Asthma is a recognized medical problem worldwide, and World Asthma Day is designated as the first Tuesday of May every year. According to the survey, there are at least 20 million asthma patients in China, but less than 5% of them have received standardized treatment. It should be noted that although asthma cannot be cured, it can be controlled by implementing the “three steps” of disease assessment, disease treatment and disease monitoring, especially by using a combination treatment plan. It can be controlled. The key to controlling asthma in China is to actively encourage patients to seek formal treatment options. We will focus on the treatment and prevention of asthma.
The causes of asthma include two main aspects, namely the patient’s constitution and environmental factors. The patient’s constitution includes “genetic quality”, immune status, psychosomatic status, endocrine and health status, and other subjective factors. Environmental factors include allergens, irritant gases, viral infections, area of residence, living conditions, occupational factors, climate, drugs, exercise, food and food additives, dietary habits, social factors and even economic conditions may be more important causes for the development of asthma.
Pathogenesis
The pathogenesis of asthma is not fully understood. Most believe that metabolic reactions, chronic inflammation of the airways, increased airway reactivity and phytonadic dysfunction interact with each other to participate in the pathogenesis of asthma.
Clinical manifestations
Symptoms associated with asthma include cough, wheezing, dyspnea, chest tightness, and coughing sputum. The typical manifestation is episodic expiratory dyspnea with croup. In severe cases, the patient may be forced to sit or breathe in a sitting position, cough dryly or produce large amounts of white foamy sputum, or even appear cyanotic. Asthma symptoms may occur within minutes, over hours to days, and may resolve with bronchodilators or on their own. Most patients with early or mild symptoms have episodes of cough and chest tightness as the main manifestations.
These manifestations lack characterization. The onset of asthma is characterized by
(i) Episodic: exacerbated episodically when triggering factors are encountered.
(2) Temporal rhythmicity: attacks or exacerbations often occur at night and in the early morning.
(3) Seasonality: Often attacks or exacerbations occur in the fall and winter.
(iv) Reversibility: Asthma medication can usually relieve symptoms, and there can be a significant remission period.
Recognizing these characteristics is beneficial to the diagnosis and differentiation of asthma.
I. Clinical diagnosis based on.
1.Recurrent attacks of wheezing, dyspnea, chest tightness or cough are mostly associated with exposure to allergens, cold air, physical and chemical stimuli, viral upper respiratory tract infections, exercise, etc.
2.Dispersive diffuse, expiratory-phase-dominated croup can be heard in both lungs during the attack, with prolonged expiratory phase.
3.The symptoms can be significantly relieved with calming drugs.
Meeting the above three conditions can establish the clinical diagnosis. The diagnosis can be established by following up the response after treatment in accordance with the pattern of asthma.
Although the etiology and pathogenesis of asthma have not been fully elucidated, the current treatment methods, as long as they can be standardized for long-term treatment, can enable the majority of patients to get ideal control of asthma symptoms, reduce recurrence or even no attacks, and live, work and study as normal people
Second, Chinese medicine treatment
Traditional medicine believes that the lung is the master of qi and the kidney is the root of qi. When an asthma attack occurs, the lung can’t be the master of qi and the kidney can’t receive qi due to deficiency, then the qi reverts upward and the asthma develops. The spleen is the source of biochemistry; spleen deficiency produces phlegm, which blocks the airway, hence the wheezing and shortness of breath. Therefore, asthma is a disease of three deficiencies: kidney, lung and spleen. Chinese medicine treatment for bronchial asthma is included in the national project of Starfire Program, and many patients are now treated with Chinese medicine.
Life precautions: avoid smoking, alcohol and spicy, cold, greasy food.
Third, Western medicine treatment
Asthma treatment drugs are often called asthma medications because they all have the effect of calming asthma, and clinically they are classified according to the main aspects of their action into.
(a) Bronchodilators
In addition to the main role of these drugs for the diastole bronchial, control the acute symptoms of asthma.
1, β2 agonists: β2 agonist drugs have dozens of varieties, which can be divided into three generations. We mainly apply the second generation: selective short-acting β2 agonists, such as salbutamol, terbutaline and phenpropathrin, etc. The duration of action is 4-6 hours, and the side effects on the cardiovascular system are significantly reduced. β2 agonists can be administered by inhalation, orally or intravenously, and the inhalation method is preferred, with rapid action, high intra-airway doses and few systemic side effects.
2, theophylline oral aminophylline general dose of 5-8mg/kg per day, slow release theophylline 8-12mg/kg per day. theophylline main adverse reactions are gastrointestinal symptoms (nausea, vomiting), cardiovascular symptoms (tachycardia, cardiac rhythm disorders, blood pressure drop), occasionally can excite the respiratory center. It should be used with caution in fever, pregnancy, pediatric or elderly patients, patients with hepatic, cardiac or renal dysfunction and hyperthyroidism. Combination
(ii) Anti-inflammatory drugs or drugs called disease-controlling drugs
Since the pathological basis of asthma is chronic non-specific inflammation, controlling chronic airway inflammation, which is the basic treatment of asthma, plays an important role in the long-term ideal control of asthma. Commonly used medications are inhaled glucocorticoids and chromogranins.