zhenglijun

Asthma is a syndrome characterized by airflow obstruction that varies markedly, both spontaneously and with treatment.

Narrowing of the airways is usually reversible,104, but in some patients with chronic asthma there may be an element of irreversible airflow obstruction. Prevalence The prevalence of asthma has risen in affluent countries over the last 30 years but now appears to have stabilized,107, with 10–12% of adults and 15% of children affected by the disease,109. In developing countries where the prevalence of asthma had been much lower, there is a rising incidence that appears to be associated with increased urbanization. Asthma is both common and frequently complicated by the effects of smoking on the lungs.

RISK FACTORS: Atopy: Atopy is the major risk factor for asthma, and nonatopic individuals have a very low risk of developing asthma.

Intrinsic Asthma : A minority of asthmatic patients have negative skin test to common inhalant allergens and normal serum concentrations of IgE.

Infections : Although viral infections are common as triggers of asthma exacerbations, it is uncertain whether they play a role in etiology,102. Genetic Considerations: The familial association of asthma and a high degree of concordance for asthma in identical twins indicate a genetic predisposition to the disease; however, whether or not the genes predisposing to asthma are similar or in addition to those predisposing of atopy is not yet clear. Environmental Factors: It is likely that environmental factors in early life determine which atopic individuals become asthmatic. The increasing prevalence of asthma, particularly in developing countries, over the last few decades also indicates the importance of environmental mechanisms interacting with a genetic predisposition. Hygiene Hypothesis The observation that allergic sensitization and asthma were less common in children with older siblings first suggested that lower levels of infection may be a factor in affluent societies that increase the risks of asthma. Diet The role of dietary factors is controversial. Observational studies have shown that diets low in antioxidants, such as vitamin C and vitamin A,105, magnesium, selenium, and omega-3 polyunsaturated fats (fish oil), or high in sodium and omega-6 polyunsaturates are associated with an increased risk of asthma,105. Air Pollution There is no doubt that air pollutants, such as sulfur dioxide, ozone, and diesel particulates, may trigger asthma symptoms, but the role of different air pollutants in the etiology of the disease is much less certain. Allergens Inhaled allergens are common triggers of asthma symptoms and have also been implicated in allergic sensitization. Exposure to house dust mites in early childhood is a risk factor for allergic sensitization and asthma, but rigorous allergen avoidance has not shown any evidence for a reduced risk of developing asthma. Pathogenesis: Asthma is associated with a specific chronic inflammation of the mucosa of the lower airways. One of the main aims of treatment is to reduce this inflammation. Inflammatory Mediators Many different mediators have been implicated in asthma, and they may have a variety of effects on the airways that could account for the pathologic features of asthma Clinical Features ; The characteristic symptoms of asthma are wheezing,107, dyspnea, and coughing which are variable, both spontaneously and with therapy,102. Symptoms may be worse at night, and patients typically awake in the early morning hours. Patients may report difficulty in filling their lungs with air.

There is increased mucus production in some patients,109, with typically tenacious mucus that is difficult to expectorate,108. There may be increased ventilation and use of accessory muscles of ventilation. Prodromal symptoms may precede an attack, with itching under the chin, discomfort between the scapulae, or inexplicable fear. Typical physical signs are inspiratory, and to a great extent expiratory, rhonchi throughout the chest, and there may be hyperinflation. Some patients, particularly children, may present with a predominant nonproductive cough.

Diagnosis:
1.Lung Function Tests.
2.Airway Responsiveness.
3.Hematologic Tests.
4.Imaging.

Homoeopathic approach: Moschus :

Intense anxiety, intense fear and a smothering sensation.

It suits those of a sensitive, highly organized, nervous temperament; neurotic types when increased anxiety and nervousness predominate.

Antimonium tartaricum :

It is a remedy used largely in some form by the allopathic school in asthma, and it is homoeopathic to certain cases.

The great keynote for the remedy is the presence of fine mucous rales throughout the chest, finer and smaller rales than are found under Ipecac.

Kali bichromicum :

The potashes produce asthmatic condition, and under Kali bichromicum we find the attacks coming on about three or four o'clock in the morning, compelling the patient to sit up to breath; he sits up and bends forward which relives somewhat, as does also the expectoration of stringy yellow mucus, which is characteristic of the remedy.

Nux vomica :

Nux vomica is a useful remedy when the asthmatic attacks are brought on by gastric disturbances; simple spasmodic asthmas; there is some relief by belching, the patient must loosen the clothing.

It must also be thought of in those who drink much coffee or liquor.

Irritable bilious temperaments also correspond to the drug.