van Schayck C P
Universiteit Maastricht, capaciteitsgroep Huisartsgeneeskunde, Care and Public Health Research Institute, Postbus 616, 6200 MD Maastricht.
Ned Tijdschr Geneeskd. 2008 Mar 8;152(10):541-2.
The second revised guideline 'Asthma in children' from the Dutch College of General Practitioners adequately describes the present state of knowledge regarding the diagnosis and treatment of asthma in children. Updates include the recommendation to investigate allergies in children aged less than 6 years, because this can contribute to a probable diagnosis of asthma. This specific recommendation, which has yet to appear in international guidelines, is based on an excellent clinical study performed in general practices in the Netherlands. It is important that the findings of this study are confirmed by at least one additional study. The revised guideline correctly asserts that fast-acting bronchodilators and inhaled corticosteroids form the cornerstone of treatment for children with asthma, and that cromoglycate no longer has a role in this setting. However, the question remains whether the currently modest role assigned to leukotriene antagonists is justified based on the most recent literature.
荷兰全科医生学院发布的第二版修订指南《儿童哮喘》充分描述了目前有关儿童哮喘诊断和治疗的知识现状。更新内容包括建议对6岁以下儿童进行过敏调查,因为这有助于哮喘的可能诊断。这一尚未出现在国际指南中的具体建议,是基于在荷兰全科医疗实践中进行的一项出色的临床研究。重要的是,这项研究的结果至少要得到另一项研究的证实。修订后的指南正确地指出,速效支气管扩张剂和吸入性糖皮质激素是儿童哮喘治疗的基石,色甘酸在这种情况下不再起作用。然而,根据最新文献,目前对白三烯拮抗剂所赋予的适度作用是否合理,这一问题仍然存在。