Over the past 20 years, the incidence of asthma in the world continues to rise, currently there are at least more than 300 million people ar
Over the past 20 years, the incidence of asthma in the world continues to rise, currently there are at least more than 300 million people around the world, China has nearly 30 million asthma patients. Moreover, the status of asthma control in China is not optimistic. According to a survey in the Asia Pacific region, our country's asthma control rate is only 3%. 2008 survey of ten major cities in China, the third grade hospital outpatient treatment of patients with asthma, asthma control rate was 28%. The survey also showed that about 20% of patients with asthma also need hospitalization, close to 1/3 of patients need to see emergency.
Gina organization proposed in 2010 "in the next 5 years in the global scope to reduce hospitalizations for asthma ratio of 50%, this year is the third year, to achieve this goal needs the whole society to work together.
Asthma is a chronic disease requiring long-term treatment
From the current perspective, asthma is a chronic inflammation. Chronic, that it is a long-standing inflammation that exists; respiratory tract swelling and inflammation caused by increased mucus, the inflammation is not usually known as bacteria, virus or microbial infection inflammation, but nonspecific inflammation (or called allergic inflammation), with antibiotics, antiviral treatment is invalid.
Because of asthma patients who have allergic airway inflammation, increased sensitivity to stimulus of bronchial foreign sector, the increase in medicine called airway hyperresponsiveness, when exposed to various external stimuli, prone to shrinkage of his bronchial reaction, paroxysmal respiratory difficulties, or asthma.
Asthma can not be eradicated, therefore, the goal of asthma treatment is to control the development of the disease, reduce and reduce acute attacks.
The first principle of asthma treatment is long term, it is impossible to cure asthma in a short time with a drug or a therapy. He said, some acute asthma attacks, due to shortness of breath, dyspnea and pain, hope the doctor quickly relieve pain, and actively cooperate with the treatment. Once the disease is not able to adhere to treatment, or even completely stop treatment. "You know, asthma treatment is a long-term project. Only pay attention to the usual prevention and treatment, can greatly reduce the number of acute asthma attacks, reduce pain, reduce the risk of death, reduce medical expenses."
Controlled drugs: "three meals a day" long-term law
Ease of drug: "emergency room down" asthma
Focus on asthma control. If long-term asthma control is not good, there will be "remodeling", lead to respiratory permanent damage, serious impact on the life of patients.
Drugs are divided into two categories: one is the control of drugs used for long-term control of asthma, is to use the drug law every day, the equivalent of our "three meals a day, this class of drugs is currently preferred inhaled glucocorticoids; the other is to ease the drug for acute asthma when rapid relief of asthma symptoms. Is equivalent to the "meal points", hungry to eat. It is a short acting beta 2 receptor agonist, which relaxes the muscles around the bronchus, which temporarily expands the spasm of the respiratory tract, which can take effect within 3~5 minutes and lasts for about 4 hours. Patients should be able to carry this type of release at any time, if necessary. He stressed that the use of relief drugs only when needed, is an emergency medicine. If you do not use these drugs alone, long-term use will decline.
Clinically, we found that many patients took the medicine away, even the nature and use of drugs are not clear." Asthma education is very important.
Long term inhaled corticosteroids do not feel alarmed"
The most effective way to treat asthma is inhalation therapy, the first line of asthma recommended by the guidelines for asthma.
"When it comes to hormones, people are afraid and feel a lot of side effects. Indeed, oral, intravenous and other systemic use of hormones, long-term use can induce high blood pressure, diabetes, osteoporosis, immune suppression caused by infection and other side effects, and even fractures." Lin Jiangtao explained that inhaled hormones and systemic hormones are two different concepts.
Inhaled corticosteroids in pharmacology, pharmacokinetics and systemic steroid hormone inhalation is not the same, also known as local hormone, local steroid bioavailability is particularly low, usually we inhaled dose unit medicine is oral hormone micrograms dose is 1 mg mg, equal to 1000 micrograms. Because of local administration, the drug can be directly applied to the lower respiratory tract, no need for systemic absorption and then distributed to the airway. If the doctors use the recommended dose, will not see systemic side effects, such as fat, long hair etc..
Inhaled corticosteroids are the hope drug can enter the airway, but every time when spraying a portion of the drug will stay in the mouth, this part of medicine we hope it does not exist here, so with each inhalation to rinse with water, the remaining amount of drugs reduced to the minimum, the partial adverse reactions after reducing spray.
Check allergen after diagnosis of asthma
We are talking about bronchial asthma, the majority of allergic bronchial asthma, for children may account for more than 80%, more than half of adults and allergies. In the condition of the hospital, in the determination of bronchial asthma, should try to help patients find the factors of allergy.
Can make the skin prick test, to see if it has no positive reaction to determine, to further clarify the test can also be combined with in vitro, through blood tests for allergen specific IGE antibody to determine the level of.
What is the significance of the original allergic? First, can not clear asthma and allergy related; second, can lead to worsening asthma screening or control risk factors is not good, to tell the patient how to avoid his exposure; third, for the treatment of meaning, can be screened out a part of patients suitable for desensitization treatment of patients. Desensitization therapy currently mature is mite, even in foreign countries some pollen desensitization preparations for these single allergens in patients with allergic asthma, including allergic rhinitis patients will have a better therapeutic effect.
Simultaneous treatment of asthma and allergic rhinitis
There are about and about 60%-80% of patients with asthma have allergic rhinitis, the incidence of allergic rhinitis is usually the first, followed by asthma, these two diseases are related, the pathological changes were also similar, inflammation is also close to the foundation. At present, the treatment of these two diseases in the treatment at the same time, the treatment of allergic rhinitis can reduce the symptoms of asthma, but also facilitate the control of asthma symptoms.
The proportion of elderly asthma increased
From the historical data, the incidence of asthma in the population, the proportion of preschool children, accounting for about 1% - 6%, adult asthma incidence of about 1%. But now the situation has changed.
Now, in fact, the incidence of all ages are increasing, for example, in the past that the elderly are rarely asthma, from our recent survey results, the proportion of elderly people suffering from asthma is also very high. This is related to our modern life, we are in contact with all sorts of harmful substances, allergen stimulation, and some physical, chemical, and infectious factors in asthma had played many roles, such external stimuli have accumulated more airway changes more obvious, so will enable the elderly to become a disease the typical patients with bronchial asthma.