Irwin R S, Corrao W M, Pratter M R
Am Rev Respir Dis. 1981 Apr;123(4 Pt 1):413-7. doi: 10.1164/arrd.1981.123.4.413.
Using a diagnostic protocol based on the anatomy and distribution of cough receptors and afferent nerves, we sought to determine the causes and outcome of specific therapy of chronic persistent cough in 49 consecutive and unselected patients. A specific diagnosis was made in all. Cough was due to chronic postnasal dip from a variety of conditions in 29%, asthma in 25%, postnasal drip plus asthma in 18%, chronic bronchitis in 12%, gastroesophageal reflux in 10%, and miscellaneous disorders in 6%. History, physical examination, and methacholine inhalational challenge diagnosed disease in 86% of all patients. Adjusted success rates for specific therapy, and average of 4.4 and 18.9 months after therapy had been prescribed, were 98% and 97%, respectively. We concluded the following about chronic persistent cough; using an anatomic, diagnostic protocol, the cause can be consistently determined; postnasal drip and/or bronchial asthma are very common causes of cough; the outcome of specific therapy, almost without exception, is successful and sustained.
我们采用基于咳嗽感受器和传入神经的解剖结构及分布的诊断方案，试图确定49例连续且未经挑选的慢性持续性咳嗽患者特定治疗的病因及结果。所有患者均做出了明确诊断。咳嗽病因如下：各种情况导致的慢性鼻后滴漏占29%，哮喘占25%，鼻后滴漏加哮喘占18%，慢性支气管炎占12%，胃食管反流占10%，其他杂症占6%。病史、体格检查及乙酰甲胆碱吸入激发试验对86%的患者做出了疾病诊断。特定治疗的调整成功率，在开始治疗后平均4.4个月和18.9个月时，分别为98%和97%。我们就慢性持续性咳嗽得出以下结论：采用解剖学诊断方案，病因能够持续确定；鼻后滴漏和/或支气管哮喘是咳嗽非常常见的病因；特定治疗的结果几乎无一例外是成功且持久的。
