Proper understanding of the role of “inhaled hormones” in asthma treatment

  Currently, long-term regular inhalation of different doses of hormones is the main measure to control all types of asthma. However, the mention of “hormone” makes many patients fearful, believing that it has obvious side effects, such as obesity, acne, feminization, etc., like oral or intravenous hormones. Some patients lack the most basic understanding of inhaled hormone, and even think it is an asthma calming drug, and only apply it when they have an asthma attack; some refuse to apply it because it cannot calm asthma.  Since the development of glucocorticoid inhalation therapy in the UK in the 1970s, glucocorticoid inhalation therapy has become the most effective and safest first-line therapy recommended by the World Health Organization and the Global Initiative for Asthma Control (GINA) expert committee for asthma control. The key to the importance of inhaled hormone therapy in the treatment strategy of asthma is that it has several advantages: First, inhaled therapy is the best method of drug delivery for the treatment of asthma. First, inhalation therapy is the best way to treat asthma. Inhalation therapy is a method of treating asthma by inhaling a drug in the form of an aerosol through the respiratory tract. The site of asthma patients is the bronchus, inhalation therapy can make the prevention and control of asthma drugs directly to the site of the lesion, quickly play a therapeutic role. The effect is fast and effective.  Secondly, these drugs have strong local anti-inflammatory effect, good selectivity and high activity in the airways, etc. Administered through the inhalation process, the drugs act directly on the respiratory tract and require smaller doses. Glucocorticoids administered orally or intravenously (e.g. prednisone, hydrocortisone, etc.) have more systemic side effects and are not suitable for long-term application. Inhaled preparations are different, because they are administered locally and enter the bloodstream mainly through the digestive and respiratory tracts, and most of the drugs are inactivated by the liver, so the systemic side effects are relatively small.  Local adverse effects of inhaled glucocorticosteroids mainly include oral mycotic infections and hoarseness. In order to reduce the above-mentioned adverse reactions, one should rinse the mouth promptly after each inhalation of glucocorticoids to be able to spit out the residual deposits in the mouth and throat with the mouthwash, which can also greatly reduce the adverse reactions.  In summary, the use of “inhaled hormones” in asthma treatment is actually not terrible. Inhalation therapy is a local drug with small dose, direct action on target organs, fast onset of action, few systemic adverse reactions, painless and non-invasive, easy to use, and especially suitable for the prevention and treatment of asthma in children. However, due to the lack of asthma-related knowledge of most patients, it often leads to non-compliance with medical treatment, drug abuse, stopping medication in the middle of the day, and irregularities in the number and dose of nebulized inhalation, etc., resulting in a vicious cycle chain of asthma, i.e., temporary relief of asthma – stopping inhalation therapy – Asthma recurrence. Some so-called “secret recipes and prescriptions” take advantage of patients’ fear of hormones and advertise themselves as “pure Chinese medicine”, but in fact, they often add a lot of oral hormones privately, causing damage to patients who do not know the truth. Asthma is a chronic disease requiring long-term treatment, and good compliance with treatment is very important to prevent recurrence. Through asthma-related education, standardized management, and correct medication, patients can understand the necessity and superiority of adhering to long-term medication. Many asthma patients have mastered the correct inhalation therapy and have achieved satisfactory results in long-term control of asthma attacks. We hope that the majority of asthma patients can pay attention to inhalation therapy, with a view to early recovery.