Carlsen Kai-Håkon, Carlsen Karin C L
Voksentoppen Department of Paediatrics, Rikshospitalet, University of Oslo, Oslo, Norway.
Curr Opin Allergy Clin Immunol. 2008 Apr;8(2):168-76. doi: 10.1097/ACI.0b013e3282f8247d.
Although great improvement has been obtained in quality of life and mastering of illness by asthmatic children over recent decades, controversies still exist related to asthma treatment. The objective of the present article is to discuss such controversies.
Results from recent publications related to childhood asthma treatment question existing dogmas. Important for prescribing correct treatment to children is correct diagnosis. Phenotypes of childhood asthma related to treatment decisions are discussed. Early use of inhaled steroids in young children is still debated as well as the preference of inhaled long-acting beta2-agonists versus leukotriene receptor antagonists as add on to inhaled steroids. When present, both allergic rhinitis and asthma should be treated to obtain improved control. Also as regards the treatment of exercise-induced asthma in children, new results concerning use of leukotriene receptor antagonists is discussed as well as the acute treatment in infants with bronchial obstruction.
There are still several controversies regarding treatment of the asthmatic child. New studies designed specifically for children are needed to solve these questions. One cannot rely on studies performed in adults for treatment in children. New studies designed for childhood asthma are needed to solve these controversies.
尽管近几十年来哮喘儿童的生活质量和疾病控制情况有了很大改善，但哮喘治疗仍存在争议。本文旨在讨论这些争议。
近期有关儿童哮喘治疗的出版物结果对现有教条提出了质疑。正确诊断对于为儿童开具正确治疗方案至关重要。文中讨论了与治疗决策相关的儿童哮喘表型。幼儿早期使用吸入性糖皮质激素以及吸入长效β2受体激动剂与白三烯受体拮抗剂作为吸入性糖皮质激素附加治疗的偏好仍存在争议。如果同时存在过敏性鼻炎和哮喘，应进行治疗以更好地控制病情。此外，关于儿童运动诱发性哮喘的治疗，讨论了白三烯受体拮抗剂使用的新结果以及婴儿支气管阻塞的急性治疗。
哮喘儿童的治疗仍存在若干争议。需要专门针对儿童设计的新研究来解决这些问题。不能依赖在成人中进行的研究来指导儿童治疗。需要针对儿童哮喘设计新的研究来解决这些争议。
