BEST ADJUSTMENT STRATEGY FOR ASTHMA IN THE LONG TERM (BASALT)

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 建议每周出现两次以上症状的哮喘患者在吸入器中使用皮质类固醇(例如，倍氯米松、布地奈德或氟替卡松)以帮助控制哮喘。在许多情况下，这种治疗可以很好地控制哮喘。共识声明表明，在哮喘得到控制后，药物可能会减少，反之，如果哮喘再次出现症状，就应该增加药物治疗。然而，目前还不知道调整治疗的最佳方式是什么。目前的指南基于许多因素进行调整，包括症状的频率和肺功能的客观测量。然而，这些指南没有考虑肺部存在的刺激性(炎症)量。大多数哮喘医生认为，肺部的炎症应该得到控制，一种测量肺部炎症相关性eNO的新机器已被FDA批准用于哮喘患者。一项研究表明，使用eNO治疗哮喘有一定的好处，但它的使用还没有与其他策略进行比较。最后，ACRN先前的一项研究表明，轻度哮喘患者与定期哮喘治疗一样，也可以进行对症治疗。 这项研究的目的是比较这三种调整哮喘药物的方法，看看哪种方法在足够长的时间内最好，足以具有临床意义(36周的干预；总共44周)。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. People with asthma who have symptoms more than twice a week are advised to use a corticosteroid in an inhaler (beclomethasone, budesonide, or fluticasone, for example) to help control their asthma. In many cases, this treatment results in good control of asthma. Consensus statements suggest that after asthma is controlled, medications may be reduced, and conversely, if asthma then becomes symptomatic again, that medications be increased. However, it is not known what the best way to adjust therapy. Current guidelines base adjustments on many factors, including the frequency of symptoms, and objective measures of lung function. However, these guidelines do not take into consideration the amount of irritation (inflammation) present in the lungs. Most asthma physicians believe that inflammation in the lungs should be controlled, and a new machine that measures eNO, a correlate of inflammation in the lungs, has been approved by the FDA for use in asthma patients. One study has shown some benefit of managing asthma by the use of eNO, but its use has not been compared with other strategies. Finally, a previous ACRN study has shown that patients with mild asthma are as well treated with symptomatic treatment as with regularly scheduled asthma treatment. The purpose of this study is to compare these three approaches to adjusting asthma medications to see which is best over a period of time long enough to be clinically meaningful (36 weeks of intervention; 44 weeks total).