课件：哮喘7版.ppt

* * * Adult – current treatment strategies III A stepwise approach to treatment is recommended in asthma guidelines, which have been developed by International Asthma bodies (GINA) and endorsed by national healthcare committees. The treatment follows a managed care approach and should be ‘stepped up’ as necessary to achieve control of asthma. Treatment should be tailored to the needs of the individual patient and reviewed regularly. Once control has been achieved, a gradual step-down should be introduced. * 那哮喘的治疗时间呢？ 已故的澳大利亚哮喘专家Woolcock在2000年ERS上发表了具有深远意义的哮喘控制图，对我们临床哮喘控制很有参考价值。 通过治疗，可以在几天内使哮喘患者没有夜间症状；几周内使哮喘患者的第一秒呼气量得到提高；通过几月时间治疗后，哮喘患者的肺功能趋于正常；要使哮喘患者达到不需使用短效?2激动剂（如沙丁胺醇）则需要近一年时间的治疗。但要使哮喘的病因：平滑肌功能障碍---气道高反应恢复正常，则需要以年计算的长期持续治疗。 一句话，哮喘的治疗需要长期持续的治疗。 * 经GINA方案正规治疗，绝大多数病人都可被控制良好，但仍有少数病人控制不满意，其主要原因可能是以上这些。 * * Slide 7 - LABAs have long-lasting effects on airway smooth muscle and reduce mucosal oedema. CS have potent anti-inflammatory effects and reduce bronchial hyper-reactivity. LABAs and CS in combination have complementary modes of action targeting different aspects of the disease. * Slide 10: Key Concepts * Slide 3. Considerations in Treating School-Aged Children With Asthma The approach to treating childhood asthma is like solving a puzzle: many pieces need to come together to effectively address the challenges in treating the symptoms of childhood asthma. 合理治疗， 早日康复！ 祝每一位患哮喘的小朋友都能得到 Have you any question? * Slide 6. Inflammation in Mild Asthma Normal: In a subject without asthma, the epithelium is intact; there is no thickening of the subbasement membrane, and there is no cellular infiltrate.1 Asthma: In contrast, in a patient with mild asthma, there is evidence of goblet-cell hyperplasia in the epithelia-cell lining. The subbasement membrane is thickened, with collagen deposition in the submucosal area, and there is a cellular infiltrate, some of which includes eosinophils.1 Reference:? 1. Busse WW, Lemanske RF Jr. N Engl J Med.