What is asthma?

Definition of Disease

Asthma, also known as bronchial asthma, is a chronic airway disease characterized by chronic inflammation in the airways. The clinical manifestations are recurrent symptoms such as wheezing, shortness of breath, chest tightness or cough, which often occur or worsen at night and early morning, most patients can be relieved by themselves or relieved after treatment.

Epidemiology

The prevalence of asthma among adults in China is 1.24%. The disease tends to occur in people with a family history of asthma, complications (such as allergic rhinitis, allergic conjunctivitis, eczema, respiratory diseases and gastroesophageal reflux disease), obesity, smoking and allergen exposure. Due to urbanization and the lifestyle changes, the prevalence of asthma is increasing year by year. According to an analysis of asthma deaths in the 5 to 34 age group, the global death rate from asthma dropped from 0.44 to 0.19 per 100,000 population between 1993 and 2006, but remained unchanged from 2006 to 2012, according to WHO's online death database. 

Disease types

I Exercise-induced asthma

It is caused by exercise and is directly related to the type, duration, volume and intensity of exercise. The episodes are acute, transient, and most resolve spontaneously..

II Asthma Drugs  

Caused by the use of certain drugs, such as aspirin, beta-blockers, etc. |Occupational asthma

It is caused by occupational asthma-causing substances such as polyurethane rigid foam, synthetic fibers, adhesives, etc., and is often caused by shortness of breath, chest tightness, and cough during or several hours after work, accompanied by rhinitis and/or conjunctiva Symptoms subsided after leaving the workplace.

III Allergic asthma

 Often caused by allergic substances acting on allergic constitution, and allergic diseases (such as allergic rhinitis, etc.) can occur, manifested as sneezing, runny nose, coughing, chest tightness, wheezing and even breathing difficulties.

Symptoms

Asthma patients often have symptoms such as wheezing, shortness of breath, chest tightness, or coughing. Generally, they can be relieved by themselves or treated with anti-asthmatic drugs.

I Typical symptoms

General performance for repeated attacks of wheezing, shortness of breath, chest tightness or cough and other symptoms;Severe attacks can occur in a short period of dyspnea and hypoxemia .

II Aura symptoms

Before the attack often foreboding symptom such as nasal congestion, sneezing and itchy eyes.

Symptoms of an acute attack of asthma
I Mild

Shortness of breath, anxiety, slight increase in breathing rate, and occasional wheezing can be heard when walking or upstairs . 

II Moderate

Shortness of breath with moderate activity, often interrupted speech, anxiety from time to time, increased breathing rate, three concave sign (referring to the obvious depression in the suprasternal fossa, supraclavicular fossa, and intercostal space during inhalation), loud, Diffuse wheezing, increased heart rate. Shortness of breath during severe rest, orthopnea, only single-word expressions, often anxiety and irritability, profuse sweating, breathing rate > 30 beats/min, often with three concave signs, hearing loud and diffuse wheezing, increased heart rate Fast and often > 120 times/min.

III Critically ill

Patients are unable to speak, drowsiness or confusion, diminished or absent wheezing, and slow or irregular pulse rate.

· Basic etiology·

I Genetic factors

Asthma has a polygenic genetic tendency, and its onset has a certain familial aggregation phenomenon, that is, the closer the kinship, the higher the prevalence, but its onset is often formed by the combined action of multiple genes and exogenous factors.

II Environmental factors

Pathogenic factors such as indoor allergens (domestic pets, cockroaches, etc.), outdoor allergens (pollen, grass powder, etc.), occupational allergens (paint, reactive dyes, etc.), food (fish, shrimp, Eggs, milk, etc.), drugs (aspirin, antibiotics, etc.) and other factors stimulated.

III Non-pathogenic factors such as air pollution, smoking, exercise, obesity, etc. may also trigger asthma.

Treatment
I Acute treatment : 

1. Mild acute asthma exacerbations can be treated with inhaled salbutamol or metaxonin aerosols, which usually work within minutes, or with oral beta 2 agonists. Symptoms are only partially improved after inhalation of bronchodilators in acute exacerbations of moderate asthma, so a combination of becloxone propionate or budesonide inhalation is often required. People with moderate asthma exacerbation often have nocturnal asthma attacks and exacerbation of symptoms, and often need to use long-acting sustained-release theophylline and other drugs to effectively prevent nocturnal asthma attacks.
2. Acute severe asthma

At this time, the effects of inhalation of β2 receptor agonists and glucocorticoids is not obvious, and it is often necessary to send to the hospital emergency department.

II General treatment

For the cause of treatment: such as respiratory infections, antibiotics are required. Symptomatic treatment: such as wheezing, it is necessary to treat spasmolysis and asthma; If dyspnea, it is necessary to keep the airway unobstructed, oxygen or even give mechanical ventilation treatment.

In addition, in daily life, asthma patients should pay attention to active disease prevention measures, moderate exercise can help reduce airway inflammation, relieve anxiety, improve the quality of life; In the climate change, pay attention to timely keep warm, as far as possible to avoid public places with many people, so as not to cause respiratory infections; Reasonable diet, regular life, maintain a good state of mind, ensure adequate sleep, improve body resistance, enhance airway anti-inflammatory, anti-allergic ability.
It is suggested that every asthma patient should have an oxygen concentrator at home, which can be inhaled at any time when the body feels unwell. Oxygen inhalation has a good effect on asthma, which can improve the oxygen concentration in the alveoli and help relieve asthma. Inhaling oxygen before going to bed can not only help alleviate the disease, but also promote sleep, reduce insomnia, easy to wake up, and then improve one's own resistance.