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咳嗽变异性哮喘(CVA)在儿童尤为常见。因为其与典型哮喘的病理特点相似,所以CVA的治疗策略基本与典型哮喘相同。主要应用以下3类药物:短效β2受体激动剂、吸入糖皮质激素(ICS)及白三烯受体拮抗剂(LTRAs)。应用支气管扩张剂和ICS是其主要治疗路径。间歇性咳嗽患者,按需吸入短效β2受体激动剂;ICS是持续性咳嗽的一线治疗药物;假如ICS单一治疗无效,可联合应用LTRAs、缓释茶碱或长效β2受体激动剂。CVA生理学上的异常较典型哮喘轻,但这并不意味着CVA是哮喘的一种较轻的形式,因为CVA患者的管理更加困难。对于儿童CVA的临床治疗尚需进一步的循证医学证据。
Cough variant asthma (CVA) is particularly common in children. Because of its pathological characteristics similar to typical asthma, the treatment strategy for CVA is essentially the same as for typical asthma. The following three main types of drugs are used: short-acting β2 agonists, inhaled glucocorticoid (ICS) and leukotriene receptor antagonists (LTRAs). Bronchodilators and ICS are the main routes of treatment. Intermittent cough, short-acting β2 agonists inhaled on demand; ICS is the first-line treatment of persistent cough; if ICS monotherapy fails, LTRAs can be used in combination, slow-release theophylline or long-acting β2 receptor agonist. CVA physiologic abnormalities are less common than typical asthma, but this does not mean that CVA is a lighter form of asthma because CVA patients are more difficult to manage. The clinical treatment of children with CVA still requires further evidence-based medicine.