Reporter Han Hongli Correspondent Chang Yuna
There are often moms and dads who have such a question: "Does the baby have asthma and need to adhere to the medication for a long time?" ”
The doctor will say without thinking: Yes!
This should be from the definition of bronchial asthma, Jinan Children's Hospital Respiratory Hospital Cheng Lu said: "Bronchial asthma is a chronic airway inflammatory disease." This "inflammation" is different from infectious "inflammation", and the "inflammation" of asthma is allergic inflammation. Therefore, routine antibiotic therapy in children with asthma is ineffective.
"Asthma is not as good as a cold or bronchitis. Chronic inflammation of the airways is present in children, both during asthma attacks and in remission. Cheng Lu said.
Before talking about treatment, we need to know what are the manifestations of asthma? What factors can trigger asthma?
In fact, the clinical manifestations of asthma are diverse, wheezing, cough, shortness of breath, chest tightness are the most common clinical manifestations, can appear alone, can also be two or three or more symptoms at the same time. Cheng Lu said, so some babies with simple cough and simple chest tightness can also be asthma, which we call cough variant asthma and chest tightness variant asthma. Asthma symptoms are most common in the early morning and/or at night, and some babies can be most pronounced when the seasons change. With the turn of spring and summer, asthma has also entered a high season.
There are many reasons for asthma symptoms, the most common external factors are allergen irritation, such as smoke, mites, animal dander, pollen, mold, seafood and so on. In addition, environmental factors may also induce asthma, such as air pollution, smog weather, newly renovated environment, cold air, strenuous exercise, etc. may induce asthma. Children with asthma are extremely sensitive to certain factors that may trigger asthma, known medically as "airway hyperreactivity." Parents should try to keep their children out of contact with factors that may trigger asthma.
Because there are many factors that cause asthma, it can be said that it is a relatively difficult disease to control, so is there a rule of law for childhood asthma?
Asthma, although difficult to control, is treatable. "First of all, you need to find a respiratory doctor to develop a systematic treatment plan after giving a systematic assessment according to the baby's daily situation, combined with lung function, exhaled nitric oxide and other examination indicators; then it is the work of Bao Mom and Dad, and adhere to and implement it carefully according to the plan given by the doctor." Cheng Lu said.
From the above, we already know that asthma is a chronic respiratory inflammatory disease, and children need long-term, persistent, standardized and individualized treatment. The purpose of continuous review during treatment is twofold: First, the doctor needs to evaluate whether the treatment plan made in the previous stage has achieved the ideal control goals such as symptom control, improvement of lung function, and relief of inflammation. Second, the child should be assessed for the risk of recurrence or exacerbation in the next or future episodes. If the control is good, the daily treatment is standardized, and the parents can distinguish the child's seizures well at an early stage and properly handle them each time, the probability of serious seizures in the child can be reduced, which also reflects the importance of review. Here we emphasize that it is best to fix the doctor throughout the process and regularly follow up the asthma clinic, so that the doctor can better understand the baby's condition and adjust the treatment plan in a timely and accurate manner.
Cheng Lu said that if the baby's asthma is in the clinical control period, then according to the doctor's plan to adhere to the treatment every day, which requires our mothers and fathers to cooperate perfectly with the baby, especially when using aerosols and dry powder treatment, we must watch the baby suck the medicine every time, if the baby's drug suction action is not standardized, it should be corrected in time. During the period, according to the doctor's requirements, it is necessary to go to the hospital for regular 1-3 months to follow up, and reflect the child's asthma symptom control during this time with his own doctor, and need to dynamically detect the level of lung function and the value of exhaled nitric oxide to assist the doctor to assess the asthma control of the child.
If the baby's asthma symptoms are not well controlled, or the lung function and other examination indicators are abnormal, the doctor will analyze the causes according to the specific situation, give guidance, treatment suggestions, and when necessary, may increase the dose of drugs or the type of drugs to achieve better control of asthma.
If the baby's asthma symptoms are very well controlled, the lung function and various inflammatory indicators are stable in the normal range, and last for at least 3 months, the drug can be considered to be gradually reduced until the dose is reduced to the minimum dose of the drug for a period of time, and finally stopped and observed. Specifically how to reduce drugs, the doctor will consider the baby's situation and parents' wishes to decide the method of drug reduction; of course, the timing of drug reduction or discontinuation is also very important, and it is necessary to avoid the influence of respiratory infections, tourism (environmental changes), school opening and seasonal changes.
Even if the child stops taking the drug, it does not mean that the baby does not need to go to the hospital for re-examination. Cheng Lu said that at this time, we often say that "stopping the drug does not equal graduation, just a holiday", after the drug is stopped, the baby needs to go to the hospital at least 1-2 times a year to review whether the baby's clinical symptoms have changed, lung function and changes in various inflammatory indicators.