Modern medicine has recognized that the pathological basis of asthma is chronic allergic inflammation of the airways and is sensitive to external stimuli. Therefore, in the treatment of bronchial asthma, should not just diastolic bronchial, but should also pay attention to anti-inflammatory and reduce airway reactivity of the treatment. The focus of asthma treatment has changed with the emergence of new perspectives on treatment. In the past, the treatment that favored the application of bronchodilators to relieve bronchoconstriction and alleviate symptoms inevitably failed to meet the patient's needs. Hormones with anti-inflammatory effects have become the main drugs in the treatment of asthma. 1, bronchodilators bronchodilators. Mainly to relieve bronchial spasm, control the acute attack of asthma, but no anti-inflammatory effect. Due to the fast and obvious action of bronchodilators, easy to be accepted by the patient, but can not rely too much on these symptomatic drugs. When using β2 agonists in patients with moderate-to-severe asthma, they should be inhaled at the same time as corticosteroids, and a two-pronged approach should be taken in order to achieve a better therapeutic effect. The commonly used bronchodilators are categorized into the following three types. (1) β2-adrenergic receptor agonists (β2 agonists): β-receptors exist in cardiovascular, pulmonary and muscular tissues and organs, and can be divided into β1 and β2. Excitatory drugs that act on β1 receptors can increase the contractility of the heart muscle, accelerate the heartbeat, and inhibit intestinal peristalsis. Excitants acting on β2 receptors dilate bronchial tubes, increase the ciliary clearance of airway epithelial cells, and reduce eosinophils in the blood. Epinephrine and isoprenaline (wheezing), etc., have an excitatory effect on both β1 and β2 receptors, so while bronchodilating the bronchial tubes, they often cause side effects such as increased heart rate, increased myocardial oxygen consumption, and cardiac arrhythmia. Beta2 agonists, such as salbutamol (salbutamol), can be taken orally or inhaled; both long-acting and short-acting formulations are available. Aerosol inhalation route is usually used, such as albuterol, generally inhaled 5 minutes to 10 minutes, that is to play a calming effect, but can only be maintained for 3 hours to 6 hours. Long-acting aerosols, such as Schlichtenstein or oral doses of Quentin or Mebizine, can last up to 12 hours. However, β2 agonists are best used on an as-needed basis when symptoms are present. If there is too much reliance on β2 agonists, it means that the anti-inflammatory treatment is not enough, or the inhalation method is incorrect, or there is a combination of other infections. β2 agonists can be inhaled by aerosol, but also can be used in the aqueous solution of salbutamol, with an air pressure pump or an oxygen cartridge as the motive force, and administered by a nebulizer, which has a fast action with few side effects, and is the preferred method of first aid for asthma at present. (2) Theophylline: aminophylline and β2 agonist effect is similar, can relax the airway smooth muscle, and have the role of excitation of the heart and the central nervous system, so that the respiratory secretion is easy to discharge, but also can restore respiratory muscle fatigue. Commonly used are ordinary aminophylline tablets and long-acting theophylline. It also has a better wheezing effect, and the concentration of the drug in the blood works at a level of 5 to 20 micrograms per milliliter. Due to the big difference in individual metabolism of the drug, it is more effective if the drug concentration can be measured and the medication can be adjusted accordingly to keep the concentration of the drug in the blood in the range of the best effective concentration. Generally, regular aminophylline tablets are taken every 6 hours to 8 hours, and children can take (4 to 5) mg/kg of body weight at a time. Long-acting theophylline is given at 12-hour intervals at (8 to 10) mg/kg body weight, and adults generally use 0.1 g to 0.15 g twice daily. There is also a preparation called "Ubiquinol" that can be taken once a day for 24 hours. However, theophylline can sometimes cause malaise, abdominal discomfort, appetite is affected, so it is appropriate to take after meals. (3) Anticholinergic drugs: brominated hydroxyisoproterenol has a strong relaxation effect on airway smooth muscle, but the effect is slow, after 30 minutes to 60 minutes to reach the peak of the drug, the role of the airway in the large and medium airway is mainly, can be used together with β2 agonists, usually with aerosol or nebulized solution inhalation. 654-2 is a cholinergic nerve blocker developed in China, which also has the effect of relaxing smooth muscle and improving microcirculation. Some chronic asthma patients can also be long-term small doses of oral. (4) Leukotriene receptor antagonist: cysteinyl leukotriene can cause airway microvascular leakage, edema and mucus secretion and cause airway eosinophil exudate, is a powerful bronchoconstrictor, from the theoretical speculation that its receptor antagonist may be an effective asthma prevention and treatment agent. This conception has now become a reality. Ltd. launched a selective leukotriene D receptor antagonist, the commercial name of Accolate, which was clinically tested in Peking Union Medical College, Chaoyang Hospital and other hospitals, and proved to be effective in the prevention and treatment of light and medium-sized bronchial asthma. This may be a new breakthrough in asthma treatment. 2, preventive drugs Preventive drugs itself is more than wheezing, but after a period of time, you can reduce the number of episodes, reduce the degree of attacks, and have a certain preventive effect. (1) Corticosteroid (steroid) inhaler: commonly used corticosteroid beclomethasone propionate ("Bicolone", "Xinkoson") and other aerosols. They can eliminate non-specific inflammation of the bronchial wall mucosa, prevent mucosal edema, and stop mucosal secretion to produce irritating chemical mediators. Because local inhalation medication reaches the lungs directly and avoids the side effects of oral administration, it is the safest and most effective commonly used medication. Long-term oral corticosteroid therapy can result in the formation of full moon face, osteoporosis, obesity, hypertension, and ulcer disease. Long-term use by children can also affect growth and development. There are many types of steroid preparations, with the inhalation method, the total dose for 1 day is only 1/10 of 1 tablet of 5 mg oral prednisone, not to mention the inhalation of aerosols, and some of them have to be discharged. After the inhalation of the drug by brushing teeth and rinsing the mouth, the residual drug in the oral cavity, the amount into the body is even less, its side effects can be said to be minimal. However, inhaled steroids do not have the ability to relax smooth muscle, so there is no immediate bronchodilating effect. As a result, its effects are often underestimated in some patients. Since 1972, some developed countries began to apply inhaled steroids, has achieved quite good results, but also accumulated a lot of experience, and inhaled steroids, as the first line of drugs for the treatment of asthma. Some doctors also advocate that applying them at the early stage of asthma will achieve good results. A small number of people who inhale steroids can cause throat discomfort or hoarseness, can gargle with water and wash the throat, can eliminate this reaction. Oral steroids (prednisone) can also be used to reduce symptoms in severe asthma attacks that are not controlled by regular asthma medications. Oral medications taken for no more than 1 week do not cause any side effects. Steroid injections are commonly used in severe asthma and persistent asthma. Hydrocortisone and dexamethasone are commonly used. Since these drugs are hormonal and have certain side effects when applied for a long time, they should be used under the guidance of a doctor. (2) Sodium cromoglycate: It is commonly used in powder capsules, inhaled with special aids, or inhaled by aerosol. It is generally believed that it can be used to prevent asthma attacks. It was later found to be effective not only for allergic asthma, but also for exercise-induced asthma. However, it is not clear how it works as a preventive agent. Sodium cromoglycate is mainly used to prevent mild and moderate asthma in children, such as in the application of 1 month to 3 months, although the symptoms are reduced, but still can not be very satisfactory control of asthma, can consider switching to corticosteroid inhalation. (3) ketotifen: can reduce the patient's allergic reactions (such as eczema, allergic rhinitis, etc.), also has a certain preventive effect on asthma attacks. Ketotifen, also known as "thiamphenicol", is an antihistamine drug. It is a tablet, usually 0.5 mg to 1 mg per dose, twice a day. The side effect of this drug is sleepiness after using the drug. However, patients can gradually tolerate it after 1 week of use. Children are more tolerant of ketotifen. In adults and school-age children, it is best to take 1 tablet daily before going to bed. 3, Immunomodulators As asthma is an allergic reaction of the immune system, and is related to other factors such as viral infections, so the application of immunomodulators can increase the immune function of the child to fight against a variety of infections, which can greatly reduce the asthma attack. Commonly used are thymus peptide, nuclear casein, transfer factor, card slow Shu syrup, milk Jane, Chinese medicine astragalus and so on. Generally in the infection-induced asthma is applied more, the application time is about 3 months to half a year. However, if allergic asthma is the main cause, it is not appropriate to use these immunomodulators alone, and comprehensive treatment should be used. 4, desensitization therapy Desensitization therapy can reduce the reaction to allergic substances, to prevent asthma attacks. Generally, the use of measures to avoid allergens and inhaled drugs-based "asthma standardized stepwise" treatment, usually can control asthma well. Specific immunotherapy should be considered only when allergen avoidance is not possible or when appropriate medications are not effective in controlling asthma symptoms. Allergic asthma is an allergic reaction characterized by bronchospasm and mucosal edema in response to allergen stimulation. Desensitization therapy is to use a small amount of allergen, constantly stimulate the patient, so that the patient gradually develops tolerance to the allergen, do not have asthma attacks after exposure to the allergen, to achieve the therapeutic purpose. Patients using this therapy must have allergic asthma and the allergens are clear; the desensitizing drugs used must be the patient's allergens in order to be effective. In addition, the method of treatment is longer, and is injected, after stopping the drug and the possibility of relapse, so the application in children is limited, has gradually been replaced by other new treatments. It is worth pointing out that all the above methods have different therapeutic responses for each patient. It is necessary to choose the appropriate drugs according to each patient's condition, rationally mix and match, and adjust them at any time according to the change of the condition, so as to achieve the best therapeutic effect. Therefore, "adhere to the consultation, follow the instructions of the medication, regular checkups" is very important. 5, antibiotics Because asthma is a chronic disease characterized by airway hyperresponsiveness, rather than bacteria-induced inflammation, antibiotics are generally not needed. However, if the attack is long, with fever or combined with bacterial infection such as bronchitis or pneumonia, antibiotics can be applied to control the infection. 6, Chinese medicine treatment (1) acute attack of asthma: according to the patient's cold and heat, deficiency and reality of each symptom identification and treatment. In the acute attack, the effect of soup is faster. (1) Cold and phlegm obstructing the lungs, with wheezing in the throat, much phlegm which is not easy to cough up, white color, no sweat, blocked nose, non-dry mouth, thin white tongue coating, floating and slippery pulse. Treatment: Warming the lungs and dispersing cold, resolving phlegm to stop coughing and calming wheezing. It can be treated with ephedra, cinnamon sticks, half-summer, fine spices, dry ginger, schizandra, almonds, baiqian, licorice and so on. The main soup is Xiao Qinglong Vapor, can also be used to shoot dry ephedra soup and so on. ② phlegm-heat obstruction of the lungs, coughing and wheezing, with wheezing, chest tightness, phlegm thick and yellow, not easy to cough out, irritability and thirst, may be accompanied by fever, red throat, dry stools, red tongue, yellowish greasy moss, slippery pulse. Treatment: clearing away heat and resolving phlegm, purging the lung and calming asthma. Available ephedra, almonds, astragalus, Draba hebecarpa, Su Zi, Sang Bai Pi, Fen Dong Hua, Sai Gan, Qian Hu and other treatments. Heat can be added gypsum; phlegm sticky can be added with piper betel, smallpox pollen and so on. The main tonics are Dingwang Tang plus reduction, or Ma Xing Shi Gan Tang treatment. (2) Relief period: In the relief period, strengthen the spleen, tonify the kidney and support the correctness. (1) Lung, spleen and qi deficiency, asthma attack for a long time, white color, fatigue, sweating, easy to catch a cold, poor appetite, scanty stools, pale tongue, thin white moss, slow and weak pulse. Available Yu Ping Feng San (atractylodes, windproof, astragalus) and ginseng spleen pill. ② kidney deficiency asthma, chronic weakness, fear of cold, cold lower extremities, pale, shortness of breath, heartbeat, nocturnal urination, loose stools, pale tongue, white tongue coating, weak pulse. Can be used "ginseng and clam" plus reduction, ginseng, mealybugs, schizandra powder mix, swallowed in small doses; can also be used to tonify the kidney to prevent asthma tablets, wheat flavored dihuang pill. ③ Usually can also be long-term use of Guilong cough and asthma Ning, mild asthma attacks and its remission period, there is a certain cough, asthma effect.