支氣管(guan)哮(xiao)喘(chuan)(chuan)是一種氣道變應性(xing)炎癥(zheng)和(he)氣道高(gao)反(fan)應性(xing)的疾病，嚴重的哮(xiao)喘(chuan)(chuan)發(fa)作可(ke)持(chi)續24小(xiao)時以上，經過一般治(zhi)療不能緩解(jie)者稱為哮(xiao)喘(chuan)(chuan)持(chi)續狀態。此時，患者表現(xian)(xian)為呼(hu)吸(xi)困難，呼(hu)氣延(yan)長、咳嗽，面部蒼白或發(fa)紫，心率增快，常(chang)在每分鐘120次以上。嚴重者血(xue)壓下降，大汗(han)淋漓，出現(xian)(xian)肺氣腫(zhong)，可(ke)神志不清而出現(xian)(xian)昏迷。
家庭(ting)的救(jiu)治(zhi)方法為(wei)：(1)協(xie)助病人(ren)(ren)取坐(zuo)位或(huo)(huo)半臥(wo)位休息；或(huo)(huo)讓(rang)病人(ren)(ren)抱著枕頭(tou)跪坐(zuo)在(zai)床上，腰向前傾。此位置有(you)利病人(ren)(ren)呼(hu)吸(xi)(xi)(xi)(xi)。(2)迅速取出家用吸(xi)(xi)(xi)(xi)氧(yang)瓶，以每(mei)(mei)(mei)分鐘3L的高流量氧(yang)氣(qi)(qi)通(tong)過鼻導管或(huo)(huo)面罩(zhao)給病人(ren)(ren)吸(xi)(xi)(xi)(xi)入(ru)。(3)舒喘靈或(huo)(huo)沙丁(ding)胺醇(喘樂(le)寧(ning))氣(qi)(qi)霧(wu)吸(xi)(xi)(xi)(xi)入(ru)，按壓1—2噴(pen)，每(mei)(mei)(mei)天不超過6—8噴(pen)。口服喘樂(le)寧(ning)，每(mei)(mei)(mei)次(ci)(ci)2—4毫克，每(mei)(mei)(mei)日(ri)3次(ci)(ci)。(4)注(zhu)意(yi)病人(ren)(ren)保暖，環(huan)境(jing)安靜(jing)，鼓(gu)勵病人(ren)(ren)配合治(zhi)療(liao)。(5)室內通(tong)風，空(kong)氣(qi)(qi)新鮮，但沒有(you)過堂風。避免(mian)室內有(you)煤油、煙霧(wu)、油漆等刺(ci)激性氣(qi)(qi)體。(6)立即向急(ji)救(jiu)中(zhong)心呼(hu)救(jiu)，或(huo)(huo)直接去醫(yi)院急(ji)診室救(jiu)治(zhi)。
在救護醫(yi)生(sheng)未到來之前，或去(qu)醫(yi)院之前，應密(mi)切觀察病(bing)情(qing)，指(zhi)導病(bing)人(ren)吸入氣霧劑(ji)、吸氧及服藥。由家屬護送去(qu)醫(yi)院者，癥(zheng)狀應基本(ben)緩解，神志清楚，血(xue)壓在安全范圍內，不間斷(duan)吸氧，并(bing)直接(jie)到急診室請醫(yi)生(sheng)緊急處理(li)。
臨(lin)床(chuang)上(shang)(shang)(shang)(shang)根(gen)據(ju)(ju)哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)發(fa)(fa)(fa)作(zuo)(zuo)(zuo)(zuo)(zuo)的(de)(de)(de)(de)(de)(de)輕(qing)(qing)(qing)重(zhong)程(cheng)度(du),采取不(bu)(bu)同(tong)(tong)(tong)的(de)(de)(de)(de)(de)(de)治(zhi)(zhi)(zhi)療(liao)方(fang)法。 (1)輕(qing)(qing)(qing)度(du)發(fa)(fa)(fa)作(zuo)(zuo)(zuo)(zuo)(zuo)的(de)(de)(de)(de)(de)(de)治(zhi)(zhi)(zhi)療(liao) 哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)輕(qing)(qing)(qing)度(du)發(fa)(fa)(fa)作(zuo)(zuo)(zuo)(zuo)(zuo),主要(yao)(yao)是(shi)指(zhi)兩肺有(you)(you)散(san)在(zai)(zai)(zai)哮(xiao)(xiao)(xiao)(xiao)鳴(ming)音(yin)(yin),病(bing)(bing)人(ren)尚(shang)能(neng)(neng)(neng)平(ping)(ping)(ping)臥(wo)和(he)堅(jian)持(chi)工作(zuo)(zuo)(zuo)(zuo)(zuo)者(zhe)(zhe)。可(ke)(ke)(ke)(ke)(ke)采取下(xia)列(lie)措施(shi)治(zhi)(zhi)(zhi)療(liao)。 ①適(shi)當休息,消(xiao)(xiao)除(chu)(chu)緊張恐懼心理(li),盡量(liang)避(bi)免(mian)能(neng)(neng)(neng)引(yin)(yin)起氣(qi)(qi)(qi)(qi)(qi)道(dao)反(fan)應(ying)(ying)(ying)(ying)(ying)(ying)性(xing)(xing)增高的(de)(de)(de)(de)(de)(de)一(yi)(yi)(yi)切內(nei)(nei)外因素(su)(su)(su),如(ru)(ru)刺(ci)激(ji)(ji)(ji)(ji)性(xing)(xing)氣(qi)(qi)(qi)(qi)(qi)體(ti)(ti)(ti)、寒冷及(ji)過(guo)分(fen)(fen)重(zhong)視藥(yao)(yao)(yao)物(wu)等(deng)(deng)(deng)。 ②首(shou)先(xian)選(xuan)擇有(you)(you)速效(xiao)(xiao)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)的(de)(de)(de)(de)(de)(de) β 2 受(shou)(shou)體(ti)(ti)(ti)激(ji)(ji)(ji)(ji)動劑(ji)(ji)口(kou)(kou)(kou)服或(huo)(huo)(huo)(huo)(huo)氣(qi)(qi)(qi)(qi)(qi)霧(wu)(wu)吸(xi)(xi)(xi)(xi)入(ru)以(yi)(yi)(yi)(yi)解痙(jing)。如(ru)(ru)舒喘(chuan)(chuan)(chuan)靈每(mei)(mei)(mei)(mei)(mei)(mei)(mei)日(ri)(ri)(ri)(ri)3次(ci)(ci)(ci),每(mei)(mei)(mei)(mei)(mei)(mei)(mei)次(ci)(ci)(ci)2～4μg口(kou)(kou)(kou)服;氯喘(chuan)(chuan)(chuan)每(mei)(mei)(mei)(mei)(mei)(mei)(mei)日(ri)(ri)(ri)(ri) 3 次(ci)(ci)(ci),每(mei)(mei)(mei)(mei)(mei)(mei)(mei)次(ci)(ci)(ci)5mg口(kou)(kou)(kou)服;氨(an)哮(xiao)(xiao)(xiao)(xiao)素(su)(su)(su)每(mei)(mei)(mei)(mei)(mei)(mei)(mei)日(ri)(ri)(ri)(ri)3次(ci)(ci)(ci),每(mei)(mei)(mei)(mei)(mei)(mei)(mei)次(ci)(ci)(ci)40ug口(kou)(kou)(kou)服等(deng)(deng)(deng),可(ke)(ke)(ke)(ke)(ke)任選(xuan)一(yi)(yi)(yi)種(zhong)使用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)。如(ru)(ru)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)舒喘(chuan)(chuan)(chuan)靈氣(qi)(qi)(qi)(qi)(qi)霧(wu)(wu)劑(ji)(ji)等(deng)(deng)(deng)起效(xiao)(xiao)較(jiao)(jiao)快,按壓(ya)氣(qi)(qi)(qi)(qi)(qi)霧(wu)(wu)器(qi)閥(fa)門2次(ci)(ci)(ci)吸(xi)(xi)(xi)(xi)入(ru),往往在(zai)(zai)(zai)吸(xi)(xi)(xi)(xi)入(ru)后(hou)2～5分(fen)(fen)鐘內(nei)(nei)即可(ke)(ke)(ke)(ke)(ke)起到平(ping)(ping)(ping)喘(chuan)(chuan)(chuan)效(xiao)(xiao)果(guo)。對以(yi)(yi)(yi)(yi)上(shang)(shang)(shang)(shang)藥(yao)(yao)(yao)物(wu)不(bu)(bu)能(neng)(neng)(neng)耐受(shou)(shou)者(zhe)(zhe),可(ke)(ke)(ke)(ke)(ke)選(xuan)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)氨(an)茶堿(jian)(jian)(jian)(jian)(jian)或(huo)(huo)(huo)(huo)(huo)喘(chuan)(chuan)(chuan)定(ding)等(deng)(deng)(deng)。為(wei)(wei)了能(neng)(neng)(neng)達到有(you)(you)效(xiao)(xiao)的(de)(de)(de)(de)(de)(de)血藥(yao)(yao)(yao)濃(nong)度(du),氨(an)茶堿(jian)(jian)(jian)(jian)(jian)每(mei)(mei)(mei)(mei)(mei)(mei)(mei)次(ci)(ci)(ci)應(ying)(ying)(ying)(ying)(ying)(ying)服0 2g,日(ri)(ri)(ri)(ri)服3次(ci)(ci)(ci)；喘(chuan)(chuan)(chuan)定(ding)每(mei)(mei)(mei)(mei)(mei)(mei)(mei)次(ci)(ci)(ci)0 2g,日(ri)(ri)(ri)(ri)服3次(ci)(ci)(ci)。 (2)中(zhong)(zhong)(zhong)度(du)發(fa)(fa)(fa)作(zuo)(zuo)(zuo)(zuo)(zuo)的(de)(de)(de)(de)(de)(de)治(zhi)(zhi)(zhi)療(liao) 中(zhong)(zhong)(zhong)度(du)哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)發(fa)(fa)(fa)作(zuo)(zuo)(zuo)(zuo)(zuo),主要(yao)(yao)是(shi)指(zhi)發(fa)(fa)(fa)作(zuo)(zuo)(zuo)(zuo)(zuo)時兩肺滿布哮(xiao)(xiao)(xiao)(xiao)鳴(ming)音(yin)(yin),病(bing)(bing)人(ren)不(bu)(bu)能(neng)(neng)(neng)平(ping)(ping)(ping)臥(wo)或(huo)(huo)(huo)(huo)(huo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)一(yi)(yi)(yi)般平(ping)(ping)(ping)喘(chuan)(chuan)(chuan)藥(yao)(yao)(yao)物(wu)僅能(neng)(neng)(neng)取得部分(fen)(fen)緩(huan)解者(zhe)(zhe),對這類哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)病(bing)(bing)人(ren)通(tong)常(chang)采用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)下(xia)列(lie)措施(shi)綜(zong)合(he)(he)處(chu)理(li): ①病(bing)(bing)人(ren)應(ying)(ying)(ying)(ying)(ying)(ying)立即到醫(yi)(yi)(yi)院進行治(zhi)(zhi)(zhi)療(liao)。 ②聯(lian)合(he)(he)應(ying)(ying)(ying)(ying)(ying)(ying)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)平(ping)(ping)(ping)喘(chuan)(chuan)(chuan)藥(yao)(yao)(yao)物(wu),如(ru)(ru)β 2 受(shou)(shou)體(ti)(ti)(ti)激(ji)(ji)(ji)(ji)動劑(ji)(ji)和(he)茶堿(jian)(jian)(jian)(jian)(jian)類合(he)(he)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong),也可(ke)(ke)(ke)(ke)(ke)以(yi)(yi)(yi)(yi)3類甚至(zhi)(zhi)4類解痙(jing)平(ping)(ping)(ping)喘(chuan)(chuan)(chuan)藥(yao)(yao)(yao)合(he)(he)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)。一(yi)(yi)(yi)般用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)1∶1000腎(shen)上(shang)(shang)(shang)(shang)腺素(su)(su)(su)0 3 ml皮下(xia)注(zhu)(zhu)(zhu)射(she)(she)(she)即可(ke)(ke)(ke)(ke)(ke)止(zhi)喘(chuan)(chuan)(chuan),如(ru)(ru)需(xu)要(yao)(yao),每(mei)(mei)(mei)(mei)(mei)(mei)(mei)隔(ge)15分(fen)(fen)鐘可(ke)(ke)(ke)(ke)(ke)再(zai)(zai)注(zhu)(zhu)(zhu)射(she)(she)(she)1次(ci)(ci)(ci),但如(ru)(ru)經2～3次(ci)(ci)(ci)注(zhu)(zhu)(zhu)射(she)(she)(she)無(wu)(wu)效(xiao)(xiao),不(bu)(bu)再(zai)(zai)繼續(xu)(xu)注(zhu)(zhu)(zhu)射(she)(she)(she)。本(ben)藥(yao)(yao)(yao)與(yu)氨(an)茶堿(jian)(jian)(jian)(jian)(jian)聯(lian)合(he)(he)使用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong),可(ke)(ke)(ke)(ke)(ke)提(ti)(ti)高療(liao)效(xiao)(xiao)。用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)氨(an)茶堿(jian)(jian)(jian)(jian)(jian)0 25g加(jia)(jia)(jia)(jia)(jia)入(ru)50%葡萄(tao)糖溶液(ye)(ye)(ye)40ml中(zhong)(zhong)(zhong)作(zuo)(zuo)(zuo)(zuo)(zuo)靜(jing)脈(mo)(mo)緩(huan)慢注(zhu)(zhu)(zhu)射(she)(she)(she),一(yi)(yi)(yi)定(ding)要(yao)(yao)求在(zai)(zai)(zai)10～15分(fen)(fen)鐘內(nei)(nei)緩(huan)慢地(di)注(zhu)(zhu)(zhu)入(ru)。也可(ke)(ke)(ke)(ke)(ke)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)氨(an)茶堿(jian)(jian)(jian)(jian)(jian)0 5g加(jia)(jia)(jia)(jia)(jia)入(ru)5%葡萄(tao)糖溶液(ye)(ye)(ye) 500ml中(zhong)(zhong)(zhong)靜(jing)脈(mo)(mo)滴(di)(di)注(zhu)(zhu)(zhu),要(yao)(yao)定(ding)時測定(ding)氨(an)茶堿(jian)(jian)(jian)(jian)(jian)血藥(yao)(yao)(yao)濃(nong)度(du),使其維持(chi)在(zai)(zai)(zai)每(mei)(mei)(mei)(mei)(mei)(mei)(mei)毫升8～20μg范圍內(nei)(nei),可(ke)(ke)(ke)(ke)(ke)改善哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)發(fa)(fa)(fa)作(zuo)(zuo)(zuo)(zuo)(zuo)狀(zhuang)態(tai)而(er)又不(bu)(bu)至(zhi)(zhi)于(yu)(yu)(yu)產生(sheng)(sheng)毒(du)(du)性(xing)(xing)反(fan)應(ying)(ying)(ying)(ying)(ying)(ying)。如(ru)(ru)上(shang)(shang)(shang)(shang)述(shu)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)藥(yao)(yao)(yao)仍反(fan)應(ying)(ying)(ying)(ying)(ying)(ying)較(jiao)(jiao)差,可(ke)(ke)(ke)(ke)(ke)考慮換用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)或(huo)(huo)(huo)(huo)(huo)聯(lian)合(he)(he)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)激(ji)(ji)(ji)(ji)素(su)(su)(su),如(ru)(ru)口(kou)(kou)(kou)服強(qiang)(qiang)地(di)松(song),每(mei)(mei)(mei)(mei)(mei)(mei)(mei)次(ci)(ci)(ci)10ml,每(mei)(mei)(mei)(mei)(mei)(mei)(mei)日(ri)(ri)(ri)(ri)3次(ci)(ci)(ci)；也可(ke)(ke)(ke)(ke)(ke)每(mei)(mei)(mei)(mei)(mei)(mei)(mei)日(ri)(ri)(ri)(ri)晨間(jian)頓(dun)服30mg。 ③如(ru)(ru)果(guo)有(you)(you)膿性(xing)(xing)粘痰, 應(ying)(ying)(ying)(ying)(ying)(ying)予以(yi)(yi)(yi)(yi)抗(kang)(kang)(kang)(kang)感(gan)染和(he)祛痰治(zhi)(zhi)(zhi)療(liao)。常(chang)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)的(de)(de)(de)(de)(de)(de)抗(kang)(kang)(kang)(kang)菌藥(yao)(yao)(yao)有(you)(you)復(fu)方(fang)新諾明(ming),或(huo)(huo)(huo)(huo)(huo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)青霉(mei)素(su)(su)(su)、鏈霉(mei)素(su)(su)(su)肌(ji)注(zhu)(zhu)(zhu)。祛痰可(ke)(ke)(ke)(ke)(ke)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)必嗽(sou)平(ping)(ping)(ping)，每(mei)(mei)(mei)(mei)(mei)(mei)(mei)次(ci)(ci)(ci)16mg,日(ri)(ri)(ri)(ri)服3次(ci)(ci)(ci)；或(huo)(huo)(huo)(huo)(huo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)鮮竹瀝每(mei)(mei)(mei)(mei)(mei)(mei)(mei)次(ci)(ci)(ci)10～15ml,每(mei)(mei)(mei)(mei)(mei)(mei)(mei)日(ri)(ri)(ri)(ri)3次(ci)(ci)(ci)。效(xiao)(xiao)果(guo)不(bu)(bu)明(ming)顯時,可(ke)(ke)(ke)(ke)(ke)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)10% 碘化(hua)(hua)(hua)(hua)(hua)鉀10ml加(jia)(jia)(jia)(jia)(jia)入(ru)200ml牛奶中(zhong)(zhong)(zhong)餐(can)后(hou)口(kou)(kou)(kou)服,每(mei)(mei)(mei)(mei)(mei)(mei)(mei)日(ri)(ri)(ri)(ri)2～3次(ci)(ci)(ci),祛痰效(xiao)(xiao)果(guo)較(jiao)(jiao)好。 (3)重(zhong)度(du)發(fa)(fa)(fa)作(zuo)(zuo)(zuo)(zuo)(zuo)或(huo)(huo)(huo)(huo)(huo)哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)持(chi)續(xu)(xu)狀(zhuang)態(tai)的(de)(de)(de)(de)(de)(de)治(zhi)(zhi)(zhi)療(liao) 哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)持(chi)續(xu)(xu)狀(zhuang)態(tai),主要(yao)(yao)是(shi)指(zhi)哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)嚴(yan)重(zhong)發(fa)(fa)(fa)作(zuo)(zuo)(zuo)(zuo)(zuo)持(chi)續(xu)(xu)24小(xiao)時以(yi)(yi)(yi)(yi)上(shang)(shang)(shang)(shang),用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)常(chang)規治(zhi)(zhi)(zhi)療(liao)方(fang)案不(bu)(bu)能(neng)(neng)(neng)緩(huan)解者(zhe)(zhe),應(ying)(ying)(ying)(ying)(ying)(ying)立即送醫(yi)(yi)(yi)院進行救治(zhi)(zhi)(zhi)。具體(ti)(ti)(ti)救治(zhi)(zhi)(zhi)措施(shi)如(ru)(ru)下(xia): ①補(bu)液(ye)(ye)(ye)及(ji)解痙(jing)平(ping)(ping)(ping)喘(chuan)(chuan)(chuan):氨(an)茶堿(jian)(jian)(jian)(jian)(jian)0 25 g加(jia)(jia)(jia)(jia)(jia)入(ru)25%～50%葡萄(tao)糖溶液(ye)(ye)(ye)20～40ml靜(jing)脈(mo)(mo)推注(zhu)(zhu)(zhu)10分(fen)(fen)鐘以(yi)(yi)(yi)(yi)上(shang)(shang)(shang)(shang),30～60分(fen)(fen)鐘后(hou)可(ke)(ke)(ke)(ke)(ke)以(yi)(yi)(yi)(yi)每(mei)(mei)(mei)(mei)(mei)(mei)(mei)小(xiao)時每(mei)(mei)(mei)(mei)(mei)(mei)(mei)千(qian)克體(ti)(ti)(ti)重(zhong)1mg氨(an)茶堿(jian)(jian)(jian)(jian)(jian)加(jia)(jia)(jia)(jia)(jia)入(ru)5%葡萄(tao)糖溶液(ye)(ye)(ye)中(zhong)(zhong)(zhong)靜(jing)脈(mo)(mo)滴(di)(di)注(zhu)(zhu)(zhu),每(mei)(mei)(mei)(mei)(mei)(mei)(mei)日(ri)(ri)(ri)(ri)總量(liang)不(bu)(bu)超(chao)過(guo)1～1 5g,根(gen)據(ju)(ju)心臟情(qing)況(kuang)每(mei)(mei)(mei)(mei)(mei)(mei)(mei)日(ri)(ri)(ri)(ri)可(ke)(ke)(ke)(ke)(ke)補(bu)液(ye)(ye)(ye)2000～3000ml,靜(jing)滴(di)(di)速度(du)控制在(zai)(zai)(zai)每(mei)(mei)(mei)(mei)(mei)(mei)(mei)分(fen)(fen)鐘40～60滴(di)(di)。 ②激(ji)(ji)(ji)(ji)素(su)(su)(su)的(de)(de)(de)(de)(de)(de)應(ying)(ying)(ying)(ying)(ying)(ying)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong):琥珀酸(suan)鈉氫化(hua)(hua)(hua)(hua)(hua)可(ke)(ke)(ke)(ke)(ke)的(de)(de)(de)(de)(de)(de)松(song)200～300mg加(jia)(jia)(jia)(jia)(jia)入(ru)補(bu)液(ye)(ye)(ye)中(zhong)(zhong)(zhong)靜(jing)脈(mo)(mo)滴(di)(di)注(zhu)(zhu)(zhu),一(yi)(yi)(yi)般在(zai)(zai)(zai)3日(ri)(ri)(ri)(ri)左右起效(xiao)(xiao),第7日(ri)(ri)(ri)(ri)可(ke)(ke)(ke)(ke)(ke)使哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)緩(huan)解,去除(chu)(chu)靜(jing)滴(di)(di)前1日(ri)(ri)(ri)(ri)宜先(xian)晨起頓(dun)服強(qiang)(qiang)地(di)松(song)30mg,以(yi)(yi)(yi)(yi)后(hou)根(gen)據(ju)(ju)病(bing)(bing)情(qing)逐漸撤(che)除(chu)(chu)每(mei)(mei)(mei)(mei)(mei)(mei)(mei)晨頓(dun)服量(liang)。亦可(ke)(ke)(ke)(ke)(ke)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)激(ji)(ji)(ji)(ji)素(su)(su)(su)氣(qi)(qi)(qi)(qi)(qi)霧(wu)(wu)劑(ji)(ji)輔助撤(che)除(chu)(chu)口(kou)(kou)(kou)服量(liang)。 ③抗(kang)(kang)(kang)(kang)感(gan)染:哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)嚴(yan)重(zhong)發(fa)(fa)(fa)作(zuo)(zuo)(zuo)(zuo)(zuo)病(bing)(bing)人(ren),大(da)(da)多(duo)在(zai)(zai)(zai)病(bing)(bing)毒(du)(du)感(gan)染的(de)(de)(de)(de)(de)(de)基礎上(shang)(shang)(shang)(shang)繼發(fa)(fa)(fa)細(xi)菌感(gan)染。有(you)(you)明(ming)確(que)細(xi)菌性(xing)(xing)感(gan)染者(zhe)(zhe)應(ying)(ying)(ying)(ying)(ying)(ying)及(ji)時選(xuan)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)抗(kang)(kang)(kang)(kang)生(sheng)(sheng)素(su)(su)(su);有(you)(you)時難(nan)以(yi)(yi)(yi)(yi)確(que)定(ding)而(er)懷疑有(you)(you)感(gan)染或(huo)(huo)(huo)(huo)(huo)年老體(ti)(ti)(ti)弱者(zhe)(zhe),均(jun)以(yi)(yi)(yi)(yi)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)抗(kang)(kang)(kang)(kang)生(sheng)(sheng)素(su)(su)(su)為(wei)(wei)妥。來不(bu)(bu)及(ji)做(zuo)藥(yao)(yao)(yao)敏試(shi)驗(yan)時,一(yi)(yi)(yi)般可(ke)(ke)(ke)(ke)(ke)先(xian)以(yi)(yi)(yi)(yi)青霉(mei)素(su)(su)(su)族肌(ji)注(zhu)(zhu)(zhu)或(huo)(huo)(huo)(huo)(huo)靜(jing)滴(di)(di)。為(wei)(wei)加(jia)(jia)(jia)(jia)(jia)強(qiang)(qiang)抗(kang)(kang)(kang)(kang)菌效(xiao)(xiao)應(ying)(ying)(ying)(ying)(ying)(ying),可(ke)(ke)(ke)(ke)(ke)以(yi)(yi)(yi)(yi)青霉(mei)素(su)(su)(su)10萬單位,鏈霉(mei)素(su)(su)(su)0 25g或(huo)(huo)(huo)(huo)(huo)慶大(da)(da)霉(mei)素(su)(su)(su)等(deng)(deng)(deng)加(jia)(jia)(jia)(jia)(jia)入(ru)超(chao)聲(sheng)霧(wu)(wu)化(hua)(hua)(hua)(hua)(hua)器(qi)噴(pen)(pen)霧(wu)(wu)吸(xi)(xi)(xi)(xi)入(ru),或(huo)(huo)(huo)(huo)(huo)放入(ru)玻璃(li)噴(pen)(pen)霧(wu)(wu)器(qi)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)橡皮管(guan)接(jie)連于(yu)(yu)(yu)氧(yang)(yang)(yang)(yang)氣(qi)(qi)(qi)(qi)(qi)筒上(shang)(shang)(shang)(shang)并加(jia)(jia)(jia)(jia)(jia)以(yi)(yi)(yi)(yi)適(shi)量(liang)異丙腎(shen)上(shang)(shang)(shang)(shang)腺素(su)(su)(su)(1∶200)5～10滴(di)(di),直(zhi)接(jie)由(you)氧(yang)(yang)(yang)(yang)氣(qi)(qi)(qi)(qi)(qi)噴(pen)(pen)霧(wu)(wu)吸(xi)(xi)(xi)(xi)入(ru), 如(ru)(ru)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)藥(yao)(yao)(yao)配(pei)伍適(shi)當,同(tong)(tong)(tong)時可(ke)(ke)(ke)(ke)(ke)起加(jia)(jia)(jia)(jia)(jia)強(qiang)(qiang)平(ping)(ping)(ping)喘(chuan)(chuan)(chuan)、祛痰、呼(hu)吸(xi)(xi)(xi)(xi)道(dao)局部消(xiao)(xiao)炎等(deng)(deng)(deng)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)。 ④祛痰:痰液(ye)(ye)(ye)粘稠不(bu)(bu)易(yi)咯出(chu)是(shi)哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)惡化(hua)(hua)(hua)(hua)(hua)的(de)(de)(de)(de)(de)(de)原因之一(yi)(yi)(yi)。上(shang)(shang)(shang)(shang)面補(bu)液(ye)(ye)(ye)本(ben)身可(ke)(ke)(ke)(ke)(ke)減(jian)少痰栓(shuan)形成(cheng),再(zai)(zai)加(jia)(jia)(jia)(jia)(jia)上(shang)(shang)(shang)(shang)抗(kang)(kang)(kang)(kang)炎平(ping)(ping)(ping)喘(chuan)(chuan)(chuan)藥(yao)(yao)(yao)及(ji)霧(wu)(wu)化(hua)(hua)(hua)(hua)(hua)器(qi)的(de)(de)(de)(de)(de)(de)同(tong)(tong)(tong)時應(ying)(ying)(ying)(ying)(ying)(ying)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong),痰液(ye)(ye)(ye)大(da)(da)多(duo)可(ke)(ke)(ke)(ke)(ke)自行消(xiao)(xiao)散(san)或(huo)(huo)(huo)(huo)(huo)咳(ke)出(chu)。一(yi)(yi)(yi)般痰液(ye)(ye)(ye)不(bu)(bu)易(yi)咯出(chu),可(ke)(ke)(ke)(ke)(ke)采用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)大(da)(da)量(liang)蒸氣(qi)(qi)(qi)(qi)(qi)或(huo)(huo)(huo)(huo)(huo)加(jia)(jia)(jia)(jia)(jia)溫的(de)(de)(de)(de)(de)(de)超(chao)聲(sheng)霧(wu)(wu)化(hua)(hua)(hua)(hua)(hua)吸(xi)(xi)(xi)(xi)入(ru),霧(wu)(wu)化(hua)(hua)(hua)(hua)(hua)液(ye)(ye)(ye)內(nei)(nei)可(ke)(ke)(ke)(ke)(ke)加(jia)(jia)(jia)(jia)(jia)10%～20%痰易(yi)凈(jing)水溶液(ye)(ye)(ye)。根(gen)據(ju)(ju)情(qing)況(kuang),還可(ke)(ke)(ke)(ke)(ke)選(xuan)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)必嗽(sou)平(ping)(ping)(ping)、鮮竹瀝、氯化(hua)(hua)(hua)(hua)(hua)胺、 10%碘化(hua)(hua)(hua)(hua)(hua)鉀等(deng)(deng)(deng)。 ⑤吸(xi)(xi)(xi)(xi)氧(yang)(yang)(yang)(yang):氧(yang)(yang)(yang)(yang)飽和(he)度(du)低(di)于(yu)(yu)(yu)70%,PaO 2低(di)于(yu)(yu)(yu)6 67kPa可(ke)(ke)(ke)(ke)(ke)出(chu)現(xian)紫(zi)紺(gan)(gan)。紫(zi)紺(gan)(gan)為(wei)(wei)給(gei)氧(yang)(yang)(yang)(yang)指(zhi)征；無(wu)(wu)紫(zi)紺(gan)(gan)者(zhe)(zhe),一(yi)(yi)(yi)般不(bu)(bu)需(xu)要(yao)(yao)給(gei)氧(yang)(yang)(yang)(yang)。有(you)(you)紫(zi)紺(gan)(gan)者(zhe)(zhe)可(ke)(ke)(ke)(ke)(ke)間(jian)隔(ge)給(gei)氧(yang)(yang)(yang)(yang),直(zhi)至(zhi)(zhi)紫(zi)紺(gan)(gan)消(xiao)(xiao)失(shi)為(wei)(wei)止(zhi)。根(gen)據(ju)(ju)臨(lin)床(chuang)缺氧(yang)(yang)(yang)(yang)情(qing)況(kuang)可(ke)(ke)(ke)(ke)(ke)采用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)每(mei)(mei)(mei)(mei)(mei)(mei)(mei)分(fen)(fen)鐘1 5～2 6L鼻導管(guan)給(gei)氧(yang)(yang)(yang)(yang),維持(chi)PaO 2在(zai)(zai)(zai)8kPa以(yi)(yi)(yi)(yi)上(shang)(shang)(shang)(shang),氧(yang)(yang)(yang)(yang)氣(qi)(qi)(qi)(qi)(qi)宜溫暖(nuan)濕化(hua)(hua)(hua)(hua)(hua), 避(bi)免(mian)引(yin)(yin)起氣(qi)(qi)(qi)(qi)(qi)道(dao)干燥痙(jing)攣。 ⑥糾正(zheng)酸(suan)中(zhong)(zhong)(zhong)毒(du)(du):當各種(zhong)藥(yao)(yao)(yao)物(wu)治(zhi)(zhi)(zhi)療(liao)無(wu)(wu)效(xiao)(xiao),應(ying)(ying)(ying)(ying)(ying)(ying)反(fan)復(fu)測定(ding)動脈(mo)(mo)血氧(yang)(yang)(yang)(yang)分(fen)(fen)壓(ya)、二(er)氧(yang)(yang)(yang)(yang)化(hua)(hua)(hua)(hua)(hua)碳(tan)分(fen)(fen)壓(ya)以(yi)(yi)(yi)(yi)及(ji)pH值(zhi)等(deng)(deng)(deng)。若病(bing)(bing)人(ren)合(he)(he)并有(you)(you)代(dai)謝性(xing)(xing)酸(suan)中(zhong)(zhong)(zhong)毒(du)(du),會影響支(zhi)氣(qi)(qi)(qi)(qi)(qi)管(guan)解痙(jing)劑(ji)(ji)的(de)(de)(de)(de)(de)(de)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)。pH值(zhi)小(xiao)于(yu)(yu)(yu)7 20為(wei)(wei)嚴(yan)重(zhong)的(de)(de)(de)(de)(de)(de)中(zhong)(zhong)(zhong)毒(du)(du)。一(yi)(yi)(yi)般二(er)氧(yang)(yang)(yang)(yang)化(hua)(hua)(hua)(hua)(hua)碳(tan)結合(he)(he)力低(di)于(yu)(yu)(yu)正(zheng)常(chang)值(zhi)或(huo)(huo)(huo)(huo)(huo)堿(jian)(jian)(jian)(jian)(jian)剩余(BE)小(xiao)于(yu)(yu)(yu)3mmol/L,即為(wei)(wei)補(bu)堿(jian)(jian)(jian)(jian)(jian)指(zhi)征。補(bu)堿(jian)(jian)(jian)(jian)(jian)可(ke)(ke)(ke)(ke)(ke)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)碳(tan)酸(suan)氫鈉靜(jing)脈(mo)(mo)滴(di)(di)注(zhu)(zhu)(zhu),但用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)量(liang)要(yao)(yao)適(shi)當,以(yi)(yi)(yi)(yi)免(mian)引(yin)(yin)起矯枉過(guo)正(zheng)的(de)(de)(de)(de)(de)(de)醫(yi)(yi)(yi)源性(xing)(xing)堿(jian)(jian)(jian)(jian)(jian)中(zhong)(zhong)(zhong)毒(du)(du)。在(zai)(zai)(zai)緊急應(ying)(ying)(ying)(ying)(ying)(ying)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)或(huo)(huo)(huo)(huo)(huo)無(wu)(wu)化(hua)(hua)(hua)(hua)(hua)驗(yan)的(de)(de)(de)(de)(de)(de)情(qing)況(kuang)下(xia),可(ke)(ke)(ke)(ke)(ke)先(xian)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)5%碳(tan)酸(suan)氫鈉100ml靜(jing)脈(mo)(mo)滴(di)(di)注(zhu)(zhu)(zhu),需(xu)要(yao)(yao)時,隔(ge)4小(xiao)時可(ke)(ke)(ke)(ke)(ke)再(zai)(zai)行同(tong)(tong)(tong)劑(ji)(ji)量(liang)靜(jing)脈(mo)(mo)滴(di)(di)注(zhu)(zhu)(zhu)。 ⑦應(ying)(ying)(ying)(ying)(ying)(ying)注(zhu)(zhu)(zhu)意氣(qi)(qi)(qi)(qi)(qi)胸(xiong)的(de)(de)(de)(de)(de)(de)發(fa)(fa)(fa)生(sheng)(sheng):病(bing)(bing)人(ren)呼(hu)吸(xi)(xi)(xi)(xi)困難(nan)加(jia)(jia)(jia)(jia)(jia)重(zhong)而(er)哮(xiao)(xiao)(xiao)(xiao)鳴(ming)音(yin)(yin)反(fan)而(er)減(jian)輕(qing)(qing)(qing)或(huo)(huo)(huo)(huo)(huo)消(xiao)(xiao)失(shi), 提(ti)(ti)示病(bing)(bing)人(ren)可(ke)(ke)(ke)(ke)(ke)能(neng)(neng)(neng)痰栓(shuan)堵塞大(da)(da)氣(qi)(qi)(qi)(qi)(qi)道(dao)或(huo)(huo)(huo)(huo)(huo)并發(fa)(fa)(fa)氣(qi)(qi)(qi)(qi)(qi)胸(xiong)。詳(xiang)細(xi)體(ti)(ti)(ti)檢和(he)床(chuang)邊胸(xiong)部攝片有(you)(you)助于(yu)(yu)(yu)診斷。如(ru)(ru)果(guo)是(shi)氣(qi)(qi)(qi)(qi)(qi)胸(xiong),應(ying)(ying)(ying)(ying)(ying)(ying)及(ji)時做(zuo)閉式引(yin)(yin)流——水封瓶排氣(qi)(qi)(qi)(qi)(qi)。若為(wei)(wei)痰栓(shuan)阻塞大(da)(da)氣(qi)(qi)(qi)(qi)(qi)道(dao),應(ying)(ying)(ying)(ying)(ying)(ying)立即在(zai)(zai)(zai)床(chuang)邊為(wei)(wei)病(bing)(bing)人(ren)插入(ru)纖維支(zhi)氣(qi)(qi)(qi)(qi)(qi)管(guan)鏡作(zuo)(zuo)(zuo)(zuo)(zuo)支(zhi)氣(qi)(qi)(qi)(qi)(qi)管(guan)灌洗,把痰栓(shuan)吸(xi)(xi)(xi)(xi)出(chu)。
哮喘的藥物治療
【專題】防治哮喘病
現代醫學已經認識到：哮喘的病理基礎是氣道慢性變應性炎癥，并對外界刺激很敏感。因此，在治療支氣管哮喘時，不應一味舒張支氣管，而應同時重視抗炎和降低氣道反應性的治療。隨著治療新觀點的出現，哮喘治療的重點也有所變化。過去偏重于應用支氣管擴張劑，采取解除支氣管收縮、緩解癥狀的治療，必然不能滿足病人的需要。具有抗炎癥作用的激素已成為治療哮喘的主要藥物。
1、 支氣管擴張劑
支氣管擴張劑即止喘藥。主要是解除支氣管痙攣，控制哮喘急性發作，但無抗炎作用。由于支氣管擴張劑作用快而明顯，易被病人接受，但不能過度依賴這些緩解癥狀的藥物。中重癥哮喘病人在用β2受體激動劑時，應和皮質激素同時吸入，雙管齊下，才能取得較好的療效。
常用的支氣管擴張劑分為以下三種。
(1)β2腎上腺素受體激動劑(β2受體激動劑)：β受體存在于心血管、肺及肌肉等組織器官內，可分為β1及β2兩種。作用于β1受體的興奮藥，能增加心肌收縮力，加快心跳，抑制腸道蠕動。作用于β2受體的興奮藥，則舒張支氣管，增加氣道上皮細胞纖毛清除作用，并能使血中嗜酸細胞減少等。腎上腺素和異丙腎上腺素(喘息定)等，對β1及β2受體均有興奮作用，因此在舒張支氣管的同時，常引起心跳加快、心肌氧消耗增加、心律不齊等副作用。
β2激動劑，如沙丁胺醇(舒喘靈)，可以口服，又可吸入；既有長效制劑，又有短效制劑。通常采用氣霧劑吸入途徑，如舒喘靈，一般吸入5分鐘至10分鐘后，即起到平喘作用，但只能維持3小時至6小時。而長效氣霧劑“施立穩”或口服“全特寧”、“美喘清”，可以維持12小時。
但是，β2激動劑最好是在有癥狀時按需作用。如果過多依賴β2激動劑，這就意味著抗炎癥治療不夠，或者吸入方法不正確，或合并有其他感染問題。β2激動劑除了用氣霧劑吸入外，還可以用舒喘靈水溶液，用空氣壓力泵或氧氣筒作動力，通過霧化器霧化給藥，作用快而副作用小，是目前哮喘急救時的首選方法。
(2)茶堿類：氨茶堿與β2激動劑作用相似，可以松弛氣道平滑肌，并有興奮心臟和中樞神經系統的作用，使呼吸道分泌物易排出，還能恢復呼吸肌疲勞。常用的有普通氨茶堿片、長效茶堿等。它的止喘作用也較好，血液里的藥物濃度在每毫升含5至20微克時起作用。由于該藥個體代謝差異大，如果能進行藥物濃度測定，據此來調整用藥，使血中藥物濃度保持在最佳有效濃度范圍，效果更佳。
一般普通氨茶堿片為每6小時至8小時服藥1次，兒童每次可用(4至5)毫克/每千克體重。長效茶堿12小時間隔服藥，每次(8至10)毫克/每千克體重，成人一般每次用0.1克至0.15克，每天2次。現在還有每日服1次能維持24小時的制劑“優喘平”。但是茶堿有時可以引起惡主、腹部不適，食欲受影響，故在飯后服用為宜。
(3)抗膽堿類藥物：溴化羥基異丙托品對氣道平滑肌有較強松弛作用，但起效較慢，用藥后30分鐘至60分鐘后達高峰，作用于大、中氣道為主，可與β2激動劑一起用，一般用氣霧劑或霧化溶液吸入。
654-2是我國研制的膽堿能神經阻斷劑，也有松弛平滑肌及改善微循環的作用。一些慢性哮喘病人也可長期小劑量口服。
(4)白三烯受體拮抗劑：半胱氨酰白三烯能致氣道微血管漏出、水腫及黏液分泌并引起氣道嗜酸細胞滲出，是一種強有力的支氣管收縮劑，從理論上推測它的受體拮抗劑可能是有效的哮喘防治劑。目前這個設想已成為事實。捷利康醫藥開發咨詢有限公司在我國市場推出一種選擇性白三烯D受體拮抗劑，商名安可來(Accolate)，經北京協和、朝陽等醫院臨床試用證實對輕中型支氣管哮喘的預防治療有較好效果。這可能是在哮喘治療上的一個新突破。
2、 預防類藥物
預防類藥物本身不止喘，但堅持用藥一段時間后，可以減少發作次數，減輕發作程度，并有一定的預防作用。
(1)皮質激素(類固醇)吸入劑：常用的皮質激素有丙酸倍氯松(“必可酮”、“信可松”)等氣霧劑。它們能消除支氣管壁黏膜的非特異性炎癥，防止黏膜水腫，能制止黏膜分泌產生刺激性化學介質。由于局部吸入用藥直接到達肺部，避免了口服給藥的副作用，是目前最安全、有效的常用藥物。
長期口服皮質激素治療，會形成滿月臉、骨質疏松、肥胖、高血壓、潰瘍病等。兒童長期服用也會影響生長發育。類固醇制劑的種類很多，用吸入方法，1天的總劑量只不過是1片5毫克口服強地松的1/10，何況吸入氣霧劑，還要排出一部分。在吸藥后通過刷牙漱口，把口腔內殘存藥物排出，進入人體內的量更少，其副作用可謂微乎其微。但是，吸入類固醇沒有松弛平滑肌的功能，所以沒有立刻舒張支氣管的作用。因此，有些病人對它的作用常常低估。自1972年以來，一些發達國家開始應用吸入類固醇，已取得了相當好的效果，也積累了不少經驗，并以吸入類固醇，作為治療哮喘病的第一線藥物。也有的醫生主張，在哮喘早期就應用，會取得很好效果。少數人吸入類固醇后，能引起喉部不適或聲音嘶啞，可用水漱口，清洗喉部，可消除此反應。
在重度哮喘發作時，一般哮喘藥物不能控制，也可采用口服類固醇(潑尼松)，來減輕癥狀。口服藥物不超過1周不會有什么副作用。
類固醇針劑是嚴重哮喘和哮喘持續狀態時常用的藥物。常用的有氫可的松、地塞米松等。由于這類藥物屬激素類，長期應用有一定的副作用，所以應在醫生指導下使用。
(2)色甘酸鈉：常用的是粉末膠囊，用特殊輔助工具吸入，也可用氣霧劑吸入。一般認為，它可用來防止哮喘發作。后來發現它不但對變態反應性哮喘，而且對運動誘發的哮喘也有效。但是對它怎樣起預防作用還不清楚。色甘酸鈉主要用來預防輕、中癥兒童哮喘，如在應用1個月~3個月后，雖然癥狀減輕，但還不能十分滿意地控制哮喘時，可考慮換用皮質激素吸入。
(3)酮替芬：能減輕病人過敏反應(如濕疹、過敏性鼻炎等)，對哮喘發作也有一定的預防作用。酮替芬又稱“噻哌酮”，屬抗組織胺藥物。它為片劑，一般每次服0.5毫克~1毫克，每日2次。該藥副作用是用藥后易困倦。但用藥1周后，病人可以逐漸耐受。兒童對酮替芬比較能耐受。在成人及學齡兒童，最好在每日臨睡前服用1片。
3、 免疫調節劑
由于哮喘屬免疫系統的過敏反應，又與病毒感染等其他因素有關，所以應用免疫調節劑，能增加患兒的免疫功能，抵抗各種感染，可大大減少哮喘的發作。常用的有胸腺肽、核酪、轉移因子、卡慢舒糖漿、乳珍、中藥黃芪等。一般在由感染誘發哮喘者應用較多，應用時間約3個月至半年。但若以過敏性哮喘為主，單用這類免疫調節劑并不恰當，應采用綜合治療。
4、 脫敏療法
脫敏療法可以減輕對過敏物質的反應，防止哮喘發作。
一般采用避免過敏原的措施及以吸入藥物為主的“哮喘規范化階梯式”治療方法，通常能很好控制哮喘。只有在不可能避免過敏原，或適當的藥物治療不能有效控制哮喘的癥狀時，才可考慮特異性免疫治療。過敏性哮喘是在過敏原刺激下的一種以支氣管痙攣、黏膜水腫為特征的過敏反應。脫敏療法則是用少量過敏原，不斷地刺激病人，使病人逐漸對該過敏原產生耐受，在接觸過敏原后不出現哮喘發作，達到治療目的。采用這種療法的病人，必須是過敏性哮喘，而且過敏原明確；所用的脫敏藥物，又必須是患者的過敏物，這樣才能有效。此外，該方法療程較長，又是注射給藥，停藥后又有復發可能，所以在兒童應用受限，已逐漸被其他新的治療法取代。
值得說明的是，以上種種方法，對每個病人的治療反應是不一樣的。要依據每個病人的病情來選擇合適的藥物，合理配伍，并根據病情變化，隨時調整，這樣才能達到最佳療效。
所以，“堅持就診，遵囑用藥，定期檢查”就顯得很重要了。
5、 抗生素
由于哮喘是以氣道高反應性為特征的慢性疾病，而不是細菌引起的炎癥，所以，一般情況下不需服用抗生素。但如果發作時間較長，有發熱或合并支氣管炎、肺炎等細菌感染時，則可以應用抗生素，以控制感染。
6、 中藥治療
(1)哮喘急性發作期：要根據病人寒熱、虛實各證候辨證施治。在急性發作時，用湯劑收效較快。
①寒痰阻肺，喉有喘鳴，痰多而不易咳出，面色白，無汗，鼻堵塞，口不干，舌苔薄白，脈浮滑。
治法：溫肺散寒，化痰止咳平喘。
可用麻黃、桂枝、半夏、細辛、干姜、五味子、杏仁、白前、甘草等治療。主要湯劑為小青龍汽，也可用射干麻黃湯等。
②痰熱阻肺，咳喘，有喘鳴，胸悶，痰稠黃、不易咳出，煩躁口渴，可伴發熱，咽紅，大便干燥，舌質紅，苔黃膩，脈滑數。
治法：清熱化痰，肅肺平喘。
可用麻黃、杏仁、黃芪、葶藶子、蘇子、桑白皮、款冬花、射干、前胡等治療。熱重可加石膏；痰黏可加用瓜蔞皮、天花粉等。主要湯劑為定喘湯加減，或麻杏石甘湯治療。
(2)緩解期：在緩解期，要健脾、補腎、扶正。
①肺脾氣虛，哮喘發作已久，面色白，疲乏，出汗多，易感冒，食欲差，大便稀，舌質淡，苔薄白，脈緩而弱。可用玉屏風散(白術、防風、黃芪)及人參健脾丸等。
②腎虛氣喘，久病體虛，怕冷，下肢發冷，面色蒼白，心跳氣短，夜間尿多，大便稀，舌質淡，舌苔白，脈細弱。可用“參蛤散”加減，黨參、蛤蚧、五味子研粉混合，分次吞服；也可用補腎防喘片、麥味地黃丸。
③平時也可長期服用桂龍咳喘寧，對輕癥哮喘發作及其緩解期，有一定止咳、平喘作用。
哮喘中藥方劑
中藥處方（一）
【辨證】痰氣交阻，肺氣不得宣降，上逆作喘鳴，肺管鑰啟闔受阻，呼吸艱難，憋悶不暢。
【治法】宣肺降氣祛痰平喘。
【方名】蜂龍湯。
【組成】蜂房6克，地龍10克，桔梗6克，蘇子12克，白果10克，百部10克，天竺黃3克，訶子6克。
【用法】水煎服，每日1劑，日服2次。
【出處】丁金元方。
中藥處方（二）
【辨證】痰熱內蘊，復感外邪，內外相合，痰阻氣道，肺氣不宣。
【治法】宣肺平喘，清降肺熱，搜痰止咳。
【方名】麻杏石甘辛茶湯。
【組成】蜜麻黃5克，杏仁6克，生石膏12克，細辛2克，炙甘草4克，茶葉1撮。生姜3片，大棗4枚。
【用法】水煎服，每(mei)日1劑，日服2次。
哮喘主要(yao)(yao)是呼(hu)吸(xi)系統的疾病，所(suo)以哮喘的人很容易會有喘不(bu)過(guo)氣(qi)、呼(hu)吸(xi)困難(nan)的情況，這種是要(yao)(yao)特別(bie)引(yin)起注意的。一些急救藥物也要(yao)(yao)近(jin)身攜(xie)帶，那么(me)晚上睡覺(jue)喘不(bu)過(guo)氣(qi)怎(zen)么(me)緩解呢(ni)？呼(hu)吸(xi)困難(nan)可(ke)以減輕(qing)嗎？
對于哮喘(chuan)，還要注意相應的(de)(de)飲食或(huo)者(zhe)(zhe)是生活起居，加以(yi)預防或(huo)者(zhe)(zhe)是鍛煉(lian)使自身的(de)(de)免疫(yi)力提高，也能起到一(yi)定的(de)(de)預防或(huo)者(zhe)(zhe)緩解(jie)的(de)(de)作(zuo)用。實驗證(zheng)明吸煙(yan)對支(zhi)氣(qi)管(guan)(guan)哮喘(chuan)疾病發(fa)作(zuo)有很大的(de)(de)影響，所(suo)以(yi)支(zhi)氣(qi)管(guan)(guan)哮喘(chuan)病者(zhe)(zhe)嚴(yan)禁吸煙(yan)，而(er)且要盡量避免接觸(chu)煙(yan)霧。
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