This study conducted a meta-analysis to evaluate the efficacy and safety of neuromodulators in treating refractory or unexplained chronic cough (R/UCC), given the limited treatment options and concerns about medication safety. Nine randomized controlled trials were included, focusing on the impact of neuromodulators on chronic cough symptoms. Results showed significant improvements in quality of life, with a mean difference (MD) in the Leicester Cough Questionnaire score of 3.21 and a reduction in 24-h cough frequency with an MD of −7.91. Gabapentin demonstrated the most substantial enhancements. Longer treatment durations, specifically 12 weeks, were found to be more effective. Sensitivity analysis and publication bias assessment confirmed the reliability of these findings, indicating the clinical efficacy of neuromodulators in managing R/UCC. Future research should investigate patient population differences and treatment strategies to expand the broader application of neuromodulators in the management of chronic cough.
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