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Asthme de I'obese ou ('importance des interventions non pharmacologiques

机译：Ilose或（非药理学干预的重要性）的哮喘

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Asthma in obese patients: The crucial role of non-pharmacological interventionsNowadays, asthma in obese patients is considered as a phenotype with its own pathophysio-logical mechanisms and a specific management. Ventilatory mechanics related to obesity is likely to play a crucial role in the underlying mechanisms, but other factors such as lifestyle modification, the pro-inflammatory role of adipose tissue and the impact of microbiota can explain the specificities of this phenotype. Obese asthmatic patients ore characterized by more severe asthma with a higher need for rescue medication and more frequent hospitalizations compared to asthmatic subjects with normal weight. As recommended in all asthmatic patients, a maintenance therapy with inhaled corticosteroid is the cornerstone of asthma treatment in obese subjects with asthma. However, a poorer response to the usual asthma medication is described in obese asthma patients. Weight loss through calorie restriction combined with exercise is a major first-line goal to improve asthma. The non-pharmacological interventions (dietetics, physiotherapy, etc.) should be part of a multidisciplinary management. Bariatric surgery is an invasive technique that may improve asthma control in patients with severe asthma that is not improved by well-managed medical interventions.
机译：肥胖患者的哮喘：非药理学干预的关键作用，没有肥胖患者的哮喘被认为是具有其自身病理学逻辑机制和特定管理的表型。与肥胖有关的通气力学可能在潜在机制中起着至关重要的作用，但是其他因素，例如生活方式修饰，脂肪组织的促炎作用以及菌群的影响可以解释这种表型的特异性。与正常体重的哮喘患者相比，肥胖的哮喘患者的特征是更严重的哮喘，对救援药物的需求更高，住院治疗更高。正如所有哮喘患者所建议的那样，用吸入皮质类固醇的维持治疗是哮喘肥胖受试者哮喘治疗的基石。但是，肥胖哮喘患者描述了对常规哮喘药物的反应较差。通过卡路里限制与运动相结合是改善哮喘的主要一线目标。非药理干预措施（饮食学，理疗等）应成为多学科管理的一部分。减肥手术是一种侵入性技术，可以改善严重哮喘患者的哮喘控制，而管理良好的医疗干预措施无法改善。

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