Morice Alyn H, Shanks Gabriella
aHull York Medical School, Castle Hill Hospital bDepartment of Medicine, Hull Royal Infirmary, Hull, UK.
Curr Opin Support Palliat Care. 2017 Sep;11(3):147-151. doi: 10.1097/SPC.0000000000000279.
Cough is a common and distressing symptom. It has a marked decrement on quality-of-life particularly in the arena of palliative care where coexisting symptoms such as pain may be exacerbated. Whilst local definitive treatment may alleviate coughing it usually requires general measures. The purpose of the review is to assess the current evidence relating to the pharmacological management of cough.
Key to understanding cough is the realization that most cough is because of a hypersensitivity of the afferent vagus nerve. Cough suppression with opioids and first-generation antihistamines may produce relief. However, much cough in palliative medicine is caused by unrecognized nonacid reflux and aspiration. Promotility agents may be dramatically effective at both preventing cough and recurrent aspiration.
The implications of this review will aid practitioners understanding of cough in a variety of settings, including palliative care.
咳嗽是一种常见且令人苦恼的症状。它对生活质量有显著影响，尤其是在姑息治疗领域，疼痛等并存症状可能会加重。虽然局部确定性治疗可能缓解咳嗽，但通常需要采取一般措施。本综述的目的是评估目前与咳嗽药物治疗相关的证据。
理解咳嗽的关键在于认识到大多数咳嗽是由于传入迷走神经的超敏反应。使用阿片类药物和第一代抗组胺药抑制咳嗽可能会缓解症状。然而，姑息医学中的许多咳嗽是由未被认识到的非酸性反流和误吸引起的。促动力药物在预防咳嗽和反复误吸方面可能非常有效。
本综述的意义将有助于从业者在包括姑息治疗在内的各种环境中理解咳嗽。
