Mengru Zhang, Alyn H Morice, Fengli Si, Li Zhang, Qiang Chen, Shengyuan Wang, Yiqing Zhu, Xianghuai Xu, Li Yu, Zhongmin Qiu
{"title":"难治性慢性咳嗽和不明原因慢性咳嗽的新认识:一项为期6年的双视角队列研究。","authors":"Mengru Zhang, Alyn H Morice, Fengli Si, Li Zhang, Qiang Chen, Shengyuan Wang, Yiqing Zhu, Xianghuai Xu, Li Yu, Zhongmin Qiu","doi":"10.4168/aair.2023.15.6.795","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Only limited studies have depicted the unique features and management of refractory chronic cough (RCC) and unexplained chronic cough (UCC). These led to the initiation of this study, which reported the demographic characteristics, manifestations, and long-term outcomes on a large series of consecutive RCC/UCC patients, providing a guideline-led real-world clinical experience.</p><p><strong>Methods: </strong>Retrospective baseline information was obtained from Clinical Research Database (January 2016 to May 2021). At least 6 months after the last clinic visit, included subjects were prospectively followed up.</p><p><strong>Results: </strong>Three hundred and sixty-nine RCC and UCC patients (199 females, 53.9%) were analyzed. The median cough duration was 24.0 (12.0-72.0) months. Laryngeal symptoms were reported in 95.9% of the patients. The common triggers for coughing were talking (74.9%), pungent odors (47.3%), eating (45.5%), and cold air (42.8%). RCC was considered in 38.2%, and the remainder of 228 patients had UCC, with an equal sex distribution (<i>P</i> = 0.66). Among the 141 RCCs, 90.8% (128) had refractory reflux cough, which was more responsive to current treatments (<i>P</i> < 0.01). Although most features and test results between RCC and UCC were similar, UCC was more commonly inappropriately treated (<i>P</i> < 0.01). Nineteen (7.7-41.1) months after the final clinic visit, 31.2% still coughed persistently, while 68.8% reported cough improvement or remission. RCC reported more favorable treatment outcomes (including cough improvement, control, and spontaneous remission) than UCC (<i>P</i> < 0.01). Coughs with long duration before the initial cough clinic visit (<i>P</i> < 0.01), frequent urinary incontinence (<i>P</i> < 0.01), and being sensitive to \"talking\" (<i>P</i> < 0.01) or \"cold air\" (<i>P</i> < 0.01) were less likely to be solved.</p><p><strong>Conclusions: </strong>The current treatments only improve cough symptoms in two-thirds of patients. Clinical indicators for treatment failure were those coughing for long duration and being sensitive to \"talking\" or \"cold air.\"</p>","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"15 6","pages":"795-811"},"PeriodicalIF":4.1000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10643855/pdf/","citationCount":"0","resultStr":"{\"title\":\"New Insights Into Refractory Chronic Cough and Unexplained Chronic Cough: A 6-Year Ambispective Cohort Study.\",\"authors\":\"Mengru Zhang, Alyn H Morice, Fengli Si, Li Zhang, Qiang Chen, Shengyuan Wang, Yiqing Zhu, Xianghuai Xu, Li Yu, Zhongmin Qiu\",\"doi\":\"10.4168/aair.2023.15.6.795\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Only limited studies have depicted the unique features and management of refractory chronic cough (RCC) and unexplained chronic cough (UCC). These led to the initiation of this study, which reported the demographic characteristics, manifestations, and long-term outcomes on a large series of consecutive RCC/UCC patients, providing a guideline-led real-world clinical experience.</p><p><strong>Methods: </strong>Retrospective baseline information was obtained from Clinical Research Database (January 2016 to May 2021). At least 6 months after the last clinic visit, included subjects were prospectively followed up.</p><p><strong>Results: </strong>Three hundred and sixty-nine RCC and UCC patients (199 females, 53.9%) were analyzed. The median cough duration was 24.0 (12.0-72.0) months. Laryngeal symptoms were reported in 95.9% of the patients. The common triggers for coughing were talking (74.9%), pungent odors (47.3%), eating (45.5%), and cold air (42.8%). RCC was considered in 38.2%, and the remainder of 228 patients had UCC, with an equal sex distribution (<i>P</i> = 0.66). Among the 141 RCCs, 90.8% (128) had refractory reflux cough, which was more responsive to current treatments (<i>P</i> < 0.01). Although most features and test results between RCC and UCC were similar, UCC was more commonly inappropriately treated (<i>P</i> < 0.01). Nineteen (7.7-41.1) months after the final clinic visit, 31.2% still coughed persistently, while 68.8% reported cough improvement or remission. RCC reported more favorable treatment outcomes (including cough improvement, control, and spontaneous remission) than UCC (<i>P</i> < 0.01). Coughs with long duration before the initial cough clinic visit (<i>P</i> < 0.01), frequent urinary incontinence (<i>P</i> < 0.01), and being sensitive to \\\"talking\\\" (<i>P</i> < 0.01) or \\\"cold air\\\" (<i>P</i> < 0.01) were less likely to be solved.</p><p><strong>Conclusions: </strong>The current treatments only improve cough symptoms in two-thirds of patients. 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New Insights Into Refractory Chronic Cough and Unexplained Chronic Cough: A 6-Year Ambispective Cohort Study.
Purpose: Only limited studies have depicted the unique features and management of refractory chronic cough (RCC) and unexplained chronic cough (UCC). These led to the initiation of this study, which reported the demographic characteristics, manifestations, and long-term outcomes on a large series of consecutive RCC/UCC patients, providing a guideline-led real-world clinical experience.
Methods: Retrospective baseline information was obtained from Clinical Research Database (January 2016 to May 2021). At least 6 months after the last clinic visit, included subjects were prospectively followed up.
Results: Three hundred and sixty-nine RCC and UCC patients (199 females, 53.9%) were analyzed. The median cough duration was 24.0 (12.0-72.0) months. Laryngeal symptoms were reported in 95.9% of the patients. The common triggers for coughing were talking (74.9%), pungent odors (47.3%), eating (45.5%), and cold air (42.8%). RCC was considered in 38.2%, and the remainder of 228 patients had UCC, with an equal sex distribution (P = 0.66). Among the 141 RCCs, 90.8% (128) had refractory reflux cough, which was more responsive to current treatments (P < 0.01). Although most features and test results between RCC and UCC were similar, UCC was more commonly inappropriately treated (P < 0.01). Nineteen (7.7-41.1) months after the final clinic visit, 31.2% still coughed persistently, while 68.8% reported cough improvement or remission. RCC reported more favorable treatment outcomes (including cough improvement, control, and spontaneous remission) than UCC (P < 0.01). Coughs with long duration before the initial cough clinic visit (P < 0.01), frequent urinary incontinence (P < 0.01), and being sensitive to "talking" (P < 0.01) or "cold air" (P < 0.01) were less likely to be solved.
Conclusions: The current treatments only improve cough symptoms in two-thirds of patients. Clinical indicators for treatment failure were those coughing for long duration and being sensitive to "talking" or "cold air."
期刊介绍：
The journal features cutting-edge original research, brief communications, and state-of-the-art reviews in the specialties of allergy, asthma, and immunology, including clinical and experimental studies and instructive case reports. Contemporary reviews summarize information on topics for researchers and physicians in the fields of allergy and immunology. As of January 2017, AAIR do not accept case reports. However, if it is a clinically important case, authors can submit it in the form of letter to the Editor. Editorials and letters to the Editor explore controversial issues and encourage further discussion among physicians dealing with allergy, immunology, pediatric respirology, and related medical fields. AAIR also features topics in practice and management and recent advances in equipment and techniques for clinicians concerned with clinical manifestations of allergies and pediatric respiratory diseases.
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