Bronchial asthma mixed form of moderate severity treatment

Mixed asthma: causes, symptoms, treatment, prognosis and prevention

Bronchial asthma is a common disease of the lower respiratory tract with various forms of manifestations. Mixed asthma is one of them, formed as a result of the combined influence of internal and external factors on the human body. The disease affects children over 5 years of age, and is less common in adults.

What is a mixed type of asthma, why does it occur, how to recognize it and what to do when the disease appears, we will consider further.

Features of mixed bronchial asthma

The mixed form of bronchial asthma is a manifestation of a chronic inflammatory process in the respiratory system, occurring in moderate to severe form.

It occurs due to increased sensitivity of the bronchi, which leads to a narrowing of the bronchial lumen under the influence of various irritants.

This condition is caused by contraction of the smooth muscles of the bronchi, swelling of the mucous membrane and the accumulation of excess mucus on its walls.

With mixed asthma, there is a direct relationship not only with external irritants (entering the body through the respiratory tract), but also with hidden infectious diseases (respiratory organs, teeth, stomach, intestines and other internal organs).

The disease is characterized by a relapsing course with multiple exacerbations and intractable attacks.

Classification of bronchial asthma

Mixed bronchial asthma is classified according to the following criteria: severity of the course, form of the disease, controllability of the process.

• The severity of the disease.

Features of the flow:

1. Mild degree - characterized by minor exacerbations, which are easily eliminated with the help of bronchodilators.
2. The average severity of the mixed form of bronchial asthma leads to a decrease in a person’s physical activity and sleep disturbances. With it, the occurrence of more severe and prolonged exacerbations is noted (several per week), sometimes accompanied by attacks of suffocation. To reduce the negative consequences, asthmatics need daily bronchodilator medications.
3. Severe degree is the most dangerous. It is accompanied by partial or complete restriction of physical activity, difficulty speaking, panic, general weakness, and frequent attacks. Attacks during this period can develop into asthmatic status, which poses a serious threat to the patient’s life.

Depending on the severity of the disease, the disease can be episodic (develop gradually with rare attacks) or be constant and occur in mild, moderate or severe form.

According to the controllability of the process, asthma is:

1. controlled - with the absence of negative manifestations and restrictions for any type of activity;
2. partially controlled - clinical signs appear with a moderate number of exacerbations;
3. uncontrolled - multiple symptoms, a significant number of exacerbations, and the occurrence of asthmatic attacks are observed.

To establish control over the disease, the patient needs to learn how to independently use a peak flow meter (to determine the maximum expiratory flow rate). This will help determine the onset of an exacerbation, take prescribed medications in a timely manner and reduce the risk of asthmatic attacks.

Causes of the disease

The genesis of mixed type bronchial asthma is based on various mechanisms that provoke the disease.

This pathology is the result of the simultaneous influence of allergic and non-allergic causes.

Exposure to exogenous factors leads to an allergic reaction to certain substances perceived by the body as foreign.

Asthma triggers are allergens that enter the respiratory tract from the external environment:

• pet hair and fluff;
• dry food;
• household cleaning, laundry and dishwashing products;
• dust mites;
• pollen of flowering plants;
• fungal spores;
• insect bites;
• pungent odors;
• smoking and inhalation of tobacco smoke;
• allergenic foods.

Endogenous (internal) causes are the results of an unstable physiological state of a person:

• complication of viral infections;
• endocrine disorders;
• chronic diseases of internal organs;
• physical and emotional overload;
• hypothermia of the body;
• climatic conditions;
• side effects from taking medications.

Since bronchial asthma of mixed form develops under the influence of allergens and infection, it is a complicated form of the disease and requires a special approach.

Mixed asthma symptoms

Mixed asthma is characterized by periods of exacerbation, subsidence of inflammatory processes and remission.

The disease is accompanied by certain clinical signs:

• labored breathing;
• the occurrence of suffocation;
• the appearance of an itchy rash;
• impaired sputum excretion;
• feeling of chest compression;
• wheezing when exhaling;
• the occurrence of cough (especially at night);
• deterioration in general health;
• the appearance of low-grade fever;
• allergic manifestations.

The main manifestation of bronchial asthma of mixed origin is prolonged attacks of suffocation. During an asthmatic attack, there is a narrowing of the bronchi, coughing and impaired respiratory function.

This condition may last for several minutes or hours and can be relieved with an inhaler. If the medicine does not have an effect and the attack does not stop, the patient must be hospitalized.

Diagnostics

Diagnostic measures are the main method for identifying mixed type bronchial asthma.

These include:

• examination and questioning of the patient;
• laboratory testing of blood and mucus samples;
• the use of spirometry to analyze functional indicators of the performance of the lungs and bronchi;
• conducting provocative tests to identify the allergen;
• X-ray studies to exclude possible complications;
• bronchoscopic examination of the lungs.

Using a thorough diagnosis, the doctor determines the severity of the disease and selects the appropriate treatment.

Treatment of mixed bronchial asthma

The primary objectives in the fight against bronchial asthma of mixed origin are:

• reduction in the severity of clinical signs;
• eliminating the influence of triggers;
• preventing exacerbations;
• assessment of respiratory function indicators;
• increasing the patient’s activity and improving his condition;
• eliminating side effects from taking medications;
• teaching an asthmatic to measure exhalation flow:
• controlling the course of the disease.

A peculiarity of the course of mixed asthma is a combination of allergic and non-allergic manifestations, which implies the use of complex treatment. It includes taking drugs with systemic and symptomatic action.

Systemic treatment is carried out over a long period of time (sometimes throughout life). It provides long-term relief, preventing exacerbations of the disease, and helps control its condition.

Basic therapy

Basic therapy includes taking the following medications:

• corticosteroids in tablets or injections - used to dilute sputum and remove it in cases of moderate severity of the disease, as well as in cases of prolonged bronchospasm and status asthmaticus;
• long-term beta-2 agonists - contribute to the expansion of the lumen of the bronchi. For moderate or severe disease, a combination of an inhaled hormone with a beta-agonist is used;
• anticholinergics - promote dilation of the bronchi, reduce mucus production, eliminate cough and shortness of breath;
• glucocorticosteroid drugs (inhaled hormones) - relieve inflammation, which reduces bronchial hyperactivity and eliminates bronchospasm, reduces swelling of the mucous membrane. They are prescribed when the disease is severe and difficult to treat. They are used in short courses, as they have serious side effects.

Each person has individual precursors to an asthma attack, so it is important to learn how to determine the onset of this moment.

Its main symptoms:

• chills;
• headache;
• anxiety;
• a sore throat;
• sneezing;
• paroxysmal cough;
• weakness.

The use of symptomatic rapid response means - aerosols and inhalers - at the right time will help improve the patient’s condition and prevent the development of an attack.

Auxiliary treatment

Physiotherapy is used as an auxiliary treatment:

• massotherapy;
• electrophoresis;
• ultrasound;
• magnetic therapy;
• amplipulse;
• cryotherapy.

Carrying out procedures can improve the functionality of the respiratory tract, reduce inflammation, normalize blood circulation, and also reduce the body’s susceptibility to allergens.

It should be remembered that all medications must be used strictly as prescribed by the doctor.

It is not recommended to interrupt treatment on your own if your overall health improves and the symptoms of the disease disappear. This can lead to the progression of the disease and the return of all manifestations in a more severe form.

Forecast

It is not possible to predict the outcome of treatment, since mixed type asthma can provoke serious disturbances in the functioning of the respiratory system and cause complications.

However, timely treatment and compliance with all doctor’s instructions can stop the development of the disease and lead to long-term remission.

Prevention of mixed asthma

Preventive measures are an integral part of the fight against mixed forms of bronchial asthma. They help prevent the progression of asthma or alleviate its symptoms.

General recommendations:

• use of protective equipment when using household and construction chemicals;
• frequent exposure to fresh air;
• hardening and increasing the protective properties of the body;
• refusal of heavy physical activity;
• exclusion from the diet of foods that are allergens;
• Carrying out daily wet cleaning of living quarters;
• limiting or completely avoiding contact with pets;
• mastering breathing exercises;
• quitting smoking and excessive alcohol consumption;
• application of methods of self-monitoring of the disease state.

Bronchial asthma cannot be cured completely. But proper treatment and regular implementation of certain rules will help establish control over the disease. This will allow the person to return to a full life.

Source: https://bronchialnaya-astma.com/vidy-astmy/smeshannaya-bronchialnaya-astma

Classification of the disease by level of control

Bronchial asthma is characterized by a chronic course, which requires mandatory monitoring of the development of symptoms, which depend on the individual characteristics of the body and the severity of the disease.

Uncontrolled, moderate and severe asthma is assessed by the severity of symptoms at night and during the day. In addition, the need for bronchodilators to treat an acute attack and the possibility of the disease affecting the patient's activity are taken into account.

In the classification of asthma according to the level of control, the following forms can be distinguished:

• fully controlled;
• partially controlled;
• uncontrollable.

Determining the level of control must be taken with full responsibility, since many asthmatics are not able to independently assess the severity of the disease, as a result of which they overestimate the possible results of treatment.

In addition, an insufficiently controlled form of the disease can dramatically change the standard of living, affecting the social and psychological status of the patient. The most common form of bronchial asthma is persistent. With an uncontrolled disease, a sudden onset of an asthmatic attack is possible, increasing the risk of developing pathological changes in the patient’s body.

The clinical course of any form of the disease depends on the number of daytime and nighttime attacks occurring during the week. Based on this, the intensity of exposure to short-acting β2-adrenergic agonists is selected.

1. The first stage includes mild intermittent asthma, manifested by shortness of breath and infrequent spasmodic cough. Symptoms of intermittent asthma can occur once every 7 days, and at night no more than once a month. Moderate symptoms are practically not observed between attacks.

1. The second stage includes persistent mild asthma. Symptoms of the disease occur no more than 2 times a month. At night, attacks occur very rarely. During exacerbations, the patient feels discomfort associated with disruption of usual activities. There is a gradual increase in the reactivity of the pulmonary system.
2. The third stage includes a persistent form of the disease of moderate severity. At the same time, almost daily attacks are observed, which contribute to a decrease in the quality of life, disrupting sleep and delaying recovery. This stage requires daily use of short-acting beta-agonists.
3. The fourth place belongs to a severe, uncontrolled form of bronchial asthma, the course of which is complicated by constant pain. In this form of the disease, it is complicated by constant asthmatic attacks, which can be repeated several times a night and require additional use of bronchodilators.

Mixed asthma or bronchial asthma of mixed origin: forms and severity, diagnosis

Mixed asthma is a respiratory disease provoked by exogenous and endogenous factors. It is not easy to cure, so therapy must be comprehensive and coordinated with the doctor throughout the entire treatment period. At the same time, it is necessary to take proper preventive measures to reduce the risk of the disease.

Mixed asthma

Causes

Internal factors usually include genetic predisposition: changes in the structure of the respiratory tract, increased concentration of IgE, gender and ethnicity. The disease can appear in children, adults and the elderly with almost equal probability.

External reasons have a more extensive list. Firstly, bronchial asthma is typical for allergy sufferers who are very sensitive to certain substances.

Medical statistics show that the number of visits due to asthma attacks increases in the spring and summer, when pollen and dust accumulate in the air. Secondly, uncontrollable coughing and choking may occur due to changes in air temperature.

Thirdly, bronchial asthma is a common disease among smokers. Tobacco smoke increases the sensitivity of the mucous membrane of the respiratory tract, causing the walls to become inflamed and block the access of oxygen.

The following reasons act as triggers for mixed asthma:

• stress, depression, strong emotional experiences;
• chronic inflammatory diseases of the respiratory system or nearby organs;
• inhalation of polluted air.

It is important to recognize the disease in time, since its attacks pose a direct threat to the patient’s life.

Asthma attacks

Symptoms

The disease can be classified according to severity:

• Easy. Asthmatic attacks occur infrequently and do not last long. They practically do not occur during sleep. Respiratory function is slightly reduced and amounts to 80%.
• Average. The attacks are daily, and from time to time sleep is disrupted by severe coughing and difficulty breathing. There is a decrease in lung function of up to 60%.
• Heavy. Attacks of this type can appear at any time of the day or night, they begin to persist, turning into a chronic stage, and often the patient has to resort to emergency treatment. Indicators of respiratory function of the lungs drop below 60%.

Typical signs of asthma at any age are attacks of dry cough, choking and shortness of breath. Due to lack of oxygen, the patient may have a headache and feel weak in the body.

Diagnosis

At the first signs of bronchial asthma, before treatment, the patient should contact a general practitioner, who is responsible for the initial examination and drawing up a clinical picture. He also listens to the characteristic sounds during inhalation and exhalation.

After this, the doctor writes out directions for research:

• Blood analysis. Based on a biochemical change in composition, the presence of inflammation can be substantiated. In particular, allergists note the level of immunoglobulin E, since its increase indicates an allergic reaction.
• Bacteriological culture of sputum. By examining bronchial mucus, infection and pathogen resistance to antibiotics are detected.
• Study of external respiration function. The procedure shows the severity of the respiratory tract pathology.
• X-ray. From the image, doctors determine the spread of inflammation and associated pathologies. Bronchographic and bronchoscopic examinations are also used for these purposes.

X-ray

The course of treatment for asthma depends on the diagnosis, so you should not neglect the procedures. Incorrect therapeutic tactics can delay recovery and even lead to complications of the disease.

Treatment

Therapy for bronchial asthma of mixed origin consists of the use of medications and the use of home remedies. It is important to remember that any method must be approved by a doctor and checked for contraindications. Self-medication of asthma is not allowed.

Medication method

Treatment of the disease is divided into two branches:

• symptomatic;
• systemic.

The symptomatic method of therapy is to relieve bronchial spasms and clear the airways of mucus.

For this purpose, glucocorticosteroids, beta-2 agonists, drugs with theophylline and anticholine energy drinks are used.

These products are recommended to be used in the form of inhalation so that the medicinal substances quickly reach the pathological area. Also, aerosols can relieve an attack of suffocation.

Drug therapy

Systemic treatment consists of using long-acting agents: corticosteroids, anti-inflammatory drugs and, in rare cases, hormonal drugs.

Other therapies

For patients suffering from asthma, doctors recommend doing special breathing exercises. In addition, we should not forget about physical therapy: physical activity helps remove toxins from the body and speeds up metabolism.

For diseases of the respiratory tract, traditional medicine advises using decoctions and infusions of medicinal herbs: chamomile, sage, rose hips, nettle, mint, femoral saxifrage. They make healthy fortified tea. An infusion of pine buds is especially effective; it has antiseptic and analgesic effects. A mixture of aloe juice and mustard also helps to relieve symptoms.

Prevention

To avoid the appearance of mixed asthma, it is necessary to minimize the harmful effects of exogenous and endogenous factors:

Healthy lifestyle

• Living areas should be kept clean. If there is a thick layer of dust on the shelves, then the chance of developing bronchial asthma increases significantly.
• You need to lead a healthy lifestyle. Smoking, alcohol abuse and poor diet have a negative impact on the immune system.
• You should not take medications thoughtlessly. Medicines cause severe suffocation if the patient is allergic to the components. Also, some of them can provoke bronchospasm.
• It is important to treat diseases in a timely manner. Chronic pathologies seriously impair immunity and increase the risk of concomitant diseases.

Bronchial asthma often appears in children, so adults need to monitor the child’s condition so as not to miss the onset of its development. The earlier treatment is started, the easier it is to take control of the disease.

Complications

Regarding the respiratory system, asthma can cause emphysema, pneumosclerosis and chronic pulmonary heart syndrome, when the right side of the muscle increases in size.

Breathing problems affect the central nervous system, as a lack of oxygen affects the cells' ability to function normally.

As a result, the patient begins to have problems with other systems: digestive and cardiovascular.

Mixed asthma is dangerous for humans because it causes serious complications. However, with proper and timely treatment, the disease can be brought under control and the risk of exacerbations and negative consequences can be significantly reduced. To do this, the patient should be diagnosed on time and follow all the doctor’s recommendations.

Source: https://pulmohealth.com/astma/smeshannaya/

Mixed form of bronchial asthma

Bronchial asthma of mixed form is a complex pathological process occurring in the respiratory organs. It is characterized by periodic exacerbations and unexpected suffocation. Allergic internal and external factors are involved in the progression of this disease. It usually develops in a short time.

Features of treatment

Bronchial asthma of mild, moderate and severe forms of mixed origin is treated comprehensively. Therapy is aimed at reducing pathogenic processes that develop in the bronchi and at easing the course of the disease.

Indispensable conditions for successful treatment are the following actions:

Endogenous component

Endogenous asthma usually occurs in middle age (not earlier than 30-40 years). It is characterized by the fact that any, even minimal, physical stimuli can serve as a stimulus for the appearance of direct symptoms of the disease. The latter include temperature fluctuations, stressful situations, short-term physical overload or respiratory infections (mainly caused by viruses). In addition, it is believed that endogenous bronchial asthma can be caused by taking aspirin and similar drugs (anti-inflammatory drugs, also containing salicylates: so-called non-steroidal anti-inflammatory drugs).

Bronchial asthma of mixed form: what it is, severity and treatment

Mixed bronchial asthma is the most severe form of the disease; its origin is influenced not only by external, but also by internal factors. This type is characterized by prolonged attacks of suffocation, the frequency of relapses, and the development of complications. Timely identification of the causes can prevent attacks and alleviate the patient’s condition.

• Symptomatic medications
• Basic treatment products
• Additional funds

Features of the development of asthma of mixed origin

Bronchial asthma of mixed origin is a chronic bronchial disease that occurs with signs of bronchial obstruction and hyperreactivity, combining several types of disease.

It is common in areas with large concentrations of factories and in areas with a humid and cold climate.

This disease develops gradually, first there is an allergic rhinitis, then sinusitis, laryngitis, turning into a pre-asthmatic state, which, in addition to cough and shortness of breath, is characterized by stool disorder and skin rashes. If you cannot cope with it, then the next stage is the appearance of bronchial asthma.

The first signs of the disease often appear in the first months of a child’s life, which by the age of 5-6 years have formed into an independent disease. Mixed asthma is characterized by a progressive course, frequency and duration of attacks; it is characterized by a violation of bronchial obstruction due to the formed narrowing of the lumen of the bronchi.

Air cannot pass easily due to the accumulation of thick and viscous sputum and swelling of the mucous membranes. The condition is worsened by bronchial collapse, leading to a reduction in air flow. Attacks occur throughout the year, especially intensifying during outbreaks of infectious diseases, as well as in cold and damp rooms.

The mixed form of bronchial asthma has a peculiar course, its formation is influenced by the following reasons:

• genetic predisposition,
• increased production of immunoglobulin E,
• change in bronchial reactivity,
• influence of allergens (house dust, medications, food products, chemicals),
• unfavorable weather conditions,
• living in a region with developed industry,
• smoking,
• presence of chronic infection,
• frequent bronchitis,
• tendency to allergic diseases,
• diseases of the gastrointestinal tract,
• physical overload,
• stressful state,
• unbalanced diet,
• nasal polyposis,
• aspirin intolerance,
• frequent diseases of acute respiratory viral infections and influenza.

If close relatives have had asthma, as well as allergic manifestations in the form of eczema, urticaria, rhinitis, conjunctivitis, neurodermatitis, drug and food intolerance, then the child’s risk of developing mixed type asthma increases sharply.

Symptoms, diagnosis and prevention of the disease

Mixed asthma most often manifests itself as follows:

1. The mild stage of the disease is characterized by the occurrence of shortness of breath only during physical activity, and there is no difficulty in speaking.
2. Bronchial asthma of a mixed form of moderate severity manifests itself in shortness of breath that occurs during a conversation and the inability to pronounce a large fragment of speech without an additional sigh. This course of the disease is also characterized by shortness of breath when lying down. When taking a sitting position, the condition is noticeably relieved.
3. During a severe course of the disease, symptoms of respiratory failure also appear in a calm state. The patient needs to take an extra breath even after uttering a few words. He is forced to take a sitting position, with a slight bend forward, in order to normalize his breathing.

Also, in severe and moderate severity, the disease may have the following symptoms:

• the occurrence of an attack of suffocation after physical or psycho-emotional stress,
• wheezing, dry cough, chest congestion, shortness of breath,
• difficulty inhaling and prolonged exhalation, accompanied by wheezing and whistling,
• pain and tightness in the chest,
• slight increase in temperature
• a child suffering from this disease may experience delayed physical development,
• In children, there are often cases when the only manifestation of the disease is a cough at night, and there is no cough during the daytime.

Important! Bronchial asthma of mixed form is characterized by moderate or severe severity; mild degrees of the disease are extremely rare.

In order to make the most accurate diagnosis, you need to consult a pulmonologist, immunologist and allergist. First of all you should do:

• laboratory blood test,
• X-ray of the respiratory tract and organs,
• analysis of physical activity indicators,
• bronchoscopy,
• culture of sputum,
• ECG,
• spirometry,
• peak flowmetry,
• allergy tests,
• Ultrasound.

The doctor draws up a general picture of the disease, paying special attention to allergic reactions and infectious diseases, determines the relationship between these manifestations and the frequency of attacks, and identifies factors influencing the severity of suffocation.

The development of mixed asthma can be avoided by using the following measures:

• timely identification of the allergen,
• frequent walks in the fresh air, preferably in a forest,
• complete exclusion of alcohol and smoking,
• regular breathing exercises,
• hardening procedures,
• balanced nutrition,
• information on the minimum consumption of food that contains dyes, flavors, flavor enhancers,
• if possible, reduce contact with chemicals,
• complete elimination of stressful situations,
• wet cleaning carried out daily in the room,
• refusal of carpets, feather pillows, heavy curtains, soft toys,
• eliminating physical overload.

Treatment of bronchial asthma

Bronchial asthma, in particular its mixed form, is treated with the help of complex therapy, which involves the use of medications that help alleviate the symptoms of the disease and suppress the negative processes that occur in the bronchi.

Symptomatic medications

The action of this group of drugs is aimed at relieving spasms occurring in the bronchi, they relieve attacks of suffocation, and restore airway patency. Bronchial asthma, its mixed form of moderate and severe severity, is characterized by the suddenness of attacks. Therefore, these medications are necessary to relieve bronchial spasm. The most effective are:

• hormonal agents – Polcortolone, Dexamethasone, Prednisolone,
• B2-agonists that have an effect that lasts a short time - Berotec, Terbutaline, Salbutamol,
• A-energy – Ipratropium Bromide,
• Theophyllion.

Short-acting agonists are released in the form of aerosols; during an attack, they are injected into the mouth as you inhale, falling directly onto the bronchi. As a result, the attack stops for a while.

These products act as an “ambulance”, but they are toxic and should be used in exceptional cases.

Their daily use is limited and should not exceed the dose recommended by the doctor.

Basic treatment products

Basic treatment agents do not have an immediate effect; they are used in the dosage prescribed by a specialist every day, regardless of whether the patient is in the stage of exacerbation or remission.

They suppress pathological processes in the bronchi and are used for several years, and sometimes throughout life.

Among the medications that control the further development of bronchial asthma, the most effective are:

• non-steroidal drugs – sodium cromoglycate, sodium Nedocromil – reduce bronchial inflammation, prevent attacks,
• aerosol hormonal drugs – Budesonide, Triamcinolone acetonide – relieve bronchial inflammation,
• Long-acting B2-agonists - Salmeterol - relieve bronchial attacks,
• Zafirlukast, Montelukast - reduce the number of asthma attacks.

Bronchial asthma of mixed forms of moderate and severe severity differs from the mild course of the disease in that the same patient experiences an unequal number of attacks at different times.

Therefore, during long-term remission, you can reduce the dosage of medications taken. However, this must be done carefully so as not to worsen the condition - in a stepwise manner, in the same way the dosage is increased during an exacerbation of the disease.

This way you can keep the development of the disease under control.

Important! During the treatment of asthma of mixed origin, it is necessary to use only those drugs prescribed by the doctor, the same applies to the dosage, otherwise you can provoke a deterioration in well-being and the occurrence of attacks.

Additional funds

The condition of an asthmatic can be improved with the help of additional treatment, which is aimed at reducing the dosage of medications and reducing the number of bronchial spasms. These methods are often used:

• acupuncture,
• exercise therapy,
• breathing exercises,
• acupressure,
• hardening,
• herbal medicine,
• aeroionotherapy.

It is necessary to understand that these methods can only be used at the stage of remission and as additional means; in no case should they replace the main treatment. If drug treatment is excluded, they can even increase the number of bronchial spasms.

Bronchial asthma of mixed origin is a rather serious illness, the treatment of which must be approached in a comprehensive manner. By following the specialist’s recommendations and eliminating factors that cause bronchial spasm, the patient’s quality of life can be improved.

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Source: https://prof-medstail.ru/bolezni-legkih/chto-takoe-bronchialnaya-astma-smeshannoj-formy

Mixed asthma: symptoms, diagnosis, treatment methods

Mixed asthma is a respiratory disease formed by a combination of internal and external factors. Most often it occurs in industrial cities and areas with unfavorable environmental conditions. Most of the patients are young children, their number is twice as high as the number of sick adults.

Description and features of the disease

Mixed asthma manifests itself as a process of chronic inflammation in the respiratory system in a moderate or severe form.

Its occurrence is due to increased sensitivity of the bronchi and narrowing of the bronchial lumen under the influence of irritating factors.

The condition is caused by contraction of smooth bronchial muscles, swelling of the mucous membrane and the accumulation of large amounts of mucus on its walls.

This form of asthma is associated not only with environmental irritants, but also with diseases of an infectious nature (teeth, respiratory organs, stomach, intestines, and other internal organs).

Classification

Mixed bronchial asthma is classified according to several criteria. According to the severity of the course, they are divided into:

• Mild degree with minor exacerbations, eliminated with bronchodilators.
• A moderate form of severity of mixed type bronchial asthma, in which the patient’s physical activity decreases and sleep patterns are disrupted.
  Severe, prolonged exacerbations with suffocating attacks occur several times a week. The patient is forced to take bronchodilators daily.
• A severe form, in which physical activity is partially or completely lost, speech is impaired, a panic state occurs, general weakness and frequent attacks.
  In some cases, attacks turn into asthmatic ones, which pose a threat to the patient’s life.

Classification according to the form of occurrence, according to which bronchial asthma of mixed origin is divided into:

Classification according to the controllability of the disease identifies:

• Controlled asthma, in which there are no negative manifestations and restrictions on any type of activity.
• Partially controlled - with the manifestation of the first clinical symptoms and a moderate frequency of exacerbations.
• Uncontrolled – characterized by multiple symptoms, a significant number of exacerbations, and the occurrence of asthmatic attacks.

The patient’s independent use of a peak flow meter (a device that measures the maximum inspiratory flow rate) will allow one to keep the disease under control, determine the onset of an exacerbation phase and take action.

Classification of the disease by level of control

The disease is classified not only by severity, course characteristics, presence[M9] of complications, but also by degree of control.

It is determined by the following parameters:

• symptomatic manifestations of the disease at different times of the day;
• activity limitation;
• functional state of the respiratory system;
• frequency of asthmatic attacks;
• the need to use emergency medications.

There are three types of asthma, differing in the degree of control:

1. Controlled bronchial asthma - there is no clinical manifestations during the treatment period. Indicators of diagnostic studies correspond to the norm. Drugs in a controlled form are prescribed to patients in minimal quantities.
2. Partially controlled - the presence of individual symptoms of the disease is noted. In this case, it is recommended to change therapeutic measures to return the disease to a controlled form.
3. Uncontrolled bronchial asthma is the most dangerous form of the disease, in which there are pronounced symptoms and frequent exacerbations with asthmatic attacks repeated several times during the week. During this period, every effort must be made to return the disease to a controlled form.

Control of the disease consists of long-term monitoring of its development (associated symptoms, frequency of recurrence of attacks) and selection of individual treatment. Complex therapy can transfer the disease into a state of long-term remission.