上气道咳嗽综合征

与上气道症状同时存在的慢性咳嗽，包括喉异物感和鼻后滴流感。

鼻部疾病引起的感觉实际上可能是感觉神经病变的表现，与鼻分泌物的速率或分泌量无关。

成年人慢性咳嗽的最常见原因。

无特殊病征发现；需综合考虑病史、体格检查、成像结果和对治疗的反应等条件进行确诊。

联用第一代抗组胺药和减充血剂的经验性治疗试验，既有诊断意义，又具有治疗意义。非药物治疗也是治疗途径的一部分。

可对生活质量造成重大影响。

美国胸科医师学会将上气道咳嗽综合征（upper airway cough syndrome, UACS）定义为一种与上气道异常有关的、以慢性咳嗽（即存在≥8 周）为特征的综合征。[1]American College of Chest Physicians. Diagnosis and Management of Cough. ​Chronic upper airway cough syndrome secondary to rhinosinus diseases (previously referred to as postnasal drip syndrome): ACCP evidence-based clinical practice guidelines. Jan 2006 [internet publication]. https://www.chestnet.org/Guidelines/Clinical-Pulmonary

​确诊的关键在于咽喉是否有异物感（例如，患者可能诉有物体卡于咽喉）。一项研究认为，UACS 是指干咳持续至少 8 周，并伴有咽喉黏液附着感。[2]Macedo P, Saleh H, Torrego A, et al. Postnasal drip and chronic cough: an open interventional study. Respir Med. 2009 Nov;103(11):1700-5. http://www.resmedjournal.com/article/S0954-6111(09)00153-X/fulltext http://www.ncbi.nlm.nih.gov/pubmed/19481918?tool=bestpractice.com

有人认为 UACS 是独立的临床疾病，而一些专注于慢性咳嗽的医生对此表示质疑。[3]Morice AH. Post-nasal drip syndrome - a symptom to be sniffed at? Pulm Pharmacol Ther. 2004;17(6):343-5. http://www.ncbi.nlm.nih.gov/pubmed/15564073?tool=bestpractice.com 此外，有人还就此综合征临床评估的诊断准确性提出过质疑。专家的意见正逐渐倾向于将 UACS 的众多特征表述为一般性咳嗽超敏反应综合征表现。[4]Morice AH, Millqvist E, Belvisi MG, et al. Expert opinion on the cough hypersensitivity syndrome in respiratory medicine. Eur Respir J. 2014 Nov;44(5):1132-48. https://erj.ersjournals.com/content/44/5/1132.long http://www.ncbi.nlm.nih.gov/pubmed/25142479?tool=bestpractice.com 此外，UACS 还可能与其他气道和呼吸系统疾病并存。

UACS 曾称为鼻后滴流综合征。[1]American College of Chest Physicians. Diagnosis and Management of Cough. ​Chronic upper airway cough syndrome secondary to rhinosinus diseases (previously referred to as postnasal drip syndrome): ACCP evidence-based clinical practice guidelines. Jan 2006 [internet publication]. https://www.chestnet.org/Guidelines/Clinical-Pulmonary ​ 现偏向于采用 UACS 一词的原因是，尚不清楚咳嗽的机制是分泌物从鼻腔或副鼻窦流入咽部所致，还是上气道的咳嗽感受器直接发炎/刺激所致。[1]American College of Chest Physicians. Diagnosis and Management of Cough. ​Chronic upper airway cough syndrome secondary to rhinosinus diseases (previously referred to as postnasal drip syndrome): ACCP evidence-based clinical practice guidelines. Jan 2006 [internet publication]. https://www.chestnet.org/Guidelines/Clinical-Pulmonary ​