難治性乾性咳嗽に対し胸部固定帯治療が鎮咳に効果を認めた1例

A Case of Persistent Dry Cough Effectively Treated by Chest Band

要旨　間質性肺炎に伴う乾性咳嗽は難治性で，患者の生活の質を損なう要因となることが多い．われわれは胸部固定帯を用い難治性乾性咳嗽に対する症状の軽快を認めた症例を経験したため，文献的考察を含めて報告する．症例は間質性肺炎の70歳男性．ステロイド治療，免疫抑制剤加療中に乾性咳嗽の悪化を認めた．中枢性鎮咳薬を使用するも咳嗽の改善を認めず．同症例に対し呼吸困難の改善を目的に胸郭下部に対して呼吸介助法を行ったところ咳嗽の軽快を認めた．自己でできる呼吸介助法として胸郭の圧迫を目的に軟性の胸部固定帯を装着したところ，同様に咳嗽の軽快を認めた．胸部固定帯治療が乾性咳嗽治療における一つの治療法となる可能性があると考えられた．

　The non-productive cough complicated with interstitial pneumonia is intractable, and the cough becomes a factor in the loss of quality of life in interstitial pneumonia patients. We encounterd one case in which a chest band was effective to relieve non-productive cough in a patient with interstitial pneumonia. The case was that of a 70-year-old man.

　He was treated with prednisolone, cyclophosphamide and cough remedy, but they had no antitussive effect for him, and his non-productive cough continued. Subsequently, we found that his cough symptom was relieved by breathing relaxation performed for dyspnea palliation. Based on this observation we attached an extensible chest band to him for thoracic cage compression, and this was an effective treatment for him. We report this experience in the hope that treatment with an extensible chest band might possibly be a good treatment for intractable non-productive cough.