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《2016年中国儿童哮喘防治指南》:重大更新、推荐意见及关键地区数据。

Chinese guidelines for childhood asthma 2016: Major updates, recommendations and key regional data.

作者信息

Hong Jianguo, Bao Yixiao, Chen Aihuan, Li Changchong, Xiang Li, Liu Chuanhe, Chen Zhimin, Zhao Deyu, Fu Zhou, Shang Yunxiao

机构信息

a Department of Pediatrics , Shanghai General Hospital, Shanghai Jiaotong University , Shanghai , China.

b National Children's Medical Center, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai , China.

出版信息

J Asthma. 2018 Oct;55(10):1138-1146. doi: 10.1080/02770903.2017.1396474. Epub 2017 Dec 11.

Abstract

OBJECTIVE

With increased industrialization and urbanization in China, pediatric asthma is becoming more prevalent. Despite a growing body of evidence, there remains a significant unmet need for adequate management of childhood asthma. The Subspecialty Group of Respiratory Diseases of the Society of Pediatrics, the Chinese Medical Association, and the editorial board of the Chinese Journal of Pediatrics have recently updated the "Guidelines for diagnosis and optimal management of asthma in children," first published in 2008.

METHODS

This article reviews the major updates to the guidelines and covers the main recommendations for diagnosis, assessment, and treatment of pediatric asthma in China. Key regional data on epidemiology, clinical features, disease burden, knowledge among children and parents, and risk factors including pollution are provided to contextualize the recommendations.

RESULTS

The major updates to the guidelines include: (1) A more practical definition of asthma; (2) assessment of asthma control that takes into account both current symptom control and future risk; (3) classification based on disease severity that corresponds with treatment step; (4) differentiation between difficult-to-treat and poorly controlled asthma; (5) an open-ended approach to pharmacological management; and (6) allergen immunotherapy (AIT) in mild- to moderate-persistent asthma.

CONCLUSIONS

The updated "Guidelines for the diagnosis and optimal management of asthma in children (2016)" combine the latest national and international clinical evidence and experience to provide practical and reliable recommendations to Chinese clinicians.

摘要

目的

随着中国工业化和城市化进程的加快,儿童哮喘日益普遍。尽管已有越来越多的证据,但儿童哮喘的充分管理仍存在重大未满足需求。中华医学会儿科学分会呼吸学组和《中华儿科杂志》编辑委员会最近更新了2008年首次发布的《儿童支气管哮喘诊断与防治指南》。

方法

本文回顾了该指南的主要更新内容,并涵盖了中国儿童哮喘诊断、评估和治疗的主要建议。提供了有关流行病学、临床特征、疾病负担及儿童和家长知识水平的关键区域数据,以及包括污染在内的危险因素,以便为这些建议提供背景信息。

结果

该指南的主要更新内容包括:(1)哮喘的定义更具实用性;(2)哮喘控制评估兼顾当前症状控制和未来风险;(3)根据疾病严重程度进行分类并与治疗步骤相对应;(4)区分难治性哮喘和控制不佳的哮喘;(5)药物治疗采用开放式方法;(6)在轻度至中度持续性哮喘中采用变应原免疫疗法(AIT)。

结论

更新后的《儿童支气管哮喘诊断与防治指南(2016年版)》结合了最新的国内外临床证据和经验,为中国临床医生提供了实用且可靠的建议。

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