Cough reflex is additively potentiated by inputs from the laryngeal and tracheobonchial receptors and enhanced by stimulation of the central respiratory neurons

The cough is an essential airway defense reflex. In this study we investigated the coordination of inputs from the laryngeal and tracheobronchial receptors in the cough reflex. In 15 beagle dogs (7–9 kg) lightly anesthetized with intravenous profobol (20–30 mg/kg/h), the cough response was elicited with mechanical stimulation of either the vocal chord or tracheal bifurcation. Simultaneous stimulation of both sites increased all the parameters of cough strength, that is, mean pleural pressure (P _pl), mean expiratory flow, number of cough bouts, and cough duration, in comparison with stimulation of the sites individually. The increases in mean P _pl and cough duration reached statistical significance (13.3 vs. 18.4 cmH₂O and 13.3 vs. 18.2 s, respectively). When the anesthetic level became deeper, the prolongation of cough duration almost disappeared, but the augmentation of mean P _pl was much less affected. During stimulation of the central respiratory neurons by intravenous dimorphoramine or acute hyperoxic hypercapnia, the cough strength increased significantly. We concluded that inputs from the laryngeal and tracheobonchial cough receptors acted in concert and potentiated the cough reflex. Furthermore, stimulation of the central respiratory neurons may increase the intensity of a cough response.     

养阴润肺口服液治疗感冒后咳嗽的临床疗效观察

目的:观察养阴润肺口服液对感冒后咳嗽的临床疗效。方法:将137例感冒后咳嗽病例分为2组:试验组69例口服养阴润肺口服液,每次20mL,每日2次;对照组68例口服川贝枇杷糖浆,每次10mL,每日3次;疗程均为10d。比较2组临床总有效率和主要症状改善情况。结果:试验组总有效率显著优于对照组(P<0.05);主要症状咳嗽、咳久痰少、咯吐不爽、痰黏或夹血丝方面较对照组有改善;而痰液性质、咽干口燥方面改善情况显著优于对照组(P<0.05)。结论:养阴润肺口服液治疗感冒后咳嗽效果较好。     

小儿喘咳液合苍耳子散对哮喘大鼠血清IFN-γ、IL-4、ECP表达影响的研究

目的：研究小儿喘咳液合苍耳子散对哮喘的疗效及作用的机制。方法：将90只大鼠随机分成空白组、模型组、西药组、喘咳液大、中、小剂量组与合方大、中、小剂量组9个组,每组10只,进行哮喘气道重塑模型制备,分别用采用不同的干预方案,观察各组大鼠症状及血清干扰素-γ（IFN-γ）、白细胞介素4（IL-4）、嗜酸性粒细胞阳离子蛋白（ECP）的变化。结果：与空白组比较,模型组大鼠血清IFN-γ水平明显下降,IL-4、ECP水平明显上升,IFN-γ／IL-4比值明显下降,差异均有非常显著性意义（P〈0．01）;与模型组比较,西药组、喘咳液各剂量组及合方各剂量组IFN-γ水平明显上升,IL-4、部分组别ECP水平下降,IFN-γ／IL-4比值明显上升,差异有显著性或非常显著性意义（P〈0．05,P〈0．01）。结论：小儿喘咳液合苍耳子散抑制气道炎症的直接作用机制为调整失衡Th1／Th2类细胞因子的比值,降低血清ECP水平。     

In vivo anti-tussive activity and structural features of a polysaccharide fraction from water extracted Withania somnifera

Aim of the study

Anti-tussive drugs are amongst the most widely used medications worldwide; however no new class of drugs has been introduced into the market for many years. The present study aims at evaluating the structural features and in vivo anti-tussive activity of a polysaccharide fraction from water extracted Withania somnifera.

Materials and methods

Herein, we have analyzed water extracted material of Withania somnifera using chemical, chromatographic, spectroscopic and biological methods.

Results

A polysaccharide fraction (F3) containing arabinosyl, galactosyl and galacturonosyl residues were obtained by anion exchange chromatography of the water extracted material. This polymer is branched and contained (1,5)-/(1,3,5)-linked arabinofuranosyl, (1,3)-/(1,6)-/(1,3,6)-linked galactopyranosyl residues together with small amount of terminal rhamnopyranosyl and terminal arabinofuranosyl residues. Peroral administration of this pectic arabinogalactan in a dose of 50 mg kg⁻¹ body weight (b.w.) decreased the number of cough efforts induced by citric acid in guinea pigs like that of codeine.

Conclusions

This study provides a scientific basis for the past and present ethnomedical uses of this plant.     

Angiotensin-converting enzyme inhibitor associated cough: deceptive information from the Physicians' Desk Reference

Background

Dry cough is a common, annoying adverse effect of all angiotensin-converting enzyme (ACE) inhibitors. The present study was designed to compare the rate of coughs reported in the literature with reported rates in the Physicians' Desk Reference (PDR)/drug label.

Methods

We searched MEDLINE/EMBASE/CENTRAL for articles published from 1990 to the present about randomized clinical trials (RCTs) of ACE inhibitors with a sample size of at least 100 patients in the ACE inhibitors arm with follow-up for at least 3 months and reporting the incidence or withdrawal rates due to cough. Baseline characteristics, cohort enrolled, metrics used to assess cough, incidence, and withdrawal rates due to cough were abstracted.

Results

One hundred twenty-five studies that satisfied our inclusion criteria enrolled 198,130 patients. The pooled weighted incidence of cough for enalapril was 11.48% (95% confidence interval [CI], 9.54% to 13.41%), which was ninefold greater compared to the reported rate in the PDR/drug label (1.3%). The pooled weighted withdrawal rate due to cough for enalapril was 2.57% (95% CI, 2.40-2.74), which was 31-fold greater compared to the reported rate in the PDR/drug label (0.1%). The incidence of cough has increased progressively over the last 2 decades with accumulating data, but it has been reported consistently several-fold less in the PDR compared to the RCTs. The results were similar for most other ACE inhibitors.

Conclusion

The incidence of ACE inhibitor-associated cough and the withdrawal rate (the more objective metric) due to cough is significantly greater in the literature than reported in the PDR/drug label and is likely to be even greater in the real world when compared with the data from RCTs. There exists a gap between the data available from the literature and that which is presented to the consumers (prescribing physicians and patients).     

小柴胡汤加味治疗感染后咳嗽邪郁少阳证的临床疗效观察

目的:观察小柴胡汤加味治疗感染后咳嗽邪郁少阳证患者的临床疗效及安全性,丰富感染后咳嗽治疗的临床思路.方法:选取2019年2月—2020年12月就诊于江西中医药大学附属医院呼吸与危重症医学科门诊的60例患者,随机分为观察组和对照组,各30例.对照组采用口服可待因桔梗片联合氯雷他定片治疗,观察组采用小柴胡汤加味治疗,比较两...     

65例咳嗽变异型哮喘临床分析

目的探讨咳嗽变异型哮喘（CVA）的临床诊断与治疗,提高对CVA的认识,减少误诊。方法回顾性分析65例咳嗽变异型哮喘患者的临床资料,总结其临床特征及治疗效果。结果CVA常以咳嗽为唯一症状,咳嗽以凌晨和／或夜间发作明显,支气管激发／舒张试验阳性,支气管扩张荆和糖皮质激素治疗有效。结论CVA是慢性咳嗽常见病因,应提高对本病的认识,ICS长期治疗可能阻止其发展成典型哮喘。     

本刊对统计学方法的要求

统计学符号按GB 3358—1982《统计学名词及符号》的有关规定一律采用斜体排印,常用：①样本的算术平均数用英文小写孑(中位数用肘);②标准差用英文小写s;③标准误用英文小写靠;④￡检验用英文小写t;⑤F检验用英文大写F;⑥膏方检验用希文小写f;⑦相关系数用英文小写r;⑧自由度用希文小写l'';⑨概率用英文大写JP(P值前应给出具体检验值,如￡值、f值、g值等),P值应给出实际数值,不宜用大于或小于表示,而用等号表示,小数点后保留3位数。     

咳嗽变异性哮喘患儿血清巨噬细胞炎性蛋白-1α水平的变化及其意义

目的 探讨咳嗽变异性哮喘患儿血清巨噬细胞炎性蛋白-1α(MIP-1α)水平的变化及其在鉴别诊断中的临床价值.方法 选择我院收治的感染性咳嗽患儿(感染性咳嗽组)49例,咳嗽变异性哮喘患儿(咳嗽变异性哮喘组)37例及体检无异常儿童30例(正常组),检测并比较3组儿童的血清MIP-1α水平.结果 3组儿童的血清MIP-1α水平间差异有统计学意义(P<0.01).其中感染性咳嗽组、正常组与咳嗽变异性哮喘组比较血清MIP-1α水平间差异均有统计学意义(P<0.05);而感染性咳嗽组与正常组儿童血清MIP-1α水平间差异无统计学意义(P>0.05).咳嗽变异性哮喘患儿血清MIP-1α水平与咳嗽的持续时间呈正相关(P<0.05).结论 血清MIP-1α水平可反映气道炎症类型,是鉴别感染性咳嗽与咳嗽变异性哮喘的一项参考指标.     

孟鲁司特治疗儿童咳嗽变异性哮喘的临床观察

目的:观察孟鲁司特治疗儿童咳嗽变异性哮喘的临床疗效和安全性.方法:将65例咳嗽变异性哮喘患儿随机分为治疗组32例和对照组33例,分别给予酮替酚和孟鲁司特口服,连用6个月.结果:治疗组达到临床缓解所需时间及随访半年的复发率均明显低于对照组(P<0.01和P<0.05),而治疗3个月及6个月时呼气峰流速(PEF)预计值>90%的比率则高于对照组(P<0.05),且未见明显不良反应.结论:孟鲁司特治疗儿童咳嗽变异性哮喘安全有效,可改善肺功能,降低复发率.