Patient's question:
Patient Gender: Three years and eight monthsPatient Age: Female
What are the differences between infantile asthma, asthmatic bronchitis, and allergic asthma? Can it be treated with traditional Chinese medicine?
Doctor's answer:
Allergic asthma occurs when there are allergens; without allergens, it does not trigger attacks. Infantile asthma is essentially capillary bronchitis, while asthmatic bronchitis is an exacerbation of bronchitis. Although asthma attacks are not limited by age, the incidence of pediatric asthma decreases as the child grows older.Domestic scholars have followed up on the outcomes of infantile wheezing and found that capillary bronchitis in infancy transforms into asthmatic bronchitis in 69%-70% of cases, while only 26%-48.9% develop into asthma. Around the age of 6, most asthma attacks (73.3%-77%) cease, with about 1/4 still experiencing recurrent episodes. Similar trends have been observed internationally. In 1986, the National Institute for Child Health and Development in the UK reported a 16-year follow-up study on newborns born in the same week in a specific area. By age 7, the incidence of wheezing was 3.3%, dropping to 4.7% by age 11 and 3.5% by age 16.
In Australia, a 1989 study by the National Institute for Child Health and Development reported a 16-year follow-up on newborns born in the same week. The incidence of wheezing was 3.3% at age 7, 4.7% at age 11, and 3.5% at age 16.
Another study in Australia (1989) used an inhalation of 7.8 micromoles of histamine to reduce forced expiratory volume by 20% as a positive indicator of airway hyperresponsiveness, indicating the presence of airway hyperresponsiveness. When tested on school-aged children (8-14 years) over a 4-year follow-up, 16.1% showed positive results in the first year, 8.8% in the second year, and 6.3% in the fourth year.
Based on these domestic and international findings, it is evident that the incidence of pediatric asthma indeed decreases gradually as the child grows older. As a result, a common belief in Chinese folk culture is that pediatric asthma will resolve on its own, and that it does not require standardized or long-term treatment to improve. However, these beliefs are clearly incorrect and one-sided.
Whether the age of asthma attacks is related to the severity of the prognosis is still undetermined, but it is important to pay attention to the "risk" factors during asthma attacks.
(1) Frequency of attacks: The more frequent the attacks within a certain period, the worse the prognosis. For example, if a child still experiences wheezing at age 10, the prognosis is poor. Some studies suggest that if asthma persists during childhood, only 20% of cases will not develop into asthma in adulthood. Others propose that surface features at age 14 can serve as good indicators of future changes. If the child frequently wheezes, 68% will develop into adult asthma. Conversely, if the number of attacks significantly decreases before puberty, treatment measures can be appropriately reduced.
(2) Genetic atopic constitution and the severity of asthma attacks often indicate that the asthma will persist and airway hyperresponsiveness will remain.
(3) Poor lung function also leads to a poor prognosis.
Therefore, we believe that most cases of pediatric asthma can be cured with treatment. However, if the attacks are frequent and persistent, especially around age 10, the child requires active and long-term treatment.
The claims of "spontaneous resolution" and "cure" only apply to a small subset of cases. Without active prevention and treatment, the condition may develop into chronic asthma. However, if the child undergoes active and proper treatment to suppress asthma for 2 years without any attacks before puberty (14 years for boys and 12 years for girls), it is possible for the attacks to cease during adolescence.