Clinical observation on moxibustion at Baihui (GV20) plus Tuina for children with postnasal drip syndrome / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of moxibustion at Baihui (GV20) plus Tuina (Chinese therapeutic massage) for children with postnasal drip syndrome (PNDS).Methods: A total of 60 cases were divided into an observation group and a control group according to the random number table method, with 30 cases in each group. Cases in the control group received mometasone furoate nasal spray and nasal irrigation with 0.9％ normal saline. Cases in the observation group received additional moxibustion at Baihui (GV20) plus Tuina at the head and face. All the cases were treated for four consecutive weeks. The clinical efficacy and traditional Chinese medicine (TCM) symptoms score were compared between the two groups. Results: The total effective rate of the observation group was 93.3％ while that of the control group was 70.0％. The difference between the two groups was statistically significant (P<0.05). After treatment, the TCM symptom scores in both groups declined significantly, showing a statistical difference from that before treatment (P<0.05), and the score of the observation group was notably lower than that of the control group (P<0.05). Conclusion: The clinical efficacy of moxibustion at Baihui (GV20) plus Tuina at the head and face on the basis of nasal spray with Western medicine is more significant than that of Western medicine alone for PNDS in children.

Efficacy and Tolerability of Theobromine in Patients with Upper Airway Cough Syndrome: A Multicenter, Double-Blind, Randomized, Active Drug Comparative Study

OBJECTIVES: The objective of this study is to evaluate the efficacy and tolerability of theobromine in patients with upper airway cough syndrome compared to those of levocloperastine. MATERIALS AND METHOD: This was a randomized, double-blind study. One hundred sixty-five patients with upper airway cough syndrome participated in a 5 day treatment; 85 subjects were included in the theobromine treatment group and 80 in the levocloperastine control group. Cough severity score, daytime cough symptom (DCS), nighttime cough symptom (NCS) and cough quality of life questionnaire (CQLQ) were analyzed for symptom analysis, and vital signs and laboratory study were performed for safety evaluation before and after medication administration. RESULTS: The primary efficacy analysis showed that the mean change in cough grade between baseline and follow-up in the treatment group was lower than that in the control group. This led to the conclusion that theobromine has similar efficacy to control treatment. The secondary efficacy analysis of changes in DCS, NCS and CQLQ verified this conclusion. Considering safety, only one case of dyspepsia was considered to be probably related to theobromine. Other tests conducted before and after treatment confirmed the safety of treatment medications. CONCLUSION: Theobromine is a novel natural antitussive medication that has similar efficacy to levocloperastine and adequate safety.

Postnasal Drip Syndrome

Postnasal drip syndrome is one of the most common causes of chronic cough, and is caused by a variety of conditions including vasomotor rhinitis, allergic rhinitis, nasal polyps and chronic sinusitis. Postnasal drip syndrome is diagnosed based on clinical symptoms, and patients may complain of tickles or drainage of liquid in the back of the throat. Cobblestoning of the nasal or oropharyngeal mucosa may be observed upon physical examination. However, in many patients cough may be the only symptom of postnasal drip syndrome. Confirmation of the diagnosis may depend on the resolution of symptoms after treatments with antihistamines and intranasal or systemic corticosteroids.

Diagnosis and Treatment of Cough

Cough remains the most common reason for patients to seek medical attention. Although the exact prevalence is difficult to estimate, recurrent cough is reported in up to 40% of the population. For the investigation and treatment of chronic cough, it is important to understand its etiology, particularly when the underlying pathology exists outside the respiratory tract. Although there is no consensus as to the best diagnostic strategy for chronic cough, many protocols combine laboratory investigations with empirical trials of treatment. Specific treatment for the underlying disease of cough along with etiologic diagnosis should be emphasized rather than nonspecific antitussive therapy because nonspecific pharmacologic treatments have changed little during the last 50 years, without any significant advances from opiatebased compounds. Recently, molecular structures of cough receptors and mediators have been identified. Vanilloid receptor-1 is one of ion channel receptors expressed on the sensory neurons of cough reflex. Substances inhibiting ion channels and receptor antagonists of tachy-or bradykinins are being investigated. Thus safer and more effective agents to deal with this common problem are believed to be available in the near future.

Chronic cough and postnasal drip syndrome / 医学研究生学报

To discuss the relativity of chronic cough and postnasal drip syndrome(PNDS) for better clinical diagnosis and treatment.

Chronic cough: the spectrum and the frequency of etiologies / 결핵

BACKGROUND: Chronic cough is a common symptom that requires the systematic diagnostic approach for proper evaluation. Postnasal drip syndrome(PNDS), bronchial asthma, gastroesophageal reflux disease(GERD), and chronic bronchitis are among the common causes. This study was conducted to evaluate the spectrum and the frequency of the causes of chronic cough. METHODS: We prospectively evaluated 93 patients who had chronic cough despite normal chest radiographic finding. History and physical examination were done along with paranasal sinus radiograph, spirometry, bronchoprovocation test and 24-hours' ambulatory aesophageal pH monitoring as necessary. RESULTS: Forty-nine(52%) of the 93 patients had PNDS, 15 patients(16%) bronchitis, 10 patients(11%) asthma, 4 patients(4%) GERD, 7 patients(8%) both PNDS and asthma, 4 patients(4%) undiagnosed condition and 4 patients(4%) were taking ACE inhibitor. Sixty-nine percent of the patients with PNDS improved after follow up, 73% patients with bronchitis, 80% patients with asthma, 50% patients with GERD, 100% patients with both PNDS and asthma, and 100% patients with ACE inhibitor. CONCLUSION: PNDS was the most common causes of chronic cough. Bronchitis was the second and asthma the third in frequency. The etiology of chronic cough can be determined easily by history and physical examination, successful therapy initiated in most patients. The response to specific therapy also was important in evaluation of chronic cough.

Chronic cough: the spectrum and the frequency of etiologies / 결핵

BACKGROUND: Chronic cough is a common symptom that requires the systematic diagnostic approach for proper evaluation. Postnasal drip syndrome(PNDS), bronchial asthma, gastroesophageal reflux disease(GERD), and chronic bronchitis are among the common causes. This study was conducted to evaluate the spectrum and the frequency of the causes of chronic cough. METHODS: We prospectively evaluated 93 patients who had chronic cough despite normal chest radiographic finding. History and physical examination were done along with paranasal sinus radiograph, spirometry, bronchoprovocation test and 24-hours' ambulatory aesophageal pH monitoring as necessary. RESULTS: Forty-nine(52%) of the 93 patients had PNDS, 15 patients(16%) bronchitis, 10 patients(11%) asthma, 4 patients(4%) GERD, 7 patients(8%) both PNDS and asthma, 4 patients(4%) undiagnosed condition and 4 patients(4%) were taking ACE inhibitor. Sixty-nine percent of the patients with PNDS improved after follow up, 73% patients with bronchitis, 80% patients with asthma, 50% patients with GERD, 100% patients with both PNDS and asthma, and 100% patients with ACE inhibitor. CONCLUSION: PNDS was the most common causes of chronic cough. Bronchitis was the second and asthma the third in frequency. The etiology of chronic cough can be determined easily by history and physical examination, successful therapy initiated in most patients. The response to specific therapy also was important in evaluation of chronic cough.