Asthma is a common chronic respiratory disease. According to incomplete statistics, there are 300 million asthma patients worldwide and about 30 million asthma patients in China. Asthma seriously affects the health and quality of life of patients. Many patients have asthma affecting their work and sleep, seeking emergency medical treatment, missing work and school, and being hospitalized due to asthma attacks. Because of this, the World Health Organization pays great attention to asthma and has designated the first Tuesday in May as World Asthma Day. The theme of Asthma Day is “Asthma can be controlled”, which aims to let all asthma sufferers around the world know that “asthma can be controlled”, so that all asthma sufferers can be well controlled.
Asthma is a chronic disease with chronic inflammation that persists throughout the course of the disease and, like diabetes, hypertension and other chronic diseases, asthma requires long-term treatment. At present still many asthma patients only take medication during acute attacks and stop taking medication once the symptoms are controlled, resulting in recurrent asthma attacks, which seriously affects patients’ quality of life, impairs lung function and increases the medical burden. This is the misunderstanding of asthma treatment. The onset of asthma is like a huge iceberg, and the symptoms of asthma are only the tip of the iceberg exposed to the sea, so the treatment of asthma should not only target the tip of the exposed sea, but also treat the whole iceberg.
Because of this characteristic of asthma, the Global Initiative for Asthma Control (GINA) in 2009 proposed that the goal of asthma treatment is to achieve and maintain control of asthma, namely
1. absence (or ≤2 episodes/week) of daytime symptoms
2. no limitation of daily activities (including exercise)
3. no nocturnal symptoms or awakening due to asthma.
4. no (or ≤2 episodes/week) requiring palliative medication.
5.Normal or near-normal lung function.
6.No acute exacerbation of asthma.
A large amount of clinical data proves that about 80% of asthma patients can be well controlled with standardized treatment and management of asthma.
How to standardize the treatment and management of asthma patients?
1.As asthma is an allergic disease, it is crucial to avoid contact with allergens and triggering factors.
2.Long-term drug treatment.
Asthma is both chronic inflammation of airways and airway constriction narrowing, so both anti-inflammatory and antispasmodic treatment are needed. Asthma treatment drugs are divided into two categories: long-term control drugs and relief drugs. Control drugs mainly include inhaled glucocorticoids, inhaled long-acting β2 agonists, leukotriene modulators, slow-release theophylline, etc., which need to be used for a long time with the purpose of controlling symptoms and preventing acute attacks; relief drugs mainly include inhaled fast-acting β2 agonists, oral short-acting β2 agonists, inhaled anticholinergic drugs, Aminophylline, systemic glucocorticoids, etc. are mainly used to relieve asthma symptoms when they are present. To achieve the goal of asthma treatment, the level of asthma control should be evaluated first, and appropriate medication should be given to achieve asthma control, and long-term monitoring should be done during treatment to maintain asthma control. Initial treatment is usually inhaled glucocorticosteroids or combined with inhaled long-acting β2 agonists (or with leukotriene modulators and slow-release theophylline). When asthma control is achieved, maintenance therapy with the original level of therapy is required for 3 months before dose reduction is considered. Discontinuation can be considered when the patient maintains asthma control after more than 1 year of maintenance therapy with the least amount of control medication. Therefore, the treatment of asthma is a long-term process, and it is important to maintain the asthma control state and prevent acute attacks with appropriate control medications during the treatment process.
3.Regular patient education.
Through various ways to make asthma patients understand the disease knowledge, make patients believe that asthma can be completely controlled through treatment, and improve patients’ compliance and treatment confidence.
It is believed that through standardized treatment and management of asthma, and through the joint efforts of both doctors and patients, many asthma patients can achieve the goals of successful GINA asthma management, namely
(1) Achieve and maintain symptom control.
(2) Maintain normal activity, including exercise capacity.
(3) maintain lung function levels as close to normal as possible
(4) prevent acute exacerbations of asthma
(5) avoidance of adverse reactions due to asthma medication
(6) Prevention of death due to asthma. To enable people with asthma to breathe healthily and enjoy life as normal people.