Asthma is a common chronic disease characterized by episodic or persistent respiratory symptoms and airflow limitation. Asthma treatment is based on a stepwise and control-based approach that involves an iterative cycle of assessment, adjustment of the treatment and review of the response aimed to minimize symptom burden and risk of exacerbations. Anti-inflammatory treatment is the mainstay of asthma management. In this review we will discuss the rationale and barriers to the treatment of asthma that may result in poor outcomes. The benefits of currently available treatments and the possible strategies to overcome the barriers that limit the achievement of asthma control in real-life conditions and how these led to the GINA 2019 guidelines for asthma treatment and prevention will also be discussed.

中文翻译：

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哮喘的治疗策略：重塑哮喘管理概念。

哮喘是一种常见的慢性疾病，特征是发作性或持续性呼吸道症状和气流受限。哮喘的治疗是基于循序渐进和基于控制的方法，该方法涉及一个反复的评估，调整治疗方法和检查反应的循环周期，旨在最大程度地减轻症状负担和加重风险。抗炎治疗是哮喘控制的主要手段。在这篇综述中，我们将讨论可能导致不良预后的哮喘治疗的基本原理和障碍。还将讨论当前可用治疗的益处以及克服现实生活条件下限制实现哮喘控制的障碍的可能策略，以及这些策略如何导致GINA 2019哮喘治疗和预防指南。