Imai T, Adachi M
First Department of Internal Medicine, School of Medicine, Showa University.
Nihon Rinsho. 1996 Nov;54(11):2969-75.
Bronchial asthma is no longer considered a condition with isolated, acute episodes of bronchoconstriction. Rather, asthma is now understood to be a chronic inflammatory disorder of the airways. Therefore anti-inflammatory agents and, more specifically, inhaled corticosteroids are at present the most effective controllers in long-term treatment and prevention of asthma. Asthma is highly variable, so precise classification of severity is needed for management. Asthma therapy recommended in guidelines follows a stepwise approach in which the level of therapy is increased (step up) as the severity of asthma increased and therapy decreased (step down) once control is achieved and sustained. In this stepwise approach, inhaled corticosteroid is a key drug and establishment of the dosage of inhaled corticosteroid is most important.
支气管哮喘不再被视为一种仅伴有孤立性急性支气管收缩发作的疾病。相反，如今人们认为哮喘是一种气道慢性炎症性疾病。因此，抗炎药物，更具体地说是吸入性糖皮质激素，目前是长期治疗和预防哮喘最有效的控制药物。哮喘具有高度变异性，因此管理中需要对严重程度进行精确分类。指南中推荐的哮喘治疗采用逐步升级的方法，即随着哮喘严重程度的增加，治疗水平提高（逐步升级），一旦实现并维持控制，则治疗水平降低（逐步降级）。在这种逐步升级的方法中，吸入性糖皮质激素是关键药物，确定吸入性糖皮质激素的剂量最为重要。
