儿童哮喘的诊治.pptVIP

* * 2005 GINA Page 117（not Page 94) Control of asthma is defined as: ? Minimal (ideally no) chronic symptoms, including nocturnal symptoms ? Minimal (infrequent) exacerbations ? No emergency visits ? Minimal (ideally no) use of p.r.n. (as-needed) 2-agonist ? No limitations on activities, including exercise ? PEF circadian variation of less than 20 percent ? (Near) normal PEF ? Minimal (or no) adverse effects from medicine. 2006 GINA (Page 16) Clinical control of asthma is defined as: - No (twice or less/week) daytime symptoms - No limitations of daily activites, inlcuding exercise - No nocturnal symptoms or awakening because of asthma - No (twice or less/week) need for reliever treatment - Normal or near-normal lung function - No exacerbations * a continuous cycle of : Assessing Asthma Control Treating to Achieve Control Monitoring to Maintain Control * In treatment-na?ve patients with persistent asthma, treatment should be start at Step 2, or, if very symptomatic (uncontrolled), at step 3. All patients with persistent asthma require one or more regular controller medications (Steps 2 through 5). Step 2 is the initial treatment for most treatment-na?ve patients with persistent asthma symptoms. If symptoms at the initial consultation suggest that asthma is poorly controlled, initial treatment may be commenced at step 3. The scheme presented in Figure is based upon these principles, but the range and sequence of medications used in each clinical setting will vary depending on local availability (for cost or other reasons), acceptability and preference. * 哮喘患者应通过风流速仪的测量，用表格或较容易读的图表来记录风流速值。至少1天2次。 理想的风流速测定应是在清晨起床后做的第一件事，这时测定的值接近病人的最低值；和晚上做的最后一件事（如果病人使用支气管扩张剂，最好在病人吸入短效支气管扩张剂后），这时测得的值通常是最高值。 用风流速仪作为哮喘的动态监测，对哮喘病人是很有帮助的。 * 2006 GINA (Page 16) Clinical control of asthma is defined as: - No (twice or less/week) daytime symptoms - No limitations of daily activites, inlcuding exercise - No nocturnal symptoms or awakening because of asthma - No (twice or less/week) nee