[Evaluation of asthma management from the surveys in 30 provinces of China in 2015-2016].

Objective: To evaluate the general level of asthma management in urban areas of China and further promote the national asthma management plan. Methods: A multi-center, cross-sectional survey was carried out in 30 provinces of China (except for Tibet) during Oct 2015 to May 2016. It's a questionnaire-based face-to-face survey which included asthma management using peak flow meter (PFM) and pulmonary function test, medication choice of maintenance therapy and asthma education. Results: A total of 3 875 asthmatic outpatients were recruited including 2 347(60.6%) females and 1 528(39.4%) males. The mean age was (50.7±16.7) years ranging from 14 to 99. Only 10.1%(388/3 837) patients used PFM as monitoring, whereas 62.1%(2 405/3 874) patients underwent pulmonary function test during the past year. There were 57.4%(2 226/3 875) patients treated with inhaled cortical steroid plus long-acting β(2)-agonist combinations (ICS+LABA) as daily medication. 43.3%(1 661/3 836) patients were followed up by physicians. Among this population, 1 362 asthmatic outpatients were recruited, who also took part in the asthma control survey in 2007-2008 in 10 cities. In this subgroup, 17.9%(244/1 360) were tested by PFM and 66.6%(907/1 362) by pulmonary function test during last year. As to the medication, 63.1%(860/1 362) selected ICS+LABA for daily control. There were 50.4%(685/1 359) patients in the follow-up cohort by physicians. Compared to the similar survey conducted in 2007-2008, the proportion of patients with ICS+LABA regimen and follow-up by physicians were markedly higher, while the rate of PFM use did not have significant improvement. Conclusion: Although the present level of asthma management in China is still far from ideal, asthma management has improved compared to 8 years ago. Yet the use of PFM does not significantly improve. Asthma action plan and application of PFM should be further promoted to improve the level of asthma management.目的： 评估我国城区支气管哮喘（以下简称哮喘）患者哮喘管理水平，为今后开展全国哮喘管理计划提供参考依据。 方法： 多中心横断面研究。2015年10月—2016年5月在全国哮喘研究协作组成员所在30个城市的30家三级甲等医院呼吸内科门诊进行面对面问卷调查，调查内容包括哮喘管理（峰流速仪使用、肺功能检测）、维持治疗药物使用、哮喘教育（哮喘行动计划、医院哮喘教育），分析我国现阶段城区哮喘患者哮喘管理水平。 结果： 共纳入3 875例门诊哮喘患者，女2 347例（60.6%），男1 528例（39.4%），年龄14~99（50.7±16.7）岁。10.1%（388/3 837）的患者使用过峰流速仪，既往一年内62.1%（2 405/3 874）的患者做过肺功能检查，57.4%（2 226/3 875）的患者选择含吸入糖皮质激素（ICS）联合长效β(2)受体激动剂（LABA）作为每日规律使用的控制性药物，43.3%（1 661/3 836）的患者有专科医生制定哮喘治疗（随访）行动计划。其中，曾在2007—2008年哮喘控制调查的10个城市在本次调查中共纳入1 362例，17.9%（244/1 360）的患者使用过峰流速仪，既往一年内66.6%（907/1 362）的患者做过肺功能检查，63.1%（860/1 362）的患者选择ICS+LABA作为每日规律使用的控制性药物，50.4%（685/1 359）的患者有专科医生制定的哮喘治疗（随访）行动计划。与2007—2008年的调查结果相比，选用ICS+LABA作为每日规律使用的控制性药物及有专科医师制定哮喘治疗（随访）计划的比例明显升高，峰流速仪的使用率未见显著改善。 结论： 目前我国哮喘总体管理水平尚不理想，曾在2007—2008年哮喘调查的10城市中可以看到，哮喘管理水平在提高，而峰流速仪使用率较8年前未有显著改善。应大力推广哮喘行动计划及峰流速仪的使用，以提高哮喘管理水平。.