吸入糖皮质激素治疗感染后咳嗽

Treatment of Postinfectious cough with inhaled corticosteroid

目的研究吸入糖皮质激素对感染后咳嗽的治疗效果及对气道炎症细胞的影响。方法采取前瞻性随机对照研究,将60例年龄在18～65岁的感染后咳嗽患者(咳嗽持续3周以上)随机分为观察组和对照组接受1周的治疗。观察组每天吸入布地奈德800μg,同时口服马来酸氯苯那敏和右美沙芬;对照组口服马来酸氯苯那敏和右美沙芬治疗。在治疗前、治疗后1周分别记录患者咳嗽特异性生活质量评分(CQLQ评分表),查诱导痰炎症细胞分类。结果治疗1周后,观察组CQLQ评分(35.38±10.65)明显降低,比对照组(46.57±7.49)降低明显(P<0.05)。观察组诱导痰中性粒细胞百分数在治疗1周后为(42.35±7.82)%,比对照组(63.24±10.24)%低(P<0.05)。结论吸入糖皮质激素对感染后咳嗽有明显疗效,可显著改善患者生活质量;气道中性粒细胞减少可能是激素的作用机制之一。

[Objective] To investigate effect of inhaled corticosteroids on postinfectious cough and the change of inflammatory cells in airway. [Methods] 60 patients （18-65 years old） with postinfectious cough （persistent cough lasting 〉3 weeks） were included in a prospective randomized controlled study. The patients were divided into two groups： observed group and controlled group. In observed group, the patient inhaled budesonide（800 μg/day） combined with chlorpheniramine and dextromethorphan for 1 weeks; The patients in controlled group only take chlorpheniramine and dextromethorphan orally. CQLQ scores, percentages of neutrophils in induced sputums were recorded before and 1 weeks later after treatment. [Results] In observed group, CQLQ score was decreased obviously after 1 weeks treatment. The score of observed group （35.38±10.65） was lower than that of controlled group（46.57± 7.49） （P 〈0.05）.The percentage of sputum neutrophil of the observed group （42.35±7.82）% was obviously lower than that of controlled group （63.24±10.24）% （P 〈0.05）. [Conclusion] Inhaled corficosteroid is effective in treating postinfectious cough. It can improve the quality of life of patients. Decrease of infiltration in airway of neutrophils may be one of the mechanism of corticosteroid action.