慢性咳嗽是一种疾病

Richard Turner, Surinder Birring
{"title":"慢性咳嗽是一种疾病","authors":"Richard Turner, Surinder Birring","doi":"10.1183/23120541.00459-2024","DOIUrl":null,"url":null,"abstract":"Chronic cough is a frequent reason for medical consultation and has significant impact on quality of life. Due to the limited effectiveness of currently available treatments, and delays in accessing care, patients are often inadequately managed. There also remains an overreliance by clinicians on outdated management algorithms, addressing chronic cough only as symptom of other medical conditions, and advocating investigation and trials of treatment of diseases which are often not present. This may lead to unnecessary cost, frustration, and potential harm. Newer clinical guidelines in essence consider chronic cough as a disease in itself, resulting from afferent neuronal hypersensitivity and central nervous system dysfunction. Secondary factors which aggravate chronic cough (smoking, asthma, gastroesophageal reflux, etc), are better considered as treatable traits associated with the primary disease process rather than direct “causes” of cough.Explicitly approaching chronic cough as a discrete entity is consistent with the way in which “diseases” are generally characterised, and has advantages. The patient should be better able to understand their condition, and may have better confidence in attempts at management. The clinician should have better focus and avoid unfruitful treatments and investigation. In general, considering chronic cough as a disease should also help to raise the profile of the condition, improve organisation of health service pathways, increase attention for research, and further the development of new treatments.","PeriodicalId":504874,"journal":{"name":"ERJ Open Research","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Chronic cough as a disease\",\"authors\":\"Richard Turner, Surinder Birring\",\"doi\":\"10.1183/23120541.00459-2024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Chronic cough is a frequent reason for medical consultation and has significant impact on quality of life. Due to the limited effectiveness of currently available treatments, and delays in accessing care, patients are often inadequately managed. There also remains an overreliance by clinicians on outdated management algorithms, addressing chronic cough only as symptom of other medical conditions, and advocating investigation and trials of treatment of diseases which are often not present. This may lead to unnecessary cost, frustration, and potential harm. Newer clinical guidelines in essence consider chronic cough as a disease in itself, resulting from afferent neuronal hypersensitivity and central nervous system dysfunction. Secondary factors which aggravate chronic cough (smoking, asthma, gastroesophageal reflux, etc), are better considered as treatable traits associated with the primary disease process rather than direct “causes” of cough.Explicitly approaching chronic cough as a discrete entity is consistent with the way in which “diseases” are generally characterised, and has advantages. The patient should be better able to understand their condition, and may have better confidence in attempts at management. The clinician should have better focus and avoid unfruitful treatments and investigation. In general, considering chronic cough as a disease should also help to raise the profile of the condition, improve organisation of health service pathways, increase attention for research, and further the development of new treatments.\",\"PeriodicalId\":504874,\"journal\":{\"name\":\"ERJ Open Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ERJ Open Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1183/23120541.00459-2024\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ERJ Open Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1183/23120541.00459-2024","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

慢性咳嗽是常见的就医原因,对生活质量有很大影响。由于目前可用的治疗方法效果有限,加上就医时间延误,患者往往得不到适当的治疗。此外,临床医生仍然过度依赖过时的管理算法,仅将慢性咳嗽作为其他疾病的症状来处理,并主张对通常并不存在的疾病进行检查和试验治疗。这可能会导致不必要的花费、挫折和潜在伤害。新的临床指南实质上将慢性咳嗽本身视为一种疾病,是由传入神经元超敏和中枢神经系统功能紊乱引起的。加重慢性咳嗽的次要因素(吸烟、哮喘、胃食管反流等)最好被视为与原发性疾病过程相关的可治疗特征,而不是咳嗽的直接 "病因"。患者应能更好地理解自己的病情,并对治疗更有信心。临床医生则可以更好地突出重点,避免治疗和调查无果而终。总的来说,将慢性咳嗽视为一种疾病还有助于提高人们对这种疾病的认识,改善医疗服务的组织结构,增加对研究的关注,促进新疗法的开发。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Chronic cough as a disease
Chronic cough is a frequent reason for medical consultation and has significant impact on quality of life. Due to the limited effectiveness of currently available treatments, and delays in accessing care, patients are often inadequately managed. There also remains an overreliance by clinicians on outdated management algorithms, addressing chronic cough only as symptom of other medical conditions, and advocating investigation and trials of treatment of diseases which are often not present. This may lead to unnecessary cost, frustration, and potential harm. Newer clinical guidelines in essence consider chronic cough as a disease in itself, resulting from afferent neuronal hypersensitivity and central nervous system dysfunction. Secondary factors which aggravate chronic cough (smoking, asthma, gastroesophageal reflux, etc), are better considered as treatable traits associated with the primary disease process rather than direct “causes” of cough.Explicitly approaching chronic cough as a discrete entity is consistent with the way in which “diseases” are generally characterised, and has advantages. The patient should be better able to understand their condition, and may have better confidence in attempts at management. The clinician should have better focus and avoid unfruitful treatments and investigation. In general, considering chronic cough as a disease should also help to raise the profile of the condition, improve organisation of health service pathways, increase attention for research, and further the development of new treatments.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信