联合用药治疗咳嗽变异性哮喘的研究进展

Research progress of combined medication therapy for cough variant asthma

咳嗽变异性哮喘(CVA)是当前呼吸科常见病之一,是哮喘的一种特殊类型,症状特异性差,以咳嗽为主,容易被误诊、漏诊,从而错过早期治疗的最佳时机,导致患者病情加重。因此CVA的早期诊断及治疗是呼吸科医师的研究重点。近年来,CVA临床常用治疗方案为布地奈德福莫特罗粉吸入剂(XBKDB)联合孟鲁司特钠,两者联合应用可发挥协同作用,缓解其咳嗽症状,改善肺功能及炎性因子指标,提高临床疗效,且联合用药安全性良好。但目前在CVA的临床研究中仍存在一定的不足:许多临床研究中CVA的诊断标准、病例入组标准、疗效判定标准尚不统一;药物应用的剂量不一致;关于XBKDB联合孟鲁司特钠治疗CVA的适应证仍不统一;关于CVA的特异性治疗的研究仍显不足。因此,今后应针对目前研究中存在的问题,进一步规范统一CVA的诊断标准、病例入组标准、疗效判定标准、药物的剂量标准、治疗疗程及随访时限,XBKDB联合孟鲁司特钠用药的适应证和用药时机,同时积极探索CVA的特异性免疫治疗。本文对XBKDB联合孟鲁司特钠治疗CVA的研究进展进行综述,期待在改善CVA患者临床症状、肺功能指标、炎性因子指标的基础上,提高CVA患者的长期疗效,改善CVA患者远期预后。

Cough variant asthma(CVA)is one of the common diseases in respiratory department at present,and it is a special type of asthma,with poor symptom specificity,mainly cough,which is easy to be misdiagnosed and missed.Thus,it will loss the best opportunity of early treatment,leading to aggravation of patients’condition.Therefore,the early diagnosis and treatment of CVA is one of the research focuses of respiratory physicians.In recent years,the commonly used clinical treatment scheme of CVA is budesonide formoterol inhalation(XBKDB)combined with Montelukast sodium.The combination of the two can play a synergistic role in relieving cough symptoms,improving lung function and inflammatory factors,and improving clinical efficacy,and the safety of combination is good.However,there are still some shortcomings in the clinical studies of CVA at present:the diagnostic criteria,case inclusion criteria and curative effect judgment criteria of CVA in many clinical studies are not unified;the dosage of drugs used is inconsistent;the indications of XBKDB combined with Montelukast sodium in the treatment of CVA are still not uniform;the research on specific treatment of CVA is still insufficient.Therefore,for the existing issues in the current resarch,in the future we should further standardize and unify the diagnostic criteria,case inclusion criteria,curative effect judgment criteria,drug dosage criteria,treatment course and follow-up duration,indications and medication timing of XBKDB combined with Montelukast sodium,while actively exploring the specific immunotherapy of CVA.This article reviews the research progress of XBKDB combined with Montelukast sodium in the treatment of CVA,hoping to improve the long-term curative effect and long-term prognosis of CVA patients on the basis of improving the clinical symptoms,lung function indexes and inflammatory factors indexes of CVA patients.