收稿日期: 2023-09-01
网络出版日期: 2024-03-18
基金资助
国家自然科学基金资助项目(82270027);上海市2020年度“科技创新行动计划”医学创新研究专项项目(20Y11902400);上海市2020年度“科技创新行动计划”医学创新研究专项项目(22ZR1449600);上海市第一人民医院院级临床研究创新团队项目(CTCCR-2019B02);上海市第一人民医院院级临床研究创新团队项目(CTCCR-2021B07);2022 年“中西医结合研究平台”建设项目(2022zxy006)
Current status and strategies of asthma questionnaire application in China
Received date: 2023-09-01
Online published: 2024-03-18
我国的支气管哮喘（简称哮喘）哮喘患病率为4.2%，与全球其他国家相近，但我国哮喘的死亡率高达36.7/10万，为日本的4倍，美国的7倍。因此，我国需加强对哮喘进行有效管理、实现高效控制以及最大限度降低相关死亡风险。在哮喘管理中，筛查和症状控制评估是关键环节。简易筛查问卷主要用于基层医疗，以迅速识别需要深入评估的哮喘患者。数值型哮喘控制问卷，如哮喘控制测试（Asthma Control Test, ACT）和哮喘控制问卷（Asthma Control Questionnaire, ACQ），则是临床及临床研究中最为广泛使用的评估工具。分类型症状哮喘控制问卷则广泛应用于临床研究。如APGAR（活动、持续性、触发因素、哮喘药物、治疗反应）哮喘问卷不仅有助于评估哮喘，还能提高患者对治疗的依从性，从而提升哮喘控制率。目前，一些哮喘问卷在中国临床应用受限，尤其是在考虑社会文化背景、特殊年龄群体和异质性表型的方面存在一定局限性。哮喘问卷设计未来可以朝着更个体化、针对不同年龄和临床表型的方向发展，整合生物标志物和智能技术，以提高对哮喘患者的准确评估和精准管理。
包婺平, 林燕美, 张旻 . 我国支气管哮喘问卷应用现状及对策[J]. 诊断学理论与实践, 2023 , 22(06) : 534 -540 . DOI: 10.16150/j.1671-2870.2023.06.004
The prevalence of bronchial asthma in China is 4.2%, similar to other countries around the world, but the mortality rate of asthma in China is 36.7 /100 000, which is four times as high as that of Japan and seven times as that of the United States. Therefore, It is urgent for China to strengthen the effectiveness of asthma management and minimize the risk of related deaths. Pivotal aspects of asthma management involve screening and assessing symptom control. Simple screening tools expedite rapid identification of patients who require more detailed assessment in primary medical care. Numerical tools like ACT and ACQ are widely used in clinical practice and clinical research. Categorical symptom control tools are extensively used in clinical studies. For example,asthma APGAR (Activities, Persistence, Triggers, Asthma medications, Response to therapy) questionnaire not only assists in assessing asthma, but also in enhancing treatment adherence, improving asthma control. Currently, some asthma questionnaires face limitations in their application in China, particularly concerning sociocultural factors, specific age groups, and heterogeneous phenotypes. More attention should be paid to individualized factors (age diverse, clinical phenotypes), and use of biomarkers and intelligent technologies in questionnaire design for enhancing management of asthma.
Key words： Asthma; Asthma management; Control questionnaires; Prevalence; Cough variant asthma
| [1] | The Global Asthma Report 2018[M]. Auckland: Global Asthma Network, 2018. |
| [2] | HUANG K, YANG T, XU J, et al. Prevalence, risk factors, and management of asthma in China: a national cross-sectional study[J]. Lancet, 2019, 394(10196):407-418. |
| [3] | MASOLI M, FABIAN D, HOLT S, et al. The global burden of asthma: executive summary of the GINA Dissemination Committee report[J]. Allergy, 2004, 59(5):469-478. |
| [4] | Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention,2023[EB/OL]. [2023-02-20]. www.ginasthma.org. |
| [5] | Asthma group of Chinese Throacic Society. [Guidelines for bronchial asthma prevent and management(2020 edition) Asthma group of Chinese Throacic Society][J]. Zhonghua Jie He He Hu Xi Za Zhi, 2020, 43(12):1023-1048. |
| [6] | CHAPMAN K R, AN L, BOSNIC-ANTICEVICH S, et al. Asthma patients' and physicians' perspectives on the burden and management of asthma[J]. Respir Med, 2021, 186:106524. |
| [7] | BARNES P J, SZEFLER S J, REDDEL H K, et al. Symptoms and perception of airway obstruction in asthmatic patients: Clinical implications for use of reliever medications[J]. J Allergy Clin Immunol, 2019, 144(5):1180-1186. |
| [8] | O'BYRNE P M, REDDEL H K, ERIKSSON G, et al. Measuring asthma control: a comparison of three classification systems[J]. Eur Respir J, 2010, 36(2):269-276. |
| [9] | LEMAY K S, ARMOUR C L, REDDEL H K. Performance of a brief asthma control screening tool in community pharmacy: a cross-sectional and prospective longitudinal analysis[J]. Prim Care Respir J, 2014, 23(1):79-84. |
| [10] | AHMED S, ERNST P, TAMBLYN R, et al. Validation of The 30 Second Asthma Test as a measure of asthma control[J]. Can Respir J, 2007, 14(2):105-109. |
| [11] | CANONICA G W, SPANEVELLO A, DE LLANO L P, et al. Is asthma control more than just an absence of symptoms? An expert consensus statement[J]. Respir Med, 2022, 202:106942. |
| [12] | JIA C E, ZHANG H P, LV Y, et al. The Asthma Control Test and Asthma Control Questionnaire for assessing asthma control: Systematic review and meta-analysis[J]. J Allergy Clin Immunol, 2013, 131(3):695-703. |
| [13] | 丁凤鸣, 周新. 哮喘控制测试方法在我国基层医院应用价值的评估[J]. 中华全科医师杂志, 2009, 8(9):628-630. |
| DING F M, ZHOU X. Validity of asthma control test questionnaire at primary-care settings in China[J]. Chin J Gen Pract, 2009, 8(9):628-630. | |
| [14] | LOUIS G, PéTRé B, SCHLEICH F, et al. A Real Life Longitudinal Study on Asthma-Related Quality of Life in a Secondary Care Center[J]. Am J Respir Crit Care Med, 2022, 205:1. |
| [15] | HUANG W C, FU P K, CHAN M C, et al. The Long-Term Effectiveness of Omalizumab in Adult Patients with Severe Allergic Asthma: Continuous Treatment Versus Boosting Treatment[J]. J Clin Med, 2021, 10(4):707. |
| [16] | JUNIPER E F, O'BYRNE P M, GUYATT G H, et al. Development and validation of a questionnaire to measure asthma control[J]. Eur Respir J, 1999, 14(4):902-907. |
| [17] | BARNES P J, CASALE T B, DAHL R, et al. The Asthma Control Questionnaire as a clinical trial endpoint: past experience and recommendations for future use[J]. Allergy, 2014, 69(9):1119-1140. |
| [18] | JUNIPER E F, BOUSQUET J, ABETZ L, et al. Identifying 'well-controlled' and 'not well-controlled' asthma using the Asthma Control Questionnaire[J]. Respir Med, 2006, 100(4):616-621. |
| [19] | JUNIPER E F, SVENSSON K, M?RK A C, et al. Measurement properties and interpretation of three shortened versions of the asthma control questionnaire[J]. Respir Med, 2005, 99(5):553-558. |
| [20] | CASTRO M, ZANGRILLI J, WECHSLER M E, et al. Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicentre, parallel, double-blind, randomised, placebo-controlled, phase 3 trials[J]. Lancet Respir Med, 2015, 3(5):355-366. |
| [21] | FITZGERALD J M, BLEECKER E R, NAIR P, et al. Benralizumab, an anti-interleukin-5 receptor α monoclonal antibody, as add-on treatment for patients with severe, uncontrolled, eosinophilic asthma (CALIMA): a randomised, double-blind, placebo-controlled phase 3 trial[J]. Lancet, 2016, 388(10056):2128-2141. |
| [22] | SCHATZ M, KOSINSKI M, YARLAS A S, et al. The minimally important difference of the Asthma Control Test[J]. J Allergy Clin Immunol, 2009, 124(4):719-23.e1. |
| [23] | NATHAN R A, SORKNESS C A, KOSINSKI M, et al. Development of the asthma control test: a survey for assessing asthma control[J]. J Allergy Clin Immunol, 2004, 113(1):59-65. |
| [24] | TSANG K C H, PINNOCK H, WILSON A M, et al. Home monitoring with connected mobile devices for asthma attack prediction with machine learning[J]. Sci Data, 2023, 10(1):370. |
| [25] | YAWN B P, ERICSON B, CUI J, et al. Comparing asthma control assessment using the Asthma Control Test and the Asthma APGAR in African American/Black and Hispanic/Latinx populations[J]. J Asthma, 2023, 60(8):1592-1600. |
| [26] | ARROBAS A, BARBOSA M P, RABIAIS S, et al. Cost-effectiveness of omalizumab in real world uncontrolled allergic asthma patients[J]. Pulmonology, 2021, 27(2):124-133. |
| [27] | PINNOCK H, BURTON C, CAMPBELL S, et al. Clinical implications of the Royal College of Physicians three questions in routine asthma care: a real-life validation study[J]. Prim Care Respir J, 2012, 21(3):288-294. |
| [28] | YAWN B P, WOLLAN P C, RANK M A, et al. Use of Asthma APGAR Tools in Primary Care Practices: A Cluster-Randomized Controlled Trial[J]. Ann Fam Med, 2018, 16(2):100-110. |
| [29] | RANK M A, BERTRAM S, WOLLAN P, et al. Comparing the Asthma APGAR system and the Asthma Control Test? in a multicenter primary care sample[J]. Mayo Clin Proc, 2014, 89(7):917-925. |
| [30] | BRUSSELLE G, MICHILS A, LOUIS R, et al. "Real-life" effectiveness of omalizumab in patients with severe persistent allergic asthma: The PERSIST study[J]. Respir Med, 2009, 103(11):1633-1642. |
| [31] | BUSSE W, CORREN J, LANIER B Q, et al. Omalizumab, anti-IgE recombinant humanized monoclonal antibody, for the treatment of severe allergic asthma[J]. J Allergy Clin Immunol, 2001, 108(2):184-190. |
| [32] | LI J, KANG J, WANG C, et al. Omalizumab Improves Quality of Life and Asthma Control in Chinese Patients With Moderate to Severe Asthma: A Randomized Phase III Study[J]. Allergy Asthma Immunol Res, 2016, 8(4):319-328. |
| [33] | SLAVIN R G, FERIOLI C, TANNENBAUM S J, et al. Asthma symptom re-emergence after omalizumab withdrawal correlates well with increasing IgE and decreasing pharmacokinetic concentrations[J]. J Allergy Clin Immunol, 2009, 123(1):107-113.e3. |
| [34] | HARRISON T W, CHANEZ P, MENZELLA F, et al. Onset of effect and impact on health-related quality of life, exacerbation rate, lung function, and nasal polyposis symptoms for patients with severe eosinophilic asthma treated with benralizumab (ANDHI): a randomised, controlled, phase 3b trial[J]. Lancet Respir Med, 2021, 9(3):260-274. |
| [35] | ISAACSON S H, ONDO W, JACKSON C E, et al. Safety and Efficacy of RimabotulinumtoxinB for Treatment of Sialorrhea in Adults: A Randomized Clinical Trial[J]. JAMA Neurol, 2020, 77(4):461-469. |
| [36] | HOWARD J, ATAGA K I, BROWN R C, et al. Voxelotor in adolescents and adults with sickle cell disease (HOPE): long-term follow-up results of an international, randomised, double-blind, placebo-controlled, phase 3 trial[J]. Lancet Haematol, 2021, 8(5):e323-e333. |
| [37] | LEE K K, MATOS S, EVANS D H, et al. A longitudinal assessment of acute cough[J]. Am J Respir Crit Care Med, 2013, 187(9):991-997. |
| [38] | HULL J H, WALSTED E S, PAVITT M J, et al. An evaluation of a throat discomfort visual analogue scale in chronic cough[J]. Eur Respir J, 2020, 55(3):1901722. |
| [39] | RAJ A A, PAVORD D I, BIRRING S S. Clinical cough IV:what is the minimal important difference for the Leicester Cough Questionnaire?[J]. Handb Exp Pharmacol, 2009,(187):311-320. |
| [40] | ZHAN W, ZHANG L, JIANG M, et al. A new simple score of chronic cough: cough evaluation test[J]. BMC Pulm Med, 2020, 20(1):68. |
| [41] | 中华医学会呼吸病学分会哮喘学组. 咳嗽的诊断与治疗指南(2021)[J]. 中华结核和呼吸杂志, 2022, 45(1):13-46. |
| Asthma Group of Chinese Thoracic Society. Chinese national guideline on diagnosis and management of cough(2021)[J]. Chin J Tubere Respir Dis, 2022, 45(1):13-46. | |
| [42] | LAI K, ZHAN W, WU F, et al. Clinical and Inflammatory Characteristics of the Chinese APAC Cough Variant Asthma Cohort[J]. Front Med (Lausanne), 2022, 8:807385. |
| [43] | ZHOU J, YI F, WU F, et al. Characteristics of different asthma phenotypes associated with cough: a prospective, multicenter survey in China[J]. Respir Res, 2022, 23(1):243. |
/
| 〈 |
|
〉 |
