Speech pathology for chronic cough: A new approach
Speech pathology for chronic cough: A new approach
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DOI：
10.1016/j.pupt.2008.11.005
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发表时间：
2009-04-01
影响因子：
3.2
通讯作者：
Vertigan, Anne E.
中科院分区：
文献类型：
--
作者：
Gibson, Peter G.;Vertigan, Anne E.
尽管对哮喘、鼻炎和胃食管反流等已知相关疾病进行系统评估和药物治疗，慢性咳嗽仍可能持续存在。这些患者患有顽固性慢性咳嗽，并且许多患者表现出感觉和运动水平上明显的喉部过敏。这方面的例子包括咳嗽反射对辣椒素的敏感性增强，以及伴有声音嘶哑和声带运动矛盾的喉部运动功能障碍。尽管接受药物治疗仍持续的慢性咳嗽可能对言语病理学干预有反应。根据用于治疗功能亢进性声音障碍和反常声带运动的方法，设计了多维言语病理学治疗方案。这包括教育、声音卫生培训、咳嗽抑制策略和心理教育咨询。在一项涉及 87 名患者的单盲、随机、安慰剂对照试验中进行测试时，治疗组参与者在干预后表现出咳嗽、呼吸、声音和上呼吸道症状显着减轻，声音质量的听觉感知评级（呼吸声、粗声、紧张和声门嘶哑）得到改善，声音声学参数（最大发声时间、抖动和谐波噪声比）显着改善。言语病理学干预可能是治疗难治性慢性咳嗽的有效方法。 (c) 2008 Elsevier Ltd. 保留所有权利。
Chronic cough may persist despite systematic evaluation and medical treatment of known associated diseases such as asthma, rhinitis, and gastro-esophageal reflux. These patients have refractory chronic cough and many exhibit laryngeal hypersensitivity that is manifest at both a sensory and motor level. Examples of this are heightened sensitivity of the cough reflex to capsaicin, and laryngeal motor dysfunction with hoarse vocal quality and paradoxical vocal cord movement. Chronic cough that persists despite medical treatment may respond to speech pathology intervention. A multidimensional speech pathology treatment programme was designed based upon methods used to treat hyperfunctional voice disorders and paradoxical vocal fold movement. This included education, vocal hygiene training, cough suppression strategies and psychoeducational counseling. When tested in a single-blind, randomized, placebo-controlled trial involving 87 patients, participants in the treatment group demonstrated a significant reduction in cough, breathing, voice and upper airway symptoms following intervention, as well as improvements in auditory perceptual ratings of voice quality (breathy, rough, strain and glottal fry) and significant improvement in voice acoustic parameters (maximum phonation time, jitter and harmonic-to-noise ratio). Speech pathology intervention can be an effective way to treat refractory chronic cough. (c) 2008 Elsevier Ltd. All rights reserved.