The “cure” and “control” of asthma

  Asthma is a disease characterized by chronic inflammation of the airways and airway hyperresponsiveness. The main manifestation of typical asthma is the presence of recurrent episodes of wheezing, dyspnea, chest tightness or coughing, which often flares up or worsens at night and early in the morning. There are also specific types of asthma, the most common being cough variant asthma, as well as drug-related asthma, exercise asthma and occupational asthma.  The theme of the 10th World Asthma Day is: Asthma can be controlled. In the health education for patients, experts mentioned most often that asthma is not curable, but early detection and early acceptance of standardized treatment in regular medical institutions, 80% of asthma patients can reach a clinical cure level of complete or good control, and some patients can even be cured for a long time and lead a healthy and energetic life. However, the early detection rate is now very low, and the standardized treatment rate is even lower. In children, for example, 34% of children with asthma are diagnosed within two years of onset, and 50% are diagnosed two years after onset. The rate of early detection in adults is still much lower than in children. Even without early detection, if they receive long-term standardized treatment, 80% of patients can achieve clinical cure and live a healthy life as normal people, especially children who can achieve cure before adolescence, even if they are not fully controlled when they enter adolescence, their condition will be greatly reduced due to active treatment in childhood.  Standardized treatment includes the following aspects: To clarify the diagnosis.  Doctors should stage, grade and classify patients with asthma according to their age of onset and degree of symptoms. Next, an individualized treatment plan is formulated according to the diagnosis, and patients must adhere to this systematic treatment for a long time in order to achieve a clinical cure. Currently, detaching from allergens is the most effective method in treatment and the first step in treatment. Then the patient should actively undergo the standardized inhalation therapy advocated by the Global Conference on Asthma Prevention and Control and be treated uninterruptedly for at least 2 to 3 years, during which time he or she should insist on daily medication and have emergency medication at home and on the go, even if the condition is effectively controlled.  Insist on long-term treatment.  In particular, do not stop taking medication after clinical control of asthma to avoid acute exacerbation of asthma. The International Medical Organization’s goals for clinical cure of asthma are minimal or no symptoms, minimal or no asthma attacks, minimal or no need for medications, no limitations in physical activity or exercise, near normal lung function, no emergency room visits, and minimal or no medication side effects. Each asthma patient is completely self-evaluating, and the medication needs to be maintained at the original dose for at least 3 months after meeting the above targets before a reduction in dosage can be considered, which must be done under the guidance of a physician in order to avoid losing the previous work. Patients should be reminded that asthma is not curable and should not be misled by unscrupulous advertising about a so-called “cure”.  It is important to note that children account for the highest proportion of all asthma cases, with more than half of all adult asthma cases starting in childhood.  If asthma has been diagnosed, for particularly mild cases, individual children may go into remission on their own without treatment. Because asthma is a metabolic disease, immune factors play a very large role. It has both endogenous and exogenous causes. The endogenous cause can also be described as an allergic constitution of the asthmatic child itself, while the exogenous causes include environmental factors such as air pollution, dust mites, infections (viruses, mycoplasma, etc.), pollen, etc., exercise, and neuropsychological factors, etc. Internal factors are difficult to change, but external factors can be changed. If the asthmatic child can get out of the environment that causes the allergic reaction or does not have recurrent viral infections of the whistle tract, the disease will have a tendency to slowly get better.  Other children who have recurrent asthma attacks triggered by recurrent whistle infections due to low immunity can also have their immune system boosted to reduce asthma attacks.  If a child is diagnosed with asthma, it is important to first bring the child to the hospital for an evaluation by a physician. If there is an immune imbalance, the child’s immune system should be adjusted. If there is no immune imbalance and the child is careful to avoid triggers, the asthma may go into remission on its own. But this is called “asthma remission” or “control”, not “cure”! Because the slow inflammation of the airways is always present, but it is not triggered, and once it is triggered, the asthma may flare up again. Furthermore, it is very difficult for children with mild asthma to completely avoid allergens, so very few children with asthma can “go into remission” on their own. For frequent asthma attacks, there is no hope of “self-remission” and medication is needed. However, this does not mean that all children need to be on medication for the rest of their lives. Some children may only need medication for 6 months, some for 2 years, and some for life. This is different for each child and needs to be evaluated by a doctor.