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治咳嗽,蜂蜜比藥物更管用

放大字體  縮小字體 發(fā)布日期:2008-03-13
核心提示:Honey is a better and safer treatment for children than over-the-counter cough syrup, a new study finds. Researchers at Penn State College of Medicine found that a small dose of buckwheat honey given before bedtime provided better relief of nighttim


    Honey is a better and safer treatment for children than over-the-counter cough syrup, a new study finds.

    Researchers at Penn State College of  Medicine   found that a small dose of buckwheat honey given before bedtime provided better relief of nighttime cough and sleep difficulty in children than no treatment or dextromethorphan (DM), a cough suppressant found in many over-the-counter cold medications.

    Honey did a better job reducing the severity, frequency and annoyance of nighttime coughing resulting from upper respiratory infection than DM or no treatment. Honey also helped the coughing child and the child’s parents get more sleep.

    DM was not significantly better at alleviating symptoms than no treatment.

    These findings are especially notable since an FDA advisory board recently recommended that over-the-counter cough and cold medicines not be given to children under 6 years old because of lack of effectiveness and potential for side effects.

    The results, described by lead author Ian Paul, are detailed in the December issue of the journal Archives of Pediatrics and Adolescent Medicine.
Paul and colleagues showed in 2004 that neither DM nor diphenhydramine, another common component of cold medications, performed better than a placebo at reducing nighttime cough or improving sleep quality. However, honey has been used for centuries in some cultures to treat upper respiratory infection symptoms like cough and is considered to be safe for children over 12 months old. Honey has well-established antioxidant and antimicrobial effects, which could explain its contributions to wound healing. Honey also soothes on contact, which may help explain its effect on cough as suggested by the World Health Organization.

    In the latest study, the researchers enrolled 105 children between the ages of 2 and 18 at a university-affiliated physician practice site. On the first night of the study, children received no treatment. Parents answered five questions about their child’s cough and sleep quality as well as about their own sleep quality. On the second night, children received either honey, artificial honey-flavored DM or no treatment about a half hour prior to going to bed. Parents answered the same five questions the following morning.

    The randomized study was partially double-blinded: Medical staff did not know what treatment each participating family received when distributing their sealed syringe-containing envelope. Parents of children who received honey or artificial honey-flavored DM in a measured syringe were blinded to their treatment group. Parents of children in the no treatment group received an empty syringe, and therefore were aware of their child’s treatment group.

    Across the board, parents rated honey as significantly better than DM or no treatment for symptomatic relief of their child’s nighttime cough and sleep difficulty. In a few cases, parents did report mild side effects with the honey treatment, such as hyperactivity.

    “Our study adds to the growing literature questioning the use of DM in children, but it also offers a legitimate and safe alternative for physicians and parents,” said Paul, a pediatrician, researcher and associate professor of pediatrics at Penn State College of Medicine and Penn State Children’s Hospital. “Additional studies should certainly be considered, but we hope that medical professionals will consider the positive potential of honey as a treatment given the lack of proven efficacy, expense and potential for adverse effects associated with the use of DM.”

    Potentially dangerous effects of DM in young children include dystonic reactions, severe involuntary muscle contractions and spasms. Further, DM is a commonly used as a drug of abuse by adolescents.

    Cough is the reason for nearly 3 percent of all outpatient visits in the United States, more than any other symptom. It is particularly bothersome at night because it disrupts sleep. Consumers spend billions of dollars each year on OTC cough and cold medications despite little evidence that these drugs provide significant relief.

    一項新的研究表明,治療兒童咳嗽,蜂蜜比非處方藥咳嗽糖漿來的更有效、更安全。

    賓州醫(yī)學(xué)院的研究人員發(fā)現(xiàn)兒童在睡前服用少量蕎麥蜜,緩解夜間咳嗽和睡眠困難的效果比不吃藥和服用右美沙芬來的好,右美沙芬是許多非處方感冒藥中的止咳成分。

    蜂蜜對于減緩由上呼吸道感染引發(fā)的激烈、頻發(fā)和煩人的夜間咳嗽比服用右美沙芬或不去治療來的更有效。蜂蜜也可以幫助咳嗽兒童和他的家長獲得更多睡眠。

    服用右美沙芬和不吃藥對于減緩癥狀沒有太大區(qū)別。

    這項發(fā)現(xiàn)成果顯著,因為美國食品及藥物管理局顧問團近日建議,由于非處方咳嗽和感冒藥效力不足和潛在的副作用,所以不適合6歲以下兒童服用。

    該結(jié)果由主要作者Ian Paul詳細刊登于12月發(fā)布的《兒童和青少年醫(yī)學(xué)雜志》上。

    Paul和同事在2004年表示,右美沙芬和苯海拉明都不如另一個感冒藥中的普通成分來的能減緩夜間咳嗽癥狀,或增強睡眠質(zhì)量。然而,蜂蜜在數(shù)世紀(jì)以來在一些文化中被當(dāng)作治療上呼吸道感染引起的咳嗽的良方,對12個月以上的兒童很安全。蜂蜜確認含有抗氧化劑和殺菌作用,這就可以解釋為什么它對于傷口愈合有效。蜂蜜對于平復(fù)疼痛有效,這也可以解釋為什么世界衛(wèi)生組織認為它對于咳嗽有效了。

    在最近的調(diào)查中,研究人員在一所大學(xué)附屬的醫(yī)生實習(xí)點聚集了年齡在2到18歲的105名兒童。研究的第一晚,孩子們沒有接受治療。家長回答了五個關(guān)于他們孩子咳嗽和睡眠質(zhì)量的問題,同時也提及了自身的睡眠質(zhì)量。第二晚,孩子們在睡前一小時分別接受了蜂蜜,人工蜂蜜味的右美沙芬,還有一部分則未接受治療。家長在第二天早上回答了同樣的五個問題。該隨機調(diào)查部分是雙盲性的:醫(yī)療機構(gòu)的工作人員不知道每個參與家庭受到何種治療,因為他們分發(fā)的是裝有注射劑的密封信封。孩子的家長收到蜂蜜或人造蜂蜜味右美沙芬注射劑對自己所在的治療團體也不清楚。未受藥物治療的孩子們的家長收到空的注射器,因此他們知道自己的孩子屬于哪個治療團體。

    通過選舉,家長將蜂蜜評為比右美沙芬或無治療對于減緩孩子夜間咳嗽和睡眠困難癥狀更有效的東西。在一些案例中,家長發(fā)現(xiàn)接受蜂蜜治療后,會出現(xiàn)輕微的副作用,例如好動。

    賓州醫(yī)學(xué)院和賓州兒童醫(yī)院的兒科醫(yī)師、研究院和副教授Paul說:“我們的研究增加了對于兒童使用右美沙芬的質(zhì)疑,但是對于醫(yī)生和家長還是可以合理、安全的做出選擇。我們也認可其他的調(diào)查,但是我們希望醫(yī)療專家能夠考慮蜂蜜作為治療藥物的積極因素,以及使用右美沙芬的功效、價格和潛在的副作用。

    年幼兒童服用右美沙芬存在的潛在副作用包括異常反應(yīng)、不隨意肌嚴(yán)重收縮和痙攣。此外,成年人通常會濫用右美沙芬。

    在美國,近3%的門診病人是因為咳嗽來看病的,比其他癥狀來的更多。咳嗽在晚上尤其麻煩,因為它會影響睡眠。消費者每年要花數(shù)十億美元在非處方咳嗽藥和感冒藥上,盡管藥物對于癥狀的緩解收效甚微。

 

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