Kleerup E C, Tashkin D P
Department of Medicine, University of California, Los Angeles (UCLA), School of Medicine 90024-1690, USA.
West J Med. 1995 Jul;163(1):49-63.
As a chronic disease with intermittent exacerbations, asthma is treated primarily in the outpatient setting by primary care physicians. Asthma is the result of complex and only partially understood interactions of respiratory, inflammatory, and neural cells and their mediators. The goals of asthma therapy are to prevent and relieve symptoms, allow normal activities of daily living, restore and maintain normal pulmonary function, avoid adverse effects from interventions, and minimize inconvenience and cost. These goals can be achieved through educating patients, assessing and monitoring asthma severity, avoiding or controlling asthma triggers, establishing an intervention plan for routine self-management and the management of exacerbations, and providing regular follow-up care. We present a stepped approach to asthma pharmacotherapy, emphasizing anti-inflammatory therapy--inhaled corticosteroids, cromolyn sodium, or nedocromil sodium--as a summary of recent national and international recommendations.
作为一种伴有间歇性加重的慢性疾病，哮喘主要由初级保健医生在门诊环境中进行治疗。哮喘是呼吸、炎症和神经细胞及其介质之间复杂且仅部分为人所理解的相互作用的结果。哮喘治疗的目标是预防和缓解症状，使日常生活活动正常化，恢复并维持正常肺功能，避免干预措施产生的不良反应，并尽量减少不便和费用。通过对患者进行教育、评估和监测哮喘严重程度、避免或控制哮喘触发因素、制定常规自我管理和加重期管理的干预计划以及提供定期随访护理，可以实现这些目标。我们提出一种哮喘药物治疗的阶梯式方法，强调抗炎治疗——吸入性糖皮质激素、色甘酸钠或奈多罗米钠——作为近期国内和国际建议的总结。
