천식 치료의 실제 - 한국 천식 진료지침 2015 -
Practical Guideline of Asthma Management - Korean Guideline for Asthma 2015 -
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초록
천식은 전 세계적으로 문제가 되는 대표적인 알레르기질환으로, 2010년 세계보건기구의 보고에 의하면 약 3억 3천 4 백만명 정도의 천식 환자가 있는 것으로 추정된다[1]. 우리나라에서는 천식으로 인한 장애보정수명(quality-adjusted life-year, －Yoon-Seok Chang. Korean guideline for asthma － - 299 - QALY) 손실은 연간 10만 명당 약 400년으로 만성 질환 중6번째로 큰 질병부담이다[1]. 연령별로 보면 소아기에 유병률이 5-9% 정도 되다가 젊은 성인 연령에서는 3% 정도로 감소되나 50대 이후 천식의 유병률이 증가하여 65세 이상에서는6.8-12%의 유병률을 보여 두 번의 피크를 보인다[1-4]. 특히50세 이후 연령층에서 천식의 유병률이 증가하고 있는 사실은 전 세계에서 가장 빠르게 고령화 사회로 진입하고 있는 우리나라에서 천식의 사회경제적 부담이 더 크게 증가할 가능성을 시사한다. 따라서 내과 의사라면 대표적인 알레르기질환인 천식이 동반된 환자를 진료하게 될 가능성이 높고, 질병에 대한 기본적인 이해와 치료의 원칙을 잘 알고 있는 것이중요하다.
Abstract
Allergic diseases such as asthma are increasing. The prevalence of adult asthma is about 3% in Korea. However, asthma becomes more prevalent with age: 6.8-12% in the elderly. In terms of socioeconomic burden, asthma is the 6th important chronic disease in Korea. The symptoms of asthma such as dyspnea, wheezing, cough, and chest discomfort may vary according to time and season. Reversible airflow limitation and airway hypersensitivity are the characteristic features of asthma. Inhaled corticosteroid is the mainstay in the management of asthma as chronic airway inflammation is the underlying mechanism. Stepwise approach is recommended according to the severity and the control status. Physicians should be aware of the control status, lung function, and the risk factors of future risk including asthma exacerbations. Doctor-patient relationship is always important to increase the adherence and treatment outcome. Patients should learn how to use inhalers: video clips on inhalers are available at the websites such as Gyeonggi-do Atopy Asthma Education Information Center. In this review, the practical approach of asthma management was described mainly referring to the Korean guideline for asthma which has been published, revised, and updated by the Korean Academy of Asthma, Allergy, and Clinical Immunology and recently published in 2015.
참고문헌 (11)
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