Vertigan Anne E, Theodoros Deborah G, Gibson Peter G, Winkworth Alison L
Division of Speech Pathology, University of Queensland, Brisbane, Australia.
J Voice. 2007 May;21(3):361-83. doi: 10.1016/j.jvoice.2005.12.008. Epub 2006 Mar 20.
Chronic cough (CC) and paradoxical vocal fold movement (PVFM) share several common features; however, there has been no systematic comparison of these two conditions. The aims of this study were to contrast and compare the symptom profiles of CC and PVFM, to clarify the relationship between the two conditions, and to explore how symptom characteristics could be used to design an individualized treatment program. Participants included 55 people with a combination of PVFM and CC that was refractory to medical treatment, 8 people with PVFM alone, 56 people with CC alone, 25 people with voice disorders, and 27 normal controls. Symptoms and descriptive features of CC, PVFM, and voice disorders were assessed via structured case history interview, symptom frequency, and severity ratings, ratings of activity limitation, and anxiety/depression ratings. Results indicated consistent overlap in the symptom profile between people with CC and those presenting with a combination of CC and PVFM. Participants with PVFM without cough and those with voice disorders overlapped with the participants with CC on some dimensions; however, there were still some significant differences between them. These data suggest that CC and PVFM are related and manifestations of a common underlying condition but that voice disorders are a discrete entity. Most participants had normal ratings on screening for anxiety and depression. Results indicated that there were no consistent psychiatric symptoms in any of the groups studied, and they do not support the label of psychogenic cough for CC that is refractory to medical treatment. Characteristics of CC such as nature and timing of the cough provide important information for developing behavioral treatment programs for individual patients who have exhausted medical options. A template has been provided that is a practical method of designing an integrated behavioral treatment program based on those individual patient characteristics.
慢性咳嗽（CC）和反常性声带运动障碍（PVFM）有几个共同特征；然而，尚未对这两种病症进行系统比较。本研究的目的是对比和比较CC与PVFM的症状谱，阐明这两种病症之间的关系，并探索如何利用症状特征来设计个性化治疗方案。参与者包括55名患有PVFM和CC且药物治疗无效的患者、8名单纯患有PVFM的患者、56名单纯患有CC的患者、25名患有嗓音障碍的患者以及27名正常对照者。通过结构化病史访谈、症状频率和严重程度评分、活动受限评分以及焦虑/抑郁评分，对CC、PVFM和嗓音障碍的症状及描述性特征进行评估。结果表明，CC患者与同时患有CC和PVFM的患者在症状谱上存在一致的重叠。无咳嗽的PVFM患者和患有嗓音障碍的患者在某些方面与CC患者重叠；然而，他们之间仍存在一些显著差异。这些数据表明，CC和PVFM相关且是一种共同潜在病症的表现，但嗓音障碍是一个独立的实体。大多数参与者在焦虑和抑郁筛查中评分正常。结果表明，在所研究的任何组中均无一致的精神症状，且不支持将难治性CC称为心因性咳嗽。CC的特征，如咳嗽的性质和时间，为为已用尽药物治疗方案的个体患者制定行为治疗方案提供了重要信息。提供了一个模板，这是一种基于个体患者特征设计综合行为治疗方案的实用方法。
