Diagnosis and management of asthma in children under 6 years old Horse Civilization in Lujiang Hospital of Traditional Chinese Med 30 The prevalence of childhood asthma in China has increased by more than 50% every 10 years.In addition, the prevalence of asthma in children under 6 years old is higher in China. Based on this, how to improve the diagnosis rate of asthma in children under 6 years old makes the diagnosis easier, making the establishment of new diagnostic criteria for asthma in children under 6 years old more urgent. Definition of bronchial asthma is a heterogeneous disease characterized by chronic airway inflammation and airway hyperresponsive ng, cough, shortness of breath and chest tightness are the main clinical manifestations, often at night a gravation in the early morning.The specific manifestations and severity of respiratory symptoms are sig e and is often accompanied by variable respiratory restriction. Diagnostic criteria for bronchial asthma fficulty in the diagnosis of bronchial asthma is mainly based on respiratory symptoms, signs and pulmonary function tests. fact, there are other diseases that can cause respiratory airflow limitation and exclude related symptoms. 1. 反复喘息、咳嗽、气促、胸闷,多与接触变应原 、冷空气、物理、化学性刺激、呼吸道感染、运动 以及过度通气(如大笑和哭闹)等有关,常在夜间 和(或)凌晨发作或加剧。 • 2. 发作时双肺可闻及散在或弥漫性,以呼气相为 主的哮鸣音,呼气相延长。 3. 上述症状和体征经抗哮喘治疗有效,或自行缓解 。 • 4. 除外其他疾病所引起的喘息、咳嗽、气促和胸 闷。 Diagnostic criteria for bronchial asthma fficulty in the diagnosis of bronchial asthma is mainly based on respiratory symptoms, signs and pulmonary function tests. fact, there are other diseases that can cause respiratory airflow limitation and exclude related symptoms. 5. 临床表现不典型者(如无明显喘息或哮鸣音), 应至少具备以下 1 项: ( 1 )证实存在可逆性气流受限: a. 支气管舒张试 验阳性:吸入速效 β2 受体激动剂(如沙丁胺醇压 力定量气雾剂 200-400ug )后 15min 第一秒用力呼 吸量( FEV1 )增加≥ 12% ; b. 抗炎治疗后肺通 气功能改善:给予吸入糖皮质激素和 ( 或 ) 抗白三 烯药物治疗 4-8 周, FEV1 增加≥ 12% ; ( 2 )支气管激发试验阳性; ( 3 )最大呼气峰流量( PEF )日间变异率(连续 监测 2 周)≥ 13% 。 Asthma can can be be diagnosed diagnosed ifif it it conforms conforms to to Articles Articles 1-4 1-4 or or 4 4 Asthma and 5. 5. and Asthma prediction Asthma prediction minary establishment of diagnostic criteria for asthma in children under 6 years of age Treatment objectives of childhood asthma ve and maintain symptom control; ning the pulmonary function level as close as possible to normal; n normal level of activity, including motor ability; dverse reactions caused by medication for asthma. on of acute attack of asthma; on of death from asthma Treatment objectives of childhood asthma Maintaining a normal level of activity is particularly important for young children, because their participation in play is important for their normal social and physical development.Parents/caregivers'goals should also be understood, as they may differ from traditional medical goals. Initial treatment of asthma Initial treatment for asthma should last at least three months. 1. 1. For For most most asthma asthma control control drugs, drugs, although although there there has has been been aa significant significant improvement improvement since since the the beginning beginning of of medication, medication, patients patients need need at at least least 3-4 3-4 months months after after treatment treatment if if they they want want to to benefit benefit fully.For fully.For patients patients with with severe severe and and chronic chronic asthma, asthma, treatment treatment may may take take longer. longer. 2. 2. Initial Initial treatment treatment should should be be used used for for at at least least three three months months to to determine determine the the effectiveness effectiveness of of good good asthma asthma control. control. Long-term treatment of asthma in children under 6 years of age Long-term treatment of asthma For children with good asthma control and stable pulmonary function (> 3 months), degraded treatment may be considered. •If asthma is controlled and maintained for at least three months, the treatment regimen may consider relegation until the lowest dose for maintaining asthma control is determined.For partial control, upgrade or intensive treatment can be considered until control is achieved. •Those who used ICS at medium and high doses alone tried to reduce the dose by 25%-50% after achieving and maintaining asthma control for 3 months.When low dose ICS can reach the control, it can be given once a day instead.If ICS and LABA are used jointly, the ICS will be reduced by about 5

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