止咳抗敏汤治疗咳嗽变异型哮喘45例

目的评价止咳抗敏汤对咳嗽变异型哮喘的临床疗效。方法将咳嗽变异型哮喘患者90例随机分为治疗组与对照组,各45例,中药组予止咳抗敏汤,对照组予西药平喘、抗过敏治疗。结果治疗组临床总有效率为93.33%,对照组临床总有效率为73.33%,两组疗效差异具有统计学意义(P<0.01);治疗组咳嗽及咳痰症状控制优于对照组(P<0.01)。结论止咳抗敏汤能有效缓解咳嗽变异型哮喘的临床症状。     

慢性咳嗽和喘息性疾病支气管肺泡灌洗液成分分析

目的 分析慢性咳嗽及喘息性疾病患儿支气管肺泡灌洗液成分。方法 应用免疫组化及ELISA方法，对哮喘（13例）、慢性咳嗽（10例）、婴幼儿喘鸣（8例）患儿和对照组（8例）共39例的支气管肺泡灌洗液进行细胞学分析及上清液IL－5浓度测定。结果 哮喘患儿支气管肺泡灌洗液嗜酸性粒细胞为3．0％（0．7％－8．8％），上皮细胞为3．0％（0．7％－12．0％），IL－5为1．7ng/L(0－16.0ng/L)，与慢性咳嗽组及婴幼儿喘鸣组相比，差异有非常显著意义（P＜0．01）；2例慢性咳嗽及3例婴幼喘鸣儿哮酸性粒细胞亦有异常增多，与组内其他必相比差异有显著意义；婴幼儿喘鸣组中性粒细胞明显增多。结论 哮喘患儿支气管肺泡灌洗液以嗜酸性粒细胞和上皮细胞明显增多为其特征性改变；慢性咳嗽患儿中有嗜酸性粒细胞异常增多者，应注意与哮喘鉴别；婴幼儿喘鸣者以中性粒细胞增多为著，抗哮喘治疗应慎重。     

长托宁、地塞米松预注抑制芬太尼咳嗽反射

目的观察长托宁、地塞米松预注抑制芬太尼咳嗽反射的有效性。方法选择全麻病人100例，随机分为实验组（Ⅰ组）和对照组（Ⅱ组），每组50例。Ⅰ组病人于芬太尼静注前10min静注长托宁0．5mg、地塞米松5mg，观察两组病人静注分太尼后1min发生反射性咳嗽的例数（发生率）并进行比较。结果Ⅰ组病人发生发射性咳嗽4例（8％）；Ⅱ组病人发生反射性咳嗽18例（36％），两组有极显著性差异（P〈0．01）。结论长托宁、地塞米松预注能够抑制芬太尼的咳嗽反射。     

澳特斯治疗急性支气管炎咳嗽的效果评价

目的探讨澳特斯治疗急性支气管炎咳嗽的效果。方法选择确诊的400例急性支气管炎，随机分成治疗组和对照组。两组均在控制感染的基础上，治疗组口服澳特斯，对照组口服急支糖浆，均不用其它镇咳化痰药物及糖皮质激素，疗程5d。观察两组治疗前、治疗后3d及5d咳嗽频度、咳嗽强度、咳痰量、咳痰难易程度评分及综合评分变化。结果两组治疗后咳嗽频度、咳嗽强度、咳痰量、咳痰难易程度均较治疗前明显减轻（P〈0．01）；治疗后3d两组咳嗽频度、咳嗽强度、咳嗽量、咳痰难易程度的有效率比较差异有非常显著性意义（P〈0．01）；疗后5d，两组咳嗽强度有效率比较差异有非常显著性意义（P〈0．01），咳嗽频度、咳痰难易程度有效率比较差异有显著性意义（P〈0．05），咳痰量有效率比较差异无显著性意义（P〉0．05）；两组咳嗽、咳痰持续时间比较差异有非常显著性意义（P〈0．01）；两组综合疗效中临床控制率、总有效率比较差异有显著性意义（P〈0．05）。结论澳特斯治疗急性支气管炎咳嗽疗效显著、依从性好、安全度高。     

不同病因慢性咳嗽的咳嗽程度比较

目的探讨不同病因慢性咳嗽患者咳嗽程度的异同及可能的影响因素。方法按慢性咳嗽病因诊断程序进行病因诊断，收集单一病因慢性咳嗽患者150例，通过咳嗽积分评价，比较不同病因患者日间及夜间咳嗽程度的差异及其与年龄、性别、病程的关系。结果纳入患者包括鼻后滴流综合征24例，咳嗽变异型哮喘26例、胃食管反流性咳嗽20例，嗜酸细胞性支气管炎31例，变应性咳嗽30例及感染后咳嗽19例。各组间的日间咳嗽积分比较差异无统计学意义（P〉0．05）。咳嗽变异型哮喘组的夜间秋分明显高于鼻后滴流综合征、胃食管反流性咳嗽、嗜酸粒细胞性支气管炎、变应性咳嗽及感染后咳嗽组（均P〈0．01）。分别对日间咳嗽积分和夜间咳嗽积分进行有序分类logistic回归分析，显示年龄与日间咳嗽积分有关（P〈0．05），性别与夜间咳嗽积分有关（P〈0．01）。结论不同病凶慢性咳嗽的日间咳嗽程度类似，但咳嗽变异型哮喘夜间咳嗽程度显著高于其他病因的咳嗽。     

Bronchial asthma and wheeze in a desert country

A cross-sectional, population-based study was conducted among school children (3300), aged 7–12 years, in the Kingdom of Saudi Arabia, during the period January, 1988–February, 1990. The aim of the study was to investigate the association between asthma, allergic rhinitis, wheeze and eczema among Saudi school children. The relationship between pet-ownership and respiratory allergy was also studied. Detailed information was collected about wheeze and asthma in 3041 children and history of asthma and allergic rhinitis in their parents. The population sample had a high prevalence rate of diagnosed asthma (6.8%), history of wheeze (10.5%), allergic rhinitis (17.9%), and eczema (10.8%). Allergic rhinitis was the most frequently seen respiratory illness when compared to other respiratory symptoms. The prevalence rate of asthma, allergic rhinitis and eczema among parents reflected the same pattern as that seen in the children. Prevalence rate for asthma in children with pets is twice that of children without pets (OR:2.4; 95%, Cl:1.8–3.1). The odds of having chronic cough (OR:3.9; 95%, Cl:2.8–5.2), chronic wheeze (OR:4.2; 95%, 3.3–5.4), allergic rhinitis (OR:8.0; 95% Cl:6.3–10.3) and eczema (OR:2.8:95 Cl:2.1–3.7) was higher in children with pets than in children without pets. The present study revealed that petownership was associated with increased respiratory symptoms.     

Diary cards and the assessment of cough symptoms in community pharmacies

The aim of this study is to compare cough symptom assessment and medication efficacy as recorded in a diary card with that obtained through direct questioning by a pharmacist. Clients visiting six pharmacies, purchasing a cough medication and meeting the inclusion criteria were recruited. They were asked to fill out diary cards to obtain a daily retrospective assessment of symptoms and medication efficacy. After three days the subjects returned to the pharmacy and were asked to recall their symptoms through a structured questionnaire administered by the pharmacist.48 clients were recruited to the study and of these 44 (92% completed the study. A good correlation was obtained between ratings of medication efficacy as recorded by diary cards and recall. Symptom assessment also showed a statistically significant correlation for days two and three only.For studies assessing symptoms over a 48 hour period, detailed poststudy assessments may not be required. The study provides further evidence for the viability of clinical trials conducted through community pharmacies.     

67例慢性咳嗽病因分析

目的 探讨67例慢性咳嗽患的病因。方法 按照慢性咳嗽解剖学诊断程序，详细询问持续咳嗽4周以上的患的现病史及既往史，仔细作体格检查和胸部和鼻窦X线检查。结果 67例慢性咳嗽患中，鼻后滴漏综合征31例(46．27％)，变异性哮喘13例(19．40％)，胃食道反流综合征5例(7．46％)，鼻后滴漏综合征 变异性哮喘6例(8．96％)，慢性支气管炎5例(7．46％)，支气管扩张4例(5．97％)，鼻窦骨瘤、囊肿各1例(2．99％)，原因不明1例(1．49％)。结论 慢性咳嗽由多种病因引起，通过解剖学诊断程序基本可以明确诊断，治疗可获得满意的效果。     

Mast cells in citric acid-induced cough of guinea pigs

It was demonstrated previously that mast cells play an important role in citric acid (CA)-induced airway constriction. To investigate the role of mast cells in CA-induced cough, three experiments were carried out in this study. In the first experiment, 59 guinea pigs were employed and we used compound 48/80 to deplete mast cells, cromolyn sodium to stabilize mast cells, MK-886 to inhibit leukotriene synthesis, pyrilamine to antagonize histamine H(1) receptor, methysergide to antagonize serotonin receptor, and indomethacin to inhibit cyclooxygenase. In the second experiment, 56 compound 48/80-pretreated animals were divided into two parts; the first one was used to test the role of exogenous leukotriene (LT) C(4), while the second one to test the role of exogenous histamine in CA-induced cough. Each animal with one of the above pretreatments was exposed sequentially to saline (baseline) and CA (0.6 M) aerosol, each for 3 min. Then, cough was recorded for 12 min using a barometric body plethysmograph. In the third experiment, the activation of mast cells upon CA inhalation was investigated by determining arterial plasma histamine concentration in 17 animals. Exposure to CA induced a marked increase in cough number. Compound 48/80, cromolyn sodium, MK-886 and pyrilamine, but not indomethacin or methysergide, significantly attenuated CA-induced cough. Injection of LTC(4) or histamine caused a significant increase in CA-induced cough in compound 48/80-pretreated animals. In addition, CA inhalation caused significant increase in plasma histamine concentration, which was blocked by compound 48/80 pretreatment. These results suggest that mast cells play an important role in CA aerosol inhalation-induced cough via perhaps mediators LTs and histamine.     

How does lobeline injected intravenously produce a cough?

In order to examine, whether the lobeline-induced cough is a true reflex or a voluntary effort to get rid of its irritating sensations in the upper respiratory tract, we systematically studied the cough response to lobeline, of subjects who were unable to make conscious discriminations i.e. were either comatose (n=4) or anaesthetized (n=5). 8 microg/kg lobeline injected into the right atrium of one and 29 microg/kg intravenously (i.v.) into another evenly and spontaneously breathing comatose subject produced a cough after 4s and 12s, respectively. Cough was repeatable and showed a dose response relationship i.e., its latency decreasing and its duration/intensity increasing with the dose. In a third subject, capable only of weak spontaneous respiration, a relatively high dose injected into the right atrium (44 microg/kg) generated a pronounced cough-like respiratory movement superimposed on the artificial ventilation and also during the apnoea after disconnecting the pump. No respiratory response was evoked in a fourth subject who had no evidence of brainstem reflexes. In five normals, cough was elicited with a mean dose of 35+/-5 microg/kg i.v. (latency 14+/-2 s; duration 10+/-3 s). After thiopental anaesthesia, injecting 41+/-7 microg/kg produced a cough within 13+/-2 s that lasted for 12+/-2 s. It may be noted that neither the later dose nor the latency or duration of cough that it produced were significantly different from the pre anaesthesia values (P>0.05). These two sets of results show unequivocally that the lobeline-induced cough is evoked reflexly; its magnitude in the conscious state could vary by subjective influences. We discuss the likelihood of its origin from juxtapulmonary capillary receptors.