急性上呼吸道感染后咳嗽的合理用药——附183例分析

The treatment of cough following acute upper respiratory tract infection

目的：探讨治疗急性上呼吸道感染（上感）后咳嗽的合理用药方案：方法：经临床诊断为上感的患者183例，分成3组，采用复方甲氧那明、酮替芬、抗菌药物治疗的61例患者为A组．采用复方甲氧那明、酮替芬治疗的60例为B组、采用抗菌药物治疗的62例为C组。疗程共10日。观察3组的咳嗽、咳痰症状得分，气道反应性分级，不良反应情况。结果：3组治疗后的咳嗽、咳痰症状得分较治疗前降低，比较差异均有统计学意义（P〈0．01～O．05），治疗后A、B组的咳嗽、咳痰症状得分低于c组，均为P〈0．05。A、B组治疗后气道反应性分级1～4级的比率相当，均较治疗前明显降低，而且与C组比较差异均有统计学意义（均为P〈0．01）。3组患者在治疗期间均有不同程度的不良反应，用药3日后逐渐减轻，停药后消失。结论：应用抗菌药物不能改善和治愈上感后咳嗽症状，复方甲氧那明联用酮替芬能改善上感后咳嗽的症状，且安全性好。因此，对于上感后的咳嗽，无细菌感染证据者无需使用抗菌药物治疗。

Objective： To investigate a proper treatment for cough following upper respiratory tract infection. Methods： One hundred and eighty three patients with acute upper respiratory tract infection were assigned to group A, B and C. Sixty-one cases in group A received compound methoxyphenamine, ketotifen and antibacterial. Sixty patients in group B received compound methoxyphenamine and ketotifen and 62 patients in group C received antibacterial only for 10 days. 3 groups were observed the symptom scores of cough and expectoration, the grade of airway reactiveness, adverse reaction. Results： The scores of cough and expectoration were lower after treatment than those before treatment in 3 groups, respectively （P 〈 0. 01 -0. 05）. Compared with C group, the scores of cough and expectoration of A and B group were lower after treatment, respectively （P 〈 0. 05 ）. The rate of airway reactivity grade 1 -4 in group A and B was also significantly improved while it remained unchanged in group Cafter the treatnent. Three groups developed mild side effects, which disappeared after the treatment. Conclusion： Antibacterial has no benefit in the treatment of cough while compound methoxyphenamine combined with ketotifen has symptomatic effect on the symptom of cough following upper respiratory tract infection. Therefore, antibacterial should not be used for cough following upper respiratory tract infection unless there are evidences of bacterial infections.