Treatment of bronchial asthma in children
Bronchial asthma is a serious harm to human health, respiratory disease, failure to receive timely and reasonable treatment, pediatric patients often develop into adults with asthma; or development of pulmonary emphysema, pulmonary heart disease, and even lead to death. Over the last decade, due to the pathogenesis of this disease a correct understanding of new, more effective anti-asthmatic drugs have been developed, the treatment of this disease has played a fundamental change, so that greatly improved the prognosis of bronchial asthma. Children with bronchial asthma through an active, rational treatment, the vast majority can be radical.
(A) the treatment of mild bronchial asthma
1. Clinical features
① intermittent short-term onset of wheezing, coughing, difficulty breathing, chest tightness, and so on, every attack "two times;
② attack intermittent period of asymptomatic;
③ activities may have a short (half hour) of the symptoms (wheezing, coughing, difficulty breathing);
④ night respite a month "2 times;
⑤ only shows chronic allergic cough for 1 month or more;
⑥ peak expiratory flow (PEF) or section 1 second forced expiratory volume (FEVl)> 80% predicted value, PEF mutation rate (PEFR) <20%.
2. Therapeutic purposes
Asymptomatic, primarily to prevent attacks. Attack, its therapeutic purposes are:
① control of symptoms;
② to maintain normal life activities;
③ avoid night attack;
④ reduce the rate of change of PEFR;
⑤ to maintain normal pulmonary function;
⑥ to reduce or eliminate airway inflammation, reduce airway hyper-reactivity.
(1) no asthma attacks or allergic manifestations of chronic persistent cough and FEV: predictive value of 80% or more
① local glucocorticoid
Daily morning spray 100ug (regardless of age), such as with the BDP (becotide) aerosol, for the two pressed (each pressed with becotide 50ug); less than 5 years old, through the Spacer (spacer) inhalation; more than 5 years old, can be directly pressed pressure quantitative inhalants (metudoseinhaler, MDl) inhalation. Or disc-type dry powder inhalers, such as the one with the will dish (becodisk), each vesicle containing two BDP 100ug or 200ug, pediatric general use lOOp. g of the dosage form, a daily one bubble. Inhaled corticosteroid aerosol, the application of clean water gargle, in order to avoid thrush.
② cell membrane stabilizer, such as the use ketotifen (ketotifen, zaditen), each with 0.5 ~ lmg (3 years of age with 0.5mg, 3 years old with lmg), every 12 hours drug use 1.
③ in sports, contact with allergens or other inhaled irritants before the β2-adrenergic receptor agonists, such as the use Ventolin Aerosol (ventolin inhaler), each one pressed, each pressed with albuterol (salbutamol) lOOug; or disc-type dry powder inhaler (diskhaler), such as the plate with the gasp-ning (ventodisk), each of vesicles containing salbutamol 200ug or 400ug 2 types of children tends to be used 200ug of the dosage form, each with a vesicle.
④ cromolyn sodium aerosol a pressed (each pressed with cromolyn sodium 3.5 ~ 5mg), inhalation method ibid.
Above ①, ④ two optional one can be.
(2), and PEF variability during an asthma attack rate of 20% or more
① local glucocorticoid, such as the BDP aerosols with punishment, and a daily 6 pressed 4 ~ (200 ~ 300ug), morning and a second inhalation. Less than 5 years old, through the Spacer inhalation; more than 5 years old, can be directly inhaled MDI. Or disc-type dry powder inhalers, such as the one with the necessary disc, then the dosage form with 100ug day 2 ~ 3 times, each time a drug bulbs, aerosol inhaled corticosteroids, the application of clean water gargle.
②'s oral or inhaled adrenergic receptor agonists, such as the use salbutamol aerosol, each one pressed, generally every 12 hours, pressed into a second, inhalation method ibid. Or disc-type dry powder inhalers, such as asthma rather dish, with 200ug of the dosage forms, daily 1 to 2 times, each time with a drug bubble. May be needed, repeat every 4 ~ 6 hours administration 1. If night-time attack, you can bedtime salbutamol controlled-release tablets - Full tnine (volmax) 4mg.
③ theophylline drugs, such as taking tea Chuanping (theovent), compared with a daily 18 ~ 24mg/kg, divided every 12 hours one time.
④ cell membrane stabilizer, such as the use ketotifen, each with 0.5 ~ lmg (3 years of age with 0.5mg, 3 years old with lmg), every 12 hours drug use 1. If according to the above regimen is invalid according to moderate bronchial asthma treatment.
Such as in hospital treatment, can also be used by 0.5% salbutamol (ventolin) with oxygen or compressed air powered spray inhalation, each with 0.5% ventolin 0.0l ~ 0.03ml/kg. The maximum amount for each lml, diluted with 2 ~ 3ml normal saline, oxygen, or compressed gas flow> 6L/min, every 4 ~ 6 hours inhaling a time.