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作者旨在评价咳嗽反射解剖学的诊断方法以确定咳嗽的病因;考查一下各种病因的范围和常见性,以及特殊治疗的效果。慢性顽固性咳嗽的条件是:①至少有一位经治医师在诊断及治疗上发生过困难;②困扰病人至少3周以上。本文研究49例中男22例,女27;年龄17～88岁;咳嗽时间3周至40年。常规采集病史,体检,X线胸片。如有指征加作:白细胞及嗜酸细胞计数,副鼻窦X线片,痰细胞学及细菌学检查,肺功能,纤维支气管镜检查,上消化道造影,食管镜活检,食管测压及pH监测,心导管。如FEV_1/FVC异常,吸异丙肾上腺素后再测。如FEV_1/FVC正常则做甲基胆碱激发试验(MIC,FEV_1降低20%为阳性)以发现咳嗽变异型哮喘。
The authors aim to evaluate the diagnostic method of cough reflex anatomy to determine the cause of cough; examine the range and commonality of various causes and the effects of specific treatments. Chronic intractable cough conditions are: ① at least one doctor in the diagnosis and treatment of difficult conditions; ② troubled patients for at least 3 weeks or more. In this study, 49 cases of 22 males and 27 females; aged 17 to 88 years; cough for 3 weeks to 40 years. Routine collection of medical history, physical examination, X-ray. If indications plus: white blood cell and eosinophil count, paranasal sinus X-ray, sputum cytology and bacteriology, pulmonary function, bronchoscopy, upper gastrointestinal imaging, esophagoscopy biopsy, esophageal manometry and pH Monitoring, cardiac catheterization. Such as FEV_1 / FVC abnormalities, retest after induction of isoproterenol. If normal FEV_1 / FVC is used for the choline challenge test (MIC, 20% reduction in FEV_1 is positive) to detect cough variant asthma.