Homnick Douglas N, Marks John H, Hare Karyl L, Bonnema Sally K
Department of Pediatrics, Kalamazoo Center for Medical Studies, Michigan State University, Kalamazoo, Michigan 49008, USA.
Pediatr Pulmonol. 2005 Sep;40(3):251-6. doi: 10.1002/ppul.20265.
Appetite stimulants have been used to help overcome decreased appetite and malnutrition in children and adults with various chronic illnesses, including cystic fibrosis (CF). Stimulants have included megestrol acetate (MA), cyproheptadine hydrochloride (CH), cannabinoids, hydrazine sulfate, anabolic hormones, and growth hormone. Many of these, including MA, have substantial side effects and may not be suitable for prolonged use. We previously studied the effects of CH on weight gain in a short-term (12 week) trial in CF with good results compared to placebo. Side effects were few, and weight gain was significant. In this study, we sought to determine the effects of CH over a longer term in order to assess its suitability for prolonged use. Sixteen CF children and adults enrolled in the original short-term study subsequently entered this study, and 12 completed the 9-month trial. All patients receiving placebo in the original short-term study received CH 4 mg up to four times a day in the long-term study continuation, and those receiving CH in the short-term study continued on the drug. No pill counts were done, and patients were queried at quarterly visits as to their CH use. Anthropometrics and spirometry were also done quarterly, and antibiotic use was quantified. Subjects who had changed from placebo (CH2 group) gained weight significantly over 3-6 months, and those continuing on CH (CH1 group) generally maintained previously gained weight over the duration of the study. Select spirometric measures improved in both groups but not significantly, and side effects were mild. CH appears to be an effective appetite stimulant in CF, and generally maintains its effect over time with an acceptable side-effect profile.
食欲刺激剂已被用于帮助患有各种慢性疾病（包括囊性纤维化，简称CF）的儿童和成人克服食欲下降和营养不良的问题。这些刺激剂包括醋酸甲地孕酮（MA）、盐酸赛庚啶（CH）、大麻素、硫酸肼、合成代谢激素和生长激素。其中许多药物，包括MA，都有严重的副作用，可能不适合长期使用。我们之前在一项针对CF患者的短期（12周）试验中研究了CH对体重增加的影响，与安慰剂相比效果良好。副作用很少，体重增加显著。在本研究中，我们试图确定CH在更长时间内的效果，以评估其长期使用的适用性。最初参与短期研究的16名CF儿童和成人随后进入了本研究，其中12人完成了为期9个月的试验。在最初的短期研究中接受安慰剂的所有患者在长期研究延续阶段接受每天最多4次、每次4毫克的CH，而在短期研究中接受CH的患者继续服用该药物。未进行药丸计数，在每季度的随访中询问患者CH的使用情况。每季度还进行人体测量和肺功能测定，并对抗生素使用情况进行量化。从安慰剂组转换过来的受试者（CH2组）在3至6个月内体重显著增加，而继续服用CH的受试者（CH1组）在研究期间总体上保持了之前增加的体重。两组的一些肺功能指标均有改善，但不显著，且副作用轻微。CH似乎是一种有效的CF食欲刺激剂，通常随着时间推移能维持其效果，且副作用可接受。
