative shadows can be seen, and if there are complications such as pulmonary atelectasis, pneumothorax or mediastinal emphysema, emphysema, etc., there will be corresponding imaging performance. 12.Why do asthma patients need to check allergens? What are the common allergens? The essence of asthma is chronic allergic inflammation of the airways, and long-term exposure to a large number of allergens is the main reason for recurrent asthma attacks and the aggravation of the disease year by year. Therefore, identifying allergens and avoiding exposure to them is the key to the prevention and treatment of allergic asthma. An allergic reaction is a super-normal reaction of the body to one or more substances, some of which are harmless to most people. The main reason for this is that the patient’s body produces too much immunoglobulin E (IgE), which can react with allergenic substances (allergens) in the environment and stimulate the body to release certain excessive chemicals and subsequently produce various symptoms. There are two general methods of detection, one is by blood test, which is to determine the level of antibody IgE in the patient’s body to determine the patient’s allergens. The other is by skin prick test. Many things in our life can become allergens, including breathing in, eating in, direct skin contact, and injecting in, such as: house dust, dust mites, pollen, plant hair, animal hair, formaldehyde, pesticides, perfume, disinfectant, artemisia, fish, shrimp, crab, some vegetables, fruits, drugs, and even milk, beans, flour, eggs, etc. All can become allergens. Although there are many allergens in nature, as long as we know what we are allergic to and pay attention to avoid it, it is not terrible.