1.What is asthma? Does asthma necessarily mean wheezing? Bronchial asthma is the most common chronic lung disease that threatens pediatric health and is increasing year by year. It is a chronic inflammatory disease of the airways involving a variety of cells, including inflammatory cells (eosinophils, mast cells, T lymphocytes, neutrophils, etc.), airway structural cells (airway smooth muscle cells, epithelial cells) and cellular components, with heterogeneity, and this airway inflammation makes susceptible individuals This airway inflammation makes susceptible individuals highly reactive in the airways, and when exposed to physical, chemical, or biological stimuli, reversible airflow limitation occurs, resulting in recurrent episodes of wheezing, dyspnea, chest tightness, and coughing, often occurring or worsening at night and/or early in the morning, and most children can be treated or resolve on their own. Most children with asthma do not always have wheezing. In general, asthma with both cough and wheeze is typical asthma, but there is a type of asthma with cough as the main or only symptom called cough variant asthma, which lasts for more than 1 month, often with attacks or exacerbations at night and/or early in the morning, with a predominantly dry cough, without clinical signs of infection, or with prolonged antibiotic treatment that is ineffective and with bronchodilators that can relieve cough attacks. or a family history of allergy, or a positive allergen test to exclude other causes of chronic cough, a positive bronchial excitation test, and normal or abnormal pulmonary function measurements. In addition, children with typical asthma may also have no wheezing in between attacks or at a fully controlled level. 2. How can I distinguish between a cough caused by asthma or a cough caused by a cold? Cough is the most common symptom of respiratory disease. Both asthma and colds can present with cough, especially cough variant asthma where cough is the main or only symptom, which is often difficult to distinguish from a cold. Generally speaking, cough caused by asthma mostly appears at night and early in the morning, or after exercise, exposure to irritating odors, cold air, allergens and other triggering factors. Simple asthma is mostly feverless, but is characterized by recurrent or persistent attacks, often accompanied by wheezing, dyspnea, chest tightness and other symptoms that last for a long time, and parents can hear a coughing sound similar to a chick’s cry when the child exhales with the ear pressed against the chest or behind the back, inhaling sugar Symptoms often improve quickly after inhaling glucocorticoids and bronchodilators. The cough after a cold usually does not have the above-mentioned pattern. The cough mostly worsens gradually without specific triggering factors and is mostly accompanied by symptoms such as nasal congestion, runny nose, sneezing and throat discomfort, while some have systemic symptoms such as fever, headache, general malaise and fatigue. Cold is the most common cause of acute asthma attacks in children. According to the 2010 National Pediatric Asthma Epidemiological Survey, 90% of acute asthma attacks in children are caused by various respiratory tract infections. In children with asthma, the body’s immune response cannot effectively clear the virus after a viral infection, making the cold persist or recurring. Therefore, asthma and colds often affect each other. 3.Can asthma be cured? Why is it so difficult to cure for some children? Pediatric asthma is a complex disease caused by many factors, one of which is the allergic reaction caused by repeated exposure to allergens. Whether asthma can be cured is a common concern for all parents of affected children. Generally speaking, adult asthma is often not easily cured. However, asthma in children, especially asthma with a young age of onset, with wheezing episodes occurring before 2-3 years of age or earlier; no parental history of asthma or allergic diseases; no significant allergy history and normal allergen tests; asthma symptoms are usually triggered by a cold when they occur, and neither asthma symptoms nor sports are affected in the absence of a cold, and pulmonary function tests are overwhelmingly normal in children, with symptoms gradually decreasing with age. The majority of children with normal lung function tests will gradually reduce their symptoms as they grow older, and about 60%-70% of children with asthma will recover spontaneously by the time they reach adolescence. In clinical practice, some children often still have wheezing episodes after adolescence, and the disease is prolonged. The reasons why asthma is difficult to treat in these children may be related to the lack of effective treatment at an early stage, or a history of severe allergies, or severe eczema, or family history. In general, asthma treatment is divided into control therapy and palliative therapy, with control therapy including inhaled glucocorticoids, leukotriene modulators, chromogranins, long-acting β2 agonists, and long-acting extended-release theophylline. Drugs for palliative treatment include fast-acting β2 agonists, short-acting theophylline, anticholinergic drugs and glucocorticoids. Inhaled glucocorticosteroids are currently used as the drug of choice for asthma treatment. When inhaled glucocorticosteroids are not effective in controlling asthma, several drugs can be used in combination, i.e., combination therapy. Clinical combination therapy methods include: inhaled glucocorticoid + long-acting beta2 agonist, inhaled glucocorticoid + leukotriene modulator, inhaled glucocorticoid + oral long-acting extended-release theophylline, inhaled glucocorticoid + specific immunotherapy. The advantage of combination therapy is to reduce the dose of glucocorticosteroids, thus reducing the side effects of glucocorticosteroids and improving the efficacy of glucocorticosteroids, so that asthma can be better controlled. 4.Why is inhalation therapy preferred for asthma? How to avoid side effects? The advantages of inhalation therapy are (1) direct action, (2) rapid onset of action, (3) high local concentration and good efficacy, (4) small dose used, avoiding or reducing the side effects of systemic hormone use. The adverse effects of inhalation therapy are thrush, hoarseness, upper respiratory discomfort, etc. The use of storage jars and gargling with water after inhalation can reduce the above side effects. 5.Why should we focus on prevention of asthma? How to prevent it? Asthma is a chronic disease and acute attacks can cause death in children. If frequent recurrent attacks occur, the airways will be in long-term inflammatory damage, the airway walls will be proliferated and thickened, irreversible narrowing of the airways will occur, remodeling will occur, and lung function will be progressively decreased, and various treatments are often ineffective at this time. Therefore, as with many other diseases, asthma should usually focus on prevention. Specific preventive measures are 1. Pay attention to strengthening physical fitness and preventing respiratory infections: respiratory infections are the main trigger for asthma attacks. 2. Pay attention to the indoor environment: animal dander is one of the triggering factors for asthma, parents should pay attention to not keeping pets such as dogs and cats, not to use carpets and pile products that can easily accumulate dust, ventilate frequently and pay attention to indoor air circulation, and try to avoid the affected children being in an air-conditioned environment for a long time. 3. Diet: The diet should follow the principle of “six inappropriate”, that is, the food should not be too salty, not too sweet, not too greasy, not too aggressive (cold, hot, spicy, spicy), not allergic food (such as fish, milk and milk products, etc.), not too full. 4, pay attention to avoid excessive exercise: exercise is a common cause of asthma and cough, parents should Avoid laughing, crying and fussing in children with asthma, as these movements can lead to hyperventilation and thus trigger asthma attacks.5. Pay attention to avoiding allergens: Common allergens include dust mites, mold and pollen, smoke or chemical odors (flower dew, perfume, freshener, mosquito or insecticide, smell of decoration materials, etc.), and attention should be paid to avoiding such allergens.6. Long-term correct use of glucocorticoid inhalation therapy (generally about 2 years, the condition is stable for 3 months to gradually reduce the dosage, no obvious side effects) is the key to prevent the recurrence of asthma. 6.Can children with asthma be vaccinated? Children with asthma can be vaccinated if they do not have asthma attacks (remission period), i.e. no coughing, wheezing and normal lung function, but it is recommended to leave only half an hour after vaccination.