难治性慢性咳嗽发病机制及治疗的研究进展  

Research Advances in Pathogenesis and Treatment of Chronic Refractory Cough

作　　者：刘智霖 马建岭[2] 史利卿[2] 王颖 王丽云[2] 李扭扭[2] 季坤[2] 董尚娟 温绍惠[2] Liu Zhilin;Ma Jianling;Shi Liqing(Beijing University of Chinese Medicine,Beijing 100029,China;Department of Respiratory and Fever Disease,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院呼吸热病科,北京100078 [3]浙江省中医院呼吸与危重症科,杭州310006

出　　处：《华中科技大学学报（医学版）》2022年第4期578-584,共7页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：国家自然科学基金资助项目(No.81373588);北京市自然科学基金资助项目(No.7192115,No.7184224);北京中医药大学科研基金资助项目(No.2017-JYB-JS-102);东方医院“1166”人才培养项目(No.040204001001002012)。

摘　　要：难治性慢性咳嗽(chronic refractory cough,CRC)是经过全面检查仍无法明确病因,或经过常规治疗后仍无明显缓解的咳嗽,其发病率在5%~12%,严重影响患者的生活质量。目前对CRC的研究尚在探索阶段,缺少专业、深入、系统的认识。关于发病机制,目前认为咳嗽高敏感性是CRC的关键特征和重要病理生理基础,与气道炎症反应、咳嗽中枢敏化、TRP通路激活有关;关于治疗,目前主要集中在药物治疗和非药物治疗两个方面,药物治疗主要包括中枢神经调节剂、受体拮抗剂以及大环内酯类抗生素、异丙托溴铵等,非药物治疗手段主要由言语病理治疗(speech pathology treatment,SPT)及咳嗽抑制性生理治疗构成。该文对CRC发病机制及治疗的研究进展进行了总结,旨在为CRC的防治和相关研究提供参考。Chronic refractory cough(CRC)is a cough that cannot be clearly identified after comprehensive examination,or has no obvious relief after conventional treatment.The prevalence of CRC is 5%-12%,and it seriously affects quality of life of patients.At present,research on CRC is still in the exploratory stage,lacking professional,in-depth and systematic understanding.In terms of pathogenesis,it is believed that cough hypersensitivity is a key feature and important pathophysiological basis of CRC,which is related to airway inflammatory response,central sensitization of cough,and activation of the TRP pathway.As for treatment,it includes pharmacological and non-pharmacological treatment.Pharmacological treatment refers to central neuromodulators,receptor antagonists,and macrolide antibiotics(such as ipratropium bromide,etc.).And non-pharmacological treatment refers to speech pathology treatment(SPT)and cough suppressive physiotherapy.In this paper,the pathogenesis and treatment of CRC will be summarize and discuss,aiming to provide reference for clinical practice and related researches.

关 键 词：难治性慢性咳嗽 发病机制 药物治疗 非药物治疗 

分 类 号：R56[医药卫生—呼吸系统]