哮喘联盟

   摘要
   慢性咳嗽是患者寻求药物治疗的一个常见原因。近几十年，“评估和治疗导致慢性咳嗽原因”理论的应用使我们取得了显著的成功。然而，我们仍然自问“慢性咳嗽的潜在机制是什么”。确实，相当一部分患者的咳嗽是先天性的，或者积极评估仍无法解释的。常见的相关情况，如鼻炎、嗜酸粒细胞支气管炎、哮喘或胃食管返流可能不是咳嗽发生的根本原因，可能是激发因素而非病因。慢性咳嗽的主要特征是持续上调的咳嗽反射，可能是生物、神经、免疫、基因、并发症和环境因素共同作用的结果。我们认为“咳嗽过敏综合征”的新理论最终可使我们进一步理解和处理慢性咳嗽。
 

（刘国梁 审校）
Asia Pac Allergy. 2014 Jan;4(1):3-13. Epub 2014 Jan 31.
 

Changing the paradigm for cough: does 'cough hypersensitivity' aid our understanding?
 

Song WJ1, Chang YS2, Morice AH3.
 

Abstract
Chronic cough is a common reason for patients to seek medication attention. Over the last few decades, we have experienced significant clinical success by applying the paradigm of 'evaluating and treating the causes for chronic cough'. However, we still ask ourselves 'what underlies chronic cough. Indeed in a considerable proportion of patients cough is idiopathic, or unexplained despite vigorous evaluation. Commonly associated conditions such as rhinitis, eosinophilic bronchitis, asthma, or gastroesophageal acidic reflux may not be fundamental to cough, and thus may be triggers rather than causes. The cardinal feature of chronic cough is persistent upregulation the cough reflex, which may be driven by complex interactions between biologic, neurologic, immunologic, genetic, comorbid, and environmental factors. We suggest the new paradigm 'cough hypersensitivity syndrome' should finally bring us further advances in understanding and management of chronic cough.
 

Asia Pac Allergy. 2014 Jan;4(1):3-13. Epub 2014 Jan 31.