针对咳嗽的特殊治疗和声带反常折叠运动治疗可以改善慢性咳嗽和喉部功能障碍
2009/05/18
基础理论：慢性持续性咳嗽与喉部功能障碍有关，后者常导致发声困难、对辣椒素高反应性、运动功能障碍伴声带反常折叠运动、变异性胸腔外气流梗阻（吸气流量下降）。对慢性持续性咳嗽的成功治疗能改善症状和气道的高反应性。慢性咳嗽治疗对喉部功能障碍的作用尚不清楚。
目的：本文研究慢性咳嗽治疗对声带反常折叠运动的作用。
方法：通过检测治疗前、后患者的生活质量、胸腔外气道对高渗盐刺激的高反应性、辣椒素咳嗽反射超敏性以及纤维支气管镜观察声带异常折叠运动，对慢性持续性咳嗽成人患者（n=24）进行评价。根据喉镜检查将慢性咳嗽患者分为声带异常运动组(n=14)和无声带异常运动组(n=10)。
结果：两组治疗后咳嗽相关的生活质量和咳嗽反射敏感性均显著改善。慢性咳嗽和声带异常运动患者的胸外气道高反应性和声带异常运动也有所改善。咳嗽反射敏感性的改善程度与胸腔外气道高反应性的改善相关。
结论：慢性持续性咳嗽患者喉部功能障碍较为常见，主要表现为声带反常折叠运动和胸腔外气道高反应性。慢性持续性咳嗽的有效治疗能显著改善上述喉部功能障碍。
（刘国梁 卫生部中日友好医院呼吸内科 100029 摘译）
（Ryan NM, et al. Cough. 2009 Mar 17;5:4）
Ryan NM, et al. Cough. 2009 Mar 17;5:4.
Chronic cough and laryngeal dysfunction improve with specific treatment of cough and paradoxical vocal fold movement.
RATIONALE: Chronic persistent cough can be associated with laryngeal dysfunction that leads to symptoms such as dysphonia, sensory hyperresponsiveness to capsaicin, and motor dysfunction with paradoxical vocal fold movement and variable extrathoracic airflow obstruction (reduced inspiratory airflow). Successful therapy of chronic persistent cough improves symptoms and sensory hyperresponsiveness. The effects of treatment for chronic cough on laryngeal dysfunction are not known.
OBJECTIVE: The aim of this study was to investigate effects of therapy for chronic cough and paradoxical vocal fold movement.
METHODS: Adults with chronic cough (n = 24) were assessed before and after treatment for chronic persistent cough by measuring quality of life, extrathoracic airway hyperresponsiveness to hypertonic saline provocation, capsaicin cough reflex hypersensitivity and fibreoptic laryngoscopy to observe paradoxical vocal fold movement. Subjects with chronic cough were classified into those with (n = 14) or without (n = 10) paradoxical vocal fold movement based on direct observation at laryngoscopy.
RESULTS: Following treatment there was a significant improvement in cough related quality of life and cough reflex sensitivity in both groups. Subjects with chronic cough and paradoxical vocal fold movement also had additional improvements in extrathoracic airway hyperresponsiveness and paradoxical vocal fold movement. The degree of improvement in cough reflex sensitivity correlated with the improvement in extrathoracic airway hyperresponsiveness.
CONCLUSION: Laryngeal dysfunction is common in chronic persistent cough, where it is manifest as paradoxical vocal fold movement and extrathoracic airway hyperresponsiveness. Successful treatment for chronic persistent cough leads to improvements in these features of laryngeal dysfunction.
目的：本文研究慢性咳嗽治疗对声带反常折叠运动的作用。
方法：通过检测治疗前、后患者的生活质量、胸腔外气道对高渗盐刺激的高反应性、辣椒素咳嗽反射超敏性以及纤维支气管镜观察声带异常折叠运动，对慢性持续性咳嗽成人患者（n=24）进行评价。根据喉镜检查将慢性咳嗽患者分为声带异常运动组(n=14)和无声带异常运动组(n=10)。
结果：两组治疗后咳嗽相关的生活质量和咳嗽反射敏感性均显著改善。慢性咳嗽和声带异常运动患者的胸外气道高反应性和声带异常运动也有所改善。咳嗽反射敏感性的改善程度与胸腔外气道高反应性的改善相关。
结论：慢性持续性咳嗽患者喉部功能障碍较为常见，主要表现为声带反常折叠运动和胸腔外气道高反应性。慢性持续性咳嗽的有效治疗能显著改善上述喉部功能障碍。
（刘国梁 卫生部中日友好医院呼吸内科 100029 摘译）
（Ryan NM, et al. Cough. 2009 Mar 17;5:4）
Ryan NM, et al. Cough. 2009 Mar 17;5:4.
Chronic cough and laryngeal dysfunction improve with specific treatment of cough and paradoxical vocal fold movement.
RATIONALE: Chronic persistent cough can be associated with laryngeal dysfunction that leads to symptoms such as dysphonia, sensory hyperresponsiveness to capsaicin, and motor dysfunction with paradoxical vocal fold movement and variable extrathoracic airflow obstruction (reduced inspiratory airflow). Successful therapy of chronic persistent cough improves symptoms and sensory hyperresponsiveness. The effects of treatment for chronic cough on laryngeal dysfunction are not known.
OBJECTIVE: The aim of this study was to investigate effects of therapy for chronic cough and paradoxical vocal fold movement.
METHODS: Adults with chronic cough (n = 24) were assessed before and after treatment for chronic persistent cough by measuring quality of life, extrathoracic airway hyperresponsiveness to hypertonic saline provocation, capsaicin cough reflex hypersensitivity and fibreoptic laryngoscopy to observe paradoxical vocal fold movement. Subjects with chronic cough were classified into those with (n = 14) or without (n = 10) paradoxical vocal fold movement based on direct observation at laryngoscopy.
RESULTS: Following treatment there was a significant improvement in cough related quality of life and cough reflex sensitivity in both groups. Subjects with chronic cough and paradoxical vocal fold movement also had additional improvements in extrathoracic airway hyperresponsiveness and paradoxical vocal fold movement. The degree of improvement in cough reflex sensitivity correlated with the improvement in extrathoracic airway hyperresponsiveness.
CONCLUSION: Laryngeal dysfunction is common in chronic persistent cough, where it is manifest as paradoxical vocal fold movement and extrathoracic airway hyperresponsiveness. Successful treatment for chronic persistent cough leads to improvements in these features of laryngeal dysfunction.
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咳嗽变异型哮喘和典型哮喘在乙酰甲胆碱诱导的支气管收缩中的表现特征：横断面研究
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咳嗽变异型哮喘和典型哮喘在乙酰甲胆碱诱导的支气管收缩中的表现特征：横断面研究
