Hamasaki Yuhei, Kohno Yoichi, Ebisawa Motohiro, Kondo Naomi, Nishima Sankei, Nishimuta Toshiyuki, Morikawa Akihiro, Aihara Yukoh, Akasawa Akira, Adachi Yuichi, Arakawa Hirokazu, Ikebe Toshiichi, Ichikawa Kunio, Inoue Toshishige, Iwata Tsutomu, Urisu Atsuo, Ohya Yukihiro, Okada Kenji, Odajima Hiroshi, Katsunuma Toshio, Kameda Makoto, Kurihara Kazuyuki, Sakamoto Tatsuo, Shimojo Naoki, Suehiro Yutaka, Tokuyama Kenichi, Nambu Mitsuhiko, Fujisawa Takao, Matsui Takehiko, Matsubara Tomoyo, Mayumi Mitsufumi, Mochizuki Hiroyuki, Yamaguchi Koichi, Yoshihara Shigemi
Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan; Japanese Society of Pediatric Allergy and Clinical Immunology, Gifu, Japan.
Pediatr Int. 2014 Aug;56(4):441-50. doi: 10.1111/ped.12389.
A new version of the Japanese pediatric guideline for the treatment and management of bronchial asthma was published in Japanese at the end of 2011. The guideline sets the pragmatic goal for clinicians treating childhood asthma as maintaining a "well-controlled level" for an extended period in which the child patient can lead a trouble-free daily life, not forgetting the ultimate goal of obtaining remission and/or cure. Important factors in the attainment of the pragmatic goal are: (i) appropriate use of anti-inflammatory drugs; (ii) elimination of environmental risk factors; and (iii) educational and enlightening activities for the patient and caregivers regarding adequate asthma management in daily life. The well-controlled level refers to a symptom-free state in which no transient coughs, wheezing, dyspnea or other symptoms associated with bronchial asthma are present, even for a short period of time. As was the case in the previous versions of the guideline, asthmatic children younger than 2 years of age are defined as infantile asthma patients. Special attention is paid to these patients in the new guideline: they often have rapid exacerbation and easily present chronic asthmatic conditions after the disease is established.
新版日本小儿支气管哮喘治疗与管理指南于2011年末以日语发布。该指南为治疗儿童哮喘的临床医生设定了务实目标，即让患儿长期维持“良好控制水平”，使其能过上无忧无虑的日常生活，同时不忘实现缓解和/或治愈这一最终目标。实现务实目标的重要因素包括：（i）合理使用抗炎药物；（ii）消除环境危险因素；（iii）针对患者及其护理人员开展有关日常生活中适当哮喘管理的教育和启蒙活动。良好控制水平指的是无症状状态，即不存在任何短暂咳嗽、喘息、呼吸困难或其他与支气管哮喘相关的症状，哪怕是短时间内也没有。与该指南的前几版一样，2岁以下的哮喘儿童被定义为婴幼儿哮喘患者。新指南对这些患者给予了特别关注：他们病情往往迅速加重，且在疾病确诊后容易出现慢性哮喘状况。
