Department of Otolaryngology-Head and Neck Surgery, Washington University in St. Louis, St. Louis, Missouri, U.S.A.
University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, U.S.A.
Laryngoscope. 2022 Jan;132(1):107-123. doi: 10.1002/lary.29146. Epub 2020 Oct 21.
OBJECTIVES/HYPOTHESIS: Neurogenic cough affects 11% of Americans and causes significant detriment to quality of life. With the advent of novel therapies, the objective of this review is to determine how procedural therapies (e.g., superior laryngeal nerve block) compare to other established pharmacologic and non-pharmacologic treatments for neurogenic cough.
With the assistance of a medical librarian, a systematic review was performed using PICOS (patients, interventions, comparator, outcome, study design) format: adults with neurogenic cough receiving any pharmacologic or non-pharmacologic treatment for neurogenic cough compared to adults with neurogenic cough receiving any other relevant interventions, or treated as single cohorts, assessed with cough-specific quality of life outcomes, in all study designs and case series with ≥ 10 cases. Case reports, review articles, non-human studies, non-English language articles, and unavailable full-text articles were excluded.
There were 2408 patients with neurogenic cough in this review, treated with medical therapy (77%), speech therapy (19%), both medical and speech therapy (1%), and procedural therapy (3%). The included studies ranged from low to intermediate quality. Overall, most interventions demonstrated successful improvement in cough. However, the heterogeneity of included study designs precluded direct comparisons between intervention types.
This meta-analysis compared various treatments for neurogenic cough. Procedural therapy should be considered in the armamentarium of neurogenic cough treatments, particularly in patients refractory to, or intolerant of, the side effects of medical therapy. Lastly, this review illuminates key areas for improving neurogenic cough diagnosis, such as strict adherence to diagnostic and treatment guidelines, sophisticated reflux testing, and standardized, consistent outcome reporting. Laryngoscope, 132:107-123, 2022.
目的/假设：神经源性咳嗽影响 11%的美国人，并导致生活质量显著下降。随着新型疗法的出现，本综述的目的是确定程序性治疗（例如，喉上神经阻滞）与其他已确立的神经源性咳嗽药物和非药物治疗相比如何。
在医学图书馆员的协助下，使用 PICOS（患者、干预、比较、结局、研究设计）格式进行了系统评价：接受任何药物或非药物治疗神经源性咳嗽的成年患者与接受任何其他相关干预或作为单一队列接受治疗的成年患者相比神经源性咳嗽，使用咳嗽特异性生活质量结局进行评估，所有研究设计和病例系列均有≥10 例。排除病例报告、综述文章、非人类研究、非英语文章和无法获取全文的文章。
本综述纳入了 2408 例神经源性咳嗽患者，接受药物治疗（77%）、言语治疗（19%）、药物和言语治疗联合（1%）和程序性治疗（3%）。纳入的研究质量从低到中等不等。总体而言，大多数干预措施均成功改善了咳嗽。然而，纳入研究设计的异质性使得难以在干预类型之间进行直接比较。
本荟萃分析比较了神经源性咳嗽的各种治疗方法。在神经源性咳嗽治疗方案中应考虑程序性治疗，特别是在对药物治疗的副作用不耐受或有抵抗的患者中。最后，本综述突出了改善神经源性咳嗽诊断的关键领域，例如严格遵守诊断和治疗指南、复杂的反流测试以及标准化、一致的结局报告。喉镜，132:107-123，2022 年。
