LUBmob hawb pob feem ntau a tus kab mob mus ntev uas yuav tsum tau kev kho mob tsis tu ncua, txawm tias ntawm kev tawm tsam. Cov pharmaceuticals tswj kev mob ntsws asthma tsis muab ib qho kev kho mob. Lawv ua pa yooj yim dua los ntawm kev ua kom qhib lub bronchi (bronchodilation) thiab txo qhov mob. Lawv feem ntau raug ntes los ntawm nqus tau pa, uas tso cai rau lawv ua sai sai, nrog tsawg tshaj qhov ua tau tshwm sim. Tus kws kho mob kuj sim muab cov tshuaj tsawg tshaj plaws rau kev tswj cov tsos mob nrog rau qhov zoo tshaj plaws ntawm kev kho mob.

Txawm li cas los xij, txawm tias muaj txiaj ntsig ntawm kev kho mob, 6 ntawm 10 tus neeg mob hawb pob tsis tswj lawv Cov tsos mob. Cov laj thawj tseem ceeb yog kev nkag siab tsis zoo ntawm tus kab mob, ntshai ntawm Sab los thiab tsis nco qab tshuaj. Txawm li cas los xij, cov kev mob tshwm sim ntawm kev kho mob los ntawm kev nqus pa yog tsawg dua piv rau cov kev pheej hmoo cuam tshuam nrog kev mob hawb pob thiab nquag.

• Metered aerosols. Koj yuav tsum co lub aerosol zoo thiab tuav nws ntsug. Tom qab maj mam nqus cov ntsws, ua pa maj mam thiab tob heev los ntawm koj lub qhov ncauj, ua rau lub aerosol thaum thawj thib ob ntawm kev tshoov siab. Tom qab ntawd koj yuav tsum tuav koj cov pa li 5 mus rau 10 vib nas this, ces maj mam ua pa tawm.
• Qhuav hmoov inhalers (xws li: Turbuhaler®). Cov txheej txheem no yooj yim dua rau kev siv vim tias lawv tsis xav tau kev sib koom tes thiab kev txhawb nqa. Koj yuav tsum ua pa nyuaj thiab sai li sai tau, thaiv koj qhov ua tsis taus pa rau 10 vib nas this thiab exhale sab nraum lub tshuab nqus pa.
• Inhalation chav. Lawv yog siv nrog ib tug metered inhaler rau cov me nyuam hnub nyoog qis dua 8 xyoo thiab cov neeg laus. Hauv cov menyuam yaus, kev nqus pa yog ua tiav nrog lub ntsej muag lub ntsej muag, uas yuav tsum tau khaws cia ntawm lub ntsej muag kom tsawg kawg 6 ua pa.

Cov neeg mob hawb pob tau raug hu kom saib xyuas lawv tus mob ua pa. Piv txwv li, cov neeg nrog mob hawb pob, tuaj yeem ntsuas lawv qhov siab kawg nkaus ntws hauv tsev (ncov ntws) txhawm rau kho lawv txoj kev kho lawv tus kheej raws li qhov tshwm sim. Kev cob qhia yuav tsum tau ua ua ntej.

pharmaceuticals

Muaj 2 pawg ntawm pharmaceuticals tswj cov tsos mob hawb pob. Thawj, hu ua kev kub ntxhov lossis cov tshuaj cawm siav, yuav tsum tau noj nyob rau hauv cov tsos mob. Lawv muaj ib qho kev pab tam sim ntawd, tab sis tsis txhob ua kom qhov mob ntawm bronchi.

Lwm yam tshuaj yog cov tswj lossis kho tom qab. Lawv yuav tsum tau noj txhua hnub, txawm tias thaum tsis muaj kev ua pa tsis xis nyob sai li sai tau thaum mob hawb pob mob hnyav thiab mob hnyav. Lawv ua kom nws muaj peev xwm txo tau qhov mob ntawm bronchi thiab ua kom qhov chaw tawm tsam. Yog tias tsis noj tsis tu ncua, qhov zaus thiab qhov hnyav ntawm kev tawm tsam yuav nce ntxiv, raws li qhov xav tau ntawm cov tshuaj cawm siav.

Kev kub ntxhov (lossis cawm) kev kho mob

Cov tshuaj muaj teeb meem raug xa mus los ntawm cov ntsiab lus sib txawv, suav nrog voos tshaus fast-acting los yog beta2 agonists luv-acting. Lawv tsuas yog siv los txo cov tsos mob ntawm kev tawm tsam ( hnoos, hauv siab nruj, hawb pob thiab ua tsis taus pa) lossis ua ntej kev tawm dag zog hauv hawb pob ntawm kev tawm dag zog. Hauv qhov mob me, mob hawb pob, kev kho mob qaug dab peg yuav yog cov tshuaj tsuas yog xav tau.

Cov tshuaj no suav nrog salbutamol ((Ventoline®, Ventilastin®, Airomir®, Apo-Salvent®, Novo Salmol®) lossis lus terbutaline (Bricanyl®). Lawv raug coj los ntawm kev nqus pa thiab nthuav dav cov pa sai sai, 1 mus rau 3 feeb. Muaj qee qhov kev mob tshwm sim yog siv qee zaus, tab sis nyob rau hauv cov koob tshuaj siab lawv tuaj yeem ua rau tshee, tshee thiab lub plawv dhia ceev. Thaum koj xav tias yuav tsum tau noj ntau zaus (feem ntau ntau dua 3 zaug hauv ib lub lis piam), nws txhais tau tias mob hawb pob tsis txaus tswj. Tom qab ntawd nws yog ib qho tsim nyog yuav tau siv cov tshuaj tom qab los kho qhov mob.

Ipratropium bromide inhalation (tsis tshua muaj). Nws yog ib qho anticholinergic uas thaiv qhov kev txiav txim ntawm cov tshuaj uas ua rau cov leeg hauv cov hlab ntsha ua rau kev cog lus. Tsis tshua muaj txiaj ntsig zoo dua li nqus tau cov beta2 agonists, qee zaum siv rau hauv cov neeg mob intolerance rau lawv. Nws yuav siv sij hawm 1 mus rau 2 teev kom tau txais txiaj ntsig siab tshaj plaws.

Tshuaj raws li ib qho yooj yim (tswj) kev kho mob

Tsis zoo li cov tshuaj qaug dab peg lossis cov tshuaj cawm siav, DMARDs (tswj) cov tshuaj tsis tuaj yeem txo cov tsos mob tam sim ntawd. Lawv ua haujlwm maj mam thiab ua haujlwm tau zoo nyob rau lub sijhawm ntev hauv kev txo qhov mob thiab qhov tshwm sim ntawm qaug dab peg. Yog li ntawd nws yog ib qho tseem ceeb kom coj lawv txhua hnub.

Corticosteroids. Corticosteroids txo qhov mob ntawm txoj hlab pas thiab yog li tsim cov hnoos qeev. Lawv feem ntau tau noj me me raws li kev nqus pa (txhaj tshuaj), nyob rau txhua hnub (piv txwv li, Alvesco® thiab Pulmicort®). Tus kws kho mob sau cov koob tshuaj qis tshaj plaws uas ua tau. Lawv tuaj yeem muab tau los ua cov ntsiav tshuaj hauv kev mob hawb pob rau lub sijhawm luv luv ntawm ob peb hnub (piv txwv li: prednisolone, methylpredinosolone). Txawm hais tias noj los ntawm kev nqus los yog hauv cov ntsiav tshuaj, lawv ua haujlwm tib yam, tab sis kev nqus pa tso cai rau cov koob tshuaj qis dua, kev ua haujlwm hauv cheeb tsam ntau dua thiab yog li muaj kev phiv tsawg dua. Cov tshuaj no yog qhov zoo tshaj plaws los tswj kev mob ntsws asthma. Lawv cov nyhuv yog hnov ​​tom qab ob peb hnub ntawm kev siv.

Cov kev phiv tshuaj

Noj los ntawm inhalation thiab nyob rau hauv me me koob tshuaj, corticosteroids muaj ob peb phiv, txawm tias noj ntev. Hoarseness thiab hoarseness los yog cov tsos ntawm Lily ntawm hav (los yog candidiasis, tshwm sim los ntawm cov poov xab ua dawb thaj ua rau thaj ntawm tus nplaig) yog cov feem ntau tshwm sim. Yog li ntawd, koj yuav tsum yaug koj lub qhov ncauj tom qab nqus tau txhua koob. Corticosteroid ntsiav tshuaj muaj cov kev mob tshwm sim ntev ntev (tsis muaj zog ntawm cov pob txha, muaj kev pheej hmoo ntawm cataracts, thiab lwm yam). Lawv tau tshwj tseg rau cov mob hawb pob hnyav, cuam tshuam nrog lwm yam kev kho mob.

Ntev ua haujlwm bronchodilators. Cov no tau muab sau ua ke thaum nqus tau corticosteroids ib leeg tsis txaus los tswj cov tsos mob hawb pob. Cov beta2 agonists Kev ua haujlwm ntev ua rau bronchodilation rau 12 teev. Lawv cov txiaj ntsig tuaj yeem ua tau sai hauv 3 mus rau 5 feeb raws li qhov formotorol® (ex Foradil®, Asmelor®) lossis qeeb dua tom qab 15 feeb zoo li cov salmeterol (Serevent®). Lawv siv ua ke nrog corticosteroid. Muaj cov inhalers uas muab ob hom tshuaj xws li Seretide® (fluticasome / salmeterol). Kev sib xyaw nrog formoterol (Symbicort®, Innovair® thiab Flutiform®) kuj tuaj yeem siv los ua cov tshuaj cawm siav, txawm hais tias lawv kuj ua rau mob rau lub sijhawm ntev.

Cov tshuaj Antileukotrienes. Noj hauv qhov ncauj, lawv txo qhov mob tshwm sim los ntawm leukotrienes, cov tshuaj uas ua rau cov lus teb inflammatory.Hauv Fabkis, muaj cov tshuaj antileukotrienes: montelukast (Singulair®). Hauv Canada, tseem muaj lezafirlukast (Accolate®). Lawv tuaj yeem siv ib leeg lossis ua ke nrog kev nqus tau corticosteroids. Lawv raug qhia kom tiv thaiv kev mob hawb pob ntawm kev tawm dag zog, mob hawb pob me, rau cov neeg uas mob hawb pob tsis tswj hwm los ntawm kev nqus cov tshuaj corticosteroids ib leeg, thiab rau cov neeg siv lawv cov tshuaj tsis raug.

Theophylline. Nws yog cov laus tshaj plaws ntawm cov bronchodilators (xws li: Theostat®). Nws tsis tshua muaj siv niaj hnub no, vim tias kev siv tshuaj zoo tsis muaj kev phiv yog qhov nyuaj nrhiav. Nws tuaj yeem raug sau ua ib ntsiav tshuaj noj nrog rau yav tsaus ntuj noj mov hauv cov neeg uas muaj teeb meem noj cov tshuaj tsuag.

Anti-immunoglobulin E. Cov tshuaj no yog npaj los kho mob hawb pob mob hawb pob rau cov neeg uas mob hawb pob nyuaj rau tswj nrog lwm yam kev kho mob. Omalizumab (Xolair®) yog tib yam tshuaj nyob rau hauv cov chav kawm no muaj nyob rau hauv 2015. Nws yog siv raws li kev txhaj tshuaj subcutaneous ib zaug lossis ob zaug hauv ib hlis.

Lub tswv yim ntawm tus kws kho mob, Dr Annabel Kerjan pulmonologist:

Thaum tus neeg mob hawb pob, lawv yuav tsum tsis txhob txais cov tsos mob yam tsis ua dab tsi. Koj yuav tsum tsis txhob, piv txwv li, ua tsis taus pa luv, hnoos me me, ua tsis taus pa thaum hmo ntuj. Tus kab mob yuav tsum tsis txhob tso cai rau hloov zuj zus, vim hais tias yog tias peb tying nws yam tsis tau kho nws, vim tias nws tuaj yeem ua rau lub bronchi degrade lub sijhawm, ua rau cov tsos mob tsis zoo mus tas li, thiab nyob rau hauv cov xwm txheej hnyav tshwm sim ntau zaus thiab mus pw hauv tsev kho mob. Nws yog qhov zoo dua los nrhiav nrog koj tus kws kho mob yam tsawg kawg nkaus kev kho mob zoo.

Qhov no tseem ceeb tshwj xeeb tshaj yog rau cov niam txiv ntawm cov menyuam yaus uas muaj mob hawb pob. Lawv feem ntau tsis kam muab tshuaj rau lawv cov menyuam thiab qhov no yog qhov nkag siab. Tab sis qhov no, lawv tsis yog lawm. Cov menyuam yaus no yuav tsum tau muab lub sijhawm los txhim kho lawv txoj kev ua pa kom zoo thiaj li muaj peev xwm muaj nyob rau hauv cov neeg laus. Thiab tom qab ntawd, tus me nyuam uas muaj cov tsos mob ntawm kev kho mob hawb pob pw tsis zoo, muaj kev nyuaj rau kev ua si thiab loj hlob tsis zoo. Thaum nrog kev kho mob, nws zoo dua thiab khaws nws lub bronchi rau yav tom ntej.