Bergner A, Bergner R K
University of Vermont College of Medicine, Burlington.
Clin Ther. 1994 Jul-Aug;16(4):694-706; discussion 693.
Effective management of asthma requires accurate diagnosis and assessment of the severity of the disease. Subjective measures, such as the degree of cough, wheezing, and chest tightness, and objective assessments of pulmonary function, provide diagnostic evidence of the presence of asthma. The diagnostic criteria included in the International Consensus Report on Diagnosis and Treatment of Asthma provide one method of classifying asthma by the degree of severity. These guidelines, which were developed by the National Institutes of Health in collaboration with the International Asthma Management Project, include the US Guidelines for the Diagnosis and Management of Asthma. Only the mildest, intermittent cases of asthma generally can be managed with an inhaled short-acting beta 2-agonist given alone as needed. As the frequency or severity of the asthma increases, inhaled corticosteroids, inhaled cromolyn, or inhaled nedocromil should be added to the treatment regimen. Sustained-release theophylline, long-acting oral or inhaled beta 2-agonists, and inhaled anticholinergic agents also have a place in the treatment of selected patients.
哮喘的有效管理需要对疾病进行准确诊断和严重程度评估。主观指标，如咳嗽、喘息和胸闷的程度，以及肺功能的客观评估，为哮喘的存在提供诊断依据。《哮喘诊断和治疗国际共识报告》中包含的诊断标准提供了一种根据严重程度对哮喘进行分类的方法。这些指南由美国国立卫生研究院与国际哮喘管理项目合作制定，包括《美国哮喘诊断和管理指南》。一般只有最轻微的间歇性哮喘病例可单独按需使用吸入性短效β2受体激动剂进行治疗。随着哮喘发作频率或严重程度的增加，应在治疗方案中添加吸入性糖皮质激素、吸入性色甘酸钠或吸入性奈多罗米。缓释茶碱、长效口服或吸入性β2受体激动剂以及吸入性抗胆碱能药物在特定患者的治疗中也有一定作用。
