Introduction
The incidence of bronchial asthma is increasing year by year, and repeated outbreaks can lead to severe effects such as lung function damage and re-engineering of the gasway. Primary health-care institutions, as the front line of health services, have important responsibilities for the early diagnosis, treatment and long-term management of bronchial asthma. Rational use of medication and precision treatment is critical for effective control of asthma symptoms, reduction of frequency of onset and improvement of the quality of life of patients.
Diagnosis and assessment of bronchial asthma
(i) Basis of diagnosis
Doctors at the primary level should provide detailed information on the patient ‘ s medical history, including the frequency of symptoms such as asthma, air stress, chest stress, cough, cause, and patterns of day and night change. Combined with medical examinations, such as pulmonary acoustics and acoustics, as well as pulmonary functions (e.g. bronchial ration tests, whistling velocity tests, etc.), a comprehensive determination of bronchial asthma.
(ii) Medical assessment
Tools such as the asthma control test (ACT) are used to quantify the patient ‘ s condition and to understand the levels of asthma control, divided into control, partial control and uncontrolled. At the same time, taking into account the number of acute onsets and the extent of damage to the lung function of the patient, asthma is classified as light, medium, heavy and dangerous in order to develop individualized treatment programmes.
III. Common bronchial asthma medication and rational use
(i) bronchial suffix
1. Beta2 receptor agonists
– Short-acting β2 receptor agonists (SABA), such as salbutamol, are the first drug of choice to mitigate acute asthma. Primary health-care facilities should be equipped with salbutamol aerosols, which can be used as needed by patients in cases of asthma attack, usually with 1-2 spraying, and can be repeated in 20 minutes if necessary. However, SABA should not be used for long-term, single-use purposes in order to avoid increased aerodynamic response.
– Long-acting β2 receptor agonists (LABA), such as Sametro, Formotro, etc., for long-term control treatment for asthma, often in conjunction with inhaled sugar cortex hormones (ICS). Patients should be instructed to use LABA correctly, to inhale at a fixed time per day, not to increase or decrease the dose at will, and should be aware of the adverse effects of heart attack, hand shaking and so on.
2. Tea-alkali drugs
– Ammonium alkaline scalable bronchial smoothing muscles, which are also more common at the grass-roots level. However, because of the narrow window of treatment and the greater number of adverse effects, such as gastrointestinal reaction, cardiac disorders, etc., blood drug concentrations are closely monitored and doses adjusted to the age, weight, liver and kidney function of the patient. Oral or intravenous drip injections are commonly used and should not be carried too quickly.
(ii) Inhaled sugar cortex hormones (ICS)
ICS is the essential drug for long-term asthma control, such as Boudinaid. Basic doctors should emphasize to patients the importance and necessity of ICS treatment and eliminate hormonal fears. The use of ICS is for inhalation, which requires guidance to the patient on the correct inhalation techniques to ensure that the drug reaches the deep air. Selecting the appropriate dose according to the severity of the asthma condition, low doses of ICS can be used for mild asthma, and medium and severe asthma may require medium and high doses of ICS or combination of other drugs. In the course of use, care should be taken to observe adverse reactions by patients, such as oral dysentery infections and acoustic acoustics, which can be reduced by, for example, the use of after-doping.
(iii) White triolene regulators
Sodium Monuste is a common white triolene regulator that can be used for long-term asthma control treatment, especially for asthma patients who have been associated with sensitive nasal inflammation. Sodium Munuste is generally oral and is taken one time before bed every night. Their negative effects are relatively small, and primary doctors may choose to use them as an alternative or complementary treatment to ICS, depending on the patient ‘ s circumstances.
IV. Long-term bronchial asthma management strategy
(i) Patient education
Primary health-care institutions should provide patients with information on bronchial asthma through a variety of forms, such as health talks, brochures, etc., including cause, induction factors, symptoms identification, treatment methods and self-management. Increased patient awareness of the disease and increased patient dependence and self-management.
(ii) Establishment of health files and follow-up visits
Establish detailed health files for bronchial asthma patients, recording information on patients ‘ condition, use of medication, lung function tests, etc. The patients are regularly followed up and the treatment programme is adapted to the patients ‘ asthma control, and the first assessment and programme adjustment is usually carried out after the initial treatment of 1-3 months, followed by every 3 – 6 months. In follow-up visits, attention should also be paid to patients ‘ adverse medical effects, complications, etc.
(iii) Environmental control
Instructing patients to avoid exposure to allergies such as pollen, dust mites, animal hair, etc., to maintain indoor cleanness, good ventilation, regular change of bed sheets, etc. Specific immunisation treatment may be considered for patients with specific allergies, subject to the guidance of a specialist at a higher hospital.
Concluding remarks
Basic medical institutions play an important role in bronchial asthma treatment. Through accurate diagnosis, assessment of the condition, rational use of bronchial scalants, ICS, white tritene regulaters, and effective long-term management strategies, including patient education, follow-up and environmental control, can achieve rational and accurate treatment of bronchal asthma, increase the rate of control of asthma, improve the quality of life of patients, reduce the medical burden on patients, and safeguard the health of bronchal asthma patients. At the same time, primary health-care institutions should strengthen their collaboration and communication with higher-level hospitals, continuously upgrading their level of care and providing better services to a large number of bronchial asthma patients.
