支气管哮喘（以下简称哮喘）已成为我国第二大呼吸道疾病，其中轻度哮喘占50%~75%。由于轻度哮喘患者症状轻或不典型，常缺乏典型哮鸣音，肺功能检查提示大气道功能指标处于正常范围，故漏诊较多，诊断率不足30%。漏诊将导致患者反复就医，甚至接受错误的治疗，疾病有进展为中重度哮喘、急性发作及死亡的风险，约1/3的哮喘死亡发生在轻度哮喘中。同时，由于哮喘治疗多侧重于症状缓解，对气道炎症控制不充分，我国轻度哮喘的诊治现状不容乐观。为此，《轻度支气管哮喘诊断与治疗中国专家共识（2023）》（共识）提出增加诊断途径来进行应对，提升轻度哮喘诊断率及规范治疗。由于既往确诊途径评估方法的局限性（轻度哮喘患者支气管舒张试验阳性率不足10%，支气管激发试验临床开展率较低等），故共识基于对小气道功能障碍病理机制的认识，确立拟诊途径。单次肺功能小气道功能联合气道炎症指标，并经年龄和性别优化模型，以及联合支气管舒张试验阴性的患者大、小气道改善程度，确立拟诊随后，行诊断性治疗以验证，避免漏诊和过度诊断。基于症状控制水平，选择适当的治疗和管理策略，以抗炎为基础，采用以患者为中心的共同决策模式，通过“评估-检测-调整”哮喘管理循环，实施个体化精准管理，建立轻度哮喘的诊治策略，能够提升轻度哮喘的整体诊治水平。

In China, bronchial asthma has emerged as the second most prevalent respiratory disease, with mild asthma constituting 50%-70% of the reported cases. The challenges in diagnosing mild asthma arise from the subtle or atypical symptoms exhibited by patients, coupled with the absence of characteristic wheezing sounds. Notably, pulmonary function tests frequently yield normal indices for large airway functions, contributing to a significant misdiagnosis rate exceeding 70%. This high misdiagnosis rate results in patients seeking medical care repeatedly， and some cases receiving inappropriate treatments, with incresed the risk of progressing to moderate or severe asthma, experiencing acute attacks, and facing the potential threat of mortalitydeath. About one-third of asthma deaths occur in mild asthma. Furthermore, the predominant focus on symptom relief rather than the effective control of airway inflammation raises significant concerns regar-ding the diagnosis and treatment of mild asthma in China. In response, the "Expert consensus on the diagnosis, treatment and management of mild bronchial asthma in China (2023 edition)" introduces two diagnostic pathways, namely definitive and presumptive diagnosis, with the aim of enhancing diagnostic accuracy and standardizing treatment approaches. Based on the limitations associated with methods for definitive diagnosis (such as a bronchodilator test's positive rate less than 10% in mild asthma patients and the low clinical implementation rate of bronchial provocation tests)， and an understanding of the pathophysiological mechanisms of small airway dysfunction, a presumptive diagnosis pathway to address these inherent shortcomings is proposed. Initially, a singular pulmonary function test is employed for presumptive diagnosis, integrating small airway function with airway inflammation indices. The model is fine-tuned based on age and gender considerations. The assessment of large and small airway reversibility in patients with negative bronchodilator tests serves as a pivotal guide for diagnostic treatment, minimizing the risks of misdiagnosis and overdiagnosis. Treatment and management strategies are selected based on the level of symptom control, with an emphasis on anti-inflammatory approaches. Employing a patient-centered shared decision-making model and implementing an "assessment-adjustment-review" asthma management cycle to individualize precision management is executed to establish diagnostic and treatment strategies for mild asthma, enhancing the overall standard of care for mild asthma.