Homnick Douglas N, Homnick Benjamin D, Reeves Andrew J, Marks John H, Pimentel Ronald S, Bonnema Sally K
Division of Pediatric Pulmonology, Department of Pediatrics, Kalamazoo Center for Medical Studies, Michigan State University, 49008, USA.
Pediatr Pulmonol. 2004 Aug;38(2):129-34. doi: 10.1002/ppul.20043.
Chronic pulmonary infection and intestinal malabsorption often lead to malnutrition in children and adults with cystic fibrosis (CF). Appetite stimulants, along with provision of adequate calories, may aid in overcoming nutritional deficits, allowing a better prognosis. We undertook a trial of cyproheptadine hydrochloride (CH) to determine its effectiveness as an appetite stimulant in 18 adults and children with CF. This was a 12-week, randomized, double-blind, controlled trial of CH vs. placebo. Eighteen subjects with documented CF (sweat or genetics positive), minimum age of 5 years, and ideal body weight for height <100% were entered, and 16 completed the study. Subjects were seen at baseline and every 4 weeks. Measures included baseline demographics, Shwachman score, anthropometrics (weight, height, body mass index, skin folds, and body composition by bioelectric impedance analysis), spirometry, caloric intake, days of oral (PO) and intravenous (IV) antibiotics, and a symptom and satisfaction survey. Subjects in the CH group showed significant increases in weight (mean 3.45 kg vs. 1.1 kg in the placebo group), height, BMI percentiles, ideal body weight/height, weight for age z-scores, and fat and fat-free mass. There were no changes or differences in PO or IV antibiotic use or spirometric changes. No significant side effects except transient mild sedation occurred in the CH group. Patient acceptance was good. In conclusion, CH appears to be an effective appetite stimulant with minimal side effects in children and adults with CF.
慢性肺部感染和肠道吸收不良常常导致患有囊性纤维化（CF）的儿童和成人出现营养不良。食欲刺激剂，连同提供充足的热量，可能有助于克服营养缺乏，从而带来更好的预后。我们进行了一项关于盐酸赛庚啶（CH）的试验，以确定其作为食欲刺激剂在18名患有CF的成人和儿童中的有效性。这是一项为期12周的CH与安慰剂的随机、双盲、对照试验。纳入了18名有CF记录（汗液或基因检测呈阳性）、最低年龄为5岁且身高对应的理想体重<100%的受试者，其中16名完成了研究。在基线时以及每4周对受试者进行观察。测量指标包括基线人口统计学数据、施瓦克曼评分、人体测量学指标（体重、身高、体重指数、皮褶厚度以及通过生物电阻抗分析得出的身体成分）、肺功能测定、热量摄入、口服（PO）和静脉注射（IV）抗生素使用天数以及症状和满意度调查。CH组的受试者在体重（平均增加3.45千克，而安慰剂组为1.1千克）、身高、BMI百分位数、身高对应的理想体重、年龄别体重z评分以及脂肪和去脂体重方面均有显著增加。PO或IV抗生素的使用情况以及肺功能测定结果没有变化或差异。CH组除了出现短暂的轻度镇静外，没有显著的副作用。患者的接受度良好。总之，CH似乎是一种有效的食欲刺激剂，对患有CF的儿童和成人副作用极小。
