1. What should asthma patients pay attention to in their family life environment? (1), reduce the breeding of mites: dust mites are the main cause of allergies, which grow on indoor fur products or other soft items, such as carpets, fur toys, mattresses, etc. There may be as many as 2 million mites in a mattress. In the arrangement and cleaning of bedding: don't use duvets and silk quilts as bedding, and don't use animal fur as bedding. Regular ironing, sunbathing quilt cover, pillowcase, window cover and other items. Bedding should always be aired and beaten. Sofas, soft chairs, curtains and cushions made of woolen cloth are forbidden indoors. It's best to scrub the floor with cement or wooden floor instead of carpet. Children should not play with plush toys made of woolen cloth or animal fur. Put such toys in the freezer 12 hours regularly (for example, once a week) to freeze mites to death. (2) Reduce other sources of foreign protein produced indoors: avoid humidity and darkness indoors to reduce the growth of mold; Avoid planting some flowering plants, especially in the peak season of pollen flying in spring, and close the doors and windows. Don't feed all kinds of pets indoors, because the fur, dander, secretions and excretions of cats, dogs, birds and other pets may be used as allergens, leading to asthma attacks. The dander and fur of dogs, cats and other pets have stronger allergic effects. Old feathers and wool can also cause allergies. The excrement of some insects (mainly cockroaches) can also cause asthma attacks. Some people think that cockroaches are the main allergens that cause asthma attacks in East China such as Shanghai and Nanjing. Try to avoid all the above allergens. (3) Reduce indoor dust: Indoor dust can be used as a carrier to induce asthma. Such as dust mites and their excrements, molds and their spores, pollen, etc. Most of these substances belong to allergic substances. When the patient inhales these dust, it may lead to asthma attack. The older the indoor dust, the stronger its allergenicity. Therefore, dust should be removed regularly, preferably by patients' families (to prevent patients from inhaling dust). Generally, it should be cleaned once every 0/-2 days and once a month. Indoor furniture should be simple and clean, and the surface should be easy to clean. (4) Reduce indoor gas pollution: It is best to avoid air pollution in the living environment, which can reduce unnecessary stimulating factors. Do not use all kinds of spray pesticides to avoid irritating smells such as camphor, perfume and cosmetics. Don't smoke indoors, and adopt appropriate methods to reduce the pollution of gas and lampblack. Pay attention to ventilation indoors. Ventilate at least twice a day, and each ventilation time is 10-30 minutes according to different seasons (except in the season when outdoor air pollution is heavy or pollen is flying at peak). If necessary, the indoor air purification device can be used to keep the indoor air clean. Second, what should asthma patients pay attention to in their diet? Many foods such as fish and shrimp (sea fish), sesame, shellfish, nuts (cashews, peanuts, etc. ), dairy products and even wheat products can be used as allergens to cause asthma attacks. In this regard, after determining the allergens, you can try to avoid eating the corresponding foods or foods that are highly suspected to be allergens through dietary adjustment. In addition, some foods are very strong and should be avoided by different patients. For example, asthma patients often have the pathogenesis of phlegm and blood stasis. Pork, fish or fatty products should not be eaten at this time, because they can help damp and produce phlegm. At this time, you can eat radish, towel gourd, coix seed, citrus, ginkgo and other products that can eliminate phlegm and promote diuresis. Patients with internal heat or phlegm heat should not eat spicy and irritating foods such as pepper, pepper, mustard and fennel. Because it is warm, you can eat things that clear away heat, such as mung beans, rape, bitter gourd and grapefruit. Asthma patients should have a warm, light and soft diet, and can eat less and eat more meals. In addition to avoiding foods that will definitely cause allergies or asthma, other foods should also be avoided so as not to lose their proper nutritional balance. When asthma attacks, you should also eat less flatulence or indigestible foods, such as beans and sweet potatoes, so as to avoid abdominal distension and oppression of the chest and aggravate breathing difficulties. Generally speaking, the foods that asthma patients should avoid (or eat less) are egg yolk, rooster, fat pork, mutton, dog meat, marine fish, clams, crabs and shrimps; Papaya, leek, day lily, bamboo shoots (or dried bamboo shoots), peanuts, pickles, peppers and peppers; Saccharin, essence, pigment, chocolate; Cold drinks such as ice cream, carbonated drinks such as soda, wine, coffee and strong tea. 1 Bronchodilator Bronchodilator is an asthma drug. It mainly relieves bronchospasm and controls acute asthma attack, but it has no anti-inflammatory effect. Bronchodilators are easy to be accepted by patients because of their quick effect and obvious effect, but we can't rely too much on these drugs to relieve symptoms. When patients with moderate and severe asthma use β2 receptor agonists, they should be inhaled at the same time with corticosteroids to achieve better curative effect. Commonly used bronchodilators are divided into the following three types. (1)β2 adrenoceptor agonist (β2 adrenoceptor agonist): β receptors exist in cardiovascular system, lungs, muscles and other tissues and organs, and can be divided into β 1 and β2. Agonists acting on β 1 receptor can increase myocardial contractility, accelerate heartbeat and inhibit intestinal peristalsis. Excitative substances acting on β2 receptor can relax bronchi, increase cilia clearance rate of airway epithelial cells and reduce eosinophils in blood. Adrenaline and isoproterenol (wheezing) have exciting effects on β 1 and β2 receptors, so while relaxing bronchi, they often cause side effects such as accelerated heartbeat, increased myocardial oxygen consumption and arrhythmia. β2 agonists, such as salbutamol, can be taken orally or inhaled; There are both long-acting preparations and short-acting preparations. Aerosol inhalation, such as salbutamol, is generally used to relieve asthma after 5 minutes to 10 minutes, but it can only last for 3 hours to 6 hours. But the long-acting aerosol "Shi Liwen" or oral "Chuanning" and "Meichuanqing" can last 12 hours. However, it is best for β2 agonists to act on demand when there are symptoms. If you rely too much on β2 receptor agonists, it means that the anti-inflammatory treatment is not enough, or the inhalation method is incorrect, or there are other infection problems. Besides aerosol inhalation, β _ 2 agonist can also be administered by aerosol inhalation, powered by pneumatic pump or oxygen cylinder, which is the first choice for asthma emergency treatment at present. (2) Theophylline: The effect of aminophylline is similar to that of β2 agonist, which can relax airway smooth muscle, excite the heart and central nervous system, make respiratory secretions easily discharged, and restore respiratory muscle fatigue. Commonly used are ordinary aminophylline tablets and long-acting theophylline. Its antiasthmatic effect is also good, and the drug concentration in blood works when it contains 5 ~ 20 micrograms per milliliter. Because the individual metabolism of this drug is very different, it would be better if the drug concentration can be determined and the drug use can be adjusted accordingly, so as to keep the drug concentration in the blood within the optimal effective concentration range. Ordinary aminophylline tablets are taken every 6 ~ 8 hours 1 time, and children can use (4 ~ 5)mg/kg body weight each time. Long-acting theophylline was taken every 12 hours, and each dose was (8 ~ 10)mg/kg body weight. Adults generally take 0. 1 g to 0. 15 g each time, twice a day. There is also a preparation "Youchuanping", which can be taken/kloc-0 times a day for 24 hours. However, theophylline can sometimes cause nausea, abdominal discomfort and affect appetite, so it should be taken after meals. (3) Anticholinergic drugs: Hydroxyipratropium bromide has a strong relaxing effect on airway smooth muscle, but the effect is slow, reaching a peak 30 minutes to 60 minutes after administration, mainly acting on large and middle airways, and can be used together with β2 agonists, usually inhaled by aerosol or atomized solution. 654-2 is a cholinergic nerve blocker developed in China, which also has the function of relaxing smooth muscle and improving microcirculation. Some patients with chronic asthma can also take small doses orally for a long time. (4) Leukotriene receptor antagonist: Cysteinyl Leukotriene is a powerful bronchoconstrictor, which can cause airway microvascular leakage, edema and mucus secretion and cause airway eosinophil exudation. Theoretically, it is speculated that its receptor antagonist may be an effective preventive and therapeutic agent for asthma. At present, this idea has become a reality. Jielikang Pharmaceutical Development Consulting Co., Ltd. introduced a selective leukotriene D receptor antagonist (Accolate) in China market, and conducted clinical trials in Peking Union Medical College Hospital and Chaoyang Hospital, which proved to be effective in the prevention and treatment of mild and moderate bronchial asthma. This may be a new breakthrough in asthma treatment. 2, preventive drugs Preventive drugs themselves are not just wheezing, but after taking drugs for a period of time, they can reduce the number of attacks, reduce the degree of attacks, and have a certain preventive effect. (1) Corticosteroid inhalers: Commonly used corticosteroids include beclomethasone propionate ("Biketone" and "Cincosone") and other aerosols. They can eliminate nonspecific inflammation of bronchial mucosa, prevent mucosal edema and prevent mucosal secretion from producing irritating chemical mediators. Because local inhalation of drugs goes straight to the lungs, it avoids the side effects of oral administration, and it is the safest and most effective commonly used drug at present. Long-term oral corticosteroids can lead to full moon face, osteoporosis, obesity, hypertension, ulcers and so on. Long-term use by children will also affect growth and development. There are many kinds of steroid preparations. Through inhalation, the total dose of 1 day is only 5 mg of oral prednisone110, not to mention inhaling aerosol, and some of it will be discharged. After taking the medicine, you can brush your teeth and rinse your mouth, and the residual drugs in your mouth will be discharged, and the amount is small, and its side effects are minimal. However, inhaled steroids have no function of relaxing smooth muscle, so they have no immediate effect of relaxing bronchi. Therefore, some patients often underestimate its role. Since 1972, some developed countries have started to use inhaled steroids, which have achieved quite good results and accumulated a lot of experience, and used inhaled steroids as the first-line drugs to treat asthma. Some doctors also believe that if it is used in the early stage of asthma, it will achieve good results. A few people will have throat discomfort or hoarseness after inhaling steroids. Flushing the throat with water can eliminate this reaction. When asthma attacks seriously, general asthma drugs can't be controlled, and oral steroids (prednisone) can also be used to relieve symptoms. Oral medication does not exceed 1 week without any side effects. Steroid injection is commonly used in severe asthma and asthma. Commonly used are hydrocortisone and dexamethasone. Because these drugs are hormones, long-term use has certain side effects, so they should be used under the guidance of a doctor. (2) Sodium cromoglycate: powder capsules are commonly used and can be inhaled with special auxiliary tools or aerosol. It is generally believed that it can be used to prevent asthma attacks. Later, it was found that it was effective not only for allergic asthma, but also for exercise asthma. But it is not clear how it plays a preventive role. Sodium cromoglycate is mainly used to prevent asthma in children with mild to moderate diseases. For example, after 1 ~3 months, although the symptoms are relieved, asthma can not be satisfactorily controlled, so inhaled corticosteroids can be considered. (3) Ketotifen: It can relieve allergic reactions (such as eczema and allergic rhinitis) of patients, and also has a certain preventive effect on asthma attacks. Ketotifen, also known as "phenylketone", is an antihistamine. It is a tablet. Generally, the dosage is 0.5 mg ~ 1 mg each time, twice a day. The side effect of this medicine is that it is easy to feel sleepy after taking it. But after 1 week, patients can gradually tolerate it. Children are more tolerant to ketotifen. In adults and school-age children, it is best to take 1 tablet before going to bed every day. 3, immunomodulator Because asthma is an allergic reaction of the immune system and is related to other factors such as virus infection, the application of immunomodulator can increase children's immune function, resist various infections, and greatly reduce the onset of asthma. Commonly used are thymosin, nuclear cheese, transfer factor, Kamanshu syrup, Ruzhen, and traditional Chinese medicine Astragalus. Generally, it is widely used in patients with asthma induced by infection, and the application time is about 3 months to half a year. However, if allergic asthma is the main disease, it is not appropriate to use this kind of immunomodulator alone, and comprehensive treatment should be taken. 4. Desensitization therapy Desensitization therapy can reduce the reaction to allergic substances and prevent asthma attacks. Generally speaking, asthma can be well controlled by taking measures to avoid allergens and "standardized step-by-step treatment of asthma" mainly by inhaling drugs. Specific immunotherapy can only be considered if allergens cannot be avoided, or if appropriate drug treatment cannot effectively control asthma symptoms. Allergic asthma is an allergic reaction, which is characterized by bronchial spasm and mucosal edema stimulated by allergens. Desensitization therapy is to stimulate patients with a small amount of allergens, so that patients gradually develop tolerance to the allergens, and asthma attacks no longer occur after contact with allergens, thus achieving the therapeutic purpose. Patients who adopt this therapy must be allergic asthma with clear allergens; In order to be effective, the desensitizing drug used must be the allergen of the patient. In addition, this method has a long course of treatment, and it is injected, and it may recur after stopping the drug, so its application in children is limited and it has been gradually replaced by other new treatment methods. It is worth noting that the above methods have different therapeutic responses for each patient. Appropriate drugs should be selected according to the condition of each patient, reasonable compatibility should be carried out, and adjustments should be made at any time according to the changes of the condition to achieve the best curative effect. Therefore, it is very important to "insist on seeing a doctor, taking medicine according to the doctor's advice and checking regularly". 5. antibiotic IV. Side effects of corticosteroids and other drugs: Because asthma is a chronic disease, it is characterized by airway hyperresponsiveness rather than inflammation caused by bacteria, so antibiotics are generally not needed. However, if the attack lasts for a long time and there are bacterial infections such as fever, bronchitis and pneumonia, antibiotics can be used to control the infection. Because glucocorticoid has obvious anti-inflammatory, anti-allergic and immunosuppressive effects, adverse reactions may occur when the dose is too large and the treatment time is too long. (1) Complications or aggravations of infection: Because hormones inhibit the body's defense response, coupled with the influence of basic diseases and other factors, the body's resistance to a variety of pathogens decreases. It is easy to cause various infections, and the number of patients with colds and lung infections will increase significantly. (2) Central nervous system complications: excitement, insomnia, depression, dependence, etc. (3) Endocrine metabolic system: centripetal obesity, diabetes, hyposexuality, menstrual disorder and hirsutism. (4) Digestive system: mild abdominal distension, abdominal pain and pantothenic acid, and severe cases of ulcer, bleeding and perforation. (5) Cardiovascular system: palpitation, hypertension, arteriosclerosis, etc. (6) Exercise system: osteoporosis, aseptic necrosis of bone and myopathy. (7) Skin manifestations: facial erythema, purple stripes, thin and brittle skin, etc. (8) Inhibitory effect on hypothalamus-pituitary-adrenal cortex system: inhibiting children's growth and development, negative nitrogen balance and negative calcium and potassium balance. (9) Others: induced cataract, glaucoma, poor wound healing, etc.