白三烯受体拮抗剂孟鲁司特在咳嗽变异性哮喘患者和过敏性咳嗽患者中的止咳作用
2010/07/07
摘要
背景：慢性咳嗽是咳嗽变异性哮喘(CVA)和过敏性咳嗽(AC)的唯一症状。研究证实，白三烯受体拮抗剂可用于治疗CVA，但未见其在AC患者中有效的报道。本试验旨在评价白三烯受体拮抗剂--孟鲁司特在治疗CVA和AC中的有效性。
方法：75名慢性咳嗽患者入选本研究，并接受诊断性支气管扩张治疗（盐酸克伦特罗治疗6天）。在75名患者中，分别有48名和27名患者满足CVA和AC的简化诊断标准。CVA患者随机分为3组：孟鲁司特组、克伦特罗组和孟鲁司特联合克伦特罗组。AC患者随机分为2组：孟鲁司特组和安慰剂组。咳嗽治疗的有效性采用主观咳嗽症状量表进行评价（0表示无咳嗽，10表示咳嗽与第1次就诊时差不多）。对治疗前及治疗2周后的咳嗽量表、肺功能检测、呼气峰值流速（PEF）进行评价。
结果：对于CVA患者，所有治疗均能显著降低咳嗽评分，孟鲁斯特联合克伦特罗治疗优于单用孟鲁司特。克伦特罗联合孟鲁司特治疗组，与治疗前相比，早上和晚上PEF值在治疗2周后显著增加。对于AC组患者，孟鲁司特组和安慰剂组患者的咳嗽评分未见显著差异。
结论：孟鲁司特能抑制CVA患者慢性干咳，但对AC患者的干咳无效。
（陈欣 审校）
Kita T, et al. Allergol Int. 2010 Mar 25;59(2). [Epub ahead of print]
Antitussive Effects of the Leukotriene Receptor Antagonist Montelukast in Patients with Cough Variant Asthma and Atopic Cough.
Kita T, Fujimura M, Ogawa H, Nakatsumi Y, Nomura S, Ishiura Y, Myou S, Nakao S.
Department of Respiratory Medicine, National Hospital Organization Kanazawa Medical Center, Toyama, Japan.
Abstract
Background: Chronic cough is the only symptom of cough variant asthma (CVA) and atopic cough (AC). Cysteinyl leukotriene receptor antagonists have been shown to be effective in CVA, but there are no reports on their effectiveness in AC. To evaluate the antitussive effect of montelukast, a leukotriene receptor antagonist, in CVA and AC.
Methods: Seventy-five patients with chronic cough received diagnostic bronchodilator therapy with oral clenbuterol hydrochloride for 6 days. Of the 75 patients, 48 and 27 met the simplified diagnostic criteria for CVA and AC, respectively. Patients with CVA were randomly divided into 3 groups: montelukast, clenbuterol, and montelukast plus clenbuterol. Patients with AC were randomly divided into 2 groups: montelukast and placebo. The efficacy of cough treatment was assessed with a subjective cough symptom scale (0 meant "no cough" and 10 denoted "cough as bad as at first visit"). The cough scale, pulmonary function test, and peak expiratory flow rate (PEF) were evaluated before and after 2 weeks of treatment.
Results: In patients with CVA, 2-week treatment with montelukast, clenbuterol, and montelukast plus clenbuterol all significantly decreased cough scores and treatment with montelukast plus clenbuterol was superior to treatment with montelukast alone. In the montelukast plus clenbuterol group, PEF values in the morning and evening significantly increased after 2 weeks compared with values before treatment. In patients with AC, scores on the cough scale did not differ significantly between the montelukast group and the placebo group.
Conclusions: Montelukast was confirmed to suppress chronic non-productive cough in CVA, whereas it was not effective in non-productive cough in AC.
上一篇：
检测咳嗽严重程度：一项新型、包含7项目的咳嗽严重程度患者主诉结果检测方法的开发和初步研究
下一篇：
欧洲13个国家治疗急性咳嗽/下呼吸道感染的资源利用和医疗开支：结果与挑战
