Early diagnosis of asthma is important. The following symptoms mainly occur: coughing, shortness of breath and chest tightness at night, after exercise, or after exposure to allergic substances or pollutants in the air. However, as some asthma only manifests as a persistent cough, the general treatment with antibacterial drugs and cough suppressants is ineffective, or the symptoms are not serious and can get better on their own, it is not easy to attract the attention of patients. However, at this time, the disease is still in the developmental stage and if left untreated, there is a risk of exacerbation and impaired lung function.
Asthma treatment has made great progress and can be brought under complete control through medication, but the neglect of asthma has made the state of asthma treatment in China not optimistic. The survey found that 79% of asthma patients in China feel that asthma limits sports and leisure activities, 74% feel that it affects normal physical activities, 22% of adult patients and 49% of pediatric patients miss work and school due to asthma, and 68% feel that asthma affects sleep.
Long-term cure, patients should not stop medication too soon
Although asthma cannot be cured, the current medication is very effective and the coughing and wheezing will improve significantly after a few days of use, at which point many patients think that they are well and do not need to use medication anymore. In fact, asthma is a chronic inflammatory disease of the respiratory tract. Although the symptoms are better, the inflammation and the related changes caused by the inflammation have not yet improved, so if the medication is stopped prematurely, the disease will easily recur or even worsen.
The principle of asthma treatment is “long-term treatment”. The treatment of asthma is a long-term process, during which regular check-ups, measurement of lung function, monitoring of drug side effects and adjustment of drug dosage are necessary. This is to ensure the effectiveness of the treatment and to avoid side effects and recurrence of the disease.
Most asthma patients can achieve satisfactory control of their condition by adhering to treatment under the guidance of a specialist: patients have no adverse symptoms during the day and do not need to use bronchodilators temporarily; they do not wake up from sleep at night and do not need to seek emergency medical treatment; and there are no side effects of medication.
Small side effects, medication is safe
At present, the most important drug for asthma treatment is inhaled glucocorticoids (generally referred to as hormones). Many people worry that hormones will cause side effects such as fatness, osteoporosis, diabetes and high blood pressure. In fact, the dose of inhaled hormones is very small and is calculated in micrograms. Moreover, inhaled drugs mainly act locally in the respiratory tract and have minimal effects on the whole body, so they are safe for long-term use.
Adherence to follow up, pregnant patients should be kept in mind
Pregnant women with asthma should be actively treated under the guidance of a specialist. Poorly controlled asthma is more harmful to the fetus than the side effects of medication. Recurrent asthma attacks can lead to preterm delivery, lower birth weight, or even more serious consequences for the fetus. In fact, the commonly used asthma medications are relatively safe for both mother and fetus, and inhaled hormones are still the first choice of medication for asthma control in pregnant women. For acute asthma attacks, it is more important to actively seek medical treatment to avoid causing fetal hypoxia. Pregnant women with asthma should closely contact and follow up with their specialist to monitor changes in their condition and take appropriate diagnostic and treatment measures in a timely manner.
Finding the cause of refractory asthma can be controlled
In Chinese medicine, it has been said since ancient times that “famous doctors do not treat asthma”. From the perspective of Western medicine, this saying has two meanings: one is that asthma cannot be cured, and the other is that the symptoms of wheezing and dyspnea caused by asthma are not easy to control. However, with the continuous progress of medicine, the treatment status of asthma has fundamentally changed in recent years.
Although asthma cannot be cured yet, most patients can have their symptoms satisfactorily controlled through standardized treatment to the extent that it does not affect their life, study, work, exercise, or even life expectancy. Unfortunately, there are still many patients with asthma, either because of irregular treatment or for other reasons, who have recurrent attacks, persistent symptoms and even a decline in lung function, which seriously affects their life and work, which is often called “refractory asthma”.
The causes of refractory asthma are complex and require an experienced respiratory or asthma specialist to look for the cause. Based on more clinical experience, we have summarized the common symptoms and treatment of refractory asthma.
History of allergy: Continuous exposure to allergens, e.g., house dust mites, pets, etc.
Treatment: Explain the medical history to the doctor and perform the necessary allergen tests to avoid exposure to allergens.
Comorbidities: Many patients with asthma also have rhinitis, sinusitis, gastroesophageal reflux, etc. These comorbidities can aggravate asthma symptoms and lead to refractory asthma.
Treatment: Multidisciplinary treatment, e.g., joint treatment by respiratory medicine and ENT specialists, allergic rhinitis and sinusitis, which are common in asthma patients, can achieve good results.
Drug resistance: A few asthma patients are nonresistant to the therapeutic effects of glucocorticoids, and neither inhaled nor oral hormones can produce the expected therapeutic effects.
Treatment: The mechanism by which hormone resistance occurs is not clear. Doctors will perform the appropriate tests and evaluations and use other therapeutic measures for the specific case.