Ishihara K
Department of Pulmonary Medicine, Kobe City General Hospital.
Nihon Rinsho. 1996 Nov;54(11):2976-81.
In 1988, we started to change our treatment policy, away from a polypharmaceutical approach including oral bronchodilators and oral anti-allergic agents available in Japan, toward an inhalation therapy including inhaled corticosteroids and inhaled beta-agonist. A marked decline in the number of asthma admission and death from asthma started coincidentally with the increased use of inhaled corticosteroid which were followed by the decreased use of inhaled beta-agonists and oral anti-asthma agents. The intensification of patient education mainly consisting of emphasizing on better understanding of benefits of inhalation therapy and a self-management is likely to play an important role in enhancing a protective effects of inhaled corticosteroids. Despite some limitations of inhaled corticosteroids, such as poorer dose response in elderly asthmatics and/or patients with severe disease, further introduction of guide-line treatment will result in a measurable improvement on asthma control.
1988年，我们开始改变治疗策略，从使用包括日本现有的口服支气管扩张剂和口服抗过敏药物在内的多种药物治疗方法，转向采用包括吸入性皮质类固醇和吸入性β-激动剂在内的吸入疗法。哮喘住院人数和哮喘死亡人数显著下降，这与吸入性皮质类固醇使用增加同时发生，随后吸入性β-激动剂和口服抗哮喘药物的使用减少。以强调更好地理解吸入疗法的益处和自我管理为主的强化患者教育，可能在增强吸入性皮质类固醇的保护作用方面发挥重要作用。尽管吸入性皮质类固醇存在一些局限性，如老年哮喘患者和/或重症患者的剂量反应较差，但进一步引入指南治疗将在哮喘控制方面带来可衡量的改善。
