At the turn of autumn and winter, asthma starts to plague some old patients again. Despite the standard treatment and taking medication strictly as prescribed, the disease still worsens from time to time, seriously affecting life, work and study. Asthma is a common disease, why is it so difficult to treat? With the development of modern medical science and technology, are there any new treatment methods that can improve the efficacy? Why is asthma “difficult to treat” According to the introduction, with the change of environment, asthma has become a global public health problem, the prevalence of which has increased significantly in the past 20 years. According to the World Health Organization, about 300 million people worldwide suffer from asthma, and the prevalence of asthma in China is about 1.2%, with a higher incidence in urban areas than in rural areas, and a higher prevalence in children than in adults. The rate of misdiagnosis and underdiagnosis of asthma in China remains high. Meanwhile, the proportion of well-controlled asthma is very low, less than 30%. Although a significant proportion of patients can effectively control their asthma with a combination of inhaled glucocorticoids and long-acting 2-agonists, studies have found that 5-10% of asthma cannot be controlled with standardized medication and control of triggers, and these patients are generally classified as “severe asthma” or “refractory asthma”. This group of patients is generally classified as “severe asthma” or “refractory asthma”. Although the proportion of refractory asthma is not too high, it accounts for a significant proportion of the associated emergency room visits, hospitalizations and medical costs. Some patients have frequent and severe symptoms and are at risk of acute respiratory failure and sudden death, and many require mechanical ventilation to save their lives. Why is asthma “hard to treat”? The reasons for this are complex, but common ones include: (1) continuous exposure to allergens such as house dust mites, pets, and the smell of paint; (2) possible comorbidities. Many asthma patients have comorbidities such as obesity, rhinitis, sinusitis, gastroesophageal reflux, sleep apnea syndrome, etc. These comorbidities can aggravate asthma symptoms and lead to refractory asthma; (3) the presence of drug resistance. Because asthma has many phenotypes, some asthma patients are resistant to glucocorticoids, so the use of hormones is not effective. What are the breakthroughs in new technology? For severe refractory asthma, Ruijin Hospital has achieved good results in recent years with the innovative procedure of “bronchial thermoplasty”. The bronchial thermoplasty system consists of a radiofrequency controller and a catheter. The head end of the bronchial thermoplasty catheter is a radiofrequency probe, consisting of a 4-arm electrode grid and a temperature sensor, and the 4-arm electrode grid is extendable. The radiofrequency probe is introduced through the bronchoscope, and the radiofrequency energy (or heat) is used to thin the airway smooth muscle that has grown on the airway wall, thereby reducing the amplitude of airway contraction during an asthma attack, and reducing the frequency and severity of the attack. This treatment is indicated for the treatment of severe persistent asthma over the age of 18. Specifically, during bronchial thermoplasty, the physician introduces a bronchoscope through the patient’s nose or mouth and delivers a small diameter catheter into the airway through the working channel of the bronchoscope, with the front end of the catheter expanding to make contact with the target airway wall. The four arms of the expanded catheter array make contact with and hold the airway wall against the airway wall, using specific safety procedures to deliver controlled heat energy from the controller for heating. The treatment is performed in three separate surgical sessions, depending on the area of the lung, with each procedure occurring approximately three weeks apart and each procedure taking approximately half an hour to one hour. This technique is very safe with minimal risk. Exacerbation of respiratory-related symptoms may occur within a week of treatment, but symptoms resolve within seven days; and with effective preoperative medication, asthma attacks generally do not occur. The results of bronchial thermoplasty are known to be quite good. Data show that within 2 years of treatment with thermoplasty, there was a 32% reduction in severe exacerbations requiring systemic steroid therapy; an 84% reduction in emergency room visits due to respiratory symptoms; a 73% reduction in hospitalizations due to respiratory symptoms; a 66% reduction in the number of days unable to work, go to school, or perform other daily activities due to asthma symptoms; and a 36 percent. Overall, patients with severe persistent asthma experienced a significant improvement in symptoms and a significant reduction in the use of healthcare resources. It is also reminded that bronchial thermoplasty is an effective treatment for severe asthma, but catheters are relatively expensive, so they are not recommended for all asthma patients. The main population for this new technique is asthma patients whose condition cannot be effectively controlled despite standard treatment.