级研究生治疗学呼吸系统常见病.pptVIP

五、药物选择 （一）发作期 控制感染：青霉素、大环内酯、头孢、氟喹诺酮，轻者口服、重者注射 祛痰止咳：祛痰为主，溴己新、止咳中成药 解痉平喘：控制发作一般以吸入疗法为佳，可选用气雾剂、干粉剂或雾化溶液 改善缺氧 一般以平喘解痉药改善通气功能 明显缺氧者和右心衰者可考虑吸氧 （二）缓解期 中医辨证施治：扶正固本 免疫疗法 转移因子、核酪口服液 支气管炎菌苗、卡介苗、灭活麻疹疫苗 预防发作 戒烟、防止粉尘、烟雾吸入 加强体育活动、进行耐寒和腹式呼吸锻炼 防止感冒等呼吸道感染 高蛋白、高营养饮食 思考题 1．哮喘的治疗目的和治疗原则有哪些？ 2．哮喘有哪些类型，临床表现如何？ 3．慢性阻塞性肺病的治疗原则有哪些？ 4. 慢性阻塞性肺病的类型有哪些，临床表现如何? * Allergic asthma remains a leading cause of morbidity and mortality, and currently affects 100-150 million individuals worldwide. Epidemiological studies show that both the prevalence and severity of asthma are increasing. Healthcare utilization and expenditure is very high, most of which is accounted for by the management of more difficult-to-treat patients (i.e. those with severe and/or poorly controlled disease). 奇脉又称吸停脉,是指在吸气时脉搏显著减弱或消失,是由于吸气时回心血量减少导致的心输出量降低,可见于大量心包积液或心包填塞,缩窄性心包炎,限制性心肌病，重度哮喘等。 * 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 Figure 2-5. Levels of Asthma Control Characteristic：Controlled Partly controlled(Any measure present in any week) Uncontrolled Daytime symptoms：None (or minimal) Twice or more/week Three or more present in any week Limitations oactivities：None Any Three or more present in any week Nocturnal symptoms/awakening：None Any Three or more present in any week Need for rescue/”reliever” treatment：None (or minimal) Twice or more/week Three or more present in any week Lung function (PEF or FEV1)：Normal or near-normal 80% predicted or personal best (if known) Three or more present in any week Exacerbations：Minimal One or more/year One in any week To include GINA 2006 update guide for step-up and step-down dosing as part to maintain asthma control a continuous cycle of : Assessing Asthma Cont