Journal of Clinical Pediatrics ›› 2022, Vol. 40 ›› Issue (10): 770-781.doi: 10.12372/jcp.2022.22e1089
• Standard·Protocol·Guideline • Previous Articles Next Articles
Received:2022-08-12
Online:2022-10-15
Published:2022-10-12
. Expert consensus on the treatment and rehabilitation management of chronic airway inflammation-related diseases in children[J].Journal of Clinical Pediatrics, 2022, 40(10): 770-781.
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| 分 类 | 代表药物 | 作用机制 | 应用范围 |
|---|---|---|---|
| 糖皮质激素 | ICS：布地奈德（BUD）、二丙酸倍氯米松（BDP）、丙酸氟替卡松（FP） | 抑制炎症递质、细胞因子释放及调节机体免疫,发挥抗炎作用[ | 哮喘、CVA、NAEB、AC、BO |
| 口服糖皮质激素（oral corticosteroids,OCS）：泼尼松、甲基泼尼松龙 | 哮喘重度持续、BO | ||
| 鼻喷糖皮质激素：莫米松、BUD和FP鼻喷剂 | AR | ||
| ICS-LABA | 布地奈德-福莫特罗、氟替卡松-沙美特罗 | 协同抗炎、平喘[ | 哮喘、CVA |
| LTRA | 孟鲁司特钠 | 竞争性结合半胱氨酰白三烯受体、阻断半胱氨酰白三烯的活性[ | 哮喘、CVA、AR、BO |
| 抗组胺药 | 氯雷他定、西替利嗪 | 抑制组胺释放以减少血管渗出和组织水肿 | AR、AC |
| 抗胆碱能药 | 噻托溴铵 、异丙托溴铵 | 舒张支气管[ | 哮喘 |
| 祛痰类药物 | N-乙酰半胱氨酸、氨溴素 | 增强气道纤毛运动、分解痰液中的黏性成分、减少痰液黏性等[ | 痰液黏稠、分泌异常、排痰功能欠佳者 |
| 大环内酯类抗菌药物 | 阿奇霉素、红霉素 | 抑制中性粒细胞及巨噬细胞的功能与活性,减少其在气道的聚集[ | BO |
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| 分 类 | 具体评估内容 |
|---|---|
| 病史评估 | 现病史、既往史、共患病等 |
| 检查评估 | 血常规和生化指标、FeNO、心电图、影像学、电子支气管镜等 |
| 功能评估 | 肺功能、咳嗽峰流速、最大吸气压（maximal inspiratory pressure,MIP）、最大呼气压（maximal expiratory pressure,MEP）、跨膈压、膈肌超声、心肺功能试验、6 min步行试验、徒手肌力检查、等长测力计、等张肌力检查、吞咽功能评估 |
| 问卷评估[ | 视觉模拟评分（visual analogue scale,VAS）1)、咳嗽特异性生活质量问卷（cough specific quality of life questionnaire,CQLQ）2)、莱斯特咳嗽问卷（leicester cough questionnaire,LCQ）3)、Borg量表4)、发育和健康状况评定量表(青少儿版)(development and well being assessment,DAWBA)5)、匹兹堡睡眠质量指数量表（Pittsburgh sleep quality index,PSQI）6)、儿童营养风险筛查工具（screening toolfor risk on nutritional status and growth,STRONGkid）7) |
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| 疾 病 | 营养管理 | 运动康复 | 呼吸训练 | 健康教育 | 心理干预 | 自我管理 | 学校管理 | 物理康复治疗 | |
|---|---|---|---|---|---|---|---|---|---|
| 手法排痰 | ACBT | ||||||||
| 哮喘 | ++ | ++ | ++ | ++ | ++ | ++ | ++ | + | + |
| CVA | + | ++ | + | ++ | ++ | ++ | ++ | - | + |
| AR | + | + | + | ++ | ++ | ++ | ++ | - | - |
| PIBO | ++ | ++ | ++ | ++ | ++ | ++ | ++ | ++ | ++ |
| NAEB | + | + | + | ++ | ++ | ++ | ++ | + | + |
| AC | ++ | + | + | ++ | ++ | ++ | ++ | - | - |
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