Asthma has its highest incidence in childhood. Among adult asthma patients, 70% to 80% of them have developed the disease in infancy and childhood, which is caused by recurrent and prolonged attacks due to the lack of reasonable treatment. Therefore, it is very important to focus on the prevention and treatment of asthma in children, especially in the early stages of the disease for proper prevention and treatment.
The symptoms of children with asthma are effectively controlled and can be implemented in three ways.
I. Active prevention
Currently, the World Health Organization has graded the prevention of asthma into three levels of preventive measures.
Primary prevention: It refers to the elimination of all high-risk/pathogenic factors that have not yet led to the development of the disease, i.e., the prevention of the disease. The main focus is to improve the environment and prevent the occurrence of allergic diseases of the whistle tract. For example, pregnant women with allergies should pay attention to ensure a balanced nutrition during pregnancy, do not eat a single diet, avoid foods that can easily cause allergies (peanuts, seafood, etc.), do not smoke, and newly renovated houses must ensure that renovation pollution is controlled within safe limits before living. After birth, breastfeeding should be adhered to, delaying the addition of allergenic foods such as milk, and consuming foods high in antioxidants such as vitamin C and omega-3 fatty acids.
Secondary prevention: It refers to the diagnosis and treatment of diseases as early as possible after their occurrence to achieve early detection, early diagnosis and early treatment. For allergic diseases, primary lesions, such as infantile eczema, rhinitis, and recurrent whistling infections, should be treated aggressively to prevent the development of distal lesions asthma. The aim of secondary prevention is to treat patients aggressively at the early onset of allergic disease to prevent progression of the disease. Secondary prevention for asthma has not yet attracted enough attention from medical personnel as well as parents, resulting in children at risk for asthma missing early intervention and eventually developing asthma. Measures such as antihistamines and leukotriene receptor antagonists are used to treat atopic dermatitis and virus-induced wheezing episodes in infants and children; allergic children should be treated with allergens such as house dust, mites, pets or roaches, and contact with these allergens should be avoided.
Tertiary prevention: This involves minimizing the risk of the disease and includes all measures to prevent exacerbation or late sequelae of the disease. In addition to avoiding allergens and non-specific triggers, the best preventive measure for children who already have asthma is standardized treatment with effective medications to prevent worsening of symptoms.
In addition, asthma prevention and control should also start with the home environment.
Some common allergens that cause asthma in our homes include: dust mites, animal (pet) dander, mold, pollen, etc. In many cases, the triggers of asthma can be identified through detailed medical history. 70% to 80% of allergic asthmatics are allergic to dust mites. If the onset occurs during the moldy season, it often suggests a possible allergy to fungi. One step to identify allergens can be a skin test or a serum specific IgE test at the hospital. If the allergens have been identified, the exposure should be avoided or reduced as much as possible, or even relocated for treatment. What can we do for our family members who have asthma? First of all, control our home environment: don’t keep pets at home; don’t smoke in the room; monitor indoor humidity with a hygrometer to keep it below 50% because too high humidity is likely to aggravate asthma; use fragrance-free soap and deodorant, no perfume, hair and body sprays; keep the home environment clean and vacuum frequently to remove dust mites, molds and other triggering factors.
Second, standardized treatment
Better control of asthma should start with standardized individualization of asthma treatment.
Each patient should not use a fixed treatment plan, but should take different treatment measures according to the severity of asthma, i.e. stepwise treatment plan or individualized treatment, using as few drugs as possible to achieve the ideal control of asthma. Specifically, asthma treatment drugs are divided into two main categories, namely, relieving drugs and controlling drugs. Relieving drugs are used to provide rapid relief of asthma symptoms during an acute asthma attack. Control medications are used for the long-term control of asthma and require long-term use. For example, inhaled glucocorticoids + long-acting β2 agonists: two drugs in the same inhalation device, that is, to reduce the inflammation of the whistle tract, but also relax the whistle tract, so that the asthma is well controlled.GINA recommends that the quantitative hand-snap inhaler (MDI) combined with a storage canister is more effective, especially for children. Although there is no single treatment or medication that can achieve a cure for asthma, bronchial asthma is not without a cure. A large global clinical trial has shown that with continued fluticasone propionate/salmeterol inhalation therapy, about 80% of patients have good control of their asthma and can live as normal.
For corticosteroid inhalers that require long-term use, there are many patients who question the safety of their long-term use.
In fact, inhaled glucocorticosteroids used to treat asthma are considered safe for long-term use by patients. With the advancement of technology, the inhaled glucocorticosteroids currently in use, even if a small amount of the hormone is swallowed and enters the body, can be rapidly excreted from the body without causing side effects. Therefore, the newer the inhaled hormone chosen, the safer it is for the patient. The adverse effects of inhaled hormones are mild, mainly local effects such as hoarseness and oropharyngeal candida infection. This can be avoided by using a storage mist canister and gargling after medication.”
III. Self-monitoring
It is important to monitor your condition. What is good asthma control? Good asthma control means.
1. not having a cough, wheezing or shortness of breath most days (≤2 times/week).
2. being able to exercise and feel well.
3. sleeping peacefully all night without coughing, wheezing, or chest tightness
4. not being unable to work or study because of asthma.
5. having normal lung function results.
6.Use asthma relief medication less than 2 times a week.
In order to accurately assess their asthma, patients are advised to do the following.
1. Keep a diary of your condition: for example, your symptoms and the time of your attacks, the location of your attacks and what you were doing at the time can help your doctor to accurately develop and adjust your medication plan.
2. Pulmonary function tests: Have regular pulmonary function tests.
3.Peak flow rate meter: insist on monitoring your peak flow rate value every day.
4.Asthma Control Test Questionnaire (ACT): Assessed once a month and available from your asthma doctor. Continuous monitoring of asthma is important. It can help patients maintain asthma control to find the lowest therapeutic dose. Cost is minimized and safety is maximized while ensuring efficacy.