Shi Guanglin, Shen Qin, Zhang Caixin, Ma Jun, Mohammed Anaz, Zhao Huan
Department of Respiratory Medicine, Nantong Pulmonary Hospital (The Sixth People's Hospital of Nantong), Nantong, China.
Medical School of Nantong University, Nantong, China.
Tuberc Respir Dis (Seoul). 2018 Jul;81(3):167-174. doi: 10.4046/trd.2017.0089. Epub 2018 Jun 19.
Despite recent clinical guidelines, the optimal therapeutic strategy for the management of refractory chronic cough is still a challenge. The present systematic review was designed to assess the evidence for efficacy and safety of gabapentin in the treatment of chronic cough. A systematic search of PubMed, Embase, Cochrane Library databases, and publications cited in bibliographies was performed. Articles were searched by two reviewers with a priori criteria for study selection. Seven relevant articles were identified, including two randomized controlled trials, one prospective case-series designed with consecutive patients, one retrospective case series of consecutive patients, one retrospective case series with unknown consecutive status, and two case reports comprising six and two patients, respectively. Improvements were detected in cough-specific quality of life (Leicester Cough Questionnaire score) and cough severity (visual analogue scale score) following gabapentin treatment in randomized controlled trials. The results of prospective case-series showed that the rate of overall improvement of cough and sensory neuropathy with gabapentin was 68%. Gabapentin treatment of patients with chronic cough showed superior efficacy and a good safety record compared with placebo or standard medications. Additional randomized and controlled trials are needed.
尽管有近期的临床指南，但难治性慢性咳嗽的最佳治疗策略仍是一项挑战。本系统评价旨在评估加巴喷丁治疗慢性咳嗽的疗效和安全性证据。对PubMed、Embase、Cochrane图书馆数据库以及参考文献中引用的出版物进行了系统检索。由两名评审员根据预先设定的研究选择标准进行文献检索。共识别出7篇相关文章，包括两项随机对照试验、一项对连续患者进行设计的前瞻性病例系列研究、一项对连续患者的回顾性病例系列研究、一项连续状态未知的回顾性病例系列研究以及两篇分别包含6例和2例患者的病例报告。在随机对照试验中，加巴喷丁治疗后咳嗽特异性生活质量（莱斯特咳嗽问卷评分）和咳嗽严重程度（视觉模拟量表评分）均有改善。前瞻性病例系列研究结果显示，加巴喷丁治疗咳嗽和感觉神经病变的总体改善率为68%。与安慰剂或标准药物相比，加巴喷丁治疗慢性咳嗽患者显示出更好的疗效和良好的安全性记录。仍需要更多的随机对照试验。
