全球儿童哮喘行动计划创议书 Global Children Asthma Action Plan Initiative

时间：2019年12月26日

哮喘是儿童最常见的慢性病。在过去20年中，哮喘症状在全球儿童和青少年中的患病率呈上升趋势，特别是在中低收入国家（LMICs）。哮喘症状通常开始于儿童早期，有可能给患儿本人、家长和社会带来一生的沉重负担。先前研究的数据显示，6岁时患有严重哮喘的儿童在50岁时仍有哮喘症状。值得注意的是，患有严重哮喘的儿童成年后患慢性阻塞性肺病（COPD）的风险增加。从这个角度看，哮喘作为非传染性慢性呼吸系统疾病，在世界范围内，必须列入每个国家当局的议事日程，并且得到重视。

Asthma is the most common chronic respiratory disease in children. During last two decades, prevalence of asthma symptoms became globally increased in children and adolescents, particularly in Low-Middle Income Countries (LMICs). Asthma usually starts in early childhood, may impose a high lifetime burden on individuals, their caregivers and the community. Data from previous studies reported that children with severe asthma at age 6 still had asthma symptoms at age 50 years. Noteworthy, children with severe asthma were those at increased risk of developing Chronic Obstructive Pulmonary Disease (COPD) in adulthood. In this perspective, asthma, as other non-communicable chronic respiratory diseases, must be included in the agenda of each national authority and globally as whole.

有效的哮喘管理需要在恰当的时间服用预防及缓解药物，并清楚地了解何时寻求紧急救助。全球哮喘防治创议委员会（GINA）建议，应为所有患者提供适合其哮喘控制水平和健康素养、文化程度的书面哮喘行动计划，以便他们知道如何识别和应对哮喘发作。

Effective asthma management requires that both preventive and rescue medications are taken at the appropriate times and a clear understanding of when to seek emergency care. Global Initiative for Asthma（GINA) recommends that all patients should be provided with a written asthma action plan appropriate for their level of asthma control and health literacy, so they know how to recognize and respond to worsening asthma.

哮喘行动计划，作为一种有效的基于指南的自我管理工具，已经在国际上推行了近30年，并被证明可以改善哮喘相关的结果。使用书面哮喘行动计划（WAAPs）可以改善许多健康结果，包括减少急性哮喘发作、急诊、住院、缺课或工作以及提高药物依从性。

Asthma Action Plan, as an effective self-management guideline-based tool, has been recommended internationally for nearly 30 years and has been proven to improve asthma-related outcomes. The use of written asthma action plans (WAAPs) can be associated with a number of improved health outcomes, including reduction of acute asthma attack, emergency visit, hospitalization, absence of school or work, and improved adherence to medications.

书面的哮喘行动计划，使用交通信号灯的颜色来提示何时以及如何调整使用缓解剂和控制药物，如何使用口服皮质类固醇，以及在症状对治疗无效时如何获得医疗救助。它还建议有哮喘严重发作史的患者在哮喘开始发作时立即去急诊就医或看医生。

The written asthma action plan, using colors of traffic lights（green， yellow and red） to indicate when and how to change reliever and controller medications, use oral corticosteroids, and access medical care if symptoms fail to respond to treatment. It also advises patients who have a history of rapid deterioration to go to an emergency facility or see their doctor immediately when their asthma starts to worsen.

基于中国儿童哮喘诊断和预防管理指南，我国于2017年2月制定了中国儿童哮喘行动计划（CCAAP）。CCAAP是中国儿童哮喘自我管理的一个里程碑。除了出版书面的哮喘行动计划外，哮喘行动计划手机app也同时发布。手机app哮喘管理平台是一个先进的家庭管理平台，包括的内容有药物治疗方案、哮喘日记记录、峰值流量监测、吸入器技术指导视频、过敏原和诱因回避、哮喘控制评估和教育工具等功能。

On the basis of Chinese guideline for diagnosis and prevention of childhood asthma, the first asthma action plan, which is called China Children Asthma Action Plan（CCAAP），was developed in February 2017. CCAAP is a milestone of asthma self-management for children in China. In addition to the publication of the Written Asthma Action Plan, an electronic version of the Asthma Action Plan mobileAPP was also released at the same time. The mobile asthma management platform is an advanced platform for the family management with functions such as medication regimens, asthma diary records, peak flow monitoring, inhaler technique guide, allergens and triggers avoidance, asthma control evaluation and education tools, et al.

近3年来，全国已有3000多名医生和6000多名患者注册了中国儿童哮喘行动计划手机app。通过这个应用程序，也介绍了200多篇哮喘治疗的文献摘要，吸引了10000多名儿科医生读者。

In the past 3 years, more than 3000 doctors and 6000 patients across the country have registered with mobile app of China children's asthma action plan. More than 200 abstracts of literature of asthma management have been introduced through the app, which have attracted more than 10000 pediatrician readers.

作为世界上人口最多的国家之一，中国也有大量的儿童人口。中国儿童哮喘的有效控制和规范化管理，将对世界范围的哮喘管理做出更大的贡献。

Being one of the most populated countries in the world, China also has a huge number of children. The effective control and standardized management of children's asthma in China will contribute in large scale to the outcome of asthma management of the world.

“每一个患有哮喘儿童都有一个哮喘行动计划”，这是GPPA的愿景和使命。所有政府卫生机构、医疗专业人员和组织、公立和私人医疗机构都应积极参与“全球儿童哮喘行动计划”，以改善儿童哮喘的管理结局，造福于患者和全世界！

It is in the hope and mission of GPPA that “every child with asthma has an Asthma Action Plan”. All government health agencies, medical professionals and organizations, public and private healthcare systems, shall take active part in the “Global Children Asthma Action Plan”, to enhance pediatric asthma management outcome, to benefit patients and our societies all of the world!