Pornsuriyasak Prapaporn, Charoenpan Poonkasem, Vongvivat Kulanee, Thakkinstian Ammarin
Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Respirology. 2005 Sep;10(4):520-4. doi: 10.1111/j.1440-1843.2005.00732.x.
The aim of this study was to determine the clinical effect of inhaled corticosteroid treatment for persistent cough, post upper respiratory tract infection (URTI) in previously healthy individuals, and on bronchial hyperresponsiveness (BHR).
This was a prospective, randomized, double-blinded, placebo-controlled study conducted at a university hospital. A total of 30 non-asthmatic, non-smoking patients who were >15 years old and who had persistent post-URTI cough for >3 weeks were assessed by a physical examination, CXR and spirometry, and were allocated to receive inhaled budesonide (400 microg/puff, twice daily) or placebo for 4 weeks. If a patient suffered from sinusitis, it was a requirement that it had been well treated. A symptom score (frequency of cough, frequency of coughing bouts, symptoms associated with cough, night-time cough, frequency of taking medications to relieve cough, and number of medications) was recorded at entry, and after 2 and 4 weeks of treatment. A methacholine challenge test was performed at entry and after 4 weeks of treatment.
The mean symptom scores for the treatment group (9.4) and the placebo group (9.8) at baseline were not significantly different (P=0.79), and no differences were found between the groups after week 2 and week 4 of treatment (3.93 and 4.27 vs 2.26 and 2.66, P=0.29). The mean change in symptom scores from baseline to week 2 and to week 4 of treatment were also not different between groups (5.93 and 5.6 vs 7.00 and 7.58, P=0.23). No difference between groups was found in the mean changes in FEV(1), FVC, and FEF(25--75%) after 4 weeks of treatment. A positive bronchial provocation test occurred in three patients (10%) but these were borderline.
Inhaled corticosteroid is ineffective in treating persistent post-URTI cough in previously healthy individuals.
本研究旨在确定吸入性糖皮质激素治疗既往健康个体上呼吸道感染（URTI）后持续咳嗽及支气管高反应性（BHR）的临床效果。
这是一项在大学医院进行的前瞻性、随机、双盲、安慰剂对照研究。共有30名年龄大于15岁、非哮喘、非吸烟且URTI后持续咳嗽超过3周的患者接受了体格检查、胸部X光检查和肺功能测定，并被随机分为两组，分别接受吸入布地奈德（400微克/喷，每日两次）或安慰剂治疗4周。若患者患有鼻窦炎，则要求已得到妥善治疗。在入组时、治疗2周和4周后记录症状评分（咳嗽频率、咳嗽发作频率、与咳嗽相关的症状、夜间咳嗽、服用止咳药物的频率及药物数量）。在入组时和治疗4周后进行乙酰甲胆碱激发试验。
治疗组（9.4）和安慰剂组（9.8）在基线时的平均症状评分无显著差异（P = 0.79），治疗第2周和第4周后两组间也未发现差异（分别为3.93和4.27对比2.26和2.66，P = 0.29）。治疗组从基线到第2周和第4周症状评分的平均变化与安慰剂组之间也无差异（分别为5.93和5.6对比7.00和7.58，P = 0.23）。治疗4周后，两组间第一秒用力呼气容积（FEV₁）、用力肺活量（FVC）和呼气流量峰值（FEF₂₅₋₇₅%）的平均变化无差异。三名患者（10%）出现阳性支气管激发试验，但结果接近临界值。
吸入性糖皮质激素对治疗既往健康个体URTI后持续咳嗽无效。
