哮喘联盟

   摘要
   前言：目前临床上仍缺乏有效的止咳药。研究表明，咳嗽是由于一系列不同的迷走神经输入导致的。目前一种比较被广为接受的理论表示，咳嗽反射敏感性的慢性增加与炎症性高敏感性相关，比如由胃食管反流性疾病导致。越来越多的证据表明，迷走神经喉支的感知障碍是重要的机制之一。神经调节药物在治疗慢性疼痛及神经病变性疾病中非常有效，因此，其可能在治疗难治性慢性咳嗽（CC）方面也是有效果的。
   研究范围：我们对加巴喷丁在难治性慢性咳嗽患者群体中的治疗效果和安全性进行评估。我们在PubMed数据库中检索近10年来发表的与咳嗽、感觉神经病和加巴喷丁相关的英文文献，包括随机对照临床试验、病例报道以及综述等。
   专家意见：加巴喷丁对于治疗慢性咳嗽以及其它感觉神经病变性疾病方面均有较好的疗效，并且可以被很好地耐受。但是目前仍缺乏相关临床试验以评估其在慢性咳嗽患者群体中的治疗效果以及安全性，因此，其在慢性咳嗽患者群体中的应用需要进一步研究。过量使用加巴喷丁仅导致微小的毒副作用或没有毒副作用。
 

（刘国梁 审校）
Expert Opin Pharmacother. 2014 Nov 7:1-11. [Epub ahead of print]

 

A review on the efficacy and safety of gabapentin in the treatment of chronic cough.
 

Ryan NM.
 

ABSTRACT
INTRODUCTION: Effective antitussives available to control cough are limited. Consolidation among different afferent branches of the vagus nerve is needed to bring about cough. A general, widely accepted view is that the chronic increase in the sensitivity of the cough reflex is associated with inflammatory hypersensitivity such as from gastro-esophageal reflux disease. There is increasing evidence that an important mechanism is a sensory disorder of the laryngeal branches of the vagus nerve. Neuromodulating drugs are effectively used in the treatment of chronic pain and neuropathic disorders and may have a role in the treatment of refractory chronic cough (CC).
AREAS COVERED: Current evidence on the efficacy and safety of gabapentin in the treatment of CC is reviewed. Relevant randomized controlled trials, case reports and reviews were identified through a PubMed search of English-language literature referring to cough, sensory neuropathy and gabapentin over the last 10 years.
EXPERT OPINION: Gabapentin appears to be effective and well tolerated in the treatment of CC and in other sensory neuropathic disorders. Relevant clinical trials investigating its efficacy and safety profile in the treatment of cough are limited and further studies are needed. Gabapentin has been shown to cause minimal to no toxicity in overdose.
 

Expert Opin Pharmacother. 2014 Nov 7:1-11. [Epub ahead of print]