It is one of the most common respiratory diseases that seriously affects the physical and mental health of children. In recent years, the prevalence and mortality of childhood asthma have been on the rise. It rose to 1.5%, which means that there are more than 10 million children with asthma in our country. In conjunction with the Biophilia Intruder device, we can detect changes in our children's health in their daily lives, so as to better protect our children's health. Causes With the progress of research on pathogenesis, immunology, molecular biology, pathophysiology, and experimental science. The research on asthma prevention and treatment has also made rapid progress in the past 50 years. Asthma has been proven to be a chronic inflammatory disease of the airways. The persistence of this chronic inflammatory response results in a hyperresponsive airway, with recurrent symptoms when exposed to triggers. The study of the pathogenesis of asthma has developed from the spasm theory to the theory of chronic airway inflammation, and has now entered the parallel theory of smooth muscle dysfunction and airway inflammation. The clinical treatment also consists of repeated antispasmodic, focusing on anti-inflammatory, anti-inflammatory and smooth muscle spasm relief. In the 1950s, non-selective epinephrine was used as an antispasmodic for the treatment of asthma. In 1956, the short-acting β2 agonist with strong selectivity (Short Acting Beta2 Agonist SABA) came out, and in 1971, the long-acting β2 agonist (Long Acting Beta2 Agonist LABA) came out. In the 1960s, oral glucocorticoids were used to antagonize airway inflammation, which was effective but had serious side effects. In 1972, beclomethasone dipropionate (BDP) was successfully developed, and budesonide (BUD) and fluticasone propionate (FP) were developed in the 1980s. ), etc., these inhaled glucocorticoids have stronger anti-inflammatory effects on the local airway, and the side effects are significantly reduced. In the late 1980s, countries around the world successively formulated their own prevention and control guidelines. In 1994, the World Health Organization and the Heart, Lung, and Blood Institute of the National Institutes of Health of the United States convened more than 30 experts from 17 countries in New York to formulate an epoch-making global asthma initiative, the GINA (Global INitiative for Asthma) program. A survey of asthma status in 16 countries on three continents was conducted in 2000, and the GINA was revised in March 2002. my country has also formulated guidelines for the prevention and treatment of childhood asthma. Childhood asthma cure In the Asthma investigation and Reality In Asia Pacific (AIRAP) study in 2000, the survey report from China showed that the asthma control status in my country is far from the long-term management goals of asthma mentioned in the GINA program. Pediatric medical workers should continuously improve the level of diagnosis and treatment of childhood asthma, especially the diagnosis of childhood asthma and asthma in young age groups formulated in combination with the GINA program; pay attention to the understanding and application of treatment content; pay attention to preventive treatment during asthma remission ; Recognize the importance of standardizing anti-inflammatory treatment and the concept that the sooner you receive anti-inflammatory treatment, the better the condition. Although adult asthma and childhood asthma have basic similarities in etiology, epidemiology, immunology, pathogenesis, pathophysiology, and clinical principles of diagnosis and treatment, it should be fully understood that children are not just "little adults", nor are they "The Epitome of Adulthood". Childhood asthma is still quite different from adult asthma in some respects. Because children are in the process of continuous growth and development of intelligence, body, immunity, psychology, etc., they have the dynamic characteristics of continuous development and improvement, especially in immunology and pathophysiology. Therefore, childhood asthma has its particularity, and there are many differences from adult asthma. Pediatricians should make full use of the dynamic characteristics of children's development and continuous improvement. Active prevention and treatment can achieve clinical cure and prevent childhood asthma from developing into severe asthma with airway remodeling. In the diagnosis of childhood asthma, the primary medical units missed and misdiagnosed, so it is more common to repeatedly abuse antibiotics to treat childhood asthma; Treatment should be inhaled as the first option" and "Inhaled corticosteroids are essential for preventing asthma exacerbations" are not known or accepted. In some mountainous areas, 18% of children with asthma never considered treatment. The popularization and promotion of asthma knowledge, the education of asthmatic children and their parents, and self-management must be strengthened. Only by promoting these prevention and treatment work can we modernize the prevention and treatment of childhood asthma in my country. History and symptoms Collection of medical history The collection of medical history is of great significance for the diagnosis, differential diagnosis, prevention, treatment and prognosis of asthma in children. Pediatricians should comprehensively and detailedly ask children with asthma about the history of present illness, atopic disease, and family history of allergies, combined with clinical symptoms. The diagnosis of asthma, the severity of asthma, and the type of asthma are determined in turn. The collection of a history of asthma in children includes the following: (1) History of present illness While knowing the age of onset, the season of onset, the frequency and frequency of onset, the duration of each onset and the degree of onset, the seizures at night, the environment of the room and feeding methods, etc., it is also important to ask whether there is any Symptoms of allergic rhinitis such as itchy nose, itchy eyes, sneezing, runny nose and nasal congestion, etc. The diagnosis of allergic rhinitis is one of the important indicators to assist in the diagnosis and classification of asthma in children. Asking the history of present illness can help us determine whether the symptoms described by the children or their parents conform to the regularity and characteristics of asthma, which is of great significance for the diagnosis of childhood asthma. A detailed medical history can also provide important clues for identifying asthma triggers. (2) History of the child's atopic disease Children with asthma are often accompanied by a history of infantile eczema, allergic rhinitis, and occasionally urticaria. Knowing the history of atopic diseases can help to determine the allergic constitution of children, and to diagnose and classify childhood asthma. have important meaning. (3) Family history of allergies Asthma in children often has obvious familial genetic tendency. Inquiring in detail about the prevalence of asthma, allergic rhinitis, eczema, and urticaria in first- and second-degree relatives has important reference value for the diagnosis and differential diagnosis of asthma in children. clinical manifestations Because children often have poor expression ability or no expression ability, many prodromal symptoms can only rely on the transmission of family members or the observation of doctors. The clinical manifestations mainly include the following aspects: (1) Onset aura and early manifestations When children are stimulated by allergens, cold air or other incentives, they often first show symptoms of upper respiratory tract allergy, such as itchy eyes, itchy nose, sneezing, runny nose, etc. Because infants and young children have difficulty expressing itching, Often only manifested as eye rubbing, nose rubbing and so on. Further manifestations are itchy palate, itchy throat, dry cough and choking cough. These symptoms usually persist for hours or days before an asthma attack. (2) Typical symptoms during seizures Dog hair triggers asthma Sudden onset of wheezing is the main feature of childhood asthma. The wheezing symptoms of childhood asthma vary greatly according to the severity of the asthma. Children may have high-pitched wheezing sounds that can be heard without a stethoscope or at a distance. Increased breathing rate, difficulty breathing, infants and young children may be manifested as mouth breathing, flapping of the nose. Many children may be accompanied by cough, usually dry cough at the beginning of the disease, coughing up white mucus-like sputum when the attack subsides. In severe attacks, it can be manifested as restlessness, cyanosis, pale complexion, and cold sweats. Physical examination revealed three concave signs, increased heart rate, and wheezing in both lungs. Further aggravation may lead to the manifestations of heart failure such as jugular vein distention, edema, middle and small blister sounds at the base of the lung, and liver enlargement. In children with chronic asthma, signs of emphysema may be seen, such as a barrel chest and a tympanic sound on chest percussion. (3) The performance of the remission period In remission, children with asthma may have no symptoms and signs, no effect on activity, or only symptoms of allergic rhinitis and pharyngitis. A small number of children may have chest discomfort, with or without wheezing in the lungs. Long-term recurrent author may have emphysema and other performance. early warning Children with asthma do not have asthma from the start, and usually have a period of aura. Here are some warning signs of childhood asthma: 1. Repeated coughing for more than a month, mainly in the morning and at night. The cough is often an irritating dry cough with little phlegm. 2. Irritant dry cough is prone to occur after exercising, inhaling cold air or eating cold drinks. 3. Repeated chest tightness, aggravated during a cold or after exercise. 4. Allergic to certain smells (such as decoration smells, toilet cleaners, perfumes, styling mousse, etc.), sneezing and coughing. 5. Allergic to seafood, some tropical fruits, some drugs, or intolerance to eggs and milk powder in infancy (often manifested as crying, vomiting, diarrhea, severe and repeated eczema, and no weight gain). 6. Have allergic rhinitis symptoms such as frequent sneezing, runny nose, nasal congestion, nasal itching, etc., often manifested as nose shrugging, nose rubbing, nose picking. 7. There is a history of obvious eczema. 8. Have a family history of allergies (need to ask relatives within three generations if they have allergic diseases). 9. Peripheral blood eosinophils increased. Treatment and Prevention The pathogenesis of asthma is complicated, and it is a chronic airway inflammation involving a variety of cells, especially mast cells, eosinophils and T lymphocytes. Symptomatic characteristics of childhood asthma: [2] ⒈ Often there are aura symptoms such as sneezing, runny nose, nasal itching (allergic rhinitis), throat itching, and coughing (allergic cough). ⒉ May have irritating cough and white foamy sputum. 3. Repeated breathing difficulties, accompanied by stridor, especially at night. ⒋ During the attack, extensive stridor can be heard in both lungs, some wet rales can be heard, and the percussion is unvoiced. ⒌Severe dyspnea occurs during an asthma attack, and there is still no relief after rational application of sympathomimetic drugs and theophylline drugs, which is called status asthmaticus. Significant hypoxia and carbon dioxide retention may occur. Visible sweating, bruising, pale, and even unconscious. Status asthmaticus has a high mortality rate. ⒍ advanced disease, may have emphysema and pulmonary insufficiency. How to treat it? The first acute treatment: sedation, oxygen. Asthma, expectorant. anti-allergy. Avoid contact with allergens. antibiotic application Remission treatment 1. Strengthen physical exercise and enhance the body's resistance. Winter exercise can improve the adaptability of respiratory mucosa to cold air. 2. Reasonably adjust the room temperature to prevent colds. In winter, the indoor temperature should not be too high, otherwise the temperature difference from the outdoor is large, and it is easy to catch a cold. In summer, it is not advisable to be cold, and the temperature of the air conditioner should be moderate. Otherwise, you will be prone to "hot cold" and bronchitis when you go out. During the flu season, try not to go to the crowd as much as possible, and do not take off your clothes suddenly if you sweat a lot to prevent cold, and pay attention to the season. Change the addition or subtraction of clothes. 3. Select the necessary multifunctional treatment and protective measures. Not only must we learn to scientifically judge children's state changes, but we must also learn to use Biophilia Intruder equipment to pay attention to children's healthy development trends and make our children healthier.
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