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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2020-17-124-131</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-5885</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Рациональная фармакотерапия</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Rational pharmacotherapy</subject></subj-group></article-categories><title-group><article-title>Хронический кашель: дифференциальная диагностика и лечение</article-title><trans-title-group xml:lang="en"><trans-title>Chronic cough: differential diagnosis and treatment</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4293-3285</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Орлова</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Orlova</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Орлова Наталья Васильевна, доктор медицинских наук, профессор, профессор кафедры факультетской терапии педиатрического факультета</p><p>117997, Москва, ул. Островитянова, д. 1 </p></bio><bio xml:lang="en"><p>Natalia V. Orlova, Dr. of Sci. (Med.), Professor</p><p>1, Ostrovityanov St., Moscow, 117997</p></bio><email xlink:type="simple">vrach315@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Российский национальный исследовательский медицинский университет им. Н.И. Пирогова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pirogov Russian National Research Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>21</day><month>11</month><year>2020</year></pub-date><volume>0</volume><issue>17</issue><fpage>124</fpage><lpage>131</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Орлова Н.В., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Орлова Н.В.</copyright-holder><copyright-holder xml:lang="en">Orlova N.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/5885">https://www.med-sovet.pro/jour/article/view/5885</self-uri><abstract><p>Кашель является одним из самых распространенных симптомов и присутствует при заболеваниях дыхательной, сердечнососудистой, пищеварительной, эндокринной и других систем. Кашель является рефлекторным актом, поэтому обусловлен стимуляцией кашлевых рецепторов вследствие патологических воздействий. В диагностике учитывают характер кашля, его продолжительность, результаты лабораторных и инструментальных методов обследования. Наибольшего внимания требует диагностика хронического кашля и исключение его жизнеугрожающих причин. Симптомами тревоги являются кровохарканье, длительный резистентный кашель, длительный интоксикационный синдром, снижение веса и др. При диагностически неясных случаях в схему обследования обязательно включают компьютерную томографию грудной клетки, магниторезонансную томографию и бронхоскопию. Сухой мучительный интенсивный кашель может приводить к развитию осложнений: снижению качества жизни, кровоизлияниям, пневмотораксу и др., поэтому требует симптоматического лечения. Частой причиной непродуктивного кашля являются вирусные заболевания, коклюш, заболевания, приводящие к гиперактивности кашлевых рецепторов. Разнообразие кашля определяет дифференцированный подход к его терапии. Основные усилия должны быть направлены на лечение основного заболевания. В случае продуктивного кашля применяются мукоактивные препараты. Для купирования непродуктивного кашля применяют противокашлевые препараты центрального и периферического действия. В рекомендациях Европейского респираторного общества представлены результаты клинических исследований по оценке эффективности и безопасности противокашлевых препаратов с морфиноподобным действием. В исследовании были выявлены побочные эффекты, ограничивающие их применение. Одним из наиболее эффективных и безопасных противокашлевых препаратов является неопиоидный препарат с центральным действием Синекод. Эффективность и безопасность препарата подтверждается проведенными клиническими исследованиями.</p></abstract><trans-abstract xml:lang="en"><p>Cough is one of the most common symptoms and is present in diseases of the respiratory, cardiovascular, digestive, endocrine and other systems. Cough is a reflex act, therefore it is caused by stimulation of cough receptors due to pathological influences. The diagnosis takes into account the nature of the cough, its duration, the results of laboratory and instrumental examination methods. The most attention is required to diagnose chronic cough and exclude life-threatening causes. Symptoms of anxiety are hemoptysis, prolonged resistant cough, prolonged intoxication syndrome, weight loss, etc. In diagnostically unclear cases, the examination schedule must include computed tomography of the chest, magnetic resonance imaging and bronchoscopy. A dry, painful intense cough can lead to the development of complications: a decrease in the quality of life, hemorrhages, pneumothorax, etc., therefore, requires symptomatic treatment. A common cause of unproductive cough is viral diseases, whooping cough, diseases leading to overactive cough receptors. The variety of coughs determines a differentiated approach to its therapy. The main efforts should be directed to the treatment of the underlying disease. In the case of a productive cough, mucoactive drugs are used. To stop unproductive cough, antitussive drugs of central and peripheral action are used. The recommendations of the European Respiratory Society present the results of clinical trials assessing the efficacy and safety of antitussive drugs with morphine-like action. The study identified side effects that limit their use. One of the most effective and safe drugs is a non-opioid drug with a central action Sinekod. The effectiveness and safety of the drug is confirmed by clinical studies.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>кашлевой рефлекс</kwd><kwd>гиперчувствительный хронический кашель</kwd><kwd>COVID-19</kwd><kwd>дифференциальный поиск</kwd><kwd>противокашлевые препараты центрального действия</kwd><kwd>мукоактивные препараты</kwd></kwd-group><kwd-group xml:lang="en"><kwd>cough reflex</kwd><kwd>hypersensitive chronic cough</kwd><kwd>COVID 19</kwd><kwd>differential search</kwd><kwd>centrally acting antitussives</kwd><kwd>mucoactive drugs</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Irwin R.S., French C.T., Lewis S.Z., Diekemper R.L., Gold P.M. Expert Cough Pane Overview of the Management of Cough: CHEST Guideline and Expert Panel Report. 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