哮喘是一種影響呼吸道的疾病，呼吸道是呼吸時進入肺臟及從肺臟吐出的空氣所經過的管道。當哮喘病患者與一種引起氣喘發作的激發物接觸，呼吸道內壁肌肉收縮，呼吸道因而變窄。呼吸道的粘膜充血而腫脹，通常這會產生粘液或痰。所有這些反應導致呼吸道變窄和受刺激 – 從而觸發哮喘的症狀。
What is asthma?
Asthma is a condition that affects the airways – the small tubes that carry air in and out of the lungs. When a person with asthma comes into contact with an asthma trigger, the muscles around the walls of the airways tighten and the airways become narrower. The lining of the airways becomes red and swollen and often sticky mucus or phlegm is produced. All these reactions cause the airways to become narrower and irritated – leading to the symptoms of asthma.
The common symptoms of asthma are:
- wheezing or a whistling noise in the chest
- shortness of breath
- tightness in the chest.
- 現代生活方式的許多方面 – 例如房屋和飲食的改變以及更衛生的環境 – 都可能增加哮喘的病例
What causes asthma?
Asthma can start at any age. It is difficult to know what causes asthma, but so far we know that:
- if one or both of your parents have asthma you are more likely to have it
- many aspects of modern lifestyles – such as changes in housing and diet and a more hygienic environment – may have added to the rise in asthma
- smoking during pregnancy increases the chance of a child developing asthma
- being exposed to cigarette smoke increases the chance of developing asthma
- irritants in the workplace such as dust and chemicals may lead to a person developing asthma
- environmental pollution can make asthma symptoms worse.
What are the things that can set off (or trigger) asthma symptoms?
A trigger is anything that irritates the airways and causes the symptoms of asthma. Everyone's asthma is different and you will probably have more than one trigger. Common triggers include colds or flu, tobacco smoke, exercise and allergies to things like pollen, furry or feathery animals or house-dust mites.
How might asthma affect my lifestyle?
Some people may have to change parts of their lifestyle because of worsening asthma symptoms. It can be difficult to identify exactly what triggers your asthma. Sometimes the link is very clear, for example when your symptoms start within minutes of coming into contact with a cat or pollen. However some people have a delayed reaction to an asthma trigger. By avoiding the triggers that make your asthma symptoms worse, and by taking your asthma medicines correctly, you can reduce your symptoms and continue to enjoy your usual lifestyle.
How is asthma treated?
There are some excellent treatments available to help you to control your asthma. The most effective way of taking most asthma treatments is to inhale the medicine so it gets straight into your lungs. There are many different inhalers available and it is important that you use an inhaler that you are comfortable with and can use properly. Your doctor or asthma nurse will advise you on the most appropriate inhaler for you and should show you how to use it correctly.
There are two main types of asthma medicine which are equally important but do different things. They are called relievers and preventers.
- Reliever inhalers are usually blue and you take them when you have symptoms (like wheeze or cough). They work quickly by relaxing the muscles surrounding the narrowed airways making it easier to breathe. Reliever inhalers are essential in treating asthma attacks. If you need to use your reliever inhaler 3–4 times a week, you should go back to your doctor or nurse and have your asthma reviewed so that you can keep it under control. If you continue to need a lot of reliever medicine over a long time there is a risk that it will become less effective in you and your asthma may worsen.
- Preventer inhalers usually come in brown, red or orange. They work by controlling the swelling and inflammation in the airways, stopping them from being so sensitive and reducing the risk of severe attacks. The effect of preventer inhalers builds up over a period of time and they need to be taken every day, usually morning and evening, even when you are feeling well. Preventers contain a steroid medicine. It is important to understand that the steroids contained in preventer medicines are not the same as anabolic steroids used by athletes to improve their performance.
There are other types of medicine that can be added to your reliever and preventer inhaler if needed, such as preventer tablets, long-acting relievers and combination inhalers (usually red and white or purple). For information about other medicines speak to your doctor or asthma nurse.
- 用以醫治哮喘的類固醇是皮質類固醇 – 一種人體自然產生類固醇的複製品。
Are the steroids in asthma medicines safe for me to take?
Yes, in fact if you are prescribed a preventer inhaler and use it properly this will greatly reduce your chance of an asthma attack. However there are some points to remember:
- The steroids used to treat asthma are corticosteroids – a copy of the steroids produced naturally in your body.
- They are completely different from the anabolic steroids used by bodybuilders and athletes.
- Inhaled steroids go straight down to the airways, so very little is absorbed into the rest of the body.
- Your doctor should prescribe the lowest possible dose.
- Inhalers can be in spray form (aerosol) or dry powder form. If you have an aerosol inhaler, using a spacer device with your inhaler is the best way to take your medicine. A spacer is a large plastic or metal container, with a mouthpiece at one end and a hole for the aerosol inhaler at the other.
- To avoid side effects you should use a spacer device and rinse your mouth after using your inhaler.
- Children’s treatment should be reviewed at least every 6 months.
- All children should use a spacer for their preventer inhaler.
Occasionally, if your asthma symptoms become severe, your doctor may give you a short course of steroid tablets. They work quickly and powerfully to help to calm your inflamed airways. Short courses of tablets, anything from 3–14 days, will not give any long-term side effects. Steroid tablets can lower the body's resistance to chickenpox, so you should contact your doctor if you are taking steroid tablets and come into contact with chickenpox. Children using steroid tablets should be monitored closely.
Why can’t I take tablets to control my asthma?
The most effective way of taking most asthma treatments is to inhale the medicine by using your inhaler so it gets straight into your lungs. Most preventer treatments contain steroids and taking them by inhaler means that a much lower dose of the steroid can be used.
Because the inhaled medicine goes straight down to the airways where it is needed, very little is absorbed into the rest of the body.
When steroids are taken in tablet form the dose is much higher and most of it will be absorbed into the rest of the body, not just your lungs. Using steroid tablets regularly or for long periods of time (months or years) can have serious side effects including brittle bones (osteoporosis), bruising easily, diabetes, cataracts, increased hunger, heartburn and indigestion. They may make you feel depressed, or have mood swings or develop a fattened face.
A small number of people need daily steroid tablets as well as their other inhalers.
- occasional short courses of tablets (anything from 3–14 days) are very unlikely to give you any long-term side effects
- if you do not take your inhaler as often as your doctor or asthma nurse has prescribed you will be more likely to need steroid tablets
- if you find you need more than one or two short courses of tablets a year you should have an asthma review with your doctor or asthma nurse.
Helping you to control your asthma
Your doctor or asthma nurse should discuss with you the best way you can control your symptoms and should give you a written record of your asthma medicines and what to do if your symptoms get worse (sometimes called a Personal Asthma Action Plan). If this plan does not suit you for any reason, go back to your doctor.
You should also have an asthma review every year, even if your symptoms are well controlled or more often if your symptoms are difficult to control. An asthma review is an appointment where you and your doctor or asthma nurse talk about ways you can control your symptoms better. They should also check that you are taking your inhaler correctly. At your asthma review, ask for an asthma medicine card and a written record of how to control your asthma (Personal Asthma Action Plan).
How do I know if my asthma is getting worse?
You may be:
- needing more and more reliever treatment
- waking at night with coughing, wheezing, shortness of breath or a tight chest
- having to take time off school/college/work because of your asthma
- feeling that you cannot keep up with your normal level of activity or exercise.
Any of these show that your asthma is not controlled and you should see your doctor or asthma nurse to get your asthma back under control.
- 如果你的情況在五分鐘內沒有好轉過來 – 或者你覺得疑慮 – 打999或緊急召喚醫生
What you must do during an asthma attack
- Take two puffs of your reliever (usually blue) inhaler.
- Sit up and loosen tight clothing.
- If no immediate improvement during an attack, continue to take one puff of reliever inhaler every minute for five minutes or until symptoms improve.
- If your symptoms do not improve in five minutes – or if you are in doubt - call 999 or a doctor urgently.
- Continue to take one puff of your reliever inhaler every minute until help arrives.
Even if you feel better you should see your doctor within 2 days.
許多患哮喘的人都有意嘗試接受不用開方藥物的治療以助控制所患的哮喘。這些常稱為補充治療和療法，包括瑜珈、針灸、同種療法，催眠狀態， Buteyko 呼吸法和其他的呼吸技術。
Will complementary therapies help me to control my asthma?
Many people with asthma are interested in trying treatments and therapies that do not use prescribed medicines to help them control their asthma. These are often called complementary therapies. They include yoga, acupuncture, homeopathy, hypnosis, Buteyko and other breathing techniques.
As complementary therapies have not been studied as much as prescription medicines, less is known about how effective they are or what harmful effects they may have.
Some people with asthma find that some complementary therapies and treatments help to relieve stress which can be a trigger for asthma. Others have been shown to help reduce asthma symptoms, such as breathlessness. It is important to remember that while symptoms may improve the underlying asthma remains.
Asthma UK recommends that anyone who would like to try a complementary therapy or treatment should speak to their doctor or asthma nurse first. Complementary therapies should always be used alongside any prescribed treatment.
It could worsen your asthma symptoms if you reduce or stop taking your regular asthma medicine.
你使用的哮喘藥對你嬰兒不會引起傷害 - 事實上，如果你的哮喘受控制， 這會令你的嬰兒得益，因此重要的是你要繼續使用你的哮喘藥品。如果你關心你的哮喘病，不妨跟你的醫生、護士或助産士交談。
I have asthma and I am pregnant, will my baby have asthma too?
This is one of the main concerns of many women with asthma. Like other allergic conditions, such as hay fever and eczema, asthma often runs in the family. Researchers are trying to show which factors in the environment also play a part.
Some, but not all, studies have shown that breast-feeding in the first few months of life may reduce the chance of your baby developing allergic conditions, including asthma.
Mothers who smoke during pregnancy are more likely to have children that develop asthma and wheezing in their early years. The most important thing you can do to reduce a baby’s chance of asthma is to avoid cigarette smoke.
Your asthma medicines won't harm your baby - in fact, your baby will do best if your asthma is under control, so it is important to continue with your asthma medicine.
If you are concerned about your asthma, speak to your doctor, nurse or midwife.
You should have your asthma reviewed by your doctor or asthma nurse if you are pregnant.
英國哮喘忠告專線(Asthma UK Adviceline)
0800 121 62 44
Where can I go to get more information?
For free confidential and independent advice about asthma, phone the Asthma UK Adviceline to speak to our asthma nurse specialists.
An interpreting service is available to answer enquiries (from UK residents) in more than 100 languages. Callers are asked which language they need, and are connected with the Language Line Service so that they can continue their conversation with an asthma nurse specialist through an interpreter.
Asthma UK Adviceline
0800 121 62 44
9am to 5pm, Monday to Friday
(Calls are free from BT landlines)