白三烯受体拮抗剂在慢性咳嗽治疗中的临床价值

目的 探讨白三烯受体拮抗剂在慢性咳嗽临床治疗中的意义.方法 选择81例慢性咳嗽患者(根据慢性咳嗽诊断流程诊断),所有患者均符合咳嗽时间≥8周,不吸烟或戒烟4周以上,无服用血管紧张素转换酶抑制剂类药物史,服用者停药观察4周,X线胸片检查未见异常,并除外胃食管反流性咳嗽、除变应性鼻炎的其他上气道咳嗽综合征、支气管内膜结核等其他慢性咳嗽病因.对诊断为咳嗽变异性哮喘、变应性鼻炎、嗜酸粒细胞性支气管炎及感染后咳嗽的患者给予孟鲁司特钠10 mg,每晚1次进行治疗4周并观察疗效.结果 81例入选患者中咳嗽变异性哮喘36例,变应性鼻炎30例,嗜酸粒细胞性支气管炎5例,感染后咳嗽10例.经孟鲁司特钠治疗后,67例患者咳嗽症状临床控制,12例患者显效,2例无效,有效率97.5%(79/81).结论 气道炎症是慢性咳嗽患者常见的病理特征,白三烯受体拮抗剂孟鲁司特钠有显著的抗炎作用,能明显改善咳嗽变异性哮喘、嗜酸粒细胞性支气管炎、感染后咳嗽、变应性鼻炎等慢性咳嗽患者的气道炎症,减轻咳嗽症状,是治疗慢性咳嗽的重要药物.

Clinical efficacy of leukotriene receptor antagonists in treatment of chronic cough

Objective To explore the clinical efficacy of leukotriene receptor antagonists in treatment of chronic cough. Methods Eighty-one patients with chronic cough, defined by the diagnostic protocol of chronic cough, were recruited. The including criteria are complaining cough 8 weeks or longer, age ≥ 14, nonsmoking or had quitted smoking≥4 weeks, not taking ACEI medicine, not complicated with gastroesophageal reflux related cough, upper airway cough syndrome (besides allergic rhinitis), tuberculosis of bronchus and with normal chest X-ray. Those diagnosed as cough variant asthma(CVA),allergic rhinitis (AR),eosinophilic bronchitis(EB),post infectious cough(PIC) were treated with leukotriene 10 mg daily at night. Results The 81 patients includes:36 cases of CVA,30 cases of AR,5 cases with EB,10 cases with PIC. After treatment based on diagnosis, cough disappeared in 67 patients, symptoms improved in 12 patients, and 2 patients' cough did not improved. Conclusions Leukotriene receptor antagonists is an aggressive anti-inflammatory therapy, which can release the symptom of cough and is an important medicine in the treatment of chronic cough.