What to do about asthma in children

  Asthma, short for bronchial asthma, is a chronic disease that seriously threatens the health of the public, especially adolescents. During attacks, symptoms such as chest tightness and shortness of breath, wheezing and coughing, nasal congestion and sneezing and coughing often occur at night and in the early morning due to spasm of the bronchial smooth muscle with varying degrees of mucosal edema and glandular hypersecretion. The disease is a major disease influencing factor in the decline of the quality of life of adolescents because of its recurrent and lingering nature, which poses a great danger to the physical and mental health of patients.  Most patients have a history of infantile eczema, allergic rhinitis, food or drug allergy, and are associated with air pollution, respiratory infections, and inhalation of allergens (such as dust, mites, pollen, smoke, etc.). About 2/3 of patients are triggered by respiratory infections, and about half of the cases start before the age of 12 years, so the prevalence is higher in children than in adults.  There are various types of asthma such as typical asthma attacks, atypical asthma (e.g. cough variant asthma, exercise asthma, episodic chest tightness, etc.), and occult asthma. The pathogenesis of asthma can be divided into: 1) exogenous asthma caused by inhalation of pollen, dust, mites, feathers and volatile chemicals or caused by food allergy; 2) endogenous asthma induced by respiratory tract infection, especially viral infection; 3) mixed asthma with the above two types of performance; 4) drug and biological asthma caused by antipyretic and analgesic drugs, antibiotics, vaccines, enzyme preparations, etc.; 5) Sports asthma that occurs after strenuous exercise; etc. Since most asthma develops at a young age, it is closely related to respiratory tract infections, especially viral infections, and once recurrent attacks occur, it is very easy to be misdiagnosed as recurrent bronchitis, pneumonia, and wheezing bronchitis.  Asthma should be prevented and treated with the principle of controlling attacks and preventing recurrences. Since chronic inflammation of the bronchial mucosa is the pathophysiological basis for the development of asthma and is the main cause of airway hyperreactivity; this chronic inflammation is a metaplastic inflammation involving a variety of cells, especially mast cells, eosinophils and T lymphocytes, and therefore anti-inflammatory therapy is essential and should be carried out throughout the treatment.  In the acute phase, the attack should be controlled with the aim of immediately relieving bronchial smooth muscle spasm, reducing bronchial mucosal edema, and decreasing mucus secretion. In general, cold asthma should be treated with Xiao Qing Long Tang and San Zi Yang Yin Tang, cold and hot asthma should be treated with Ding Qi Tang, hot asthma should be treated with Ma Heng Shi Gan Tang and Su Scap Shen Wan, phlegm asthma should be treated with Scutellaria Er Chen Tang, and deficiency asthma should be treated with Tonic Lung Tang.  In the remission period, the cause should be removed and anti-inflammatory treatment should be given to prevent recurrence. The modern concept of asthma treatment is to focus on the remission period. If the treatment with bronchodilators in the acute period is like putting out a fire, then the treatment with bronchial anti-inflammatory drugs in the remission period is like moving the salary. Bronchodilators alone can only temporarily relieve airway spasm but not eliminate inflammation, and even aggravate inflammation by making more irritants enter the bronchus due to bronchodilation, therefore, long-term anti-inflammation is necessary. Anti-inflammatory means anti-airway allergic inflammation, choose glucocorticoid nebulized inhalation, ketotifen oral, internal Chinese medicine Fu Zheng San, Gu Ben cough and wheeze tablets, etc., through the elimination of chronic inflammation of the bronchial mucosa to achieve the purpose of prevention and treatment. In addition, avoid contact with allergens and irritants, actively prevent and control respiratory infections, pay attention to weather changes and dietary hygiene, exercise moderately, remove environmental factors that can aggravate asthma, and eliminate nervous and fearful psychological factors, etc. are also indispensable links in the prevention and treatment of asthma.