Patient's question:
Patient Gender: Three years and eight monthsPatient Age: Female
What are the differences between infantile asthma, wheezing 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 69%-70% of capillary bronchitis in infancy progresses to asthmatic bronchitis, while only 26%-48.9% progress to asthma. Around the age of 6, most asthma attacks (73.3%-77%) cease, with about 1/4 still experiencing recurrent attacks. Similar findings have been reported 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, showing that the incidence of wheezing at age 7 was 3.3%, decreasing to 4.7% at age 11 and 3.5% at age 16. Australia reported in 1989 that inhaling 7.8 micromoles of histamine, causing a 20% decrease in forced expiratory volume in one second, served as a positive indicator for airway hyperresponsiveness, suggesting the presence of airway hyperresponsiveness. When checked in 8-14-year-old school-aged children and followed up for 4 years, 16.1% tested positive 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 popular belief has spread in China that pediatric asthma will resolve on its own, and that it does not require standardized and long-term treatment to improve. In reality, these statements 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) The frequency of attacks: the more frequent the attacks within a certain period, the worse the prognosis. For example, if asthma still occurs at age 10, the prognosis is poor. Some studies indicate that if asthma persists during childhood, only 20% of cases do not develop into asthma in adulthood. It has been suggested that the characteristics observed at age 14 can serve as a good indicator of future changes. If the child frequently wheezes, 68% of cases will develop into adult asthma. If the frequency of attacks significantly decreases before puberty, treatment measures can be appropriately reduced. (2) The atopic constitution and severity of asthma attacks in patients often suggest that asthma will continue to occur and that airway hyperresponsiveness will persist. (3) Poor lung function also indicates 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 in children around the age of 10, more aggressive and long-term treatment is needed. The claims of "spontaneous resolution and cure" only apply to a small portion of children. If not actively prevented and treated, it may develop into chronic asthma. However, if the child is actively and correctly treated to suppress asthma for 2 years without any attacks before puberty (14 years for boys and 12 years for girls), it is hoped that the attacks will cease during puberty.