Last Friday, I met a five-and-a-half year old patient in the clinic. The child was brought in for reexamination due to asthma attack by his mother.
The child was treated by a well-known professor in a major hospital. He received inhaled hormone therapy for 2 years, and then stopped taking the medicine. Finding the cause of recurrent asthma now requires a series of tests, including blood tests, hypersensitive C responses, allergens, nitric oxide and lung function.
“No infection at all! As part of the examination was just done last week, the child’s mother felt bored and puzzled: “The eosinophilic cell count checked a week ago was not high, but the allergen examination indicated that the milk was weak and positive. We also avoided food and took singulair, but how did the child still relapse? Since the lung function is normal, a professor said my child may not be asthma, how to treat it?”
At this time, I stressed again that we should review the blood routine, hypersensitive C reaction and other above tests, and if necessary, we should check the immune function to determine the reason for the child’s recurrence, so as to determine the next step of treatment.
But the mother flatly refused any tests. She said that the doctor in the other hospital recommended asthma treatment, and she just wanted to hear my advice. Unfortunately, I did not give her advice immediately, and asked her to have another test, which caused her great resentment.
A large number of children with asthma are misdiagnosed and mistreated
Standard treatment has a good prognosis
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I understand the parents’ feelings very well. I have treated many children with asthma who were mistakenly treated as infection. Standard treatment is the cornerstone of their recovery.
Liang Liang was once a child with severe asthma. When she was 3 years old, she often coughed and wheezed, and was treated with dexamethasone and cephalosporin every time at a community hospital or clinic for bronchitis. The child had to get injections almost every month and was treated with antibiotics at several hospitals for pneumonia.
The family is very anxious, by the introduction to find our hospital, after a detailed examination of lung function, nitric oxide, diagnosed Liangliang suffering from asthma.
Parents were educated about asthma and a detailed treatment and management plan was developed, including daily doses of susurone. After a year, Bright’s asthma symptoms gradually disappeared. Today, the once thin little boy is tall, handsome, smart and strong.
This shows that the prognosis of this disease can be very good. The key to cure asthma is to conduct standardized systematic examination and treatment, regular review, regular adjustment of the program.
If a listen to asthma, examination, hormones and so on blind rejection, or “good on the close”, no compliance, can not adhere to long-term normative management of the idea, the child will suffer repeatedly.
What exactly is asthma?
Airway allergic inflammation
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In recent years, the pathogenesis of asthma has a new concept, and it has been clear that it is caused by airway allergic inflammation, which leads to airway hyperreactivity, and the interaction between the two forms a vicious cycle.
On the basis of early (rapid) asthma response and late (delayed) asthma response, foreign scholars also proposed that there are changes of acute allergic inflammation and chronic allergic inflammation in airway.
Leukotriene is the most important substance for the formation of acute allergic inflammation. In addition to the involvement of inflammatory cell chemokines, which aggravate airway allergic inflammation, the most important substance for the formation of chronic allergic inflammation has recently been considered to be cytokines.
Currently, 25 out of 50 cytokines have been found to participate in chronic allergic inflammation, among which interleukin 3, 4 and 5, which are closely related to mast cell survival, IgE production, and necessary for eosinophilic differentiation, survival and activation, play a key role.
This not only makes the airway allergic inflammation deeper and more complex, but also becomes more permanent, making the airway stenosis and airway remodeling caused by chronic allergic inflammation become irreversible changes.
As chronic airway inflammation persists, airway hyperresponsiveness is also difficult to disappear, forming a potential factor for recurrent intractable asthma.
Therefore, asthma can be triggered by mild irritations in everyday life that do not work in normal people, such as upper respiratory tract viral infections, inhaling certain allergens, airborne smoke, smells and mental factors.
Why does the child’s asthma always recur?
There are five main reasons
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There are no regular reviews and evaluations
Some patients do not have regular review at all, more no regular detection of lung function, do not understand the state of the child’s body, do not understand the child in different seasons when the lung function changes, do not understand the high incidence of disease how to prevent medication and care, that a period of time does not attack, you can stop the drug.
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Blind reliance on one doctor
Patients’ trust in renowned professors is beyond reproach. However, if a well-known professor is not in the clinic, I don’t know who to look for, so I stop taking the medicine.
Children with asthma should set up asthma file, regular review, preferably find a doctor review. But you should never blindly rely on one doctor.
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Follow-up tests should be done
There are many reasons why asthma can return. Besides allergies, it can also be caused by bacterial, viral or mycoplasma infections.
If the condition changes do not improve, more than three days, must pay attention to review. If the usual treatment is not effective, further tests such as chest radiograph, liver function, myocardial enzymes, immune function and allergens are needed.
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Learn popular science about asthma
Many parents of sick children never learn, only rely on doctors to prescribe medicine. Children asthma recurrence, can be caused by pollen, food, irritating smell, dust mites and so on? Or a recent infection? Is the child a picky eater, constipation, lack of exercise? Does anyone in the house smoke? Is the child’s lung function checked regularly? How to prevent medication when the seasons change and live in different places? How do you wash your nose? There is so much knowledge that parents need to know and learn.
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Psychological reason
Children with asthma have many common characteristics. They are delicate, sensitive, demanding perfection, timid and afraid of the dark, and require more understanding, care and guidance.
However, many parents don’t know it because they are too busy to spend time with others, or even because they are allergic themselves. A significant number of parents of asthmatic children, especially mothers, are quite forceful, even paranoid. When couples can’t agree on how to treat a child, the child’s asthma is prone to relapse.
How can you prevent asthma from recurring?
Stick to these three principles
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- Early and reasonable use of drugs to eliminate airway allergic inflammation.
Inhaled corticosteroids and leukotriene antagonists (such as Montelukast sodium) are commonly used, which have varying degrees of blocking airway allergic inflammatory responses.
Inhaled corticosteroids, domestic and foreign scholars agree that it has the strongest anti-inflammatory effect and relatively few side effects, is listed as the first choice for the prevention and treatment of recurrent asthma attacks.
- Avoid all kinds of allergens and irritants to the greatest extent.
For example, no smoking, combination of work and rest, early prevention and treatment of respiratory virus infection, appropriate physical exercise, according to the immune function can use immunomodulator to increase physical fitness.
3, prevention and treatment of co-existing allergic rhinitis.
Allergic rhinitis is the outpost of induced asthma. Both diseases belong to respiratory allergic diseases, and there are many coexisting diseases. Nasal washing, drugs and other prevention and treatment are indispensable.
Dietary advice for asthma
Be careful not to eat eggs while you are sick
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- Balanced nutrition and light diet.
Pay attention to supplement protein, such as lean meat, tofu, milk, such as milk protein allergy, can choose hypoallergenic milk powder and iron. Children who have long inhaled hormones need vitamin D supplements.
There is now a lot of evidence that eggs are one of the most common foods to induce asthma.
- Eat more fruits and vegetables.
Take care to eat less allergenic fruits (apples, pears, bananas, watermelon are relatively low allergy rates of fruits). Fresh vegetables can not only supplement various vitamins and inorganic salts, but also help clear phlegm and fire; Fruit can not only expectorant cough, but also can strengthen the spleen and kidney and lung.