Diagnosis and treatment practice of chest tightness variant asthma in China

doi:10.16150/j.1671-2870.2023.06.001

Abstract

Abstract:

Chest tightness variant asthma (CTVA) is an atypical form of asthma, characterized by chest tightness as the primary symptom, without the typical asthma symptoms， such as recurrent wheezing and shortness of breath. Since it was first reported and named internationally in 2013, CTVA has gradually been recognized by clinical physicians in China and has undergone extensive clinical practice. As for diagnosis of CTVA ，doctors should integrate symptoms of chest tightness and objective evidence of variable airflow restriction, exclude chest tightness caused by other diseases, and find effective results of asthma treatment in patients. The treatment principle of CTVA is similar to that of typical asthma. An appropriate initial treatment level should be selected based on the patient's chest tightness attack, and the stepwise treatment plan should be followed for upgrade and downgrade treatment. Based on clinical diagnosis and treatment practices, this article systematically introduces the diagnostic criteria, diagnostic procedures, management evaluation, and treatment plans of CTVA,which is to help clinical physicians in standardizing the diagnosis and treatment of CTVA.

Key words: Chest tightness variant asthma, Diagnosis and treatment, practice, Inhale corticosteroids, Peak expiratory flow

CLC Number:

HUA Wen, SHEN Huahao. Diagnosis and treatment practice of chest tightness variant asthma in China[J]. Journal of Diagnostics Concepts & Practice, 2023, 22(06): 513-519.

Figures/Tables 1

References 34

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症状	肺功能	治疗选择
胸闷次数<2次/月	FEV₁占预计值≥80%	首选按需使用低剂量ICS+福莫特罗
胸闷次数≥2次/月或需使用缓解药物	FEV₁占预计值≥80%	低剂量ICS+按需SABA；或低剂量ICS+福莫特罗
大多数日子有胸闷或因胸闷觉醒>1次/周	FEV₁占预计值在60%~79%	首选低剂量ICS+LABA维持；按需治疗（ICS+福莫特罗；或SABA）
严重未控制	FEV₁占预计值<60%	初始短程口服糖皮质激素+控制药物（高剂量ICS+LABA；或中等剂量ICS+LABA）