The Global Initiative for Asthma (GINA) was established in 1993 by the World Health Organization and the US National Heart Lung and Blood Institute to improve asthma awareness, prevention and management worldwide. GINA develops and publishes evidence-based, annually updated resources for clinicians. GINA guidance is adopted by national asthma guidelines in many countries, adapted to fit local healthcare systems, practices, and resource availability. GINA is independent of industry, funded by the sale and licensing of its materials. This review summarizes key practical guidance for primary care from the 2022 GINA strategy report. It provides guidance on confirming the diagnosis of asthma using spirometry or peak expiratory flow. GINA recommends that all adults, adolescents and most children with asthma should receive inhaled corticosteroid (ICS)-containing therapy to reduce the risk of severe exacerbations, either taken regularly, or (for adults and adolescents with “mild” asthma) as combination ICS–formoterol taken as needed for symptom relief. For patients with moderate–severe asthma, the preferred regimen is maintenance-and-reliever therapy (MART) with ICS–formoterol. Asthma treatment is not “one size fits all”; GINA recommends individualized assessment, adjustment, and review of treatment. As many patients with difficult-to-treat or severe asthma are not referred early for specialist review, we provide updated guidance for primary care on diagnosis, further investigation, optimization and treatment of severe asthma across secondary and tertiary care. While the GINA strategy has global relevance, we recognize that there are special considerations for its adoption in low- and middle-income countries, particularly the current poor access to inhaled medications.

全球哮喘防治倡议 (GINA) 由世界卫生组织和美国国家心肺血液研究所于 1993 年成立，旨在提高全世界对哮喘的认识、预防和管理。GINA 为临床医生开发和发布基于证据的、每年更新的资源。许多国家的国家哮喘指南都采用了 GINA 指南，并根据当地的医疗保健系统、实践和资源可用性进行了调整。GINA 独立于行业，其资金来自其材料的销售和许可。本综述总结了 2022 年 GINA 战略报告中初级保健的关键实践指南。它提供了使用肺活量测定法或呼气峰流量来确认哮喘诊断的指南。GINA 建议所有成年人，青少年和大多数哮喘儿童应接受含吸入皮质类固醇 (ICS) 的治疗，以降低严重恶化的风险，或者定期服用，或者（对于患有“轻度”哮喘的成人和青少年）根据症状需要服用 ICS-福莫特罗组合宽慰。对于中重度哮喘患者，首选方案是使用 ICS-福莫特罗的维持缓解疗法 (MART)。哮喘治疗不是“一刀切”；GINA 建议对治疗进行个体化评估、调整和审查。由于许多难治性或严重哮喘患者未及早转诊接受专科检查，我们为初级保健提供更新的二级和三级保健诊断、进一步调查、优化和治疗严重哮喘的指南。虽然 GINA 战略具有全球意义，