治疗慢性咳的方法
1Institute for Lung Health, Department of Respiratory Medicine, Allergy and Thoracic Surgery, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
Lancet (London, England)
|April 22, 2008
概括
慢性咳通常需要二次护理. 新的方法区分eosinophilic和non-eosinophilic咳,强调加剧的咳反射,以更好地开发治疗.
科学领域:
- 肺部病理学 肺部病理学
- 临床医学 临床医学
- 病理生理学 病理生理学
背景情况:
- 无法解释的慢性咳是经常转诊到二级护理的原因.
- 目前的管理通常依赖于病例系列,将咳归因于喘,逆流或上呼吸道疾病.
- 在二级护理中,很大一部分患者无法达到令人满意的咳控制.
研究的目的:
- 倡导慢性咳管理的范式转变.
- 要区分对皮质类固醇反应的异性气道疾病和抗皮质类固醇的非异性咳.
- 鼓励研究加剧咳反射的病理生理学和新型抗咳治疗方法.
主要方法:
- 对慢性咳管理现有证据的审查.
- 根据呼吸道炎症和反射灵敏度重新分类咳的建议.
- 评估加重因素与内在反射异常的建议.
主要成果:
- 对喘,逆流和上呼吸道疾病的传统治疗方法对慢性咳并不普遍有效.
- 有相当数量的慢性咳患者在标准治疗中耐药.
- 认为伴随性疾病仅仅是咳的原因,可能会阻碍反射病理生理学的研究.
结论:
- 需要明确区分eosinophilic和non-eosinophilic咳是必要的.
- 证据较弱的因素应被认为是加重咳反射异常的原因,而不是原因.
- 对加剧咳反射的机制和药理控制的进一步研究对于开发改进的治疗方法至关重要.
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