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稳定型慢性支气管炎导致的慢性咳嗽:CHEST 专家组报告。

Chronic Cough Due to Stable Chronic Bronchitis: CHEST Expert Panel Report.

机构信息

Pharmacy Practice Department, Creighton University, Omaha, NE.

Adamstown, MD.

出版信息

Chest. 2020 Aug;158(2):705-718. doi: 10.1016/j.chest.2020.02.015. Epub 2020 Feb 24.

Abstract

BACKGROUND

Chronic cough due to chronic bronchitis (CB) causes significant impairment in quality of life, and effective treatment strategies are needed. We conducted a systematic review on the management of chronic cough due to CB to update the recommendations and suggestions of the American College of Chest Physicians (CHEST) 2006 guideline on this topic.

METHODS

This systematic review asked three questions: (1) What are the clinical features of the history that suggest a patient's cough-phlegm syndrome is due to CB? (2) Can treatment of stable CB improve or eliminate chronic cough? (3) Can therapy that targets chronic cough due to CB prevent or reduce the occurrence of acute CB exacerbations? Studies of adult patients with CB were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on by using the CHEST organization methodology.

RESULTS

The search strategy used an assortment of descriptors and assessments to identify studies of chronic cough due to CB.

CONCLUSIONS

The evidence supporting the management of chronic cough due to CB is limited overall and of low quality. This article provides guidance on treatment by presenting suggestions based on the best currently available evidence and identifies gaps in our knowledge and areas for future research.

摘要

背景

慢性支气管炎(CB)引起的慢性咳嗽会显著降低生活质量,因此需要有效的治疗策略。我们对慢性支气管炎引起的慢性咳嗽的治疗进行了系统评价,以更新美国胸科学会(CHEST)2006 年关于该主题指南的建议和推荐。

方法

本次系统评价提出了三个问题:(1)哪些病史特征提示患者的咳嗽-咳痰综合征是由 CB 引起的?(2)稳定期 CB 的治疗能否改善或消除慢性咳嗽?(3)针对 CB 引起的慢性咳嗽的治疗能否预防或减少急性 CB 加重的发生?纳入了成人 CB 患者的研究,并对其相关性和质量进行了评估。根据系统评价,使用 CHEST 组织方法制定并投票确定了指南建议。

结果

搜索策略使用了各种描述符和评估方法来确定慢性支气管炎引起的慢性咳嗽的研究。

结论

支持慢性支气管炎引起的慢性咳嗽治疗的证据总体上有限且质量较低。本文通过基于现有最佳证据提出建议,为治疗提供了指导,并确定了我们知识的差距和未来研究的领域。

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