Bronchial Asthma Prevention and Control On December 11, 1998, the Global Asthma Prevention and Control Founding Committee and the European Respiratory Society proposed to carry out World Asthma Day and made it the first World Asthma Day. Since 2000, World Asthma Day has been the first Tuesday in May each year. This year’s theme is “You can control your asthma!” As another World Asthma Day approaches, it seems to bring a very important message that asthma should not be ignored! In many countries and regions, the morbidity and mortality of asthma is on the rise, so asthma has become a serious problem affecting human health and public health. Currently, about 300 million people worldwide suffer from asthma, accounting for 5% of the global population. It is expected that by 2025, the number of people suffering from this disease will increase to more than 400 million worldwide. According to surveys, the urbanization of the population and the westernization of lifestyles are the main reasons for the surge in the number of people with asthma, especially in developing countries where the incidence of asthma is much higher in cities than in rural areas. Many people are aware of going to hospitals for treatment of acute asthma attacks, but often neglect the long-term standardized prevention and treatment of their disease in remission, resulting in an extremely high morbidity and mortality rate of asthma in the Asia-Pacific region. Because asthma patients often have asthma symptoms, they often suffer from frequent asthma attacks or exacerbations that result in emergency room visits, hospitalization, missed work and school, which severely limits their lifestyle and quality of life. It has been proven that every patient with asthma symptoms, whether pediatric or adult, mild or severe, has airway inflammation and the presence of airway hyperresponsiveness that does not go away on its own, even during asthma remission, and that each symptomatic episode exacerbates or leads to irreversible lesions, providing an important basis for the need for long-term standardized asthma control. We must recognize that asthma is a chronic process and should follow the advanced strategy of the Global Initiative for Asthma Prevention and Control, actively promote the new concept of “early detection, early diagnosis, early prevention and treatment, the earlier the better”, and focus on the principle of individualized “standardized prevention and treatment, long-term management”. We hope that through the activities of Asthma Day, we can raise awareness of the importance of asthma prevention and treatment. Through the activities of Asthma Day, we hope to draw the attention of doctors, patients and health authorities to asthma, so that asthma patients can receive standardized treatment, improve the quality of life of asthma patients and further reduce their economic burden. What is asthma Asthma is a chronic airway inflammation, currently believed to be caused by various triggering factors that lead to episodic bronchospasm narrowing and chronic airway inflammation, which prevents the normal flow of gases. The main symptoms of asthma include episodes of dyspnea, coughing, wheezing and a feeling of pressure in the chest. The attacks can last for several minutes or ten minutes, or in severe cases, for several days, usually at night and in the morning, and as normal when they do not occur. If the attack is repeated, it can be complicated by emphysema, pulmonary heart disease, and in severe cases, sudden asthmatic death. The bronchial tubes of asthmatic patients are all relatively sensitive, called respiratory hyperresponsiveness. Stimuli that have no obvious effect on normal people, such as abnormal odors, can cause a violent bronchial reaction in asthmatics, leading to an asthma attack. Pulmonary function measurement can evaluate whether it is necessary to stop the medication after asthma is controlled Some asthma patients think that my asthma is controlled and then they can stop using medication, this belief is wrong, and some patients even suffer from it. The result was that he was hospitalized 7 times in 3 months, spending a lot of money on hospitalization but not controlling his asthma. Therefore, asthma is a chronic inflammatory process and inflammation is always present. Therefore, controlling inflammation, reducing airway inflammation hyperresponsiveness and minimizing the risk of asthma attack is a long-term and persistent treatment that every asthma friend needs to do. But it is important to clarify that inflammation here is not the inflammation that we usually talk about with antibiotics. If asthma is controlled, how to downgrade the treatment According to the 2006 Global Asthma Control Initiative, continuous monitoring is required to maintain asthma control after it has been controlled, and to establish the minimum dose of medication needed for treatment, if inhaled glucocorticosteroids are applied after 3 months of achieving asthma control; a 50% dosage reduction can be tried; in cases where asthma is controlled by a combination of inhaled hormones and long-acting beta2 receptor If the asthma is controlled by the combination of inhaled hormones and long-acting β2 agonists, it is best to reduce the inhaled hormone dosage by 50% and continue to use long-acting β2 agonists; if control is still achieved, the inhaled hormone dosage should continue to be reduced until a small dose is maintained, at which point discontinuation of long-acting β2 agonists can be considered. Which conditions require prompt medical attention When shortness of breath or chest congestion, or severe coughing, which occur daily and cannot be controlled with the application of your asthma medication When you have difficulty breathing, cannot walk or talk normally, and do not improve with aerosol medication. When you have a recurrent cough that does not clear up, is paroxysmal, is pronounced at night or in the early morning, and coughs when you smell an unusual irritating odor, but antibiotics are ineffective. How can I prevent asthma attacks? Asthma is an allergic disease with recurrent attacks. If you take active preventive measures against asthma, you can avoid and reduce the number of asthma attacks. The first step is to carefully identify the allergens that cause asthma attacks and avoid or remove them to effectively prevent asthma attacks. For example, sweep the room for dust mites, which are so small that they cannot be seen by the naked eye and live mainly on the dander metabolized by the human body. It is not too difficult to eliminate them: wash sheets and blankets in hot water every week and dry them in the sun; wrap pillows and bedding with an airtight outer cover; avoid carpets and replace them with lacquered cloth or wooden floors; use plastic, leather or simple wooden furniture; try to use vacuum cleaners with filters and keep indoor humidity below 50%. Eliminate indoor odors and keep away from tobacco smoke. Whether or not you smoke and are a passive smoker, smoke has a lot of irritants that irritate the airways, which can trigger asthma. It is best not to keep small animals. Eliminate cockroaches and clean the house thoroughly and often. Use odorless insecticides, but make sure the patient is not indoors during the spraying process. Avoid contact with pollen: If an asthma patient is diagnosed with pollen allergy, the first and foremost measure is to avoid or minimize contact with pollen, especially now that it is spring and the “May 1st” is coming up, some friends will choose to go out to play, so during the trip, you should pay attention to avoid going to the park during the season of pollen and willow dispersal. A few patients need to wear a mask when they are outdoors during the season. Of course, it is more ideal to move temporarily to an area with no or less allergenic pollen during the pollen dispersal season. In the spring and summer when pollen is abundant, asthma patients should avoid the areas where flowers and plants are concentrated or wear a mask when they go out and do not stay in humid areas for a long time. Molds like to live in humid places. Reducing indoor humidity and cleaning all wet areas frequently will prevent mold from growing in your home. Keep windows and doors closed in hot dry or windy weather to prevent pollen from drifting indoors and triggering asthma. If you are allergic, you should pay special attention to the medications you take. In particular, aspirin and the cardiovascular drug betalactam, which are commonly used by the elderly, can trigger an asthma attack and should be used with care to prevent an asthma attack. If asthma is caused by food allergy, make sure to clarify which kind of food it is and then arrange it rationally, and avoid blindly avoiding food that causes nutrient deficiency. Secondly, establish a reasonable life regime and diet regime. Ensure good sleep, do not be overly tired and avoid emotional tension fluctuations. Athletic asthma patients should avoid strenuous exercise, but suitable physical forging is still needed to help enhance physical fitness, improve resistance to disease, and actively prevent and reduce the occurrence of colds is important for asthma patients. This is because cold is both an important causative factor and an important trigger for the aggravation of their condition. In addition to the attention needed in daily life, Chinese herbal medicine can be applied to prevent it, because the ancestral medicine is profound and has accumulated rich experience in the treatment and prevention of asthma. Chinese herbal medicine can be used to dissolve phlegm, calm asthma and stop cough, and the theory of nourishing Yang in summer has been applied to create a summer treatment for winter diseases, which is used to prevent asthma attacks with an efficiency of more than 87%. Using the theory that human acupuncture points are connected with organs, we apply acupuncture point injection and cupping therapy to treat and prevent asthma attacks without pain for patients, but asthma can be controlled for a long time. Why urban people are more prone to asthma Modern people, especially those in urban areas, live and work in indoor environments for longer periods of time and spend too little time outdoors. Physiologically speaking, many scientists are now testing the “hygiene hypothesis”, which states that increasing urban sanitation and reduced exposure to germs has led to a subsequent overreaction of the immune system, resulting in allergies. Most asthma is caused by allergies. It can bring on a host of illnesses. Wherever outdoor exercise is neglected due to increased indoor recreational activities, the body’s resistance to disease decreases and the incidence of asthma increases. In addition, as living conditions improve and leisure time increases, some families like to keep dogs, cats, birds and other pets to add interest to their lives. However, with this, there may also be an impact on our health. Their dander, shedding, excrement, etc. may be allergens for humans. Also, indoor air pollution is becoming increasingly serious with the relative closure of modern living rooms and the increase in decorative materials. Family room decoration, the need to use many paints, coatings, fillers, adhesives, solvents, pipes, plates, plaster parts, etc., most of these materials contain volatile substances harmful to humans (benzene, aldehyde, phenol, chlorine, etc.) and heavy metals (lead, mercury, etc.). Irritation of the respiratory tract caused by newly relocated living rooms or newly added furniture paint also often causes tears, sneezing, coughing and allergic asthma. Outdoor air, including industrial fumes and car exhaust, can also cause sensitization, which can lead to asthma attacks. Why long-term standardized prevention and control of asthma is needed It is currently believed that, in addition to genetic factors, asthma may be mainly related to social development, environmental changes and climate change, but it cannot be ignored that it may be related to the lack of significant changes in the traditional concept of prevention and control, the abuse of symptomatic drugs and antibiotics, the rare use of drugs that reduce inflammation and decrease airway hyperreactivity, and the lack of understanding of standardized prevention and control programs for asthma in remission. A recent survey on the status of asthma in the Asia-Pacific region showed that 9% of asthma patients applied inhaled anti-inflammatory agents, while only 6% in China, which is far from the asthma prevention and control goals proposed by global asthma control guidelines. Many people know to go to hospital for treatment of acute asthma attacks, but often neglect the long-term standardized management of the disease in remission, resulting in a very high morbidity and mortality rate of asthma in the Asia-Pacific region. China has one of the highest rates of asthma deaths. Because asthma patients often have asthma symptoms, they often suffer from frequent asthma attacks or exacerbations. The number of people who need hospitalization or emergency treatment is 33%; the number of people who have lost employment due to asthma is 58%; the number of people who are unable to perform sports and leisure activities due to asthma is 79%; the number of people who have changed their original lifestyle due to asthma is 63%; the number of people who have sleep disorders due to asthma is 68%; and the number of people who are unable to perform normal physical activities due to asthma is 74%. This severely limits the lifestyle and quality of life of people with asthma. It has been proven that every patient with asthma symptoms, whether child or adult, mild or severe, has airway inflammation and the presence of airway hyperresponsiveness that does not go away on its own, even in asthma remission, and that each symptomatic episode exacerbates or leads to irreversible lesions, which is why long-term standardized asthma control is needed. The degree of bronchial constriction to help diagnose asthma and estimate the severity of the condition. Why asthma education is needed China has one of the highest asthma mortality rates and there are quite few people in China who are eligible for complete asthma control. The main reason for this situation is that asthma prevention and treatment is still under-diagnosed, some patients do not receive proper medical treatment, treatment is not standardized, and medication is used when an attack occurs but not when it does not, which is not enough. In addition, there is poor compliance with treatment, and patients retreat once they hear that it is hormones; some overestimate asthma control and other problems. Some patients also seek treatment indiscriminately, believing in small advertisements or even small prescriptions, which results in recurrent asthma attacks that are difficult to control. Therefore, patients need to contact and communicate more with respiratory physicians and make individual medication according to their conditions. At present, our department has established an asthma home, and every Saturday afternoon, through preventive education and individualized guidance of medical staff to asthma patients, patients can get the opportunity to control their asthma. Because asthma is a disease that can be prevented and controlled, the asthma home is used to reduce asthma attacks and change the status quo of asthma treatment. Whether asthma can be cured Because the causes of asthma are complex and the pathogenesis is not yet clear, there is no cure. The current treatment goals are to eliminate the cause, control acute attacks, consolidate treatment, improve lung function, prevent recurrence, and improve the patient’s quality of life. For the majority of asthma patients, this can be achieved with systematic treatment. Zhong Nanshan said, “With the update of asthma drugs and improvement of treatment methods, we can now have asthma completely controlled, that is to say, we can achieve a ‘clinical cure’, which not only allows patients to have no asthma attacks at all, no discomfort in daily life, but also to participate in study, work and physical exercise as usual. work and physical exercise as usual.”