Miwa Nanako, Nagano Tatsuya, Ohnishi Hisashi, Nishiuma Teruaki, Takenaka Kazuhiro, Shirotani Tomohiko, Nakajima Takeo, Dokuni Ryota, Kawa Yoshitaka, Kobayashi Kazuyuki, Funada Yasuhiro, Kotani Yoshikazu, Nishimura Yoshihiro
Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Respiratory Medicine, Akashi Medical Center, Akashi, Japan.
Kobe J Med Sci. 2018 Dec 4;64(4):E134-E139.
Cough-variant asthma is one of the most common reasons for chronic cough. It is important to treat appropriately cough-variant asthma because 30% to 40% of cough-variant asthma becomes a typical asthma. However, little is known about the treatment of cough-variant asthma except for inhaled corticosteroid (ICS). The aim of this study was to validate the additive efficacy of a leukotriene receptor antagonist (LTRA) on cough score and respiratory function in patients with cough-variant asthma being treated with ICS. A total 28 patients were randomly assigned to either an ICS + LTRA group or an ICS group. There were statistically significant improvements in cough scores in the ICS + LTRA group from 0 weeks (6.7 ± 4.4) to 2 weeks (2.9 ± 3.2) (P < 0.05), 4 weeks (0.7 ± 1.1) (P < 0.001), and 8 weeks (0.8 ± 1.2) (P < 0.001). However similar improvements were not evident in the ICS group from 0 weeks (6.7 ± 4.4) to 2 weeks (5.6 ± 10.0) (P = 0.59), 4 weeks (4.6 ± 7.6) (P = 0.32), and 8 weeks (2.9 ± 5.2) (P = 0.08). On the other hand, no significant changes were evident in the forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC). In conclusion, the LTRA was useful in improving cough in patients with cough-variant asthma, even though it appeared to be ineffective in improving respiratory function.
咳嗽变异性哮喘是慢性咳嗽最常见的原因之一。恰当治疗咳嗽变异性哮喘很重要,因为30%至40%的咳嗽变异性哮喘会发展为典型哮喘。然而,除吸入性糖皮质激素(ICS)外,对于咳嗽变异性哮喘的治疗知之甚少。本研究的目的是验证白三烯受体拮抗剂(LTRA)对接受ICS治疗的咳嗽变异性哮喘患者咳嗽评分和呼吸功能的附加疗效。总共28例患者被随机分为ICS + LTRA组或ICS组。ICS + LTRA组的咳嗽评分从0周(6.7±4.4)到2周(2.9±3.2)(P<0.05)、4周(0.7±1.1)(P<0.001)和8周(0.8±1.2)(P<0.001)有统计学意义的改善。然而,ICS组从0周(6.7±4.4)到2周(5.6±10.0)(P = 0.59)、4周(4.6±7.6)(P = 0.32)和8周(2.9±5.2)(P = 0.08)没有明显类似的改善。另一方面,一秒用力呼气容积(FEV1)和FEV1/用力肺活量(FVC)没有明显变化。总之,LTRA有助于改善咳嗽变异性哮喘患者的咳嗽,尽管它似乎对改善呼吸功能无效。