Source 丨21 Healthnews21 original work
Author 丨Ji Yuanyuan
Editor 丨 Xu Xu
Picture 丨 Figure Worm
Asthma is now the second largest chronic respiratory disease on the mainland, after COPD, and is a chronic inflammatory disease of the airways. Clinically, many asthma patients will basically cause the disease in the spring and autumn, and asthma attacks usually in addition to asthma, there are symptoms of chest tightness cough, once acute exacerbation, itself is very smooth airway will form bronchial spasm, spasm after the spasm will lead to a decline in ventilation function, gas is not easy to exhale, it is not easy to inhale, and then cause breathing difficulties, and even cause respiratory failure heart failure, and eventually cause death.
Recently, many places across the country are facing a new round of epidemic impact, which brings challenges to the medication and treatment of asthma patients, and if the daily care is not paid attention to disease management and standardized medication, it is easy to increase the risk of acute attack. Especially during the fight against the epidemic at home, there is a particular need to deepen the attention to this disease.
This year, 3 May marks the 24th World Asthma Day, and this year's theme is "Closing gaps and achieving homogeneous management of asthma". How to do a good job of asthma management under the epidemic to reduce the risk of acute attacks? In this regard, Shen Huahao, vice chairman of the Respiratory Disease Branch of the Chinese Medical Association and head of the asthma group and director of the Department of Respiratory and Critical Care Medicine of the Second Affiliated Hospital of Zhejiang University School of Medicine, pointed out that the long-term and standardized treatment of asthma is an important means to effectively control asthma. "At the moment of the epidemic, the uncertainty faced by patients has increased, and this requires patients to adhere to the daily dosage, and carry alleviation drugs with them, prepare sufficient drug reserves, pay attention to avoiding asthma triggers, and do a good job of self-monitoring and evaluation of diseases, so as to reduce the risk of disease attacks."
The outbreak poses a risk to the lives of people with asthma
As early as June 2019, Academician Wang Chen, President of the Chinese Academy of Medical Sciences and Peking Union Medical College, led the completion of the country's first large-scale epidemiological study on asthma, which combined with the 2015 National Population Survey data, revealed the epidemic status, risk factors and disease management of asthma in mainland China. According to the results of the survey, for the first time, the prevalence of asthma in people aged 20 and over in mainland China was 4.2%, and the number of people affected reached 45.7 million. The study took a rigorous epidemiological investigation method of multi-stage stratified group random sampling, and the results were published in the international authoritative medical journal The Lancet.
In recent years, the number of asthma patients has been increasing. Most of the reasons for the poor disease control rate of asthma are the misunderstandings in the patient's own disease cognition and management. At present, the insufficient diagnosis rate and low control rate of asthma are common pain points. Surveys have shown that the difficulty of asthma management in China is first of all a serious lack of diagnosis, as high as 71.2% of asthma patients have not been diagnosed by a doctor before. Then there is insufficient treatment, which is reflected in the fact that the medication compliance is not good enough, and the incidence of adult patients not following the doctor's instructions is about 50%.
The latest 2017 survey of the control level of outpatient bronchial asthma patients in 30 provinces and cities in mainland China included a total of 3875 patients, and according to the classification of asthma control levels defined by GINA, the results showed that the overall control rate of asthma in urban areas in mainland China was 28.5%.
This is mainly because in daily life, there are also many patients who have insufficient understanding of disease management. Because asthma is mainly manifested as episodic cough, chest tightness, wheezing symptoms, can be "sudden stop", it is possible to alleviate on its own, which makes many patients have a misunderstanding or fluke psychology, thinking that no treatment can also be alleviated, so that asthma is more and more serious, frequent attacks, and eventually lead to chronic obstructive pulmonary disease, respiratory failure and other serious complications.
Some patients mentioned that after the diagnosis of asthma was diagnosed, some patients failed to inhale drugs in sufficient quantities according to the doctor's instructions, did not develop the habit of carrying drugs with them, and stopped taking the drugs after the symptoms were relieved.
"These disease management misunderstandings are more common among asthma patients in mainland China, but in fact, they all lay hidden dangers for asthma exacerbations." Shen Huahao said that in addition, due to the impact of the new crown epidemic, many asthma patients, especially young white-collar patients, have been disrupted in their work and life rhythm, coupled with their lack of attention to the disease, forgetting and neglect caused by busy life, which will increase the risk of asthma recurrence and even acute attack. If you do not pay attention to the standardized management of the disease, and there is no sufficient stock of drug "surplus food" at home, when the disease recurs or acutely attacks, it may bring threats to life.
"The goal of asthma treatment is to control it well and minimize acute recurrence and lung damage. Interruption or delay in treatment can greatly reduce asthma control, not only making the frequency of attacks more frequent, but also making the disease more severe. Shen Huahao stressed.
Discontinuation or discontinuation of the drug should be prevented during the epidemic
For asthma patients, if you want to alleviate the negative impact of the epidemic and reduce the risk of disease recurrence, the premise is that the disease is effectively controlled. The realization of this goal is inseparable from the long-term standardized treatment of asthma.
The premise of treatment is to monitor asthma. It should be noted that the essence of asthma is inflammation, and the reduction of symptoms does not mean that the inflammation disappears, so the habit of medication according to symptoms cannot effectively control asthma. Patients with diabetes and hypertension will assess the control of their disease by measuring blood glucose and blood pressure, and asthma also has evaluation indicators, namely peak expiratory flow (PEF) and asthma control test (ACT).
It is understood that PEF is the maximum amount of gas exhaled per minute when exhaling forcefully, when the respiratory tract is narrow, the amount of gas we exhale will decrease, when the amount of exhalation is reduced to between 60% and 80%, indicating that asthma control is not good, it is necessary to increase the amount of therapeutic drugs and closely observe, when the amount of exhalation is reduced to
In addition, ACT is a test questionnaire to assess the status of asthma control, including five questions, if the total score is less than 20 points, it is necessary to communicate with the doctor as soon as possible, reformulate the asthma treatment plan, if the score is between 20-24 points, indicating that the control is good, but does not mean that the symptoms of the disease are completely controlled, and it needs to be reviewed regularly; if the asthma control is good and needs to be maintained and adhered to if the asthma control is good and the medication needs to be maintained and adhered to. This questionnaire needs to be tested every 4 weeks.
"At present, the clinical treatment of asthma is mainly based on drug treatment, including control drugs and relief drugs." Shen Huahao introduced: "The former can reduce the sensitivity of the trachea and bronchi to external stimuli, and reduce respiratory inflammation such as congestion, swelling, and increased secretions. Among them, inhaled glucodermic hormone is currently the most effective control drug. Because the airway inflammatory response in asthmatics is persistent, these control drugs need to be used daily. ”
Shen Huahao suggested that for controlled drugs, asthma patients should ensure that they are used in sufficient quantities, can be carried with them every day, and prepared in places within reach of all parts of the home, office and other places, in case of unforeseen needs. With the COVID-19 epidemic still being sporadic everywhere, patients should also prepare adequate medication in advance to prevent drug discontinuation or discontinuation. At the same time, self-management is also needed in life and diet, and some disease-inducing sources or irritating foods should pay attention to prevention and avoidance. If you wear a mask when you go out, avoid spicy frozen foods, and pay attention to keeping warm to prevent colds.
Shen Huahao finally concluded: "At the moment of the epidemic, asthma patients do not have to panic and worry, and doing a good job in allergen prevention and control, insisting on medication and other asthma management measures are of great benefit to their own asthma control and physical health. ”