哮喘控制测试表在支气管哮喘患者健康教育中应用的意义

目的探讨哮喘控制测试（ACT）量表在支气管哮喘健康教育中应用对控制好坏的影响。方法支气管哮喘患者52例随机分为干预组（A组）和对照组（B组），B组由护理人员在患者住院期间对患者进行简明扼要的健康教育，告知患者哮喘是可以应用正确的方法预防和控制的，尽可能消除患者的焦虑抑郁心理，同时介绍如何规范正确地用药及怎样进行预防发作等知识。患者在病情缓解出院后按支气管哮喘防治指南规范使用沙美特罗替卡松治疗，A组在B组的基础上在患者住院期间向患者讲解ACT量表各项的意义及填写，患者出院后以电话形式进行跟踪随访，每周1次。若患者达不到满意的25分，嘱患者进行自检吸入方法是否正确，若吸入方法不正确则予以告知纠正；若吸入方法正确则说明吸入量不足，嘱患者增加吸人量。治疗2个月后复诊进行肺通气功能检查（第1秒用力呼气量、清晨呼气流速及气道反应性）。结果A组患者FEV。及清晨PEF均比B组患者改善（P〈0．05），A组患者气道反应性比B组患者减轻（P〈0．01）。结论用ACT评价支气管哮喘控制的好坏并以指导患者治疗用药比常规的健康教育指导可使患者肺功能得到较好的改善。

Meaning of application of asthma control test(ACT) in healthy instruction in patients with asthma

Objective To explore the effect of applying asthma control test(ACT)to healthy instruction in patients with asthma.Methods Fifty-two asthma patients were assigned to interfere group(group A)and control group(group B)randomly.The patients in group B were given concised and condensed healthy education.The patients were told that asthma could be prevented and controled by proper methods.Their anxiety-depression mood was done the best to reliefed,and they were instructed to apply drug standardly and exactly.The patients in group B were treated with salmeterol/fluticasone propionate standardly according to the guide of asthma cure and prevent after post-discharge.The patients in group A were told the meaning of each item and the way to fulfill the table of ACT basis on the way of group B and were follow-up visited by telephone one time a week after post-discharge.The patients that were not achieved 25 scores of ACT were told to check whether they inhale the drug properly.If they did not inhaled properly,they were instructed to correct the way of inhale drug.If they had done it properly,they were told to increase dose of the drug.The fuction of lung ventilation of all the patients were examined after post-discharge of 2 months.Results The forced expiratory volume in one second and peak expiratory flow of the patients in group A had been greatly improved than those of the patients in group B(P< 0.05).Moreover the airway reactivity of the patients in group A had been significantly reduced than those of patients in group B(P<0.01).Conclusion The patients with asthma are instructed to treated by appling ACT to evaluated the degree of asthma to be controled can greatly improved the fuction of lung ventilation.