Chiropractic Management of Common Conditions：脊医管理常见的病症.ppt

Chiropractic Management of Common Conditions Asthma Patient Presentation Parents report: Episodic or persistent coughing Wheezing Shortness of breath Rapid breathing or chest tightness Worse in the evening or early morning hours Associated with triggers exercise, allergen exposure 50-80% of children develop symptoms before 5 Differential Diagnosis Wheezing is not present in all patients with asthma! Wheezing is not a sign exclusive to asthma Respiratory infections Rhinitis Sinusitis Vocal cord dysfunction Consider differentials that may cause similar symptoms Foreign body aspiration Cystic fibrosis Heart disease Diagnosis “In most children, the primary diagnostic tool is clinical assessment.” Pulmonary function tests (spirometry) should be performed as soon as possible Unreliable in infants and many preschoolers Poor technique, adult-sized equipment More reliable after 3-4 years of age Allergy testing Atopy is the strongest predictor for wheezing progressing to asthma “Allergic March” Infancy Food Allergy-Associated GI Disorders and Dermatitis Early Childhood Allergic Rhinoconjunctivitis Asthma Medical Treatment Patient education Trigger avoidance Drug therapy Compliance is a major problem Route of administration Frequency of dosing Medication effects Risk or concern of side-effects Chiropractic Care Asthma Evidence is adequate to support the “total package” of chiropractic care as providing benefit to patients with asthma Symptoms were reported to improve Medication use decreased One study (Guiney) showed improved peak expiratory volume No adverse effects were reported What is the goal of treatment? Reduce symptoms (wheeze and cough) Improve lung function Reduce the risk and number of acute exacerbations Minimize adverse effects of treatments Minimize sleep disturbances Minimize absences from school What is the “Total Package”? What does the average chiropractor do when a patient presents with asthma