在医生办公室咳嗽

G. Shakirova, E. D. Gizatullina, A. S. Burchagina
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引用次数: 0

摘要

咳嗽是一种需要就医的常见症状。发生咳嗽的疾病范围很广。不仅是支气管肺病患者,胃肠道疾病、心血管系统疾病、上呼吸道疾病、服用药物和其他一些原因也会引起咳嗽。咳嗽有不同的发病机制和临床特点。治疗咳嗽的主要目的是消除引起咳嗽的病因,即引发这一症状的病理形式。然而,咳嗽往往需要复杂的长期诊断和个性化的治疗方法。在慢性咳嗽的病因确定之前,急性和亚急性咳嗽患者往往需要对症治疗。在选择咳嗽对症治疗时,有必要针对具体的临床情况,采取区别对待的方法选择药物。联合用药是治疗咳嗽的有效对症疗法,尤其是在患者同时出现多种症状(咳嗽、痰液粘稠、难以分离、支气管阻塞)的情况下。这种联合用药的例子包括溴己新(粘液溶解剂)、愈创木酚碱(粘液溶解剂/粘液激酶)和沙丁胺醇(β2-拟肾上腺素)。这些药物具有协同作用,具有止咳效果,提高粘膜纤毛清除率,改善支气管分泌物的流变学特性,降低支气管的过度张力,从而迅速清除支气管内改变的支气管分泌物,减少/停止咳嗽。
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Cough at the doctor’s office
Сough is a common symptom that requires medical attention. The range of diseases in which cough occurs is quite large. These are not only patients with bronchopulmonary pathology, cough can also occur in diseases of the gastrointestinal tract, cardiovascular system, diseases of the upper respiratory tract, taking medications and a number of other reasons. Cough has different developmental mechanisms and clinical characteristics. Treatment of cough should be primarily aimed at eliminating the cause of cough, the nosological form that triggered the development of this symptom. However, cough often requires a complex long-term diagnosis and personalized approach to therapy. Symptomatic treatment is often required before the cause of chronic cough is established and for patients with acute and subacute cough. When choosing symptomatic cough therapy, it is necessary to focus on a specific clinical situation and take a differentiated approach to the choice of medications. Combination medications are an effective symptomatic remedy in the treatment of cough, especially in situations where the patient has several symptoms at the same time (cough, viscous, difficult-to-separate sputum, bronchial obstruction). An example of such a combination are drugs that include bromhexine (mucolytic), guaifenesine (mucolytic/mucokinetic) and salbutamol (β2-adrenomimetic). The drugs have a synergistic effect, have an antitussive effect, improve mucociliary clearance, improve the rheological properties of bronchial secretions, reducing excessive bronchial tone, which leads to rapid cleansing of the bronchi from altered bronchial secretions and a decrease / cessation of coughing.
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