What are the principles and goals of treatment for pediatric asthma?
The principles of asthma treatment: anti-inflammatory treatment should be early and adhere to the principles of long-term, continuous, standardized and individualized treatment.
(1) Exacerbation period: rapid symptom relief, anti-inflammatory, and asthma calming.
(2) In remission: long-term symptom control, anti-inflammatory, reduction of airway hyperresponsiveness, avoidance of triggers, and self-care.
The goals of treatment are
1. Minimal or no symptoms, including nocturnal symptoms;
2.Minimal or no asthma attacks;
3.No need for emergency room visits for asthma attacks;
4.Minimal need for relieving medications;
5.Normal mobility (including exercise);
6.Normal or near-normal lung function;
7.Minimal or no adverse drug reactions.
What are the treatment measures for pediatric asthma?
1.Avoid causative factors and irritants, especially allergens;
2.Medication: choose appropriate medication according to the severity of the disease under the guidance of the doctor, treatment must be individualized, inhalation therapy is preferred;
3, self-management education: teach the prevention and treatment knowledge to family members and children to mobilize their enthusiasm to fight the disease;
4.Immunotherapy: chronic children with clear allergens that cannot be avoided and for whom general treatment is ineffective can be considered for specific immunotherapy, but there are more and more experts who propose that immunotherapy can be used as the first-line treatment because treatment is the only allopathic treatment.
Is asthma related to allergies?
Although many people will have both asthma and allergies, the two conditions are not necessarily linked together. Some people have asthma without allergies, and many people with allergies do not have asthma. If a person has both asthma and allergies, it is likely that those allergic reactions (to house dust mites, for example) will exacerbate their asthma symptoms. What exactly are the allergens we are talking about? Asthma-related allergens are those that cause rhinitis, skin eczema and hives. Other allergens, such as drug allergies to penicillin, are not as relevant to asthma.
Can aggressive treatment of allergic rhinitis prevent asthma from occurring?
Allergic rhinitis and bronchial asthma are allergic inflammatory diseases of the respiratory tract, and they have very similar features in common except for the location. According to statistics, bronchial asthma occurs in up to 40-60% of patients suffering from allergic rhinitis. Therefore, the risk of bronchial asthma is at least 8-20 times higher in patients with allergic rhinitis than in normal people. If you or your child has frequent itchy nose, continuous sneezing, runny nose and nasal congestion, it is important to consult a doctor. This is because active treatment of allergic rhinitis can prevent the development of bronchial asthma. Anti-allergy medications are commonly used to treat allergic rhinitis.
What are mites?
A significant number of asthma cases are caused by a tiny animal, the dust mite. Mites that have been linked to human allergic reactions include house dust mites and dust mites. Dust mites mainly live on bedding, mattresses, pillowcases and human clothes in bedrooms, and feed on the dander shed from the body.
A large number of clinical data at home and abroad prove that dust mites are a powerful allergen, and the cause of allergy is not live mites crawling into the human body, but the mites’ corpses, feces, eggs and shed skin shells, which are inhaled into the human respiratory tract with the floating dust and cause the disease. In the north, dust mite reproduction peaks in the spring and fall, when the highest levels of mites are found indoors and in food; in the south, the air is humid, which is more conducive to the growth and reproduction of dust mites. Patients who are allergic to dust mites often develop the disease throughout the year, and the symptoms can be aggravated during the dust mite breeding season.
How to avoid mite allergy?
Removing this allergen from the living room is the most direct and effective way to prevent and control it. According to the characteristics of dust mites fearing heat, some people propose to expose mattresses and clothes to 40℃ for 24 hours; 45℃ for 8 hours; 50℃ for 2 hours; or even 60℃ for 10 minutes, which can kill the mites. Accordingly, the mites can be removed by exposing the clothes in hot and cold climates or by scalding with boiling water. Most scholars believe that frequent wiping of furniture, diligent laundry, keeping the room dry and clean, reducing the accumulation of debris, and using plastic sheeting around mattress pads and chair cushions can greatly limit the reproduction and growth of dust mites, and the number of dust mites per square meter indoors should preferably not exceed 20.
Rice, flour and other grains stored at home are prone to mites, so they should be kept ventilated and dry, especially not stored too much and left too long. If you find a large number of mites growing in grain and flour, you should deal with them promptly.
Patients who are allergic to dust mites can receive satisfactory results by applying mite preparations for desensitization therapy.
What is desensitization therapy?
Desensitization therapy is also known as standardized antigen-specific immunotherapy (SIT). It is the only treatment currently available that addresses the cause of the disease and is recommended by the World Health Organization as “the only treatment that can affect the pathogenesis of allergic diseases and thus alter their natural course”. The basic method is to use the detected allergens to which the patient has an allergic reaction, make extracts of different concentrations, and repeatedly inject the patient subcutaneously with small to large doses and low to high concentrations, gradually inducing the patient to tolerate the allergens without having an allergic reaction, or to reduce the allergic reaction. The entire treatment process takes 3 to 5 years. In addition to altering the natural course of allergic disease and preventing the occurrence of new allergic phenomena; the efficacy is about 75-95%, and the therapeutic protection can last for more than three years after the cessation of treatment, and in some cases, the efficacy of long-term remission can be achieved. Especially in children allergic rhinitis treatment can prevent the occurrence of further asthma; desensitization therapy, although not a substitute for drug treatment, is more effective as one of the overall treatment methods, early treatment or combined treatment. It is mainly applied to the treatment of allergic rhinitis and allergic asthma.
What is the key to successful desensitization treatment?
The key to successful desensitization therapy is the selection of suitable patients, application of standardized allergen vaccines, adherence to an adequate course of treatment and combination with anti-inflammatory symptomatic drugs. Younger patients (children) respond better to immunotherapy than adults. It is suggested to intervene in the natural course of the disease at an early stage, i.e. before it enters a chronic irreversible state of deterioration. Considering that 0.006-0.100% of patients experience systemic adverse reactions (including asthma attacks, urticaria, anaphylaxis, etc.) during SIT, it is necessary to perform this technique in specialized medical institutions, with specialized doctors and nurses. Our Asthma and Allergic Immunotherapy Center is the first one in Zhejiang Province to carry out this treatment program. It passed the international certification in 2008, and has specially trained doctors and nurses to work on this technology, and has gained rich experience in treatment.
How to properly care for children with asthma?
Many parents believe that children with asthma should wear more clothes to avoid getting cold. When they see their child sneezing or having a runny nose, they think it is because of the cold and keep adding more clothes to the child. Many experts believe that children with asthma should start to exercise systematically in the summer to increase their ability to adapt to the cold. The specific measures include planned clothing reduction, appropriate exposure to cold water, and daily morning jogging. The process should be gradual, so as not to cause excessive cold. Children with asthma who have undergone cold tolerance exercises are not only less afraid of the cold in winter, but also have fewer asthma attacks. In fact, for most children with asthma, their bodies are not afraid of the cold, but the key is to inhale air that is too cold, too dry or too wet, which can easily irritate the airways and trigger asthma, so it is effective to wear a mask to ease the inhalation of air during the season when there is a big change in temperature. The most appropriate form of exercise for children with asthma is swimming. Taking your child swimming in the summer is a good way to exercise, but be aware that some children may be allergic to the chlorine disinfectant in the pool, so an outdoor pool is recommended.
Why do children with asthma need regular follow-ups?
Although children in remission do not have clinical manifestations, their lung function may still be abnormal and chronic inflammation of the airways may exist, and a series of insidious manifestations are not easily detected. After the initial outpatient visit, the doctor will establish a medical record for you, and you should be reviewed one week after the initial visit to understand your reaction and changes in your condition after one week of medication; after that, the review time is usually: once every 1-2 weeks when the condition is unstable, and once every 1-3 months when the condition is stable.