徐凌云

【摘要】 目的：探讨在基层医院及社区卫生服务中心应用经验治疗慢性咳嗽的可行性，为提高慢性咳嗽诊治率提供实践依据。方法：对2010年3月-2013年3月笔者所在卫生院门诊及社区卫生服务中心收治的28例慢性咳嗽患者既往病史、临床表现及应用经验性治疗的情况进行回顾性分析。结果：经经验性治疗后，28例患者中26例咳嗽消失，未复发；1例转上级医院诊断为支气管内膜结核；1例疗效差，病因不详。结论：慢性咳嗽作为临床上常见病症，经验性治疗在基层医院及社区卫生服务中心较为适用。

【关键词】 慢性咳嗽； 社区卫生服务中心； 经验性治疗

中图分类号 R56 文献标识码 B 文章编号 1674-6805（2014）19-0114-02

The Effect Analysis of Empirical Therapy Method in 28 Cases with Chronic Cough/XU Ling-yun.//Chinese and Foreign Medical Research，2014，12（19）：114-115

【Abstract】 Objective：To investigate the feasibility of application of treating chronic cough with empirical therapy method in primary hospital and community health service center，and to provide practical evidence for increasing the rates of diagnosis and treatment.Method：28 cases with chronic cough who were treated in machinery factory health center and community health service center from March 2010 to March 2013 were enrolled.All the subjects were retrospectively analyzed by previous history，clinical conditions and situation after being treated by empirical therapy method.Result：By Giving symptoms obviously alleviated，26 cases of cough disappeared in 28 patients，without recurrence.1 case was diagnosed endobronchial tuberculosis by the superior hospital.1 case was poor effect，the cause was unknown.Conclusion：Chronic cough is so common a disease in clinical practice，and empirical therapy method is applicable in primary hospital and community health service center.

【Key words】 Chronic cough； Community health service center； Empirical treatment

First-authors address：Shengnan Community Machinery Factory Health Center of Shengli Petroleum Administrative Bureau，Dongying 257000，China

慢性咳嗽是臨床上的一种常见病症，而在基层医院及社区卫生服务中心尤为常见。胸部X线无明显异常的慢性咳嗽约占呼吸专科门诊的20%～30%[1]，且误诊误治率很高，多达80%的慢性咳嗽患者被误诊为“慢性支气管炎或慢性咽喉炎”等疾病[2-3]。有资料报道，一组最终确诊为UACS、CVA、EB及GERC的慢性咳嗽患者全部经历了误诊过程，其中多数误诊为支气管炎和咽炎[4]。如果慢性顽固性咳嗽长期得不到有效诊治，则影响患者睡眠，以致患者生活质量显著下降，对患者造成极大的心理压力、经济压力，并且造成抗生素的滥用。病因导向的诊断流程是慢性咳嗽诊断治疗的基础，可减少盲目性，提高治疗成功率。但病因诊断需要一定的设备和条件，对在基层医院或经济条件有限的患者难于实施，因此，当客观条件有限，经验性治疗可以作为一种替代措施[5]。……