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Diagnosis of asthma - A new approach

机译：哮喘的诊断-一种新方法

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Current definition of asthma involves four cornerstones: inflammation, hyperresponsiveness, bronchoconstriction, and symptoms. In research, the symptoms have had the slightest attention. According to international guidelines, the asthma symptoms are episodic breathlessness, wheeze, cough, tightness of the chest, and shortness of breath. As there are several symptoms, a primary question is how they are related to bronchoconstriction, the main clinical feature of asthma. Symptoms and lung function tests are regularly used for the evaluation of clinical health status and effect of treatment. However, there is no or poor correlation between these two variables, which means that they represent different mechanisms. Reduced lung function, such as a low FEV 1, represents bronchial constriction, what do the symptoms represent? Some symptoms such as breathlessness and shortness of breath seem not to be evidence-based asthma symptoms. Focusing on bronchial obstruction is important in view of the potential risk of asthma attacks, but nonobstructive symptoms occur frequently and may also cause severe discomfort and poor quality of life. Interpreting all symptoms as signs of bronchoconstriction (asthma) may lead to misinterpretation when assessing health status and effect of treatment. Although a 'soft' variable, the strength of symptoms is that they are representing various mechanisms. The physiological preconditions for control and defense of respiration must be considered in the diagnostic process, regardless of inflammation, allergy, psychology, or other etiological factors. Based on studies on dyspnea in cardiopulmonary diseases, including asthma and asthma-like disorders, there seems to be a continuous spectrum of symptoms and mechanisms integrated in a single asthma syndrome.
机译：当前对哮喘的定义涉及四个基石：炎症，反应过度，支气管收缩和症状。在研究中，症状受到的关注最小。根据国际指南，哮喘的症状是发作性呼吸困难，喘息，咳嗽，胸闷和呼吸急促。由于存在多种症状，一个主要问题是它们与支气管收缩（哮喘的主要临床特征）有何关系。经常使用症状和肺功能检查来评估临床健康状况和治疗效果。但是，这两个变量之间没有相关性或相关性很差，这意味着它们表示不同的机制。肺功能降低，例如FEV 1低，表示支气管狭窄，症状代表什么？某些症状，如呼吸困难和呼吸急促，似乎不是基于证据的哮喘症状。考虑到哮喘发作的潜在风险，关注支气管阻塞很重要，但是非阻塞性症状经常发生，并且还可能导致严重的不适和不良的生活质量。在评估健康状况和治疗效果时，将所有症状解释为支气管收缩（哮喘）的迹象可能会导致误解。尽管是一个“软”变量，但症状的强度在于它们代表了各种机制。在诊断过程中，无论炎症，过敏，心理或其他病因如何，都必须考虑控制和防御呼吸的生理前提。根据对包括哮喘病和哮喘样疾病在内的心肺疾病呼吸困难的研究，似乎在单一哮喘综合症中存在连续的症状和机制。

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