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首页> 外文期刊>Palliative medicine >Management of chronic cough in patients receiving palliative care: Review of evidence and recommendations by a task group of the Association for Palliative Medicine of Great Britain and Ireland
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Management of chronic cough in patients receiving palliative care: Review of evidence and recommendations by a task group of the Association for Palliative Medicine of Great Britain and Ireland

机译：接受姑息治疗的患者的慢性咳嗽的治疗：英国和爱尔兰姑息医学协会任务组对证据和建议的审查

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Background: Chronic cough is a disruptive and exhausting symptom, reported as very distressing in a quarter of those in their last year of life. Existing guidelines for management of chronic cough primarily deal with the commonest benign causes of cough: asthma; eosinophilic bronchitis; gastro-oesophageal reflux disease; rhinosinusitis. Aim/design: to examine what literature evidence exists and formulate recommendations for managing chronic cough in patients with advanced, progressive, life-limiting illnesses. Data sources: Electronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, Google Scholar); hand-search; grey literature. Results: Of 11 initially eligible studies, 5 provided evidence at level 2 or better. The small size of these studies, heterogeneity of study population and diversity of interventions and outcome measures used meant that comparison across studies and compilation of guidelines based on high-quality evidence was not possible. Pragmatic recommendations based on available evidence were formulated, drawing on the included studies and, in addition, extrapolating from two other well-designed studies involving patients with chronic cough. They also took into consideration convenience, toxicity and minimizing burden and harm of intervention, as well as considering the potential for disease-directed treatment and the possibility of pharmacological and co-existing benign causes of chronic cough. Conclusions: These recommendations (Grade D) include simple linctus, therapeutic trial of sodium cromoglycate and then prescription of an opioid or opioid derivative (dextromethorphan, morphine or codeine). Further research is clearly and urgently required in this area for more effective approaches to managing cough, tested in trials that have sufficient size, power and validity.
机译：背景：慢性咳嗽是一种破坏性且令人筋疲力尽的症状，据报道，在最后一生中，有四分之一的人感到非常痛苦。现行的慢性咳嗽治疗指南主要涉及咳嗽的最常见良性原因：哮喘;嗜酸性支气管炎;胃食管反流病;鼻鼻窦炎。目的/设计：检查存在的文献证据，并提出治疗晚期，进行性和生命受限疾病患者慢性咳嗽的建议。数据来源：电子数据库（MEDLINE，EMBASE，CINAHL，Cochrane图书馆，Google Scholar）;手工搜索;灰色文学。结果：在11项最初合格的研究中，有5项提供了2级或更高水平的证据。这些研究的规模小，研究人群的异质性以及所采用的干预措施和结果指标的多样性意味着不可能进行跨研究的比较和基于高质量证据的指南的汇编。根据所包括的研究，并根据其他两项精心设计的涉及慢性咳嗽患者的精心设计的研究，提出了基于现有证据的实用建议。他们还考虑了便利性，毒性以及最小化干预的负担和危害，并考虑了针对疾病的治疗潜力以及可能产生药理和慢性咳嗽的良性原因的可能性。结论：这些建议（D级）包括简单的斜方肌，色甘酸钠的治疗试验，然后开具阿片或阿片衍生物（右美沙芬，吗啡或可待因）的处方。在这一领域，迫切需要进一步的研究，以找到更有效的治疗咳嗽的方法，并在具有足够规模，功效和有效性的试验中进行测试。

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