哮喘联盟

   摘要
   上、下呼吸道的完整气道的概念有待关注。有些证据表明慢性鼻窦炎和哮喘相关，但对病理生理学和综合管理的理解仍然不足，这亦引起了争论。支气管哮喘在慢性鼻窦炎患者中更为普遍。换言之，哮喘患者比无哮喘患者鼻窦炎的患病率更高。慢性鼻窦炎在伴或不伴鼻息肉对哮喘治疗的影响（无论是药物还是手术治疗）尚存争议。一些研究表明会影响治疗，一些表明有助改善治疗，而另外一些表明对治疗无影响。很少有手术和药物治疗之间的直接对比。目前在这有趣的综合管理方面，绝大多数可用的文献还不能提供一个很好的证据级别。因此，为更好的理解管理，当哮喘和CRS同时发生时，应选择随机的临床试验。本文旨在针对不同的治疗方案的疗效总结目前两者之间的关系。
 

（林江涛 审校）
Curr Allergy Asthma Rep. 2014 Jun;14(6):440. doi: 10.1007/s11882-014-0440-x.

 

Management of chronic rhinosinusitis in asthma patients: is there still a debate?
 

Lehrer E1, Mullol J, Agredo F, Alobid I.
 

Abstract
The united airway concept in which upper and lower respiratory conditions are present in one patient requires special consideration. There is some evidence linking chronic rhinosinusitis and asthma, but a good understanding of the pathophysiology and combined management is still lacking, a fact that leads to discussion. Bronchial asthma is more prevalent in patients who suffer chronic rhinosinusitis. On the other hand, patients with asthma have a greater prevalence of rhinosinusitis than patients without asthma. The effect of chronic rhinosinusitis in patients with or without nasal polyps on asthma treatment, whether medical or surgical, is controversial. Some studies show worsening, other trials improvement, and others no effect. Direct comparisons between surgical and medical treatments are few. Most of the current literature available about this intriguing combination does not provide a good level of evidence. Thus, randomized clinical trials should be performed to better understand the management when asthma and CRS occur together. This review aims to summarize the current state of this association regarding the effects of different types of treatment.
 

Curr Allergy Asthma Rep. 2014 Jun;14(6):440. doi: 10.1007/s11882-014-0440-x.