Every year, spring is the high incidence season of asthma. There are about 15 million patients suffering from asthma in China, and experts point out that not only the prevalence of asthma is increasing, but also the clinical manifestations of asthma are becoming increasingly atypical, which can easily lead to misdiagnosis and mistreatment.
Bronchial asthma, or asthma for short, is a chronic metabolic inflammatory disease of the airways dominated by infiltration of eosinophils, mast cells and other cells. The symptoms of asthma attack include shortness of breath, dyspnea, cough, chest tightness and lack of oxygen, etc. If asthma lasts too long, symptoms such as irritability, sweating, depression, pallor and blue lips may occur due to lack of oxygen, and in serious cases, life threatening. At present, there are about 15 million patients suffering from asthma in China, and Dr. Yi Shangyong of Xi’an Jiaotong University School of Medicine pointed out that not only the prevalence of asthma is increasing, but also the clinical manifestations of asthma are becoming more and more atypical.
A domestic survey shows that its delayed diagnosis rate is as high as 42%. To improve the correct diagnosis rate of asthma, the common specific types of asthma are listed as follows.
Nocturnal asthma
Nocturnal asthma refers to asthma patients whose wheezing symptoms appear or worsen at night, which not only interferes with normal sleep but can also cause hypoxemia and even death. These patients have asthma attacks not only at night, but also during the day with asthma symptoms or acute asthma attacks, and are also more likely to occur around the time of menstruation or in the case of sudden changes in climate, temperature and humidity. Nocturnal asthma attacks often occur between midnight and early morning. Patients may start with a cough, followed by an asthma attack. Changing from a lying to a sitting position does not relieve asthma symptoms, which can only be relieved by the use of asthma medication. To prevent nocturnal asthma attacks, patients can take oral long-acting aminophylline or inhaled sodium cromoglycate before going to bed. At the same time, the triggers should be actively sought and eliminated.
Intercourse asthma
Intercourse asthma refers to asthma caused by men and women during intercourse, which may be caused by
(1) first intercourse, nervousness and excitement, which can cause psychogenic asthma.
②Newlywed feasting and drinking, tobacco and alcohol stimulate the bronchial tubes and make them spasm, which leads to asthma.
③Women who are allergic and develop allergy to semen, condom or vaginal diaphragm can develop allergic asthma.
④Women with a history of asthma are also prone to asthma when they have a fast heartbeat, rapid breathing and blood vessel spasms during orgasm. Regardless of which factor causes asthma, intercourse should be terminated immediately with the use of bronchodilators and anti-allergy drugs, both of which can calm asthma. Before the next intercourse, appropriate preventive measures should be taken for different causes.
Medication asthma
There are more than 100 types of medications that can cause asthma, of which the most common asthma symptoms are aggravated and even life-threatening. Therefore, for asthma patients with worsening symptoms after medication, or non-asthmatic patients with asthma attacks after medication, they should be considered as caused by medication and should be immediately discontinued or replaced with other medication, while giving asthma calming medication.
Cardiogenic asthma
In fact, it does not belong to the category of bronchial asthma, but is only named because it behaves similarly to asthma during an attack, and care must be taken to distinguish it from true asthma. This disease is characterized by a history of hypertension, coronary heart disease or wind heart disease, and attacks often occur at night after sleep or exertion. Any adult with asthma of the above characteristics for the first time should go to hospital for a comprehensive examination.
Exercise asthma
This type of asthma refers to asthma that may be triggered or exacerbated after strenuous exercise. It can be seen at any age, but has a higher incidence in male children. It is characterized by chest tightness, wheezing and dyspnea after strenuous exercise lasting more than 5 minutes, and croup can be heard. The symptoms mostly appear 5 to 10 minutes after the cessation of exercise, but can also appear during exercise and last 0.5 to 1 hour for gradual relief. This type of asthma is related to the type of exercise, time, intensity and the climate at that time. Exercises shorter than 5 minutes, or light exercises such as walking or tai chi, usually do not induce asthma. Outdoor walking, climbing, running and ball games in the cold and dry season have a significantly higher rate of triggering than swimming and cycling in the summer. This type of asthma can be easily prevented by avoiding strenuous and prolonged exercise, or by using various drugs such as ketotifen and sodium cromoglycate 15 minutes before exercise.
Occupational asthma
Occupational asthma is an occupational disease in which asthma attacks or exacerbations are related to the occupation. It is a reversible airway obstructive disease caused by exposure to occupational pathogenic substances and is characterized by coughing, chest tightness and wheezing. It is characterized by no previous history of asthma, but develops soon after starting a new job or being exposed to a new material, and similarly in other workers in the same environment; asthma attacks or worsens after each exposure to the work environment, but does not attack or gradually decreases once the environment is removed. This type of asthma should be removed from occupational exposure, and the attack can be treated as general asthma. To prevent the occurrence of this disease, attention should be paid to improving the working environment, reducing harmful gases in the air, preventing asthma-causing substances from entering the body, and strengthening personal protection.
Esophageal reflux asthma
Esophageal reflux asthma is caused by reflux of acidic gastric contents into the esophagus and pharynx, which can be accidentally inhaled into the airway. As long as a small amount of acidic material enters the trachea and bronchi, it will cause coughing, shortness of breath and suffocation. At the same time, the bronchial smooth muscle will be stimulated to spasm and asthma will occur, and in serious cases, aspiration pneumonia may occur. Preventive treatment measures are.
① Eating less sweets, fried foods and spices, avoiding alcohol, prohibiting smoking and not drinking coffee.
② not to eat within 4 hours before bedtime, wait for the stomach to empty before bed rest, and elevate the head of the bed 15-20 degrees, undress and untie to reduce abdominal pressure.
③ Taking antacids such as metformin, ranitidine or famotidine.
(iv) Enhance the tone of the lower esophageal sphincter with gastrofacial, morpholine, etc.
⑤ avoiding the application of smooth muscle relaxants, such as atropine, dopamine, aminophylline, progesterone, etc.
⑥If internal treatment does not improve, fundoplication can be done to control reflux.