Patient's question:
Could you please translate the following content into English? The line breaks () do not need to be translated and should be returned as they are. All other Chinese text should be translated into English:"Please ask if a elderly patient with cough, sputum, and wheezing unable to lie flat has auscultatory wheezes, (elevated eosinophils in blood tests), and symptoms are relieved after using bronchodilators (such as theophylline), with no other causes of asthma but a history of hypertension and coronary heart disease. Can the asthma symptoms in this case be diagnosed as bronchial asthma? Some doctors say that the initial diagnosis of bronchial asthma cannot be used for elderly patients. Is this statement correct? Thank you!
First follow-up question: (2007-8-26 7:45:35) If PEF (Peak Expiratory Flow) testing has not been performed, can this patient be diagnosed as having bronchial asthma? Besides bronchial asthma, what other conditions could be considered?"
Doctor's answer:
Asthma is a chronic inflammatory disease of the airways, characterized by difficulty breathing. The two main causes of asthma symptoms are inflammation and bronchoconstriction; asthma symptoms include shortness of breath, wheezing, chest tightness, and coughing. Inflammatory reactions irritate the airway tissues, leading to congestion, edema, and persistent airway inflammation, which causes bronchoconstriction and results in airway narrowing. It may even exist to some extent even without symptoms. During an asthma attack, the inner surface of the airways swells, the airways become blocked with mucus, and the muscles surrounding the airways become tense, leading to difficulty breathing. Asthma is essentially a variable disease because, for every asthma patient, symptoms can differ daily and vary with different seasons. The severity of asthma can range from a mild, intermittent disease to a chronic, severe, debilitating disease, with patients experiencing almost continuous difficulty breathing daily. The classification of the disease is based on the frequency of symptom onset, nighttime attacks, and other factors. The inflammatory response in the airways not only causes difficulty breathing but also increases sensitivity to various stimuli, including exercise, cold air, and pollen. These triggers can cause the airway walls to constrict. There are 100 to 150 million asthma patients worldwide, making it one of the most common chronic diseases. Globally, the prevalence rate of asthma in adults is 6%, and this rate has increased by an average of 50% every 10 years. Asthma is a chronic bronchial disease where the trachea swells due to inflammation, narrowing the airways and causing difficulty breathing. Asthma can be divided into extrinsic and intrinsic types.1. Extrinsic Asthma: Extrinsic asthma is an allergic reaction to allergens, which include dust, pollen, animal hair, clothing fibers, etc. However, not all asthma patients are equally sensitive to these allergens, so patients should identify the allergens that affect them. Most patients with extrinsic asthma are children and adolescents. In addition to allergens, emotional excitement or intense exercise can also trigger attacks.
2. Intrinsic Asthma: Intrinsic asthma is more common in adults and females. In the early stages, there are generally no obvious symptoms, and the symptoms are often similar to common illnesses like colds. Sometimes, even skin tests may show negative reactions. Generally, intrinsic asthma does not respond as well to medication as extrinsic asthma, and even after treatment, the airways may not return to normal easily. Patients can still enjoy a vibrant life like healthy people, and even exercise. However, about 94% of asthma patients have not received standardized treatment and are still suffering from the constraints of asthma.
Recently, at a relevant symposium, medical experts pointed out that asthma patients must learn to manage themselves and "fight alongside" their doctors to achieve good results. Currently, many asthma patients lack the ability to manage themselves and only seek help from doctors when they are symptomatic, at which point the condition is already very severe. Journalists learned that some patients are overly dependent on acute medications, leading to long-term suffering from the disease, while others inaccurately report their condition, enduring silently despite severe symptoms. Experts introduced that although asthma cannot be cured, it can be prevented, and adhering to regular preventive treatment is the key to controlling asthma. Professor Huang Shaoguang, Director of the Respiratory Department at Ruijin Hospital and Chairman of the Shanghai Medical Association's Pulmonary Society, pointed out that asthma, like diabetes and hypertension, requires lifelong "management." Asthma patients must learn to manage themselves, work alongside their doctors, develop a gradual management plan, make clear diagnoses, choose appropriate medications, identify and avoid triggers, conduct long-term monitoring, and continuously adjust asthma treatment. Asthma is unpredictable, but if long-term maintenance treatment is adhered to, patients can lead normal lives.
Step 1: Clear Diagnosis
The first step in effectively controlling asthma is obtaining a clear diagnosis from a doctor. Patients should allow the doctor to observe them to accurately assess the severity of asthma before medication.
Step 2: Choose Appropriate Medication
A doctor's good treatment of asthma patients also requires a comprehensive understanding of the patient, considering factors such as age group, the need for lifestyle adjustments (e.g., reducing exposure to triggers), the severity of the disease, suitable medications, and the method of administration (inhalation or oral).
Step 3: Identify Triggers
Have you matched asthma with its triggers? Doctors remind patients that they must know what factors can trigger asthma. Once relevant allergens are identified, exposure to these substances should be reduced. Some measures can improve asthma symptoms and reduce medication intake. For example, avoiding pets (or at least reducing dander in the bedroom, using covers that allergens cannot penetrate for beds and pillows to prevent contact with dust) or reducing indoor humidity to prevent mold growth. Especially, tobacco smoke is the most important environmental allergen and can often cause asthma symptoms in both children and adults. Therefore, asthma patients should avoid smoking and being in smoky environments. Other outdoor and indoor allergens, such as vehicle exhaust and allergens in the workplace, should also be avoided. Respiratory infections, especially in children and infants, should be detected and treated promptly.
Step 4: Long-Term Monitoring and Adjusting Treatment Plan
As time passes, asthma also changes, so the severity of asthma cannot always be based on the initial diagnosis. Asthma patients must undergo regular peak flow rate checks to assess the severity and control of their asthma. Using a peak flow meter to test lung function can determine how easily air enters and exits the patient's lungs.
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Tea Therapy for Bronchial Asthma: Cactus Tea
Ingredients: 60 grams of fresh cactus stem (peeled and spined), 30-40 grams of honey.
Function: Clear heat, detoxify, stop coughing, and calm asthma.
Indications: Bronchial asthma with symptoms of wheezing, inability to lie flat, coughing up yellow, thick sputum, dry mouth and red tongue, slippery and rapid pulse. Suitable for hot asthma.
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Preventing Bronchial Asthma in Winter and Spring
Bronchial asthma (commonly referred to as asthma) currently has a global incidence rate of 3% to 5%, and China currently has at least 1 million asthma patients, with an increasing trend. Therefore, it should attract common social attention. Asthma attacks are caused by factors such as swelling of the bronchial membrane and excessive mucus secretion, leading to obstruction of the airway. The most obvious symptom is a high-pitched whistling sound during exhalation. Clinically, it manifests as episodic wheezing during exhalation, lasting from several minutes to several hours, and in severe cases, it can persist for several days or recur in a chronic course, potentially leading to chronic bronchitis and emphysema. Cold air stimulation, viral and bacterial infections, emotional activity, and allergic factors are all potential triggers for asthma. Winter and spring are peak seasons for bronchial asthma. Asthma attacks can cause bronchial lesions, leading to symptoms such as coughing, chest tightness, and difficulty breathing, which can be life-threatening in severe cases. The principle of asthma treatment is to remove the cause, control the attack, and prevent recurrence. Generally, desensitization therapy and bronchodilators are used, mainly including adrenergic drugs, theophylline, anticholinergic, and glucocorticoid drugs. In severe cases, priority is given to relieving hypoxia, dehydration, and eliminating complications, while also performing bronchial spasm relief and anti-infection treatment, such as oxygen inhalation, intravenous aminophylline, fluid replacement to correct dehydration, antibiotic anti-infection, and hydrocortisone or dexamethasone to inhibit the release of biologically active mediators. For chronic, recurrent infection-type or mixed-type asthma, a non-specific immune therapy, such as injecting asthma vaccines, is now available and has shown good effects. Controlling childhood asthma primarily involves inhaling hormones, which has become a first-line treatment and a consensus among asthma prevention and treatment professionals. Joint efforts between doctors and patients are crucial for preventing and treating bronchial asthma, especially during winter and spring.
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How Asthma Patients Should Adjust Their Diet
There are various types of food, each containing different nutritional components. Only by rationally matching different foods can the human body obtain various nutrients to meet the needs of physiological activities. Therefore, the diet should be comprehensive, and nutrition should be sufficient, which is a necessary condition for ensuring human growth, development, and longevity. Food has five flavors: sour, bitter, sweet, pungent, and salty, each having different effects on the human body. A balanced combination of flavors is beneficial to health, while an imbalance can cause disease. Dietary moderation refers to having a controlled diet, which includes two aspects: the amount of food consumed and the timing of meals. A moderate diet means eating at regular intervals and in appropriate quantities, which is beneficial to health. The changing seasons and climates of nature have a significant impact on the human body, so traditional Chinese health preservation methods have long included the concept of "adjusting to the four seasons." Among these, diet is one aspect.
- Spring: With the awakening of all things and the rise of yang energy, the human body's yang energy also rises. At this time, it is necessary to pay attention to diet to support yang energy. For example, scallions, cilantro, fermented beans, jujubes, and astragalus are suitable.
- Summer: With the flourishing growth of all things and the dominance of yang energy over yin energy, it is advisable to eat less pungent and dry foods to avoid excessive damage to yin energy. Instead, consume more sweet and sour, moisturizing foods, such as mung beans, green vegetables, Chinese bayberry, watermelon, etc.
- Autumn: It is the season when fruits mature, the weather turns cool, and the climate is dry. Pay attention to using less pungent and dry foods, such as chili peppers and raw scallions, and consume more nourishing foods like sesame, glutinous rice, common rice, honey, loquat, sugarcane, pineapple, and dairy products. Older adults can adopt the morning rice method to nourish the stomach and generate fluids.
- Winter: It is the season when all things are dormant, and the climate is cold, so it is advisable to protect yin and store yang. Consume foods like grains, goat, turtle, and black fungus, and pay attention to eating warm foods to protect yang energy. For the physically weak and elderly, winter is the best time for dietary supplements.
In addition to regulating diet based on its characteristics, the human body's characteristics, and seasonal changes, it is also necessary to pay attention to differences in age, constitution, personality, and habits, and not make generalizations.
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Asthma is a common respiratory disease, recognized by the world medical community as one of the four major refractory diseases and listed as one of the top ten causes of death. It is reported that more than 25 million people in China suffer from this disease. It is a serious threat to people's physical and mental health, reduces labor capacity, and is difficult to cure. A recent survey report shows that the condition of asthma patients is not ideal, with as high as 27% of asthma patients experiencing sleep disturbances at least once a week. In 2003, 22% of adult patients missed work due to asthma, and 49% of child patients missed school. 33% of patients received emergency care at the hospital last year, and 15% were hospitalized as a result. This has brought to their lives and studies, making the prevention and treatment of asthma urgent.
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(Note: The remaining content is a list of related topics and references, which do not need to be translated as they are already in English or are titles of articles. If you need specific translations, please let me know.)