It includes cysteinyl leukotriene receptor antagonists and 5-lipoxygenase inhibitors. Apart from inhaled hormones, they are the only long-acting control agents that can be applied alone, and can be used as alternative treatment drugs for mild asthma and combination therapy for moderate to severe asthma. Currently, cysteinyl leukotriene receptor antagonists are mainly used in China to inhibit the wheezing and inflammatory effects of cysteinyl leukotrienes released from mast cells and eosinophils by antagonizing leukotriene receptors on the surface of airway smooth muscle and other cells, producing mild bronchodilation and reducing allergens, exercise and sulfur dioxide (SO2)-induced bronchospasm, as well as having a certain degree of anti-inflammatory effect. It also has a degree of anti-inflammatory effect. This product can reduce asthma symptoms, improve lung function and reduce the deterioration of asthma. However, it is not as effective as inhaled hormones and cannot replace them. As one of the drugs in combination therapy, it can reduce the daily dose of inhaled hormone in patients with moderate to severe asthma and improve the clinical efficacy of inhaled hormone therapy, but the efficacy of combining it with inhaled hormone is slightly worse than that of combining inhaled LABA with inhaled hormone. However, this product is convenient to take. It is especially suitable for the treatment of patients with aspirin asthma, exercising asthma and asthma with allergic rhinitis. This product is relatively safe to use. Although Churg-Strauss syndrome has been reported in patients treated with these drugs, the causal relationship with leukotriene modulators has not been established and may be related to a reduction in the dose of systemic hormones. 5-Lipoxygenase inhibitor zileuton may cause liver damage, and liver function should be monitored. It is usually administered orally. The leukotriene receptor antagonist zallust 20 mg twice daily, montelukast 10 mg once daily, and isatinostat 10 mg twice daily. Theophylline has a diastolic effect on bronchial smooth muscle, and has cardiotonic, diuretic, coronary artery dilation, respiratory center and respiratory muscle excitation and other effects. Some research data show that low concentration of theophylline has anti-inflammatory and immunomodulatory effects. As a symptom reliever, although theophylline is still used intravenously in the treatment of severe asthma in clinical practice, short-acting theophylline for asthma exacerbation or worsening is controversial because it has no advantage in diastaging the bronchi, compared with rapid β2-agonists used in adequate doses, but it may improve respiratory drive. Short-acting theophylline is not recommended for patients already taking prolonged-release theophylline, except when that patient has a low serum theophylline concentration or when serum theophylline concentration monitoring is available. Oral administration: Includes aminophylline and controlled (extended) release theophylline. For mild to moderate asthma attacks and maintenance therapy. The general dose is 6-10 mg/kg/day, and the oral controlled (extended) release theophylline has a stable blood concentration around the clock and can maintain the asthma control effect for 12-24 h. It is especially suitable for the control of asthma symptoms at night. The combination of theophylline, hormone and anticholinergic drugs has a synergistic effect. However, when combined with β2-agonists, the product is prone to increased heart rate and arrhythmia, and should be used with caution and dose reduction. Intravenous administration: Aminophylline is added to glucose solution and injected slowly intravenously (injection rate should not exceed 0.25 mg·kg-1·min-1) or intravenously by drip, for patients with acute asthma attacks who have not used theophylline drugs in the last 24h. The loading dose is 4-6 mg/kg, the maintenance dose is 0.6-0.8 mg·kg-1·h-1. Because the theophylline “therapeutic window” narrow, and the theophylline metabolism there are large individual differences, can cause arrhythmia, blood pressure drop, and even death, in the case of conditions should be monitored its blood concentration, timely The concentration and titration rate should be adjusted in time. The effective and safe blood concentration of theophylline should be in the range of 6-15 mg/L. There are many factors affecting theophylline metabolism, such as febrile diseases, pregnancy, anti-tuberculosis treatment can reduce the blood concentration of theophylline; while liver disorders, congestive heart failure and the combination of metformin or quinolones, macrolides and other drugs can affect the metabolism of theophylline and slow down its excretion, increasing the toxic effect of theophylline, which should attract the attention of clinicians and adjust the dose as appropriate. The effect of doxorubicin is the same as that of aminophylline, but the adverse effects are lighter. The effect of dihydroxypropyl theophylline is weaker and has fewer adverse reactions. Anticholinergic drugs: Inhaled anticholinergic drugs such as ipratropium bromide, oxytropium bromide and tiotropium bromide can block the postganglionic vagal efferent branches, which can relax the bronchi by decreasing the vagal tone. Its bronchodilator effect is weaker than β2-agonists, and the onset of action is slower, but long-term application is less likely to produce drug resistance, and its efficacy in the elderly is not less than that of young people. The product is available in aerosol and nebulized solution forms. The common dose of ipratropium bromide aerosol by pMDI inhalation is 20-40μg, 3-4 times a day; the common dose of ipratropium bromide solution by nebulizer pump inhalation is 50-125μg, 3-4 times a day. It is a new long-acting anticholinergic drug with selective inhibitory effect on M1 and M3 receptors, and only needs to be administered by inhalation once a day. It has a synergistic and complementary effect with β2-agonists in combination. It is suitable for elderly asthmatic patients with a history of smoking, but should be used with caution in women in early pregnancy and in patients with glaucoma or prostatic hypertrophy. Although ipratropium bromide has been used in some patients with asthma due to intolerance of β2-agonists, there is no evidence to date that it is significantly effective in the long-term management of asthma. Anti-IgE therapy Anti-IgE monoclonal antibody (omalizumab) can be used in asthma patients with increased serum IgE levels. It is currently used in patients with severe asthma whose symptoms remain uncontrolled after a combination of inhaled glucocorticoids and LABA. No significant adverse effects of anti-IgE therapy have been found in treatment studies of asthma patients aged 11 to 50 years, but because the clinical use of this drug is still short, its long-term efficacy and safety need further observation. The high price also limits its clinical use. Allergen-specific immunotherapy: Common inhaled allergen extracts (e.g., dust mite, cat hair, ragweed, etc.) are given subcutaneously to reduce asthma symptoms and airway hyperresponsiveness in patients with clear allergens but difficult to avoid asthma. Its long-term efficacy and safety are yet to be further studied and evaluated. The standardization of allergen preparation also needs to be enhanced. The application of this therapy in asthma patients should be strictly under the guidance of a physician. Sublingual administration of allergen immunotherapy has been tried, and SIT should be considered in cases where strict environmental isolation and pharmacological interventions (including inhaled hormones) are not effective. There are no studies comparing the difference in efficacy between this and pharmacological interventions. There is no evidence at this time to support the value of immunotherapy with compound allergens. Other medications for asthma: antihistamines: oral second-generation antihistamines (H1 receptor antagonists) such as ketotifen, loratadine, astemizole, azulfidine, and terfenadine have anti-allergic effects and have a weaker role in the treatment of asthma. They can be used in the treatment of asthma patients with allergic rhinitis. The main adverse effect of these drugs is drowsiness. Astemizole and terfenadine can cause serious cardiovascular adverse reactions and should be used with caution. Other oral anti-allergic drugs such as tranilast and repirinast can be used in the treatment of mild to moderate asthma. The main adverse effect is drowsiness. Drugs that may reduce the dose of oral glucocorticoids include oral immunomodulators (methotrexate, cyclosporine, gold, etc.), certain macrolide antibiotics, and intravenous immunoglobulins. Their efficacy has yet to be further studied.