课件：难治性支气管哮喘的诊断与治疗.ppt

* * * * 13 Controller medications are used long term. They get and keep asthma under control. They may interrupt the development of airway inflammation and therefore have a prophylactic action as well as a suppressive action on existing asthma symptoms. Anti-inflammatory agents (especially corticosteroids) are the most effective asthma controller medications. * GINA，全球哮喘防治创议（WHO和美国国立心肺和血液病研究所共同创议）已提出了治疗指南，以达到改善全球哮喘管理的目的 阶梯式治疗方式，是根据哮喘严重程度给予相应治疗。如：哮喘症状未控制（已经检查吸入 技术和病人依从性良好），用药的数量和频度需增加（升级） 这些指南仅为推荐的方法，要根据当地药物资源和病人个体状况来决定针对性治疗方案 * * * Slide 16 ? When classifying asthma severity according to the GINA guidelines, it is important to realise that the ‘clinical’ setting can be very different from the situation in real life for many reasons * Slide 16 ? When classifying asthma severity according to the GINA guidelines, it is important to realise that the ‘clinical’ setting can be very different from the situation in real life for many reasons * 2 The goals of asthma management are: Minimal, but ideally, no chronic symptoms both during the day and at night Minimal, or at least infrequent, exacerbations No emergency visits Minimal need for prn Beta2-agonists No limitations on activities, including exercise Near normal PEFR values variability 20% Minimal, but ideally, no adverse effects from the medicines used * * In addition to constriction (narrowing) of the airways, due to contraction of the smooth muscle in the airway wall, asthma is also associated with specific inflammatory changes. These inflammatory processes include exudation of mucus and plasma, oedema and shedding of the damaged epithelium Narrowing of the airways in asthma is produced by a combination of smooth muscle contraction, thickening of the airway wall, oedema and mucus in the airway lumen * In addition to constriction (narrowing) of the airways, due to contraction of the smooth muscle in the airway wall, asthma is also associated with specific inflammatory changes. These inflammatory