长期低剂量红霉素治疗不明原因咳嗽：一项双盲安慰剂对照试验
2010/12/17
摘要
目的：不明原因的慢性咳嗽治疗起来疗效常常不令人满意。前期的研究显示，咳嗽可能与中性粒细胞性炎症有关。本试验在不明原因慢性咳嗽患者中研究长期低剂量红霉素治疗是否能够减少诱导痰液中的中性粒细胞计数和24h咳嗽频率。
方法：存在不明原因的慢性咳嗽，且持续8周以上的30名患者入选本项研究。这些患者随机分为250 mg红霉素每天一次组(n=15)和安慰剂组(n=15)。治疗持续12周，采用双盲平行组研究方法。在基线状态及第6、12和24周时，评价咳嗽频率、咳嗽反射敏感性和咳嗽严重程度。主要检测结果为第12周时的24 h咳嗽频率变化情况。
结果：两组在12周及其它时间点时，咳嗽频率不存在显著差异（平均变化倍数差异1.1；95% CI 0.7～1.5；p=0.585）。痰液中性粒细胞计数变化在12周时，两组间存在显著差异（红霉素组和安慰剂组分别为−10.2% vs +6.6%；平均差异16.8%；95% CI 1.6至32.1；p=0.03），但在其它时间点时未见显著差异。其它咳嗽指标两组间未见显著差异。
结论：采用低剂量红霉素治疗12周能减少不明原因慢性咳嗽患者诱导痰液中的中性粒细胞计数，但对咳嗽频率和咳嗽严重程度无显著影响。
（陈欣 审校）
Thorax. 2010 Oct 21. [Epub ahead of print]
Long-term low-dose erythromycin in patients with unexplained chronic cough: a double-blind placebo controlled trial.
Yousaf N, Monteiro W, Parker D, Matos S, Birring S, Pavord ID.
Institute for Lung Health, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
Abstract
Aims Unexplained chronic cough is a common condition with no satisfactory treatments. Previous work has suggested that cough may be linked to neutrophilic airway inflammation. This study tested the hypothesis that long-term low-dose erythromycin reduces the induced sputum neutrophil count and 24h cough frequency in patients with unexplained chronic cough. Methods 30 patients with an unexplained chronic cough lasting more than 8 weeks were randomly assigned to take 250 mg erythromycin once daily (n=15) or placebo (n=15) for 12 weeks in a double-blind parallel group study. Cough frequency, cough reflex sensitivity and cough severity were assessed at baseline, 6, 12 and 24 weeks. The primary outcome measure was change in 24 h cough frequency at 12 weeks. Results There was no difference in the change in cough frequency between the erythromycin and placebo groups at 12 weeks (mean difference in fold change 1.1; 95% CI 0.7 to 1.5; p=0.585) or at other times. There was a statistically significant between-treatment difference in the change in sputum neutrophils at 12 weeks (−10.2% vs +6.6% with erythromycin and placebo; mean difference 16.8%; 95% CI 1.6 to 32.1; p=0.03) but not at other times. There was no difference in the change in other measures of cough between treatments. Conclusions Treatment with low-dose erythromycin for 12 weeks reduces the induced sputum neutrophil count but not cough frequency or severity in patients with unexplained chronic cough.
Thorax. 2010 Oct 21. [Epub ahead of print]
目的：不明原因的慢性咳嗽治疗起来疗效常常不令人满意。前期的研究显示，咳嗽可能与中性粒细胞性炎症有关。本试验在不明原因慢性咳嗽患者中研究长期低剂量红霉素治疗是否能够减少诱导痰液中的中性粒细胞计数和24h咳嗽频率。
方法：存在不明原因的慢性咳嗽，且持续8周以上的30名患者入选本项研究。这些患者随机分为250 mg红霉素每天一次组(n=15)和安慰剂组(n=15)。治疗持续12周，采用双盲平行组研究方法。在基线状态及第6、12和24周时，评价咳嗽频率、咳嗽反射敏感性和咳嗽严重程度。主要检测结果为第12周时的24 h咳嗽频率变化情况。
结果：两组在12周及其它时间点时，咳嗽频率不存在显著差异（平均变化倍数差异1.1；95% CI 0.7～1.5；p=0.585）。痰液中性粒细胞计数变化在12周时，两组间存在显著差异（红霉素组和安慰剂组分别为−10.2% vs +6.6%；平均差异16.8%；95% CI 1.6至32.1；p=0.03），但在其它时间点时未见显著差异。其它咳嗽指标两组间未见显著差异。
结论：采用低剂量红霉素治疗12周能减少不明原因慢性咳嗽患者诱导痰液中的中性粒细胞计数，但对咳嗽频率和咳嗽严重程度无显著影响。
（陈欣 审校）
Thorax. 2010 Oct 21. [Epub ahead of print]
Long-term low-dose erythromycin in patients with unexplained chronic cough: a double-blind placebo controlled trial.
Yousaf N, Monteiro W, Parker D, Matos S, Birring S, Pavord ID.
Institute for Lung Health, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
Abstract
Aims Unexplained chronic cough is a common condition with no satisfactory treatments. Previous work has suggested that cough may be linked to neutrophilic airway inflammation. This study tested the hypothesis that long-term low-dose erythromycin reduces the induced sputum neutrophil count and 24h cough frequency in patients with unexplained chronic cough. Methods 30 patients with an unexplained chronic cough lasting more than 8 weeks were randomly assigned to take 250 mg erythromycin once daily (n=15) or placebo (n=15) for 12 weeks in a double-blind parallel group study. Cough frequency, cough reflex sensitivity and cough severity were assessed at baseline, 6, 12 and 24 weeks. The primary outcome measure was change in 24 h cough frequency at 12 weeks. Results There was no difference in the change in cough frequency between the erythromycin and placebo groups at 12 weeks (mean difference in fold change 1.1; 95% CI 0.7 to 1.5; p=0.585) or at other times. There was a statistically significant between-treatment difference in the change in sputum neutrophils at 12 weeks (−10.2% vs +6.6% with erythromycin and placebo; mean difference 16.8%; 95% CI 1.6 to 32.1; p=0.03) but not at other times. There was no difference in the change in other measures of cough between treatments. Conclusions Treatment with low-dose erythromycin for 12 weeks reduces the induced sputum neutrophil count but not cough frequency or severity in patients with unexplained chronic cough.
Thorax. 2010 Oct 21. [Epub ahead of print]
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