1、 Understanding "Asthma"
Asthma is a heterogeneous disease characterized by chronic inflammation of the airway, involving multiple cells and cellular components, including structural cells, functional cells, and their cytokines. The clinical manifestations include recurrent wheezing, shortness of breath, with or without chest tightness, cough, and phlegm, often occurring at night and/or in the morning, accompanied by airway hyperresponsiveness and reversible airflow limitation. As the disease progresses, airway remodeling may occur. From the perspective of traditional Chinese medicine, asthma belongs to the categories of "asthma disease", "wheezing syndrome", "cough", etc. It is a paroxysmal phlegm wheezing asthma disease caused by factors such as body deficiency, phlegm stagnation in the lungs, sensory stimulation, phlegm obstruction of the airway, loss of lung clearance, phlegm qi obstruction, and rapid airway spasm. The basic clinical features include wheezing in the throat, shortness of breath, and even inability to lie flat due to wheezing.
2、 What are the hazards of asthma?
1. Short term hazards of acute asthma attacks: Acute asthma attacks can cause insufficient lung ventilation, leading to hypoxia in the body. In severe cases, patients may experience respiratory failure and even endanger their lives.
2. Long term harm of poor asthma control: Repeated poor asthma control can cause airway inflammation to persist in a vicious cycle, leading to irreversible airway obstruction over time, which can have a greater impact on the patient's health and quality of life.
3. Poor asthma control in elderly patients can easily lead to secondary/induced systemic diseases: asthma, shortness of breath, and other symptoms are more pronounced, and long-term lung ventilation resistance increases, the body's ventilation is insufficient, and the body is in a chronic state of consumption and hypoxia for a long time, which can easily induce the aggravation of other underlying diseases and exacerbate the rapid decline of overall body function.
3、 The manifestations of asthma
Typical asthma symptoms include wheezing, shortness of breath, chest tightness, cough, and other respiratory symptoms, with reversible airway constriction and restricted respiratory airflow, often worsening at night and early morning. Atypical asthma patients present with recurrent coughing, chest tightness, or other respiratory symptoms, such as cough variant asthma, chest tightness variant asthma, and occult asthma. Cough variant asthma is characterized by cough as the only or main clinical manifestation, which is a stimulating dry cough that is more severe, especially at night, without obvious symptoms or signs such as wheezing or shortness of breath, but with airway inflammation and airway hyperresponsiveness; Variant asthma with chest tightness is characterized by chest tightness as the only or main symptom, without obvious typical symptoms and signs such as coughing, wheezing, and shortness of breath; Hidden asthma does not have clinical manifestations such as recurrent wheezing, shortness of breath, chest tightness, or cough, but examination reveals long-term airway hyperresponsiveness.
4、 Which asthma patients are more suitable for integrated traditional Chinese and Western medicine treatment?
According to traditional Chinese medicine theory, its onset is mainly caused by two factors: internal and external factors. The internal cause is due to innate deficiencies, leading to dysfunction of the lungs, spleen, and kidneys, resulting in phlegm retention in the lung orifices, becoming the root cause of asthma. External factors are often caused by feeling external pathogens or coming into contact with foreign objects, odors, and eating and emotional disorders. Traditional Chinese medicine advocates treating asthma primarily during attacks, addressing the root cause during remission, and treating both symptoms and symptoms during chronic duration. Based on the TCM syndrome differentiation and treatment system, more targeted individualized diagnosis and treatment plans can be provided for asthma patients. The combination of traditional Chinese and Western medicine treatment can achieve better clinical efficacy as follows:
1. Patients with refractory (chronic persistent) bronchial asthma: This group has recurrent asthma symptoms of varying degrees throughout the year, and after multiple treatment plans, the control goals cannot be achieved. Most of them have already developed irreversible chronic airway obstruction of varying degrees, which seriously affects daily life and activities.
2. Special phenotype hormone therapy for insensitive asthma patients: With the continuous deepening of asthma research, the medical field still recognizes that it is not as simple as the traditional understanding that "allergies" dominate, nor can all asthma patients be controlled solely through inhaled hormones and anti allergic treatment.
3. Patients with chronic rhinitis and asthma: Asthma accompanied by chronic rhinitis and pharyngitis has a high incidence rate, and chronic inflammation in the upper airway of these patients can easily form a mixed effect with the condition of asthma, making asthma control more difficult.
4. Combining asthma patients with other diseases: For example, patients with bronchiectasis are prone to chronic respiratory infections, long-term colonization of pathogenic microorganisms, and other factors that make asthma difficult to control, and infections are more likely to recur and worsen; In addition, if combined with obesity and fatty liver, this patient group is also known as "obese asthma", and clinical inhaled hormone therapy is often unsatisfactory; For example, merging with other neuroendocrine diseases.
5. Long term control requires descending the ladder for asthma patients: Currently, there are clear recommended treatment plans for descending the ladder, but many patients experience unstable conditions during the descending process, which makes it difficult to implement descending the ladder treatment smoothly.
Summary
Bronchial asthma is a unique chronic disease, and its prevention and treatment require the development of long-term and detailed individualized treatment plans. Asthma needs to be managed and actively controlled throughout the entire process. By continuously improving patients' understanding of asthma, increasing the standardized treatment rate of asthma, better integrating the advantages of traditional Chinese and Western medicine resources, and working together with doctors and patients, we can improve the asthma control rate in China, ultimately enabling asthma patients to achieve the goals of control, non attack, and not affecting daily life and activities.