哮喘联盟

   摘要
   咳嗽是患者就医的最常见的原因之一。来自多个国家和协会的咳嗽指南可帮助临床医生对咳嗽患者进行调查和管理。我们回顾咳嗽领域中一些可能导致这些指南修订的最新进展。在慢性咳嗽成人患者中，新的原因如阻塞性睡眠窒息症已经确定。咳嗽过敏综合征（CHS），一个新的术语已经在慢性咳嗽患者中提出，强调咳嗽反射过敏是一个重要特征。现在有新的治疗选择可选，特别是对难治性或特发性慢性咳嗽患者，其中包括加巴喷丁，言语病理学管理和吗啡。随着生活质量调查问卷和咳嗽频率监测工具的发展，对咳嗽的评估已经有长足的进步。儿童常见的病因与成人不同，那些根据指南管理的患者相比常规治疗有更好的结果。新的诊断实体，如长期细菌性支气管炎已有描述。儿科专用的咳嗽评估工具，如亲子生活质量调查问卷，有利于改善患者的评估。进一步的研究是必要的，可提高今后的临床指南建议的证据基础。未来的指南也应力求达到更广泛的受众，其中包括初级保健医生，非专业人士和患者。

 

（苏欣 审校）
PulmPharmacolTher. 2015Feb11.pii:S1094-5539(15)00019-X.doi:10.1016/j.pupt.2015.01.007. [Epub ahead of print]
 

Adult and paediatric cough guidelines: Ready for an overhaul?
 

Birring SS1, Kavanagh J2, Lai K3, Chang AB4.

Author information
 

Abstract
Cough is one of the most common reasons that patients seek medical attention. Cough guidelines from numerous countries and societies are available to assist the clinician to investigate and manage patients with cough. We review some of the recent progress in the field of cough that may lead to revision of these guidelines. In adults with chronic cough, new causes such as obstructive sleep apnoea have been identified. A new terminology, cough hypersensitivity syndrome (CHS), has been proposed for patients with chronic cough, which emphasises cough reflex hypersensitivity as a key feature. New therapeutic options are now available, particularly for patients with refractory or idiopathic chronic cough, which include gabapentin, speech pathology management and morphine. There has been great progress in the assessment of cough with the development of validated quality of life questionnaires and coughfrequency monitoring tools. In children, common aetiologies differ from adults and those managed according to guidelines have better outcomes compared to usual care. New diagnostic entities such as protracted bacterial bronchitis have been described. Paediatric-specific cough assessment tools such as the Parent/Child Quality of Life Questionnaire will help improve the assessment of patients. Further research is necessary to improve the evidence base for future clinical guideline recommendations. Guidelines in future should also aim to reach a wider audience that includes primary care physicians, non-specialists and patients.
 

PulmPharmacolTher. 2015Feb11.pii:S1094-5539(15)00019-X.doi:10.1016/j.pupt.2015.01.007. [Epub ahead of print]