专家建议:控制哮喘是场持久战,要学会与哮喘病“和平共处”

2018-05-01 尹琳整理 健康报医生频道

2018年5月1日是第二十个“世界哮喘日”,今年哮喘日的主题是“重视气道疾病防治:从现在开始”。


2018年5月1日是第二十个“世界哮喘日”,今年哮喘日的主题是“重视气道疾病防治:从现在开始”。

哮喘仍是世界公认的医学难题

中日友好医院呼吸内科林江涛教授:支气管哮喘是一种呼吸道的慢性炎症疾病,长期存在,表现为发作性咳嗽、胸闷及呼吸困难。当呼吸道的这种炎症程度越重时,正常呼吸就越困难。如果没有采取任何抗炎的措施,将会导致支气管阻塞或挛缩,甚至可能因呼吸困难而危及生命。近年来其患病率在全球范围内逐年增加。据估计,目前全球至少有3亿以上,我国有3000万哮喘患者。截至目前,哮喘仍是世界公认的医学难题,被世界卫生组织列为疾病中四大顽症之一,它也成为仅次于癌症的世界第二大致死和致残疾病。

大数据的防控现状及管理成为今后哮喘防治工作的一大亮点。为了更好地了解我国哮喘控制、疾病管理与自我管理、疾病认知水平近年的变化,中国哮喘联盟和全国哮喘研究协作组分别于2007年~2008年和2015年~2016年进行了两次全国城区哮喘患者控制现状和疾病认知程度的调查。调查显示,我国哮喘控制水平及疾病认知有了显著提升,哮喘发作住院患者病死率明显降低。危重症哮喘是导致哮喘死亡的重要原因,做好危重症哮喘的管理是降低哮喘发作病死率的关键。通过哮喘发作征兆的早期识别,加强患者自我管理水平有助于改善患者生活质量,预防哮喘急性发作,降低疾病负担。

正确使用峰流速仪和准确记录哮喘日记是哮喘患者自我管理的重要内容之一,可有效预防和减少哮喘发作次数,对症状严重或症状不明显的患者是一种有用的监测方法,是客观判断哮喘病情最常用的手段。今后应进一步加强呼吸专科医师的哮喘管理培训,转变观念,从而推动哮喘管理工作进一步开展。

控制哮喘是一场持久战

南京医科大学第一附属医院呼吸内科殷凯生教授:哮喘治疗不光需要医生对症下药,也需要患者配合遵医嘱,规范用药,积极治疗,方能达到哮喘管理的最佳效果。临床常见到患者对于哮喘认知不足,觉着偶尔有咳嗽和气喘不算严重,没有及时就医。哮喘轻微的症状也提示气道的炎症没有被控制。如果不经过规范的治疗,这种慢性炎症会导致气道结构的破坏,造成永久性的肺功能损害。没有被控制的哮喘,无论平常症状轻还是重,由于哮喘急性发作引起死亡的患者比例是相同的。提醒患者无论有没有症状,哮喘患者均需要长期持续的控制药物治疗。

哮喘是慢性疾病,控制哮喘是一场持久战,有些患者治疗一段时间后,丧失信心,觉得“哮喘不能控制,肯定经常犯”。研究表明,哮喘经过规范治疗,完全能得到良好控制,不影响正常生活。患者配合医生治疗,做到坚持用药,坚持峰流速和肺功能监测,定期随诊,才能及早回归正常工作和生活。

随着哮喘知识的普及,公众对于哮喘的认知有了显著提高。但还有极少数患者,治病心切,误信偏方,耽误治疗的最佳时机,导致哮喘急性发作住院。呼吁广大患者到正规医疗单位就医,避免偏方带来的伤害。

哮喘患者需要自我管理

上海交通大学附属第一人民医院呼吸内科周新教授:哮喘是可治疗的呼吸道慢性疾病,掌握哮喘相关的知识和技能对患者的自我管理至关重要。哮喘自我管理的主要内容包括哮喘自我管理相关的健康教育、哮喘自我管理的工具、哮喘急性发作先兆的识别和处理3个方面。

哮喘患者应该学会的自我管理相关知识和技能,包括能够准确描述哮喘及其治疗方法;主动参与哮喘的控制和管理;知晓哮喘发作的诱发因素;知晓避免或减少接触发作因素的措施;能够描述哮喘发作的症状和体征;能够制定就诊计划,理解定期随访的重要性;能够依从医嘱的具体方案;掌握正确的药物吸入方法,特别是干粉吸入粉剂、定量气雾剂等吸入装置;针对不同状况采取恰当的预防和处理措施;针对日常治疗和急性发作选择合适的医疗资源;记录哮喘相关的症状和客观测量指标;识别影响治疗依从性的因素;熟练使用哮喘自我管理工具(如哮喘日记和哮喘行动计划等)。(中日友好医院尹琳整理)

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=313972, encodeId=3d573139e203, content=学习了 非常感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35e76003, createdName=871538379, createdTime=Fri May 11 05:14:32 CST 2018, time=2018-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311451, encodeId=5bd531145100, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/15/8213228fe923915543544ad3da7e1c64.jpg, createdBy=6bd82014262, createdName=秀红, createdTime=Thu May 03 05:11:37 CST 2018, time=2018-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311344, encodeId=62283113449a, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJ6VKTBLeEm0k8CfowXtdj2bKPdYZZ1ic3I2RicDp2PHfdDfKX6ibD4F08Le1WD0h6wIcNB9ica3HGJ5g/132, createdBy=738f1693639, createdName=1de6402cm45(暂无匿称), createdTime=Wed May 02 17:43:35 CST 2018, time=2018-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311042, encodeId=51e831104209, content=谢谢分享.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/23/557c1f19aaf5459a8405411e38903c4b.jpg, createdBy=dfc02088287, createdName=cscdliu, createdTime=Tue May 01 21:18:10 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311033, encodeId=98bb311033b5, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Tue May 01 20:39:05 CST 2018, time=2018-05-01, status=1, ipAttribution=)]
    2018-05-11 871538379

    学习了 非常感谢

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=313972, encodeId=3d573139e203, content=学习了 非常感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35e76003, createdName=871538379, createdTime=Fri May 11 05:14:32 CST 2018, time=2018-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311451, encodeId=5bd531145100, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/15/8213228fe923915543544ad3da7e1c64.jpg, createdBy=6bd82014262, createdName=秀红, createdTime=Thu May 03 05:11:37 CST 2018, time=2018-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311344, encodeId=62283113449a, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJ6VKTBLeEm0k8CfowXtdj2bKPdYZZ1ic3I2RicDp2PHfdDfKX6ibD4F08Le1WD0h6wIcNB9ica3HGJ5g/132, createdBy=738f1693639, createdName=1de6402cm45(暂无匿称), createdTime=Wed May 02 17:43:35 CST 2018, time=2018-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311042, encodeId=51e831104209, content=谢谢分享.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/23/557c1f19aaf5459a8405411e38903c4b.jpg, createdBy=dfc02088287, createdName=cscdliu, createdTime=Tue May 01 21:18:10 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311033, encodeId=98bb311033b5, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Tue May 01 20:39:05 CST 2018, time=2018-05-01, status=1, ipAttribution=)]
    2018-05-03 秀红

    学习了

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=313972, encodeId=3d573139e203, content=学习了 非常感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35e76003, createdName=871538379, createdTime=Fri May 11 05:14:32 CST 2018, time=2018-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311451, encodeId=5bd531145100, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/15/8213228fe923915543544ad3da7e1c64.jpg, createdBy=6bd82014262, createdName=秀红, createdTime=Thu May 03 05:11:37 CST 2018, time=2018-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311344, encodeId=62283113449a, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJ6VKTBLeEm0k8CfowXtdj2bKPdYZZ1ic3I2RicDp2PHfdDfKX6ibD4F08Le1WD0h6wIcNB9ica3HGJ5g/132, createdBy=738f1693639, createdName=1de6402cm45(暂无匿称), createdTime=Wed May 02 17:43:35 CST 2018, time=2018-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311042, encodeId=51e831104209, content=谢谢分享.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/23/557c1f19aaf5459a8405411e38903c4b.jpg, createdBy=dfc02088287, createdName=cscdliu, createdTime=Tue May 01 21:18:10 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311033, encodeId=98bb311033b5, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Tue May 01 20:39:05 CST 2018, time=2018-05-01, status=1, ipAttribution=)]
    2018-05-02 1de6402cm45(暂无匿称)

    谢谢分享.学习了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=313972, encodeId=3d573139e203, content=学习了 非常感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35e76003, createdName=871538379, createdTime=Fri May 11 05:14:32 CST 2018, time=2018-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311451, encodeId=5bd531145100, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/15/8213228fe923915543544ad3da7e1c64.jpg, createdBy=6bd82014262, createdName=秀红, createdTime=Thu May 03 05:11:37 CST 2018, time=2018-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311344, encodeId=62283113449a, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJ6VKTBLeEm0k8CfowXtdj2bKPdYZZ1ic3I2RicDp2PHfdDfKX6ibD4F08Le1WD0h6wIcNB9ica3HGJ5g/132, createdBy=738f1693639, createdName=1de6402cm45(暂无匿称), createdTime=Wed May 02 17:43:35 CST 2018, time=2018-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311042, encodeId=51e831104209, content=谢谢分享.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/23/557c1f19aaf5459a8405411e38903c4b.jpg, createdBy=dfc02088287, createdName=cscdliu, createdTime=Tue May 01 21:18:10 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311033, encodeId=98bb311033b5, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Tue May 01 20:39:05 CST 2018, time=2018-05-01, status=1, ipAttribution=)]
    2018-05-01 cscdliu

    谢谢分享.谢谢

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=313972, encodeId=3d573139e203, content=学习了 非常感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35e76003, createdName=871538379, createdTime=Fri May 11 05:14:32 CST 2018, time=2018-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311451, encodeId=5bd531145100, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/15/8213228fe923915543544ad3da7e1c64.jpg, createdBy=6bd82014262, createdName=秀红, createdTime=Thu May 03 05:11:37 CST 2018, time=2018-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311344, encodeId=62283113449a, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJ6VKTBLeEm0k8CfowXtdj2bKPdYZZ1ic3I2RicDp2PHfdDfKX6ibD4F08Le1WD0h6wIcNB9ica3HGJ5g/132, createdBy=738f1693639, createdName=1de6402cm45(暂无匿称), createdTime=Wed May 02 17:43:35 CST 2018, time=2018-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311042, encodeId=51e831104209, content=谢谢分享.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/23/557c1f19aaf5459a8405411e38903c4b.jpg, createdBy=dfc02088287, createdName=cscdliu, createdTime=Tue May 01 21:18:10 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311033, encodeId=98bb311033b5, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Tue May 01 20:39:05 CST 2018, time=2018-05-01, status=1, ipAttribution=)]
    2018-05-01 戒馋,懒,贪

    谢谢分享学习了

    0

相关资讯

Semin Arthritis Rheu:女性类风湿性关节炎和COPD、哮喘的发病风险

在这项前瞻性队列研究中,RA与偶发性COPD风险升高相关,与生活方式混杂因素和包括吸烟在内的诊断后介质无关。

J Asthma:秋天花粉诱导的过敏性鼻炎中,血清特异性lgE水平与哮喘相关性研究

艾草和葎草花粉在中国北方是2中最为重要的秋季过敏过敏原。在2001年的代表性数据表明了过敏性鼻炎总是领先或者是同时和中国北方的秋季花粉过敏病人哮喘发生。最近,有研究人员利用代表性的数据调查了血清特异性lgE (slgE)水平与葎草和/或艾草花粉的相关性,时间点事秋季花粉诱导的过敏性鼻炎患者哮喘开始时。研究包括了1096名秋季花粉病患者,并且进行了面对面交谈和对葎草和艾草的slgE测试,阐释和记录了

Int Arch Allergy Immunol:气道变应性炎症患者中,第二组先天性淋巴细胞的增加与嗜酸性粒细胞相关

辅助T(Th2)类型响应被认为是过敏性气道疾病的本质,包括了哮喘和过敏性鼻炎(AR)。然而,有研究表明过敏性气道炎症同样依赖于先天免疫,并且与第二组先天性淋巴细胞(ILC2s)密切相关。最近,有研究人员在哮喘患者、哮喘和过敏性鼻炎患者以及健康个体中评估了ILC2的水平,并且尝试分析调查了临床数据和ILC2水平之间的关系。研究发现,哮喘患者和患有哮喘的过敏性鼻炎病人与健康对照相比,具有更低水平的IL

雾化吸入药物,你选择对了吗?

看似简单的雾化吸入,其实隐藏着大学问,是否每种激素或抗生素都可用作雾化吸入药物呢?

Eur Respir J:支气管哮喘患者血嗜酸性粒细胞与肺功能下降的关系!

由此可见,血嗜酸性粒细胞与气流阻塞和肺功能的加速下降有关,独立于哮喘和吸烟。嗜酸性粒细胞增多症是气流阻塞的危险因素,即使在没有症状的人群中也是如此。

Allergy Asthma Proc:过敏性鼻炎和花粉过敏儿童中,关于哮喘在围产期风险因子的研究

流行病学研究结果确定了学龄期儿童哮喘的一些风险因子。最近,有研究人员为了调查是否父母和围产期风险因子、以及婴儿的喂养方式与患有花粉过敏和过敏性鼻炎儿童的哮喘相关。研究包括了293名儿童(200名男孩(68.3%)),平均年龄为10.2岁(范围为7.4到13岁)。总共有109名儿童(37.2%)患有伴随的哮喘。在患有哮喘的儿童中,鼻炎症状的起始平均年龄更小(5.3岁 [IQR, 4.0-8.0 岁]