How to manage asthma in children

  It is often thought that what is the problem of asthma in children? In fact, it is the result of inadequate management and health education. It is not enough to have proper diagnosis and treatment, but management and health education is the key for a chronic disease like children.  Once a child is diagnosed with asthma, parents immediately become fearful, anxious, and even refuse to accept it, and then choose to flee, repeatedly visiting different hospitals in the hope of finding a “panacea” that can cure it immediately. The parents may also choose “prescriptions and experimental remedies”, resulting in the child’s condition being repeated and aggravated.  After more than ten years of promotion of the “Guidelines for the diagnosis and treatment of children”, we have become more familiar with the diagnosis and treatment, and can basically diagnose children’s asthma and choose the medication reasonably. However, due to the misunderstanding of the “guidelines” and the lack of clinical experience, they are unwilling or afraid of long-term management of children, as shown by the temporary use of leukotriene antagonists or the administration of Chinese herbal medicine or immune enhancers, and often the administration of inhaled surface corticosteroids, but due to the lack of the principle of “long-term management and However, because the principle of “long-term management and assessment of control level at any time” is not applied, or the correct inhalation method is not taught, the treatment fails and the parents lose confidence, thus losing visits. As a result, although some doctors have treated more children, few of them have really treated the whole process from “diagnosis, treatment, adjustment of plan, cure, relapse, and re-treatment”, and therefore the accumulation of clinical experience is not possible.  Compared with diabetes mellitus and hypertension, the public awareness of childhood asthma is still low, and the adherence to treatment is below 30%, which means that few people can adhere to long-term treatment, and therefore, the effect of asthma treatment is also poor, which shows that the road to standardized diagnosis and treatment of childhood asthma is still long, and we need to make extra efforts.  The latest “GINA Program” published in May 2014 has noted the importance of asthma management and health education, pointing out that “the treatment of childhood asthma will not be effective with good treatment protocols and medications alone, but without management and health education”. The importance of management and health education for children with asthma should be put on the Japanese agenda.  Having worked in the pediatric asthma clinic for more than 10 years, I deeply appreciate that the road to standardized treatment is still long and long, and we still need to work harder. According to our experience, when a child is first diagnosed with asthma, we should give instructions on how to treat, the course of treatment and regression, and not rush to give long-term control medication, and then give long-term control medication if there is another attack or if we already know something about childhood asthma treatment.  The standardized diagnosis and treatment of childhood asthma has just started, and we need your participation and support, so that we can work together for the tomorrow of standardized diagnosis and treatment of childhood asthma.