When I talked to my father on the phone last year
Found him old coughing
It's the kind of thing that doesn't finish a sentence
It's as if the qi can't come up
Then the cough began
I didn't cough badly
But it's quite frequent
I have been doing medical science for so many years
Xiaobian has associated with all kinds of terrible possibilities
After a series of examinations in respiratory medicine
Doctors made the diagnosis "cough variant asthma."
……
asthma
A lot of the diseases that appear in the TV series
So far
Suddenly it was so close again
Today we're going to order it
——
Wheezing
Li Wen, Chief Physician of the Department of Respiratory Medicine, the Second Affiliated Hospital of Zhejiang University School of Medicine
Talk about asthma and advocate early screening and early treatment of asthma
1 in 16 people has asthma
Sometimes, asthma is invisible
We often think that asthma, "asthma" is its manifestation, but in fact, in addition to asthma, chest tightness, cough may also be asthma, such as "cough variant asthma" and "chest tightness variant asthma", are different categories of bronchial asthma.
Therefore, if you find that someone around you often has cough and chest tightness symptoms, you must remind him to go to the hospital for assessment as soon as possible.
Chronic airway inflammatory diseases with recurrent episodes of wheezing, shortness of breath, or without chest tightness or cough, are bronchial asthma, which is accompanied by airway hyperreactivity and variable airflow restriction.
The 2015 Global Burden of Disease Survey (GBD) estimated that 358 million people worldwide have asthma (a rough estimate of one in every 16 people in the world developing asthma). According to the China Lung Health Study (CPH), the prevalence of asthma in adults over the age of 20 in China is 4.2%, and it is estimated that 45.7 million people with asthma over the age of 20 are estimated.
3 May 2022 is the twenty-fourth World Asthma Day. The theme of this year's World Asthma Day is "Closing gaps and achieving homogeneous management of asthma"
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If you have asthma, the following 6 points should be done well
Sometimes, "management" is as important as "governance."
At present, asthma cannot be cured
But through effective management
Asthma can be well controlled
Asthma management is a process in which physicians and patients work together, and it's important to build an interactive doctor-patient partnership.
Asthma patient management and education is an ongoing process that runs through all medical behaviors, whether it is a first-time or follow-up patient, whether it is a mild or severe patient, whether it is an outpatient or a ward, whether it is a community grassroots or an asthma specialist clinic in a tertiary hospital.
As an asthma patient, how to properly manage it, the following six points are very important.
1
Learn about asthma
It is a controllable chronic airway disease, often at night and early morning onset, exacerbation, most patients can be relieved by themselves or after treatment, through reasonable treatment and long-term management, asthma symptoms can be controlled, avoid acute attacks. However, irregular treatment or poor adherence can lead to recurrent acute attacks, emergency visits, hospitalizations, and even death!
2
Actively look for possible triggers for seizures and avoid them as much as possible
Different asthma sufferers have different triggers for attacks, common ones are hairy animals, smoking/second-hand smoke, smoke, dust from bedding and pillows, flying dust, strong odors and aerosols, pollen, weather changes, colds, exercise, and exertion.
Common inhalation allergens in life include: dust mites, pollen, fungi, cat hair/dog hair, cockroaches, common ingestion allergens include: fish and shrimp, eggs, fruits, milk, nuts, etc. In China, dust mites are the most important allergen.
Home mite removal tips
Reduce indoor relative humidity and keep indoor dry and ventilated;
Mattresses and pillows wrapped in special anti-mite materials using wrapping sleeves;
Bedding is washed, dried and dried in a timely manner;
Carpets, fabric curtains and home décor are regularly replaced and cleaned;
Plush toys and small items (such as pillows and clothing) can be frozen in the refrigerator for 24 hours to kill mites and then washed to remove allergens such as mite carcasses and metabolites.
3
Inhaled hormones are the cornerstone, and first aid medications are carried with you
Asthma medications include both control and remission medications.
Controlled drugs: need to be used daily and maintained for a long time. As the saying goes, "when eating", three meals a day can not fall, inhalation drugs twice a day can not fall, can not be reduced or stopped at will.
Current guidelines explicitly emphasize inhaled hormones (ICS) as the cornerstone of asthma treatment, and all patients no longer recommend the treatment of asthma alone with short-acting beta2 receptor agonists (SABA) without inhaled hormones.
Inhaled hormone (ICS) is a glucocorticoid, but because of inhalation administration, high safety, few adverse reactions, mainly in the oropharynx, including hoarseness, pharyngeal discomfort and Candida infection, so it is necessary to rinse the mouth carefully after use.
Remission drugs: also known as emergency drugs, drugs that are used as needed during an acute attack, life-saving, and it is recommended that asthma patients should carry them with them in case they are urgently needed.
The preferred remission is low-dose inhaled hormone (ICS) plus formoterol, and other alternative remissions are short-acting beta2 receptor agonists (SABA). Physicians should evaluate whether patients can adhere to controlled therapy with ICS to reduce the risk of acute exacerbations associated with SABA alone.
4
It is important to use the inhalation device correctly
Xiaobian remembers that when he accompanied his father to the first consultation, the doctor repeatedly told him to return to the doctor after getting the inhalation drug, and the doctor would carry out on-site "teaching", which was an important link related to the correct treatment of asthma patients.
Up to now, the father has been treated for more than half a year, but as the daughter's editor is still not at ease, always through the family camera (parents in the hometown, we are not at ease, so in the living room installed a camera) to ask the father about the medication, to see if he uses accurately.
There are many types of inhalation devices, and improper use can lead to poor asthma control, so it is important for asthma patients to learn to use inhaled preparations correctly.
Patients who get the inhalation preparation for the first time can first scan the two-dimensional code of the product according to the doctor's guidance to watch the teaching video, and then physically demonstrate the inhalation device, practice repeatedly, and then carry the inhalation device for each outpatient follow-up visit, so that the doctor can check and guide the inhalation method, find the problem and correct it in time.
When you find that the effect of using this suction drug is not so good, you must come to the hospital in time and ask the doctor to check whether the method used by the inhalation device is correct.
5
Self-monitoring for early identification of acute exacerbations
Cough is the first early sign of an acute attack of asthma.
If asthma patients have a bad cough repeatedly, they cannot be treated as a hard shoulder of upper respiratory tract infection, and it is recommended to come to the hospital in time.
Peak Expiratory Flow (PEF) monitoring is a very simple and easy-to-use home monitoring method, and it is recommended that every asthma patient have a peak flow meter, just like a blood pressure meter is often available at home for patients with hypertension.
How to use the peak flow rate meter
1. Dial the peak velocity meter pointer to the position of the ruler "0";
2. Stand up, take a deep breath (quickly and deeply inspirantly), hold your breath and put the peak flow meter mouthpiece into the mouth (the above teeth are lightly bitten at the front of the mouthpiece, and the lips are tightly wrapped around the mouthpiece as standard), exhale quickly and vigorously, blow like a candle, and do not stop in the middle;
3. Write down the exponential value of the pointer and dial the pointer back to the "0" bit;
4. Do 1 monitoring in the morning and 1 time in the evening, and repeat the air blowing at least 3 times each time (the difference in measured values between the best 2 of the 3 times <40L/min), and record the value of the best of the 3 measurements.
6
Get into the good habit of keeping a journal
Asthma diary content can include weather, diet, exercise and work, symptoms of the day, PEF values, medication use, etc.
An asthma diary is the key to self-management of asthmatics, and it is also helpful to summarize and analyze asthma attacks and treatment patterns with doctors, and then select and adjust treatment options.
There are many ways to help asthma patients self-manage, including asthma management mini programs, home intelligent lung function measurement connected to mobile phones, intelligent medication monitoring devices, etc. Looking forward to the advent of wearable devices that can monitor asthma exacerbations in real time in the future, asthma management will become more and more simple and intelligent.
Department Introduction
Founded in the 1960s, the Department of Respiratory and Critical Care Medicine of the Second Hospital of Zhejiang University is one of the research, teaching, diagnosis and treatment centers for respiratory diseases in Zhejiang Province. The Department of Respiratory and Critical Care Medicine is the first batch of national clinical key specialty construction units, the first batch of state food and drug administration drug clinical trial institutions (respiratory specialties) in the mainland, the national clinical key specialties of the respiratory specialist training base of the Ministry of Health, the core unit of the national clinical research center of the first batch of PCCM excellent bases, the respiratory medicine training base of the Chinese Medical Doctor Association, the key discipline of medicine in Zhejiang Province, the key scientific and technological innovation team of Zhejiang Province, and the supporting discipline of medical innovation. At the same time, it is the lead unit of the Institute of Respiratory Diseases of Zhejiang University, the leading unit of the Zhejiang Provincial Research Center for the Diagnosis and Treatment of Difficult Lung Diseases, and the Key Laboratory of Diagnosis and Treatment of Respiratory Diseases in Zhejiang Province.
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Author | Department of Respiratory and Critical Care Medicine, Second Hospital of Zhejiang University Hua Wen
Audit | Chen Guozhong, Fang Xu, Li Wen
Editor-in-charge | Tong Xiaoxian
Image | Some are from the Internet, if there is infringement, please leave a message to contact
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