Reinke L F, Hoffman L
Zablocki VA Medical Center, Milwaukee, WI, USA.
Heart Lung. 2000 May-Jun;29(3):225-36. doi: 10.1067/mhl.2000.107298.
This article advances the theory that the key to creating an effective partnership is teaching asthma patients what to self-treat, how to self-treat, and when to consult a clinician. The five comanaging rules that the health educator is encouraged to emphasize with the adult asthma patient are: know your own unique asthma symptoms and triggers; keep written records; see appropriate specialists; know your medicines and follow your action plan; and accept no treatment you do not understand. Current research shows asthma to be a chronic inflammatory disorder of the airways. In susceptible individuals, this inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough, particularly at night and in the early morning. The stepwise approach to asthma therapy divides asthma into several levels of severity. However, patients at any level of severity can have mild, moderate, or severe exacerbations. Asthma triggers; how to use a metered dose inhaler (MDI), a dry powder inhaler (DPI), and a peak flow meter; and how to follow an asthma action plan are thoroughly covered. The last section of the article deals at length with the indications for and actions of long-term-control medications, used to achieve and maintain control of persistent asthma, and quick-relief medications, used to treat symptoms and exacerbations.
本文提出了一种理论,即建立有效合作关系的关键在于教导哮喘患者自我治疗的内容、方法以及何时咨询临床医生。鼓励健康教育工作者向成年哮喘患者强调的五项共同管理规则是:了解自己独特的哮喘症状和诱发因素;做好书面记录;咨询合适的专科医生;了解自己的药物并遵循行动计划;不接受任何自己不理解的治疗。当前研究表明,哮喘是一种气道慢性炎症性疾病。在易感个体中,这种炎症会导致反复出现喘息、气促、胸闷和咳嗽,尤其是在夜间和清晨。哮喘治疗的逐步方法将哮喘分为几个严重程度级别。然而,任何严重程度级别的患者都可能出现轻度、中度或重度发作。本文全面介绍了哮喘诱发因素、如何使用定量吸入器(MDI)、干粉吸入器(DPI)和峰流速仪,以及如何遵循哮喘行动计划。文章的最后一部分详细讨论了用于实现和维持持续性哮喘控制的长期控制药物以及用于治疗症状和发作的快速缓解药物的适应证和用法。