Traditional Chinese Medicine Nursing Protocols for Wheezing Disease(Bronchial Asthma)

Wheezing disease( bronchial asthma) is a common but refractory disease among pulmonary diseases. It tends to attack repeatedly,and is difficult to be cured. In recent years,some studies have shown that effective traditional Chinese medicine( TCM) nursing interventions on the wheezing disease can significantly ameliorate the treatment compliance of patients,reduce the attack and improve the quality of life. Therefore,it is important for patients with different patterns of syndrome to receive effective and reasonable TCMnursing intervention. This article mainly explored the key points of common syndromes,TCMnursing methods and health guidance of wheezing disease in order to further develop the advantages of TCM,improve its efficacy and standardized its nursing behavior.

Clinical Study on Rexiao decotion for asthma of heat wheezing type at acute stage

Objective:To study the safety,efficacy and mechanism of Wang Yulin self-made recipe Rexiao decoction in the treatment of acute bronchial asthma(BA).Methods:80 patients with acute attack BA were randomly divided into western medicine group(n=40)and traditional Chinese and western medicine group(n=40).The control group was treated with routine western medicine:salmeterol was inhaled twice a day,combined with oxygen therapy and inducement therapy.The Chinese and Western medical group was treated with Rexiao decoction in the western medical group.The course of treatment is 15 days.Their syndrome score,blood gas analysis(PaC02,Pa02)and induced sputum IL-5,EOS,IL-1 were observed.3.Pulmonary function(record of kidney,liver function,blood routine and adverse reactions in PEF%Pred,FEV1%Pred),group).Results:the total effective rate was 85%in western medicine group and 92.5%in traditional Chinese and western medicine group(P<0.01).After treatment,the score of TCM syndromes in the Chinese and western medicine group was better than that in the western medicine group(P<0.05).After treatment,the pulmonary function(FEV1%Pred)of the traditional Chinese and western medicine group was better than that of the western medicine group,and the PEF%Pred of the Chinese and western medicine group was better than that of the western medicine group.Analysis of Blood Gas in traditional Chinese and Western Medicine Group after treatment(PaO2)was significantly higher than that in the control group(P<0.05).There was no significant difference in the improvement of blood gas analysis(PaCO2)between the western medicine group and the traditional Chinese and western medicine group(P>0.05).The decrease of IL-13,EOS and IL-5 in sputum of traditional Chinese and western medicine group was more than that of western medicine group(P<0.01).There was no significant difference in liver function(AST,ALT),renal function(Cr,Urea),blood routine(WBC,RBC,PLT)before and after treatment in traditional Chinese and western medicine group(P>0.05),but no obvious adverse reactions were found.Conclusions:heat Asthma decoction is safe and effective in the treatment of hot asthma syndrome in acute attack.The target and inflammatory factors,eosinophils are likely to decrease,and the effect of airway inflammation and high reaction are decreased.

Parkinson Disease Patient with Wheezing Manifestations: A Case Report

The dosing of anti-Parkinson drugs is considered as the optimal control of the symptoms of PD,and increasing the dose of drugs is a common method to treat the aggravate state of PD.However,this is a case of PD elderly patient who had nephritic syndrome,with an increase in the dose,the symptoms did not get improved,but a series of other adverse effects appeared.

Clinical manifestations of respiratory syncytial virus infection and the risk of wheezing and recurrent wheezing illness:a systematic review and meta‑analysis

Background Respiratory syncytial virus(RSV)infection in infants is a global health priority.We aimed to investigate the common manifestations of RSV infection by age group and human development index(HDI)level and to assess its association with the development of wheezing and recurrent wheezing illness.Methods We searched the literature published between January 1,2010 and June 2,2022 in seven databases.Outcomes included common manifestations and long-term respiratory outcomes of RSV infection in children.Random-and fixed-effect models were used to estimate the effect size and their 95%confidence intervals.Subgroup analysis was conducted by age and HDI levels.This review was registered in PROSPERO(CRD42022379401).Results The meta-analysis included 47 studies.The top five manifestations were cough(92%),nasal congestion(58%),rhinorrhea(53%),shortness of breath(50%),and dyspnea(47%).The clinical symptoms were most severe in infants.In our analysis,compared to very high and high HDI countries,fewer studies in medium HDI countries reported related manifestations,and no study in low HDI countries reported that.The RSV-infected infants were more likely to develop wheezing than the non-infected infants[odds ratio(OR),3.12;95%CI,2.59–3.76]and had a higher risk of developing wheezing illnesses after recovery(OR,2.60;95%CI,2.51–2.70).Conclusions Cough and shortness of breath are common manifestations of RSV infection.More attention should be given to infants and areas with low HDI levels.The current findings confirm an association between RSV infection and wheezing or recurrent wheezing illness.

Bronchiolitis in young infants: is it a risk factor for recurrent wheezing in childhood?

Background:Acute bronchiolitis in infancy is considered a risk factor for recurrent wheezing episodes in childhood.The present study assessed prevalence,clinical manifestaffons and risk factors for recurrent wheezing events during the first 3 years of life and persistent wheezing events beyond this age in children hospitalized as young infants with acute bronchioliffs.

Lung Function in Wheezing Infants after Acute Lower Respiratory Tract Infection and Its Association with Respiratory Outcome

Background： Wheezing is common in early childhood and remains an important health concern. The aim of this study was to assess the lung function of wheezing infants and to investigate the relationship between lung function and respiratory outcome. Methods： Infants 〈2 years of age with acute lower respiratory tract infection （ALRTI） who had undergone lung function tests were included in the study. They were assigned to wheeze or no wheeze group based on physical examination. Infants without any respiratory diseases were enrolled as controls. Lung function was measured during the acute phase and 3 months after ALRTI. One-year follow-up for infants with ALRTI was achieved. Results： A total of 252 infants with ALRTI who had acceptable data regarding tidal breathing were included in the final analysis. Compared with the control and the no wheeze groups, infants in the wheeze group had significantly decreased time to peak tidal expiratory flow as a percentage of total expiratory time （TPTEF/TE） （20.1 1 6.4% vs. 34.4 ± 6.2% and 26.4 ±8.3%, respectively, P 〈 0.0001） and significantly increased peak tidal expiratory flow （PTEF） （90.7 ± 26.3 ml/s vs. 79.3 ± 18.4 ml/s and 86.1 ± 28.0 ml/s, respectively, P 〈 0.01）, sReff and Reff. The infants in the wheeze group still had lower TPTEF/TE and volume to peak tidal expiratory flow as a percentage of total expiratory volume （VPTEF/VE） than the no wheeze infants 3 months after the ALRT1. Moreover, there was a significant inverse relationship between TPTEF/TE, VPTEF/VE, and the recurrence of wheezing and pneumonia. Conclusions： Impaired lung function was present in wheezing infants with ALRTI and the deficits persisted. In addition, the lower level of TPTEF/TE and VPTEF/VE was a risk factor for poor respiratory outcome.

Rhinovirus infections,wheezing and asthma

Rhinovirus(RV)are best known as a common cold virus,but infections with these viruses are also major causes of lower respiratory morbidity in younger children and in children and adults with asthma.Cofactors related to the virus,the host and the environment modify the risk of more severe illness.There are three RV species,and the A and C viruses are most often associated with wheezing illnesses.Host factors that influence the risk of virus-induced wheeze include age,genetics,allergy and asthma and lung function.In addition,the airway microbiome influences the probability of RV wheeze,and RV wheezing illnesses are associated with changes microbial community composition that include increased detection of respiratory pathogens.Interestingly,the host and environmental cofactors that promote wheezing in infancy and in children and adults with asthma are similar.Identification of modifiable host and environmental risk factors for RV wheeze suggests that there are several therapeutic opportunities for prevention and treatment.

Evaluation of Asthma Symptoms to Assess Asthma Control Status in a Primary Care Setting: An Exploratory Analysis of Pooled Data from Three Trials

Background: Primary care physicians in Japan see many patients in a given day;consequently, they find it challenging to devote sufficient time for detailed clinical consultation and evaluation of asthma control status. The aim of this study was to investigate asthma symptoms that reveal the presence of inadequately controlled asthma. Methods: A pooled analysis of baseline data from 100 patients with asthma treated with inhaled corticosteroid(s) (ICS) alone or ICS/long-acting beta-agonist who participated in three previous clinical trials was performed. Asthma control status and asthmatic symptoms were determined using a five-item Asthma Control Questionnaire, and whether asthmatic symptoms reflect clinical markers was investigated. Results: Nocturnal awakening owing to asthmatic symptoms was observed only in the uncontrolled asthma group. Patient-reported wheezing was not observed in the group with well-controlled asthma, but was observed in all patients in the uncontrolled asthma group. Virtually all patients, irrespective of asthma control status, reported symptoms in the morning, limitation of normal daily activities, and shortness of breath. Conclusions: The presence of nocturnal awakening due to asthma and wheezing likely reflected uncontrolled asthma. These results will lead to re-recognition that clinical interview, querying nocturnal awakening from asthma and wheezing is a simple and useful approach to assess asthma control status in a primary care setting.

Performance of commonly used respiratory questionnaire items in a cohort of infants born preterm

Background: Items from respiratory questionnaires validated in older children are often used in research studies of preterm infants, although they have not been validated in this population. We aimed to assess both test-retest reliability and convergent validity of a group of commonly used respiratory questionnaire items in a cohort of preterm infants. Methods: The health status of 300 preterm infants was assessed by telephone questionnaire as part of a prospective cohort study. The questionnaire items analyzed in this study included six commonly used respiratory questions. The questionnaire responses used in this analysis were from the telephone follow-up in this cohort at six months of age adjusted for prematurity. A repeat interview one to two weeks after this interview was performed in a subset of subjects to assess test-retest reliability. The convergent validity of the respiratory items was also assessed by calculating the associations among the responses to the respiratory questions. Results: A total of 43 infants were singletons that met the criteria for test-retest reliability analysis. All of the respiratory questions demonstrated fair to strong test-retest reliability. Among 206 respondents, respiratory questionnaire items also demonstrated strong convergent validity, in that caretakers reporting wheezing or whistling in the chest were significantly more likely to also report other respiratory events. Conclusions: This selection of standard respiratory questionnaire items performed well for research purposes in this population.

Interactions between traffic air pollution and glutathione S-transferase genes on childhood asthma

AIM: To evaluate the role of glutathione S-transferase P1(GSTP1) genetic polymorphisms potentially modifying the association between NO2 and asthma/wheeze in Taiwan Residents children. METHODS: We investigated 3714 schoolchildren in Taiwan Children Health Study from 14 communities. Children's information was measured from questionnaire by parents. The traffic air pollutant was available from Environmental Protection Administration monitoring stations. RESULTS: A two-stage hierarchical model and a multiple logistic regression model were fitted to estimate the effects of NO2 exposures and GSTs polymorphisms on the prevalence of asthma and wheeze. Among children with GSTP1 Ile/Val or Val/Val genotypes, those residing in high-NO2 communities had significantly increased risks of asthma(OR = 1.76, 95%CI: 1.15-2.70), lateonset asthma(OR = 2.59, 95%CI: 1.24-5.41), active asthma(OR = 1.93, 95%CI: 1.05-3.57), asthma under medication(OR = 2.95, 95%CI: 1.37-6.32) and wheeze(OR = 1.54, 95%CI: 1.09-2.18) when compared with children in low-NO2 communities. Significant interactions were noted between ambient NO2 and GSTP1 on asthma, late-onset asthma, asthma under medication and wheeze(P for interaction < 0.05). However, we didnot find any association with polymorphisms in GSTM1 and GSTT1. CONCLUSION: Children under high traffic air pollution exposure are more susceptible to asthma, especially among those with GSTP1 Val allele.

Wheeze detecting method based on spectrogram entropy analysis

In order to eliminate the subjectivity of wheeze diagnosis and improve the accuracy of objective detecting methods,this paper introduces a wheeze detecting method based on spectrogram entropy analysis.This algorithm mainly comprises three steps which are preprocessing,features extracting and wheeze detecting based on support vector machine(SVM).Herein,the preprocessing consists of the short-time Fourier transform(STFT) decomposition and detrending.The features are extracted from the entropy of spectrograms.The step of detrending makes the difference of the features between wheeze and normal lung sounds more obvious.Moreover,compared with the method whose decision is based on the empirical threshold,there is no uncertain detecting result any more.Results of two testing experiments show that the detecting accuracy(AC) are 97.1%and 95.7%,respectively,which proves that the proposed method could be an efficient way to detect wheeze.

A FINITE DIFFERENCE METHOD FOR THE MODEL OF WHEEZES

In this paper, a finite difference scheme for the linear and nonlinear models of wheezes are given. The stability of the finite difference scheme for the linear model is obtained by using of von Neumann method. Moreover, the convergence and stability of the finite difference scheme for the nonlinear model are studied by the energy inequalities method. By some numerical computations, the relationships between angular frequency and wall position, fluid speed and amplitude are discussed. Finally, the author shows that the numerical results are coincided with Grotberg's theoretical results.

A study on wheeze models

In this paper, the finite differenee schemes for the linear and nonlinear models of wheezes are given. The waveform of wheczes is analysed. It is shown that the numerical results of the lincar model of wheezes and Grotberg's theorehcal results coincide well. The numerical results of the nonlincar model of wheczes are in qualita tive agreement with our expcrimental observations. It is suggested that the nonlinear elastance coefficient (β) causes damping, and is closely related to the flow limitation and the airway collapse. Wheezes result from the interachon between the fluid forces and the wall forces and the airway wall flutter is a forced-vibration, rather than a self vibration.