BACKGROUND Childhood asthma is a common respiratory ailment that significantly affects preschool children.Effective asthma management in this population is particularly challenging due to limited communication skills ...BACKGROUND Childhood asthma is a common respiratory ailment that significantly affects preschool children.Effective asthma management in this population is particularly challenging due to limited communication skills in children and the necessity for consistent involvement of a caregiver.With the rise of digital healthcare and the need for innovative interventions,Internet-based models can potentially offer relatively more efficient and patient-tailored care,especially in children.AIM To explore the impact of an intelligent Internet care model based on the child respiratory and asthma control test(TRACK)on asthma management in preschool children.METHODS The study group comprised preschoolers,aged 5 years or younger,that visited the hospital's pediatric outpatient and emergency departments between January 2021 and January 2022.Total of 200 children were evenly and randomly divided into the observation and control groups.The control group received standard treatment in accordance with the 2016 Guidelines for Pediatric Bronchial Asthma and the Global Initiative on Asthma.In addition to above treatment,the observation group was introduced to an intelligent internet nursing model,emphasizing the TRACK scale.Key measures monitored over a six-month period included the frequency of asthma attack,emergency visits,pulmonary function parameters(FEV1,FEV1/FVC,and PEF),monthly TRACK scores,and the SF-12 quality of life assessment.Post-intervention asthma control rates were assessed at six-month follow-up.RESULTS The observation group had fewer asthma attacks and emergency room visits than the control group(P<0.05).After six months of treatment,the children in both groups had higher FEV1,FEV1/FVC,and PEF(P<0.05).Statistically significant differences were observed between the two groups(P<0.05).For six months,children in the observation group had a higher monthly TRACK score than those in the control group(P<0.05).The PCS and MCSSF-12 quality of life scores were relatively higher than those before the nursing period(P<0.05).Furthermore,the groups showed statistically significant differences(P<0.05).The asthma control rate was higher in the observation group than in the control group(P<0.05).CONCLUSION TRACK based Intelligent Internet nursing model may reduce asthma attacks and emergency visits in asthmatic children,improve lung function,quality of life,and the TRACK score and asthma control rate.The effect of nursing was significant,allowing for development of an asthma management model.展开更多
Setting: Three pediatric pneumatologist offices in Bucaramanga, Colombia. Objective: To establish the concordance between medical criteria and the Childhood-Asthma Control Test (cACT). Design: Study of the assessment ...Setting: Three pediatric pneumatologist offices in Bucaramanga, Colombia. Objective: To establish the concordance between medical criteria and the Childhood-Asthma Control Test (cACT). Design: Study of the assessment of diagnostic technology using transverse sampling. 127 asthma patients aged between 4 and 11 years and their parents filled before clinical evaluation made by a pediatric pneumologist. Patients were classified as controlled or not controlled. Criteria validity was established comparing this classification using Cohen’s kappa and performance indicators according to ROC analysis. Results: 78% of the patients were controlled;patients who are not controlled have a higher score in cACT (mean difference: 3.25 points). Concordance among cACT subscales is acceptable (ρ = 0.554). cACT’s sensitivity was 53.6%, specificity 78.8%, positive likelihood ratio (LR+) 2.53, and negative likelihood ratio (LR-) 0.59. The best cut-off point is 15, with 98% sensitivity, a specificity of 14.3%, LR+ in 1.14, and LR- in 0.14. Conclusions: cACT is a valid tool to determine asthma control in children without replacing medical criteria or other clinical tests. In populations with difficult access to high complexity services, it is useful to decide whether urgent referral to the specialist is necessary.展开更多
Background: Primary care physicians in Japan see many patients in a given day;consequently, they find it challenging to devote sufficient time for detailed clinical consultation and evaluation of asthma control status...Background: Primary care physicians in Japan see many patients in a given day;consequently, they find it challenging to devote sufficient time for detailed clinical consultation and evaluation of asthma control status. The aim of this study was to investigate asthma symptoms that reveal the presence of inadequately controlled asthma. Methods: A pooled analysis of baseline data from 100 patients with asthma treated with inhaled corticosteroid(s) (ICS) alone or ICS/long-acting beta-agonist who participated in three previous clinical trials was performed. Asthma control status and asthmatic symptoms were determined using a five-item Asthma Control Questionnaire, and whether asthmatic symptoms reflect clinical markers was investigated. Results: Nocturnal awakening owing to asthmatic symptoms was observed only in the uncontrolled asthma group. Patient-reported wheezing was not observed in the group with well-controlled asthma, but was observed in all patients in the uncontrolled asthma group. Virtually all patients, irrespective of asthma control status, reported symptoms in the morning, limitation of normal daily activities, and shortness of breath. Conclusions: The presence of nocturnal awakening due to asthma and wheezing likely reflected uncontrolled asthma. These results will lead to re-recognition that clinical interview, querying nocturnal awakening from asthma and wheezing is a simple and useful approach to assess asthma control status in a primary care setting.展开更多
Background The performance of asthma control test （ACT） at baseline for predicting future risk of asthma exacerbation has not been previously demonstrated. This study was designed to explore the ability of the basel...Background The performance of asthma control test （ACT） at baseline for predicting future risk of asthma exacerbation has not been previously demonstrated. This study was designed to explore the ability of the baseline ACT score to predict future risk of asthma exacerbation during a 12-month follow-up. Methods This post hoc analysis included data from a 12-month prospective cohort study in patients with asthma （n=290）. The time to the first asthma exacerbation was analyzed and the association between baseline ACT scores and future risk of asthma exacerbation was calculated as adjusted odds ratio （OR） using Logistic regression models. Further, sensitivity and specificity were estimated at each cut-point of ACT scores for predicting asthma exacerbations. Results The subjects were divided into three groups, which were uncontrolled （U, n=128）, partly-controlled （PC, n=111）, and well controlled （C, n=51） asthma. After adjustment, the decreased ACT scores at baseline in the U and PC groups were associated with an increased probability of asthma exacerbations （OR 3.65 and OR 5.75, respectively）, unplanned visits （OR 8.03 and OR 8.21, respectively） and emergency visits （OR 20.00 and OR 22.60, respectively） over a 12-month follow-up period. The time to the first asthma exacerbation was shorter in the groups with U and PC asthma （all P 〈0.05）. The baseline ACT of 20 identified as the cut-point for screening the patients at high risk of asthma exacerbations had an increased sensitivity of over 90.0% but a lower specificity of about 30.0%. Conclusion Our findings indicate that the baseline ACT score with a high sensitivity could rule out patients at low risk of asthma exacerbations and predict future risk of asthma exacerbations in clinical practice.展开更多
Background Asthma control in African Americans(AA)is considered more difficult to achieve than in Caucasian Americans(CA).The aim of this study was to compare asthma control over time among AA and CA children w hose a...Background Asthma control in African Americans(AA)is considered more difficult to achieve than in Caucasian Americans(CA).The aim of this study was to compare asthma control over time among AA and CA children w hose asthma is managed per NAEPP(EPR-3)guidelines.Methods This was a one-year prospective study of children referred by their primary care physicians for better asthma care in a specialty asthma clinic.All children received asthma care per NAEPP guidelines.Results were compared between CA and AA children at baseline and then at three-month intervals for one year.Results Of the 345 children,ages 2-17 years(mean=6.2±4),220(63.8%)were CA and 125(36.2%)were AA.There were no significant differences in demographics other than greater pet ownership in CA families.At baseline,AA children had significantly more visits to the Emergency Department for acute asthma symptoms(mean=2.3±3)compared to CA(1.4±23,P=0.003).There were no other significant differences in acute care utilization,asthma symptoms(mean days/month),or mean asthma control test(ACT)scores at base line.Within 3-6 months,in both groups,mean ACT scores,asthma symptoms and acute care utilization significantly improved(P<0.05 for all)and change over time in both groups was comparable except for a significantly greater decrease in ED visits in AA children compared to CA children(P=002).Conclusion Overall,improvement in asthma control during longitudinal assessment was similar between AA and CA children because of consistent use of NAEPP asthma care guidelines.展开更多
OBJECTIVE:To compare the curative effects of heat-sensitive moxibustion with conventional drugs on chronic persistent asthma and seek a valuable therapy to replaceWestern Medicine.METHODS:The participants in this mult...OBJECTIVE:To compare the curative effects of heat-sensitive moxibustion with conventional drugs on chronic persistent asthma and seek a valuable therapy to replaceWestern Medicine.METHODS:The participants in this multi-center,randomized,and controlled study were randomly divided into two groups:group A(n=144),treated with heat-sensitive moxibustion(50 sessions)and group B(n=144),treated with Seretide(salmeterol50μg/fluticasone 250μg,twice a day).The scores of asthma control test(ACT),forced expiratory volume in 1 second(FEV1),peak expiratory flow(PEF),and attack frequency were measured after 15,30,60,and 90 days of treatment.Patients followed up3 and 6 months after treatment.RESULTS:There was a significant difference(P=0.0002)in the ACT score and lung function between the two groups after 3 months of treatment and(P=0.000 03)during the follow-up visits.In addition,heat-sensitive moxibustion reduced attack frequency in the period from inclusion to the6-month follow-up visit.CONCLUSION:This study shows that heat-sensitive moxibustion may have a comparable curative effect toSeretide(salmeterol/fluticasone)on asthma.展开更多
Background Little is known about asthma control and perception of asthma among asthmatic patients in China.This study marked the first survey conducted on a national scale that aimed at obtaining baseline information ...Background Little is known about asthma control and perception of asthma among asthmatic patients in China.This study marked the first survey conducted on a national scale that aimed at obtaining baseline information on asthma control and patients＇ perception of asthma and providing a point of reference for future studies.Methods This face-to-face,questionnaire-based survey was conducted from April 2007 to March 2008 with 3 069 asthmatic patients from the respiratory outpatient clinics of 36 general hospitals located in 10 geographically dispersed cities.Results Consistent with the Global Initiative for Asthma （GINA） guidelines,28.7% and 45.0% of our patients achieved control and partial control,respectively.Of the patients in the study,only 21.8% had used a peak flow meter （PFM）,and 6.6% of these patients used it daily.Inhaled corticosteroids （ICS） plus a long-acting β2 agonist （LABA） and ICS were the two most common medication regimens and were used in 45.6% and 30.4% of patients,respectively.Asthma had a significant effect on the patients＇ life and work.A considerable number of hospitalizations,emergency department visits,and sick days were observed.Conclusion Despite improvements in asthma control and ICS and PFM compliance compared with past literature,the current level of asthma control countrywide continues to fall short of the goals set in the GINA.展开更多
The authors aimed to assess Thl （T-helper cell 1）/Th2 （T-helper cell 2） balance, through evaluation of serum IFN-γ （interferon gamma） and IL-4 （interleukin 4）, during asthma exacerbation and study the effect ...The authors aimed to assess Thl （T-helper cell 1）/Th2 （T-helper cell 2） balance, through evaluation of serum IFN-γ （interferon gamma） and IL-4 （interleukin 4）, during asthma exacerbation and study the effect of anti inflammatory therapy. A randomized prospective case-control study was designed. The sludy included 30 asthmatic patients, aging 8-14 years. All were diagnosed as partly controlled asthmatics. Twenty, age and sex matched, healthy children were included in the study as control group All participants were subjected to medical history, clinical examination, pulmonary function testing, eosinophilic blood counting, estimation of serum interleukine-4 and interferon gamma. Patients were treated for 6 weeks with 2 different anti inflammatory drugs. All methods were then repeated for follow up. IL-4 serum level was significantly higher in subjects with partly controlled asthma than in control subjects （P = 0.01）, and then in asthmatic patients after therapy （P = 0.0000）, while IFN-）, serum level was significantly lower in subjects with partly controlled asthma than in control subjects （P = 0.01）, and than in asthmatic patients after therapy （P = 0.0000）. Interferon gamma showed a significant negative correlation with IL-4 among the healthy control group （r = -0.559, P = 0.010）. Both LTA （leukotriene antagonist） and ICS （inhaled corticosteroids） therapy lead to significant improvement, but there were no statistically significant differences （P 〉 0.05） between them as regard the pulmonary functions and the laboratory evaluating parameters. Both serum levels of IL-4 and IFN-γ, could be used as a reliable inflammatory biomarker for the evaluation and follow up of asthmatic patients.展开更多
目的:通过meta分析综合评价针刺对支气管哮喘急性发作期的临床疗效。方法:通过计算机检索8个数据库(PubMed、Embase、Web of Science、The Cochrane Library、中国生物医学文献数据库、维普数据库、中国知网和万方)从建库至2024年10月1...目的:通过meta分析综合评价针刺对支气管哮喘急性发作期的临床疗效。方法:通过计算机检索8个数据库(PubMed、Embase、Web of Science、The Cochrane Library、中国生物医学文献数据库、维普数据库、中国知网和万方)从建库至2024年10月1日针刺治疗哮喘急性发作期的随机对照试验。2名研究员独立评估纳入文献的质量并提取数据。使用RevMan 5.4对数据进行合并和分析。二分类结果以风险比(RR)报告,连续结果以均数差(SD)/标准化均数差(SMD)报告,均报告95%CI。采用Cochrane工具评估偏倚风险,采用GRADE方法对证据质量进行评级。结果:共纳入19项随机对照试验,涉及2137名患者。meta分析结果显示:针刺治疗后的有效率[RR=2.01,95%CI(1.32,3.06),n=90,I^(2)=0%,P=0.001,低质量]优于假针,针刺治疗后的中医症状体征总积分[MD=−5.99,95%CI(−9.32,−2.66),n=90,I^(2)=93%,P=0.0004,低质量]低于假针。与药物治疗相比,针刺可提高治疗后的的IFN‑γ水平[SMD=0.27,95%CI(0.02,0.53),n=249,P=0.04,I^(2)=3%,低质量],FVC[SMD=0.54,95%CI(0.15,0.94),n=233,I^(2)=52%,P=0.006,极低质量],降低治疗后中医症状体征总积分[MD=−1.04,95%CI(−1.76,−0.32),n=606,I^(2)=76%,P<0.00001,低质量]。但是,针刺对治疗后有效率[RR=1.11,95%CI(0.98,1.26),n=1006,I^(2)=94%,P=0.11,极低质量]、FEV1[SMD=0.10,95%CI(−0.29,0.49),n=1329,I^(2)=90%,P=0.61,极低质量]、FEV1/FVC[MD=1.40,95%CI(−2.45,5.25),n=840,I^(2)=71%,P=0.47,极低质量]、PEF[SMD=0.13,95%CI(−0.23,0.48),n=1239,I^(2)=87%,P=0.49,极低质量]和IL‑4[SMD=−0.43,95%CI(−1.04,0.18),n=249,I^(2)=82%,P=0.17,极低质量]与药物治疗相比几乎没有差异。针刺联合对照可提高治疗的有效率[RR=1.22,95%CI(1.13,1.32),n=418,I^(2)=0%,中质量]、IFN‑γ[MD=4.96,95%CI(3.23,6.68),n=234,I^(2)=43%,P<0.00001,低质量]和治疗后肺功能,包括FVC[SMD=0.57,95%CI(0.31,0.83),n=234,I^(2)=0%,P<0.00001,低质量]、FEV1[SMD=1.03,95%CI(0.31,1.76),n=464,I^(2)=92%,P=0.005,低质量]和PEF[SMD=1.27,95%CI(0.23,2.31),n=288,I^(2)=94%,P=0.02,极低质量]。但与对照组相比联合治疗对治疗后FEV1/FVC[MD=11.54,95%CI(−1.03,24.11),n=230,I^(2)=97%,P=0.07,极低质量]和治疗后IL‑4水平[MD=−8.78,95%CI(−18.31,0.76),n=234,I^(2)=90%,P=0.07,极低质量]几乎没有差异。结论:证据表明针刺在治疗急性哮喘加重期可能比假针灸更有效。联用针刺的综合疗法在提高治疗的有效率、改善肺功能以及促进IFN‑γ表达比单用药物更有效。然而,研究之间的证据强度较低,需要新的高质量研究来提供更明确的证据。展开更多
基金Supported by Science and Technology Research Project of Songjiang District,No.2020SJ340.
文摘BACKGROUND Childhood asthma is a common respiratory ailment that significantly affects preschool children.Effective asthma management in this population is particularly challenging due to limited communication skills in children and the necessity for consistent involvement of a caregiver.With the rise of digital healthcare and the need for innovative interventions,Internet-based models can potentially offer relatively more efficient and patient-tailored care,especially in children.AIM To explore the impact of an intelligent Internet care model based on the child respiratory and asthma control test(TRACK)on asthma management in preschool children.METHODS The study group comprised preschoolers,aged 5 years or younger,that visited the hospital's pediatric outpatient and emergency departments between January 2021 and January 2022.Total of 200 children were evenly and randomly divided into the observation and control groups.The control group received standard treatment in accordance with the 2016 Guidelines for Pediatric Bronchial Asthma and the Global Initiative on Asthma.In addition to above treatment,the observation group was introduced to an intelligent internet nursing model,emphasizing the TRACK scale.Key measures monitored over a six-month period included the frequency of asthma attack,emergency visits,pulmonary function parameters(FEV1,FEV1/FVC,and PEF),monthly TRACK scores,and the SF-12 quality of life assessment.Post-intervention asthma control rates were assessed at six-month follow-up.RESULTS The observation group had fewer asthma attacks and emergency room visits than the control group(P<0.05).After six months of treatment,the children in both groups had higher FEV1,FEV1/FVC,and PEF(P<0.05).Statistically significant differences were observed between the two groups(P<0.05).For six months,children in the observation group had a higher monthly TRACK score than those in the control group(P<0.05).The PCS and MCSSF-12 quality of life scores were relatively higher than those before the nursing period(P<0.05).Furthermore,the groups showed statistically significant differences(P<0.05).The asthma control rate was higher in the observation group than in the control group(P<0.05).CONCLUSION TRACK based Intelligent Internet nursing model may reduce asthma attacks and emergency visits in asthmatic children,improve lung function,quality of life,and the TRACK score and asthma control rate.The effect of nursing was significant,allowing for development of an asthma management model.
文摘Setting: Three pediatric pneumatologist offices in Bucaramanga, Colombia. Objective: To establish the concordance between medical criteria and the Childhood-Asthma Control Test (cACT). Design: Study of the assessment of diagnostic technology using transverse sampling. 127 asthma patients aged between 4 and 11 years and their parents filled before clinical evaluation made by a pediatric pneumologist. Patients were classified as controlled or not controlled. Criteria validity was established comparing this classification using Cohen’s kappa and performance indicators according to ROC analysis. Results: 78% of the patients were controlled;patients who are not controlled have a higher score in cACT (mean difference: 3.25 points). Concordance among cACT subscales is acceptable (ρ = 0.554). cACT’s sensitivity was 53.6%, specificity 78.8%, positive likelihood ratio (LR+) 2.53, and negative likelihood ratio (LR-) 0.59. The best cut-off point is 15, with 98% sensitivity, a specificity of 14.3%, LR+ in 1.14, and LR- in 0.14. Conclusions: cACT is a valid tool to determine asthma control in children without replacing medical criteria or other clinical tests. In populations with difficult access to high complexity services, it is useful to decide whether urgent referral to the specialist is necessary.
文摘Background: Primary care physicians in Japan see many patients in a given day;consequently, they find it challenging to devote sufficient time for detailed clinical consultation and evaluation of asthma control status. The aim of this study was to investigate asthma symptoms that reveal the presence of inadequately controlled asthma. Methods: A pooled analysis of baseline data from 100 patients with asthma treated with inhaled corticosteroid(s) (ICS) alone or ICS/long-acting beta-agonist who participated in three previous clinical trials was performed. Asthma control status and asthmatic symptoms were determined using a five-item Asthma Control Questionnaire, and whether asthmatic symptoms reflect clinical markers was investigated. Results: Nocturnal awakening owing to asthmatic symptoms was observed only in the uncontrolled asthma group. Patient-reported wheezing was not observed in the group with well-controlled asthma, but was observed in all patients in the uncontrolled asthma group. Virtually all patients, irrespective of asthma control status, reported symptoms in the morning, limitation of normal daily activities, and shortness of breath. Conclusions: The presence of nocturnal awakening due to asthma and wheezing likely reflected uncontrolled asthma. These results will lead to re-recognition that clinical interview, querying nocturnal awakening from asthma and wheezing is a simple and useful approach to assess asthma control status in a primary care setting.
基金This study was supported by grants from the National Natural Science Foundation of China （No. 30971326 and No. 30901907）Sichuan Youth Science ＆ Technology Foundation （No. 2010JQ008）, and Youth Science Funding of Sichuan University （No. 2011SCU04B 17）.
文摘Background The performance of asthma control test （ACT） at baseline for predicting future risk of asthma exacerbation has not been previously demonstrated. This study was designed to explore the ability of the baseline ACT score to predict future risk of asthma exacerbation during a 12-month follow-up. Methods This post hoc analysis included data from a 12-month prospective cohort study in patients with asthma （n=290）. The time to the first asthma exacerbation was analyzed and the association between baseline ACT scores and future risk of asthma exacerbation was calculated as adjusted odds ratio （OR） using Logistic regression models. Further, sensitivity and specificity were estimated at each cut-point of ACT scores for predicting asthma exacerbations. Results The subjects were divided into three groups, which were uncontrolled （U, n=128）, partly-controlled （PC, n=111）, and well controlled （C, n=51） asthma. After adjustment, the decreased ACT scores at baseline in the U and PC groups were associated with an increased probability of asthma exacerbations （OR 3.65 and OR 5.75, respectively）, unplanned visits （OR 8.03 and OR 8.21, respectively） and emergency visits （OR 20.00 and OR 22.60, respectively） over a 12-month follow-up period. The time to the first asthma exacerbation was shorter in the groups with U and PC asthma （all P 〈0.05）. The baseline ACT of 20 identified as the cut-point for screening the patients at high risk of asthma exacerbations had an increased sensitivity of over 90.0% but a lower specificity of about 30.0%. Conclusion Our findings indicate that the baseline ACT score with a high sensitivity could rule out patients at low risk of asthma exacerbations and predict future risk of asthma exacerbations in clinical practice.
文摘Background Asthma control in African Americans(AA)is considered more difficult to achieve than in Caucasian Americans(CA).The aim of this study was to compare asthma control over time among AA and CA children w hose asthma is managed per NAEPP(EPR-3)guidelines.Methods This was a one-year prospective study of children referred by their primary care physicians for better asthma care in a specialty asthma clinic.All children received asthma care per NAEPP guidelines.Results were compared between CA and AA children at baseline and then at three-month intervals for one year.Results Of the 345 children,ages 2-17 years(mean=6.2±4),220(63.8%)were CA and 125(36.2%)were AA.There were no significant differences in demographics other than greater pet ownership in CA families.At baseline,AA children had significantly more visits to the Emergency Department for acute asthma symptoms(mean=2.3±3)compared to CA(1.4±23,P=0.003).There were no other significant differences in acute care utilization,asthma symptoms(mean days/month),or mean asthma control test(ACT)scores at base line.Within 3-6 months,in both groups,mean ACT scores,asthma symptoms and acute care utilization significantly improved(P<0.05 for all)and change over time in both groups was comparable except for a significantly greater decrease in ED visits in AA children compared to CA children(P=002).Conclusion Overall,improvement in asthma control during longitudinal assessment was similar between AA and CA children because of consistent use of NAEPP asthma care guidelines.
基金Supported by the Major State Basic Research and Development Program of People's Republic of China(No.2009CB522902)National Key Technology R&D Program(No.2006BAI12B04-2)+2 种基金National Natural Science Foundation of China(No.81160453)National Natural Science Foundation of China(No.81202854)Jiangxi Key R&D Project
文摘OBJECTIVE:To compare the curative effects of heat-sensitive moxibustion with conventional drugs on chronic persistent asthma and seek a valuable therapy to replaceWestern Medicine.METHODS:The participants in this multi-center,randomized,and controlled study were randomly divided into two groups:group A(n=144),treated with heat-sensitive moxibustion(50 sessions)and group B(n=144),treated with Seretide(salmeterol50μg/fluticasone 250μg,twice a day).The scores of asthma control test(ACT),forced expiratory volume in 1 second(FEV1),peak expiratory flow(PEF),and attack frequency were measured after 15,30,60,and 90 days of treatment.Patients followed up3 and 6 months after treatment.RESULTS:There was a significant difference(P=0.0002)in the ACT score and lung function between the two groups after 3 months of treatment and(P=0.000 03)during the follow-up visits.In addition,heat-sensitive moxibustion reduced attack frequency in the period from inclusion to the6-month follow-up visit.CONCLUSION:This study shows that heat-sensitive moxibustion may have a comparable curative effect toSeretide(salmeterol/fluticasone)on asthma.
文摘Background Little is known about asthma control and perception of asthma among asthmatic patients in China.This study marked the first survey conducted on a national scale that aimed at obtaining baseline information on asthma control and patients＇ perception of asthma and providing a point of reference for future studies.Methods This face-to-face,questionnaire-based survey was conducted from April 2007 to March 2008 with 3 069 asthmatic patients from the respiratory outpatient clinics of 36 general hospitals located in 10 geographically dispersed cities.Results Consistent with the Global Initiative for Asthma （GINA） guidelines,28.7% and 45.0% of our patients achieved control and partial control,respectively.Of the patients in the study,only 21.8% had used a peak flow meter （PFM）,and 6.6% of these patients used it daily.Inhaled corticosteroids （ICS） plus a long-acting β2 agonist （LABA） and ICS were the two most common medication regimens and were used in 45.6% and 30.4% of patients,respectively.Asthma had a significant effect on the patients＇ life and work.A considerable number of hospitalizations,emergency department visits,and sick days were observed.Conclusion Despite improvements in asthma control and ICS and PFM compliance compared with past literature,the current level of asthma control countrywide continues to fall short of the goals set in the GINA.
文摘The authors aimed to assess Thl （T-helper cell 1）/Th2 （T-helper cell 2） balance, through evaluation of serum IFN-γ （interferon gamma） and IL-4 （interleukin 4）, during asthma exacerbation and study the effect of anti inflammatory therapy. A randomized prospective case-control study was designed. The sludy included 30 asthmatic patients, aging 8-14 years. All were diagnosed as partly controlled asthmatics. Twenty, age and sex matched, healthy children were included in the study as control group All participants were subjected to medical history, clinical examination, pulmonary function testing, eosinophilic blood counting, estimation of serum interleukine-4 and interferon gamma. Patients were treated for 6 weeks with 2 different anti inflammatory drugs. All methods were then repeated for follow up. IL-4 serum level was significantly higher in subjects with partly controlled asthma than in control subjects （P = 0.01）, and then in asthmatic patients after therapy （P = 0.0000）, while IFN-）, serum level was significantly lower in subjects with partly controlled asthma than in control subjects （P = 0.01）, and than in asthmatic patients after therapy （P = 0.0000）. Interferon gamma showed a significant negative correlation with IL-4 among the healthy control group （r = -0.559, P = 0.010）. Both LTA （leukotriene antagonist） and ICS （inhaled corticosteroids） therapy lead to significant improvement, but there were no statistically significant differences （P 〉 0.05） between them as regard the pulmonary functions and the laboratory evaluating parameters. Both serum levels of IL-4 and IFN-γ, could be used as a reliable inflammatory biomarker for the evaluation and follow up of asthmatic patients.
