慢性咳嗽治疗的新概念
2011/03/28
摘要
过去10年间，咳嗽治疗领域取得了显著进步。近期发现，阻塞性睡眠呼吸暂停、扁桃体肿大和环境真菌感染是慢性咳嗽的潜在病因。对胃食管反流(GOR)评价的改进，加深了对咳嗽与GOR相关性的了解，有可能改变GOR相关咳嗽的治疗方式。研究不明原因慢性咳嗽患者的表型，为咳嗽治疗提供了新视野。不明原因慢性咳嗽的患者主要为女性，主要在月经期出现咳嗽，而且特异性自身免疫性疾病（特别是甲状腺功能减退）的发生率较高。支气管肺泡淋巴细胞增多表明，自身免疫性炎症初始部位的炎症细胞存在向肺部迁移。咳嗽反射的重要性使得一些研究者认为，应该将慢性咳嗽定为咳嗽高反应性综合症(CHS)。已经开发出一些主观和客观工具，用于评价咳嗽敏感性。止咳药物的开发及其在随机对照试验中对这些药物的评价也不断出现，也是咳嗽研究的一个热点领域。
（林江涛 审校）
Pulm Pharmacol Ther. 2011 Jan 18. [Epub ahead of print]
New concepts in the management of chronic cough.
Birring SS.
King’s College London, Division of Asthma, Allergy and Lung Biology, London, United Kingdom.
Abstract
There has been significant progress in the field of cough in the past 10 years. Obstructive sleep apnoea, tonsillar enlargement and environmental fungi have recently been described as causes of chronic cough. The advances in the assessment of gastro-oesophageal reflux (GOR) have led to a greater understanding of the relationship between cough and GOR and are likely to change the approach to managing patients with GOR-cough. The investigation of the phenotype of patients with idiopathic chronic cough has provided novel insights. Patients with an idiopathic chronic are predominantly female, have an onset of cough around the menopause and have a high prevalence of organ specific autoimmune disease, particularly hypothyroidism. The presence of bronchoalveolar lymphocytosis suggests there is homing of inflammatory cells from primary sites of autoimmune inflammation to the lungs. The importance of heightened cough reflex sensitivity has led to some investigators to suggest that chronic cough be recognised as unique entity called Cough Hypersensitivity Syndrome (CHS). A number of subjective and objective tools have been developed recently to assess cough severity. Antitussive drug development and their assessment in randomised controlled clinical trials is an emerging and exciting area of cough research.
Pulm Pharmacol Ther. 2011 Jan 18. [Epub ahead of print]
过去10年间，咳嗽治疗领域取得了显著进步。近期发现，阻塞性睡眠呼吸暂停、扁桃体肿大和环境真菌感染是慢性咳嗽的潜在病因。对胃食管反流(GOR)评价的改进，加深了对咳嗽与GOR相关性的了解，有可能改变GOR相关咳嗽的治疗方式。研究不明原因慢性咳嗽患者的表型，为咳嗽治疗提供了新视野。不明原因慢性咳嗽的患者主要为女性，主要在月经期出现咳嗽，而且特异性自身免疫性疾病（特别是甲状腺功能减退）的发生率较高。支气管肺泡淋巴细胞增多表明，自身免疫性炎症初始部位的炎症细胞存在向肺部迁移。咳嗽反射的重要性使得一些研究者认为，应该将慢性咳嗽定为咳嗽高反应性综合症(CHS)。已经开发出一些主观和客观工具，用于评价咳嗽敏感性。止咳药物的开发及其在随机对照试验中对这些药物的评价也不断出现，也是咳嗽研究的一个热点领域。
（林江涛 审校）
Pulm Pharmacol Ther. 2011 Jan 18. [Epub ahead of print]
New concepts in the management of chronic cough.
Birring SS.
King’s College London, Division of Asthma, Allergy and Lung Biology, London, United Kingdom.
Abstract
There has been significant progress in the field of cough in the past 10 years. Obstructive sleep apnoea, tonsillar enlargement and environmental fungi have recently been described as causes of chronic cough. The advances in the assessment of gastro-oesophageal reflux (GOR) have led to a greater understanding of the relationship between cough and GOR and are likely to change the approach to managing patients with GOR-cough. The investigation of the phenotype of patients with idiopathic chronic cough has provided novel insights. Patients with an idiopathic chronic are predominantly female, have an onset of cough around the menopause and have a high prevalence of organ specific autoimmune disease, particularly hypothyroidism. The presence of bronchoalveolar lymphocytosis suggests there is homing of inflammatory cells from primary sites of autoimmune inflammation to the lungs. The importance of heightened cough reflex sensitivity has led to some investigators to suggest that chronic cough be recognised as unique entity called Cough Hypersensitivity Syndrome (CHS). A number of subjective and objective tools have been developed recently to assess cough severity. Antitussive drug development and their assessment in randomised controlled clinical trials is an emerging and exciting area of cough research.
Pulm Pharmacol Ther. 2011 Jan 18. [Epub ahead of print]
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持续非特异性咳嗽儿童和成人中胃-食管反流病的治疗
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慢性咳嗽评价和治疗的争论
