成人慢性咳嗽患者66例病因分析

Analysis of the Diagnosis and Treatment of 66 Adult Patients Suffering from Chronic Persistent Cough

目的:探讨成人慢性咳嗽的常见病因及其治疗方法。方法:通过询问病史、体格检查、胸部X线、肺功能、食道pH监测等检查,明确病因,对病因进行分类,并针对病因进行特异性治疗。结果:通过66例成人慢性咳嗽病因分析发现,咳嗽变异性哮喘占33.3%,鼻后滴漏综合征占27.3%,胃食管反流占21.2%,嗜酸细胞性支气管炎占9.1%,药物因素占3.0%,病因未明者占6.1%(4/66)。经针对病因特异性治疗后,95.2%(59/62)患者咳嗽症状明显减轻或消失。结论:慢性咳嗽病因主要为变异性哮喘、鼻后滴漏综合征、胃食管反流、嗜酸细胞性支气管炎,占总病因的90.9%;严格遵循慢性咳嗽的诊疗原则及行试验性诊断治疗是病因诊断的重要环节。

Objective： To look into the common causes as well as treatment methods for adult patients suffering from chronic persistent cough （CPC）. Methods： To identify and classify causes of CPC through examinations such as inquiring upon disease history, medical examination, chest X-ray examination, pulmonary function tests, as well as esophageal pH monitoring and make specific treatment accordingly. Results： Out of 66 patients examined with CPC, cough variant asthma （CVA）, postnasal drip syndrome （PNDS） , gastro- esophageal reflux （GER） , eosinophilic bronchitis （EB）, and drug factors account for 33.3% （ 22/66 ） , 27.3 % （18/66） , 21. 2% （ 14/66 ） , 9. 1% （6/66） , and 3% （2/66） respectively while no clear cause could be identified for the remaining 6.1% （4/66）. After specific treatments aiming at different causes, the coughing symptom of 59 patients out of the 62 treated （95.2%） was either significantly alleviated or even disappeared. Conclusion： The major causes of CPC include cough variant asthma, postnasal drip syndrome, gastro - esophageal reflux, and eosinophilic bronchitis, accounting for a total of 90.9% of causes leading to CPC. It is of crucial importance towards the cause identification of CPC to strictly abide by the diagnosis and treatment principle of CPC and try out experimental diagnosis and treatment.