Guelaud C, Similowski T, Bizec J L, Cabane J, Whitelaw W A, Derenne J P
Service de Pneumologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Eur Respir J. 1995 Feb;8(2):235-7. doi: 10.1183/09031936.95.08020235.
Chronic hiccup is a rare but potentially severe condition, that can be symptomatic of a variety of diseases, or idiopathic. Many therapeutic interventions have been reported, most often as case reports. Among other drugs, baclofen has been suggested as a therapy for chronic hiccup. In a large series of patients, we have evaluated its therapeutic position. In patients with chronic hiccup, defined as hiccup spell or recurring hiccup attacks lasting more than 7 days, investigation of the upper gastro-oesophageal tract (fibroscopy, manometry, and pH monitoring) was systematically performed. Most patients had tried numerous drugs in the past, without success. Baclofen was used as a first treatment in patients without evidence of any gastro-oesophageal disease (n = 17), and was undertaken only after full treatment of such disease (n = 55) had failed to solve the hiccup problem (n = 20). Baclofen has, therefore, been administered to 37 patients with chronic hiccup (average duration 4.6 yrs). Baclofen produced a long-term complete resolution (18 cases) or a considerable decrease (10 cases) of hiccups in 28 of the 37 patients. There was no significant difference between patients with or without gastro-oesophageal disease. We conclude that so-called idiopathic chronic hiccup often results from gastro-oesophageal abnormalities. Also, if controlled studies confirm our encouraging results, baclofen can be a major element in the treatment of chronic hiccup that is idiopathic, or that cannot be helped by treatment of gastro-oesophageal diseases.
慢性呃逆是一种罕见但可能很严重的病症，可能是多种疾病的症状表现，也可能是特发性的。已有许多治疗干预措施的报道，大多是病例报告。在其他药物中，巴氯芬已被提议作为慢性呃逆的一种治疗方法。在一大组患者中，我们评估了它的治疗地位。对于定义为呃逆发作或反复呃逆发作持续超过7天的慢性呃逆患者，系统地进行了上消化道食管检查（纤维内镜检查、测压和pH监测）。大多数患者过去尝试过多种药物，但均未成功。对于没有任何胃食管疾病证据的患者（n = 17），巴氯芬被用作首选治疗药物；对于胃食管疾病经过充分治疗（n = 55）但呃逆问题仍未解决（n = 20）的患者，也使用了巴氯芬。因此，共有37例慢性呃逆患者（平均病程4.6年）接受了巴氯芬治疗。巴氯芬使37例患者中的28例呃逆得到长期完全缓解（18例）或显著减轻（10例）。有无胃食管疾病的患者之间没有显著差异。我们得出结论，所谓的特发性慢性呃逆通常是由胃食管异常引起的。此外，如果对照研究证实我们令人鼓舞的结果，巴氯芬可能成为治疗特发性慢性呃逆或胃食管疾病治疗无效的慢性呃逆的主要药物。
