As a disease characterized by chronic airway inflammation and airway hyperresponsiveness, physicians prescribe inhaled drugs to patients diagnosed with asthma, especially those with a history of exacerbations However, due to the lack of awareness of inhaled drugs and blind fear of hormones, many patients are very resistant to long-term medication.
When we interviewed Professor Xie Jiaxing from the National Respiratory Medicine Center of the First Affiliated Hospital of Guangzhou Medical University and the Guangzhou Institute of Respiratory Health, he said, “It is indeed the case, not only worry, fear, even Refusing to use inhaled drugs, there are still many patients who think long-term medication will be used for a lifetime, but this is not the case.”
Long-term medication ≠ life-long medication, many patients with good compliance and good symptom control can switch to on-demand medication
Professor Xie introduced that asthma is a heterogeneous disease, which can be understood simply from the literal meaning. The characteristics of the disease determineit needs to be targeted at each individual Assessment and treatment are individualized for different conditions, and each asthma patient’s situation is unique.
Inhaled glucocorticoids are used as the basic drug for asthma. If the symptoms are more obvious, the lung function is relatively weak, or the asthma-related examinations, such as the nitric oxide index is relatively high, the blood routine is addicted For patients with high eosinophils, it is true that longer-term medication or life-long medication is required.
However, for some asthma patients with mild asthma symptoms, or usually no symptoms, just like seasonal pollen allergies, during this period, because of the fall, they have been exposed to a large number of grass pollen allergens. However, patients who usually have no asthma symptoms and normal lung function tests during the non-pollen season do not necessarily need lifelong medication. They only need to start medication before the allergy season. After this period, they may migrate to the south to escape. With the allergen, his symptoms can be very stable.
In some cases, like many young asthma patients contacted by the outpatient clinic, their asthma is not too serious, and the main reason for poor control is that they always stay up late at work, do not pay attention to rest, I don’t exercise, although I do have asthma, but the lung function and other indicators are relatively good. At this time, in addition to using inhaled drugs, it is very important to adjust my unhealthy lifestyle, diet, and rest. After adjustment, generally patients can have asthma. The control is very stable and also does not require lifelong medication.
Asthma sufferers like these many times have been assessed to be able to control their attacks with very small doses of inhaled medication, or they can be switched to on-demand medication, which means they only need to take them with them on a daily basis. Bring your asthma emergency medication and use it when you have symptoms.
The symptoms of cough and asthma are relieved, and the lung function test also shows a slight decline. Why does the doctor say “the medicine cannot be stopped”
Professor Xie introduced that many such patients in the clinic feel that they are mild and do not need medication just because the pulmonary function test indicates “mild obstructive ventilation function decline”, and even the symptoms are slightly relieved Feeling better, I stopped taking the medicine. Don’t be fooled by the word “mild”, as long as there are comorbidities, and the various indicators checked out are still relatively high, there is still a risk of severe asthma attacks.
In addition, the symptoms of asthma are very fluctuating, and they are no different from normal people when they do not attack. However, the relief of asthma patients may not mean that the inflammatory response of the airway has disappeared. The control of airway inflammation requires a relatively long-term process. Even if the symptoms of cough and asthma are relieved after effective treatment, chronic airway inflammation still exists, and it still needs to be controlled by maintenance therapy, thereby reducing acute asthma attacks. possible. If the dose is reduced or stopped without authorization, it will lead to aggravation of airway inflammation, further development of the disease, frequent acute attacks, and “rapid decline” of lung function, which directly affects the prognosis.
I have been taking medication regularly and my symptoms are well controlled. When can I stop taking the medication? Can you stop, listen to the doctor!
Professor Xie introduced that just now we mentioned that the symptoms of asthma are optional, it is such a a dynamic chronic disease, and the treatment also needs to be dynamically based on The changes in the condition at different times determine the treatment plan.
Generally, physicians will first assess the stage of asthma, whether it is an acute exacerbation or a chronic persistent phase, or if the symptoms are stable and clinically controlled, if It is true that the patient’s asthma symptoms are well controlled and can be maintained for at least 3 months, and the patient’s pulmonary function tests have also returned to stable, and de-escalation of treatment can be considered. Our goal is to use the smallest drug dose to achieve the best control of the patient’s asthma. .
However, it is not up to the patient to decide how much to reduce the dosage or the number of times, and it is not for the doctor to say that it can be downgraded and then the follow-up is over. All patients need close observation and regular follow-up evaluation. Once the symptoms worsen, the patient needs to resume the original treatment plan.
Whether the medicine can be reduced, can it be stopped, A simple sentence is to listen to the doctor! Although asthma is a lifelong disease, it does not mean lifelong medication. With early diagnosis, early treatment, regular follow-up, and standardized medication, asthma patients can still lead a healthy and normal life.