哮喘联盟

摘要
   背景：患者自己进行雾化吸入利多卡因治疗慢性咳嗽的长期安全尚不清楚。
   方法：本试验为一项回顾性研究，2002～2007年间接受利多卡因雾化吸入的成人慢性咳嗽患者入选本研究。设计调查问卷，在利多卡因雾化吸入试验后采用该问卷询问有关不良反应和雾化吸入利多卡因的有效性。对于未收到回复者，通过2次邮件和1次邮件后电话访谈进行随访。若问卷调查显示出现不良反应，则进行结构式电话访谈，以获取更多的详细信息。
   结果：165名患者入选本研究，99名（60%）患者对问卷进行回复。回复者的平均年龄为62岁（范围：29～87岁），77名（79%）为女性，80名（82%）为白人。在利多卡因雾化吸入治疗前，平均咳嗽病程为5年。在采用利多卡因雾化吸入的患者中（93%的调查回复者），43%的患者主诉出现不良反应。然而，这些不良反应不需要急诊就诊、住院治疗，也无因吸入性肺炎而需抗生素治疗的患者。治疗前的咳嗽严重程度评分为8.4 (1.6) ，治疗后为5.9 (3.4) （P<0.001）。主诉咳嗽症状改善的患者中（49%），80%的患者主诉在用药后2周内即出现改善。
   结论：成人能耐受自我给药进行利多卡因雾化吸入治疗难治性咳嗽。49%的患者咳嗽症状得到控制，未观察到严重的不良反应。

                                                                                            (林江涛 审校)
                                    Chest. 2012 Dec 13. doi: 10.1378/chest.12-1533. [Epub ahead of print]


Long-Term Safety of Nebulized Lidocaine for Adults with Difficult-to-Control Chronic Cough: A Case Series.

Lim KG, Rank MA, Hahn P, Keogh KA, Morgenthaler TI, Olson EJ.

Abstract
ABSTRACT BACKGROUND: The long-term safety of patient-administered nebulized lidocaine for control of chronic cough has not been established.
METHODS: We performed a retrospective study of adults who received a prescription and nurse education for nebulized lidocaine for chronic cough between 2002 and 2007. A survey questionnaire inquiring about adverse reactions and the effectiveness of nebulized lidocaine was developed and administered to these individuals after the nebulized lidocaine trial. We conducted 2 mailings and a postmailing phone follow-up to nonresponders. When adverse events were reported in the questionnaire response, a structured phone interview was conducted to obtain additional details.
RESULTS: Of 165 eligible patients, 99 (60%) responded to the survey. Responders were a median age of 62 years (range, 29-87 years), 77 (79%) were female, and 80 (82%) were white. The median duration of cough was 5 years before treatment with nebulized lidocaine. Of the patients who used nebulized lidocaine (93% of survey responders), 43% reported an adverse event. However, none of these events required an emergency visit, hospitalization, or antibiotic therapy for aspiration pneumonia. The mean (SD) of the pretreatment cough severity score was 8.4 (1.6) and posttreatment was 5.9 (3.4) (P&lt;.001). Of the patients reporting improvement in cough symptoms (49%), 80% reported improvement within the first 2 weeks.
CONCLUSIONS: Adults tolerated self-administration of nebulized lidocaine for difficult-to-control chronic cough. No serious adverse effects occurred while providing symptomatic control in 49% of patients.

Chest. 2012 Dec 13. doi: 10.1378/chest.12-1533. [Epub ahead of print]