208例慢性咳嗽患者的临床病例分析  

Clinical analysis of 208 cases of chronic cough

作　　者：魏兵[1] 畅怡[1] 赵松林[1] 周玉涛[1] 陈玉[1] 张威[1] 

机构地区：[1]首都医科大学宣武医院呼吸科,北京100053

出　　处：《临床肺科杂志》2017年第8期1418-1421,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨慢性咳嗽患者的临床诊治流程。方法收集2015年3月至2016年6月于首都医科大学宣武医院住院治疗及门诊就诊的慢性咳嗽患者208例,其中女98例,男110例,平均年龄48.64±12.14岁,采集病史、辅助检查、治疗用药。结果 36例有过敏性鼻炎或过敏家族史,21例有家庭装修及周围环境变化诱因,28例有高血压病史,其中7例应用ACEI类药物,59例有吸烟史。208例患者酌情进行了相关检查:包括血常规、嗜酸细胞计数、过敏原、Ig E、气道激发试验、胸片或CT、呼出气一氧化氮、睡眠呼吸监测、食道PH值监测、冷凝集试验、支原体抗体、D-二聚体、心电图、心脏超声、支气管镜检查,176例患者进行了耳鼻喉科专科检查;95%患者诊断明确,5%的患者慢性咳嗽病因未明;所有患者均接受了药物治疗,其中186例患者接受了中药治疗。结论咳嗽变异性哮喘是慢性咳嗽第一位原因,慢性咳嗽治疗应全面评估患者,经验性治疗及病因导向治疗相结合。Objective To investigate the clinical diagnosis and treatment of chronic cough patients. Methods A total of 208 patients with chronic cough, including 98 males and 110 males, with an average age of 48.64±12.14 years, were recruited from Xuanwu Hospital of Capital University of Medical Sciences from March 2015 to June 2016.Their medical history, auxiliary examination, and treatment medication were collected.Results There were 36 cases of allergic rhinitis or family history of allergies, 21 cases of home decoration or environment changes, 28 cases of a history of high blood pressure, including 7 cases of application of ACEI drugs, and 59 patients with a history of smoking.They were given blood routine, acidophilic cell counting, allergic source, IgE, airway proocation tests, chest X-ray or CT, breath nitric oxide, sleep apnea monitoring, esophageal PH monitoring, condensation test, mycoplasma antibodies, D-dimer, electrocardiogram, echocardiogram, and bronchoscopy.176 patients underwent ENT specialist examination.95% of patients diagnosed, and 5% of patients with chronic cough cause were unknown.All patients were treated with drugs, of which 186 patients received traditional Chinese medicine treatment.Conclusion Cough variant asthma is the first cause of chronic cough, and the treatment of chronic cough should be a comprehensive assessment, combined with empiric therapy and etiology-oriented therapy.

关 键 词：慢性咳嗽 经验性治疗 病因导向治疗 

分 类 号：R56[医药卫生—呼吸系统]