哮喘联盟

   摘要
   研究背景：慢性难治性咳嗽（CRC）是一种很难治疗的疾病。言语病理学治疗（SPT）能改善症状但治疗并不完全。中枢神经递质也能改善咳嗽症状，但不能改善咳嗽反射敏感性，且效果短暂。我们假设SPT和中枢神经递质联合治疗效果优于SPT单独治疗。
   目的：评估普瑞巴林和SPT联合治疗是否比SPT单独治疗更有效。
   方法：安慰剂随机对照试验。40例CRC患者随机接收SPT和普瑞西林300mg/天联合治疗或SPT与安慰剂联合治疗。收集基线、治疗结束和治疗结束后4周的疗效判定指标。主要疗效判定指标采用莱斯特咳嗽监测仪评估咳嗽频率、采用视觉模拟评分（咳嗽VAS）评估咳嗽严重程度、采用莱斯特咳嗽问卷（LCQ）评估咳嗽相关生活质量。
   主要结果：两组的咳嗽严重程度、咳嗽频率和咳嗽相关生活质量都有所改善。与SPT单独治疗组相比，SPT和普瑞西林联合治疗组的LCQ和咳嗽VAS改善程度更高；LCQ的平均差为3.5，95%可信区间为1.1-5.8；咳嗽VAS的平均差为25.1,95%可信区间为10.6-39.6。两组在咳嗽频率改善方面无显著差异。普瑞西林停用后无症状加重。SPT和普瑞西林联合治疗组的平均辣椒素敏感性从15.7µM改善到47.5µM，SPT单独治疗组从3.93µM改善到15.7µM。
   结论：与SPT单独治疗相比，SPT和普瑞西林联合治疗能减少CRC患者的症状，并能改善生活质量。

 

（苏欣 审校）
Chest. 2015 Oct 8. doi: 10.1378/chest.15-1271. [Epub ahead of print]


 

Pregabalin and speech pathology combination therapy for refractory chronic cough: A randomised controlled trial.
 

Vertigan AE, Kapela SL, Ryan NM, Birring SS, McElduff P, Gibson PG.
 

Abstract
RATIONALE:Chronic refractory cough (CRC) is a difficult problem to treat. Speech pathology treatment (SPT) improves symptoms but resolution is incomplete. Centrally acting neuromodulators also improve cough symptoms but not cough reflex sensitivity and the effect is short lived. We hypothesised that combined SPT and centrally acting neuromodulators would have a superior outcome than SPT alone.
OBJECTIVES:To determine whether combined pregabalin and SPT is more effective than SPT alone.
METHODS:Randomised placebo controlled trial. Forty patients with CRC were randomly assigned to receive either combined SPT and pregabalin 300mg daily or combined SPT and placebo. Outcome measures were collected at baseline, end of treatment and four weeks after the end of treatment. Primary outcome measures were cough frequency using the Leicester Cough Monitor, cough severity using a visual analogue scale (coughVAS) and cough related quality of life using the Leicester Cough Questionnaire (LCQ).
MAIN RESULTS:Cough severity, cough frequency and cough quality of life improved in both groups. The degree of improvement in LCQ and coughVAS was greater with combined SPT and pregabalin than SPT alone; the mean difference in LCQ was 3.5, 95%CI of difference 1.1-5.8; the mean difference in coughVAS was 25.1, 95%CI of difference 10.6-39.6. There was no significant difference in improvement in cough frequency between groups. There was no deterioration in symptoms once pregabalin was withdrawn. Median capsaicin cough sensitivity improved from 15.7-47.5µM with combined SPT and pregabalin and from 3.92-15.7µM with SPT alone.
CONCLUSIONS:Combined SPT and pregabalin reduces symptoms and improves quality of life compared to SPT alone in patients with in CRC.
 

Chest. 2015 Oct 8. doi: 10.1378/chest.15-1271. [Epub ahead of print]