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目的：探讨哮喘专病门诊在哮喘规范化治疗和管理中的重要性。方法：随机选取于 2013 年 7 月至 2013 年 12 月新疆自治区人民医院哮喘专病门诊就诊的患者，其中初诊患者 84 例，复诊患者 96 例，合计 180 例。由经过培训的医师采用问卷调查的形式针对哮喘患者在疾病控制、管理和用药，以及对该病的认知程度等方面进行调查，比较初诊患者和复诊患者在哮喘的控制情况、管理情况、用药情况以及对哮喘的认知程度等方面的差异性，采用 SPSS 11 . 5 软件进行统计学分析。结果： 1.哮喘控制方面，初诊和复诊患者在过去一年中的急诊就医比例 (40.5 % vs 21 .9 %)、住院比例 (14.3 % vs 10.4 %)、需要使用急救药物比例 (66.7 % vs 29.2 %)，初诊患者均较复诊患者高，其中需要急诊就医和需要急救药物这两方面初诊与复诊相比有显著性差异(P<0.01)，但在住院比例两者间的差异无统计学意义（ P>0.05）；初诊和复诊患者的哮喘控制测试评分分别为 1 5.46± 5.2， 20.23± 5.12 (P<0.01)。根据评分，初诊和复诊患者达到哮喘完全控制的比例为 (5.4 % vs 28.6 %)、良好控制的比例为 (1 4.3 % vs 47.8 %)，未控制的比例为 (80.3 % vs 23.6 %)，复诊患者均明显高于初诊患者( P<0.01)。 2.哮喘管理方面，初诊和复诊患者在过去一年内测定过肺功能的比例为 (20.2 % vs 93. 7 %)、初诊患者无人使用峰流速仪，复诊患者的比例为 17. 8%，复诊患者均明显高于初诊患者，两者有明显的统计学差异 (P<0.01)。此外，复诊患者 3 月内至少一次随访的比例明显高于初诊患者， 1 5.3 %的初诊患者 3 月内前往呼吸科门诊至少就诊一次，而复诊患者则为 64. 2 %(P<0.05)。 3.哮喘治疗方面 , 仅 48.9 % 的初诊患者使用过吸入性糖皮质激素(inhaled corticosteroids, ICS)，而复诊患者中使用的比例高达 91 .7 %( P<0.01)。 4.哮喘认知方面，认为哮喘是气道炎症性疾病，初诊与复诊比例（ 1 9 % vs 91 .7 %）， ICS 是长期控制药物初诊与复诊比例（ 38.1 % vs 92.7 %），两者相比有着显著性差异 (P<0.0001)，在对哮喘疾病的认知方面复诊患者明显优于初诊患者。结论：复诊患者无论在哮喘的控制、管理和用药方面，还是对疾病的认知方面均明显优于初诊患者，这提示哮喘专病门诊的设立有利于对哮喘患者的治疗和管理，有必要加强对呼吸科医师哮喘知识的再培训，推广哮喘专病门诊，同时有必要加强对哮喘患者的健康教育。

英文摘要:

Objective:To evaluate the importance of the specialist clinic for bronchial asthma (asthma) in standardized management and treatment of asthma.Methods:84 outpatients of the first visit and 96 of the return visit at the specialist clinic for asthma in People’ s Hospital of XinJiang Autonomous Region were randomly selected from July to December 201 3. The trained physicians used the form of questionnaire to survey such as disease control, management, medication and cognition for asthma patients, then used SPSS11 .5 for statistical analysis.Results:The proportion of seeing a doctor in emergency and using rescue inhaler in the first visit outpatients were higher than the return visit outpatients (40.5% vs 21 .9%, 66.7 vs 29.2%) with statistical significance (P<0.05); for the scores of asthma control test, the former were significantly lower than the latter (15.46± 5.23 vs 20.23± 5.1 2). The proportion of full or good control of asthma in the first visit out patients were 5.4% and 14.3% respectively, in the return visit ones were 28.6% and 47.8%. In the past year, both of the proportion of checking pulmonary function and peak flow rate in the former were significantly lower than in the latter(20.2% vs 93.7%, 0 vs 17.8%). The frequency of seeing a doctor every three months in the first visit outpatients was significantly lower than that of the return ones(15.3 vs 64.2%). There were only 48.9% outpatients ofthe first visit who ever used inhaled corticosteroids (ICS), however, the return visit ones were 91 .7%; for the cognition of asthma, thinking asthma as airway inflammation, in the first visit outpatients was significantly lower than in the return ones (1 9% vs 91.7%). In the outpatients who regarded ICS as the first- line control drugs, the first visit outpatients were 38.1 %, while the return visit ones were 92.7%. There were obvious statistical significance(P<0.0001 ).Conclusion:No matter where in the asthma control, management, medication and cognition, the return visit outpatients were superior to the first ones. It suggested that the establishment ofthe specialist clinic for asthma would be in favor ofpatients with asthma, so it should be popularized.

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