支气管激发试验联合经验性治疗在慢性咳嗽诊治中的临床意义

Clinical significance of bronchial provocation test combined with empirical therapy in the diagnosis and treatment of chronic cough

目的观察分析支气管激发试验联合经验性治疗在慢性咳嗽诊治中的临床意义。方法选取本院2016年10月～2018年6月收治的300例慢性咳嗽患者(所有患者在接受相关治疗前接受血常规和肺通气功能检查加支气管激发试验检测),所有慢性咳嗽患者均应用经验性治疗方法或者初始治疗方法。采用统计学分析300例慢性咳嗽患者的常见临床慢性咳嗽症状(咳嗽变异性哮喘、嗜酸性粒细胞性支气管炎/变应性咳嗽、上气道咳嗽综合征以及胃食管反流性咳嗽等),按照患者的临床表现和检查结果等提供针对性用药。结果 300例慢性咳嗽患者中支气管激发试验为阳性者有100例(诊断为咳嗽变异性哮喘患者)、支气管激发试验为阴性者有200例,差异有统计学意义(P <0.05);按照患者的临床表现和检查结果等诊断嗜酸性粒细胞性支气管炎/变应性咳嗽患者有90例、诊断为上气道咳嗽综合征患者有81例、诊断为胃食管反流性咳嗽患者有29例、诊断为咳嗽变异性哮喘患者有100例;经验性治疗后的嗜酸性粒细胞性支气管炎/变应性咳嗽患者、上气道咳嗽综合征患者、胃食管反流性咳嗽患者、咳嗽变异性哮喘患者治疗总有效率显著高于初始治疗,差异有统计学意义(P <0.05)。结论支气管激发试验筛查联合经验性治疗在慢性咳嗽诊治中的临床意义显著。

Objective To observe and analyze the clinical significance of bronchial stimulation test combined with experiential treatment in the diagnosis and treatment of chronic cough.Methods 300 patients with chronic cough admitted by our hospital(from October 2016 to June 2018)(all patients received blood routine and pulmonary ventilation function examination plus bronchial stimulation test before receiving relevant treatment)were selected,and all patients with chronic cough were treated with empirical treatment or initial treatment.Statistical analysis of common clinical chronic cough symptoms in 300 patients with chronic cough(cough variant asthma,eosinophilic bronchitis/allergic cough,upper airway cough syndrome,and gastroesophageal reflux cough),targeted medications are provided according to the patient's clinical manifestations and test results.Results Of the 300 patients with chronic cough,100 were positive for bronchial provocation test(diagnosed as cough variant asthma)and 200 were negative for bronchial provocation test(P<0.05).The difference was statistically significant(P<0.05).According to the patient's clinical manifestations and examination results,there were 90 patients diagnosed with eosinophilic bronchitis/allergic cough,81 patients diagnosed with upper airway cough syndrome,and those diagnosed with gastroesophageal reflux cough.There were 100 patients with cough variant asthma diagnosed in 29 cases;Patients with eosinophilic bronchitis/allergic cough after empiric therapy,patients with upper airway cough syndrome,patients with gastroesophageal reflux cough,and cough The total effective rate of treatment for patients with variant asthma was significantly higher than the initial treatment(P<0.05).Conclusion The clinical significance of bronchial provocation test combined with empiric therapy in the diagnosis and treatment of chronic cough is significant.