ASTHMA EDUCATION, SYMPTOMS AND AIRWAY INFLAMMATION

哮喘是一种严重的、慢性的、可能危及生命的疾病。 影响美国1,000-1,300万人。这种疾病已经 重大社会影响，引起，因症状和症状限制活动 每年有数百万人次的门诊就诊。呼吸道炎症被认为是 是哮喘发病机制的关键和核心组成部分。当前 管理方法要求患者正确地进行复杂 治疗方案。然而，这些方法在很大程度上取决于 患者对自我管理的认识和技巧 减少哮喘并发症。 所有哮喘患者都必须接受哮喘教育(国家哮喘 教育计划，1991)，但必须高效地完成 常规医疗护理。这个项目的总体目标是研究 哮喘教育干预的影响，旨在适应背景 关于哮喘的临床标志物的常规医疗预约 诱导性呼吸道炎症的控制和生物标志物 痰。哮喘控制的临床标志物包括症状测量 强度、肺功能和吸入β-受体激动剂的频率。 这些标记物受成功的自我管理的影响 正确使用吸入性药物。三叉神经痛的主要临床结局 本研究旨在降低症状强度。呼吸道生物标志物 炎症包括细胞计数、不同的嗜酸性阳离子 哮喘患者痰中蛋白(ECP)、白蛋白。初级阶段 这项研究的生物学结果是减少了 痰中ECP浓度。 具体目的是：(1)测试哮喘患者的影响 教育干预对主要临床结局、症状强度、 以及主要的生物学结果，痰中ECP浓度 样本；以及，(2)描述哮喘教育的效果 哮喘二级临床和生物学标志物的干预研究 控制：峰值流量、β-受体激动剂使用频率、肺功能和 诱导痰标本中嗜酸性粒细胞、中性粒细胞和白蛋白的数量 哮喘患者。这项研究的结果将导致进一步的完善 和选择有用的结果来监测哮喘的效果 教育干预。 一项前瞻性随机对照试验将用于54名成年受试者 哮喘被分配到干预组或对照组。干预措施 小组将接受30分钟的哮喘教育干预，包括 信息和行为组件，每隔两分钟重复三次 每隔一周。症状、峰值流量和β-受体激动剂频率 每日记录，每次探视5次将记录肺功能 超过9周，痰成分将在治疗前后进行分析 干预。这个项目的长期贡献是改善 通过向患者提供基本信息和治疗来控制哮喘 自我管理疾病所需的技能，并确定其有用性 监测护理的生物学和临床结果 干预。

Asthma is a serious, chronic, and potentially life-threatening disease affecting 10-13 million persons in the United States. The disease has major societal impact, causing, restricted activity due to symptoms and millions of outpatient visits per year. Airway inflammation is thought to be a critical and central component of asthma pathogenesis. Current management approaches require that patients correctly carry out complex treatment regimens. However, these approaches depend heavily on the patient's understanding and skill in carrying out self-management to decrease asthma complications. Asthma education is mandated for all people with asthma (National Asthma Education Program, 1991) but must be accomplished efficiently as part of routine medical care. The overall objective of this project is to study the impact of an Asthma Education Intervention, designed to fit the context of the usual medical care appointment, on clinical markers of asthma control and biological markers of airway inflammation in samples of induced sputum. Clinical markers of asthma control include measures of symptom intensity, pulmonary function, and frequency of inhaled beta agonist use. These markers are affected by successful self-management through consistent and correct use of inhaled medication. The primary clinical outcome of this study is reduction of symptom intensity. Biological markers of airway inflammation include cell counts, differential eosinophilic cationic protein (ECP), and albumin in sputum of asthmatic subjects. The primary biological outcome of this study is reduction of the reduction of the concentration of ECP in sputum. The specific aims are: (1) to test the impact of the Asthma Patient Education Intervention on the primary clinical outcome, symptom intensity, and the primary biological outcome, concentration of (ECP) in sputum samples; and, (2) to describe the effect of the Asthma Education Intervention on secondary clinical and biological markers of asthma control: peak flow, frequency of beta agonist use, pulmonary function, and quantity of eosinophils, neutrophils, and albumin in induced sputum samples of asthmatics. The findings of this study will lead to further refinement and selection of useful outcomes to monitor the effect of asthma educational interventions. A prospective, randomized control trial will be used with 54 adult subjects with asthma assigned to an Intervention or Control group. The Intervention group will receive a 30-minute Asthma Education Intervention, with Information and behavioral components, which is repeated three times at two week intervals. Symptoms, peak flow, and beta agonist frequency will be recorded daily, pulmonary function will be recorded at each of 5 visits over 9 weeks, and constituents of sputum will be analyzed pre- and post- intervention. The long term contribution of this project is to improve control of asthma by providing patients with essential information and skills needed to self-manage the illness, and to determine the usefulness of monitoring biological as well as clinical outcomes of nursing intervention.