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[关于一种含有旱金莲草和辣根的草药制剂在儿童急性鼻窦炎、急性支气管炎和急性尿路感染中的疗效和安全性的持续研究,并与其他抗生素治疗方法进行比较]

[On-going investigations on efficacy and safety profile of a herbal drug containing nasturtium herb and horseradish root in acute sinusitis, acute bronchitis and acute urinary tract infection in children in comparison with other antibiotic treatments].

作者信息

Goos Karl-Heinz, Albrecht Uwe, Schneider Berthold

机构信息

Repha GmbH, Biologische Arzneimittel, Langenhagen, Germany.

出版信息

Arzneimittelforschung. 2007;57(4):238-46. doi: 10.1055/s-0031-1296611.

Abstract

PATIENTS AND METHODS

In this study which was carried out in the period between 1st May until 4th October 2006 in 65 study sites as a prospective cohort study in 858 children, adolescents and juveniles in the age between 4 and 18 years who consulted the physician due to an acute sinusitis, acute bronchitis or acute urinary tract infection (UTI). Data of in total 858 patients were recorded. The patients were treated either with the herbal drug preparation Angocin Anti-Infekt N (test group, n = 523, 61%) or with a standard antibiotic (control group, n = 335, 39%) according to the decision of the physician. The duration of treatment as well as the dosage was determined by the physician. 297 patients suffering from acute sinusitis (197 test group 66%, 100 control patients 34%), 290 patients suffering from acute bronchitis (178 test group 61%, 112 control patients 39%) and 271 patients with acute urinary tract infection (148 test group 55%, 123 control patients 45 %) were included. The patients recorded in a diary the utilization of the medication, concomitant procedures and adverse events (AEs). The physician recorded at study start and at the end of the study the compliance in a standardised form. Single symptoms were recorded according to their intensity with a score ranging from 0 = no symptom to 3 = severe symptoms. At the end of the study (disease free or after 7-14 days) the physicians finally judged on the course of the treatment as well on the efficacy as observed. The patients recorded their satisfaction with the treatment. Primary efficacy criterion was the change of the complaints quantified by the change of the relative symptom score average over all symptoms between result at study start and study end related to the baseline value.

RESULTS

The two therapy groups differ in their basis data with regard to the mean age (test group 12.2 years, control group 13.5 years; p > 0.001) and the frequency of concomitant diseases (test group 6.3%, control group 2.4%; p = 0.008). At start of treatment the complaints in the test group were significantly less severe (mean of the complaint score 1.67) compared to the control group (mean 2.00; p > 0.001). At the end of treatment there were no significant differences in the mean complaint score between the groups (test group 0.41, control group 0.49; p = 0.722). The mean reduction of the complaint score expressed in percentages was for the indication acute sinusitis in the test group 84.8% and in the control group 85.5%, for the indication acute bronchitis in the test group 82.1% and in the control group 77.7% and for the indication acute urinary tract infection in the test group 89.9% and in the control group 93.1%. In total the mean reduction of the complaint score for the test group was 85.3% and in the test group 85.7% (p = 0.828). The 95% confidence interval for difference of the expected reductions between test group and control group ranged from -3.87% up to 3.10%. With a border of +/- 10% the mean reduction for both groups is equivalent, and more importantly non-inferior for the test group compared with the control group. Adverse events were recorded for 3 patients (0.6%) of the test group and for 14 patients (3.9%) of the control group (p = 0.001). In conclusion it was demonstrated that therapy with the herbal drug preparation in the indications acute sinusitis, acute bronchitis and acute urinary tract infection is--with regard to efficacy--comparable to a treatment with standard antibiotics. The test preparation displayed in all indications a significantly lower potential for adverse events compared to a treatment with standard antibiotics and, therefore, a better safety profile could be concluded.

摘要

患者与方法

本研究于2006年5月1日至10月4日期间在65个研究地点进行,作为一项前瞻性队列研究,研究对象为858名4至18岁因急性鼻窦炎、急性支气管炎或急性尿路感染(UTI)而就诊的儿童、青少年和少年。共记录了858例患者的数据。根据医生的决定,患者要么接受草药制剂Angocin Anti-Infekt N治疗(试验组,n = 523,61%),要么接受标准抗生素治疗(对照组,n = 335,39%)。治疗持续时间和剂量由医生确定。纳入了297例急性鼻窦炎患者(试验组197例,66%;对照组100例,34%)、290例急性支气管炎患者(试验组178例,61%;对照组112例,39%)和271例急性尿路感染患者(试验组148例,55%;对照组123例,45%)。患者通过日记记录用药情况、伴随治疗和不良事件(AE)。医生在研究开始和结束时以标准化表格记录依从性。根据症状强度记录单个症状,评分范围从0 = 无症状到3 = 严重症状。在研究结束时(无疾病或7 - 14天后),医生最终对治疗过程以及观察到的疗效进行判断。患者记录他们对治疗的满意度。主要疗效标准是通过研究开始和结束时所有症状的相对症状评分平均值相对于基线值的变化来量化的症状变化。

结果

两个治疗组在基础数据方面存在差异,平均年龄(试验组12.2岁,对照组(13.5)岁;(p > 0.001))和伴随疾病频率(试验组6.3%,对照组2.4%;(p = 0.008))不同。治疗开始时,试验组的症状明显不如对照组严重(症状评分平均值为1.67)(对照组平均值为2.00;(p > 0.001))。治疗结束时,两组之间的平均症状评分无显著差异(试验组0.41,对照组0.49;(p = 0.722))。以百分比表示的症状评分平均降低值,对于急性鼻窦炎指征,试验组为84.8%,对照组为85.5%;对于急性支气管炎指征,试验组为82.1%,对照组为77.7%;对于急性尿路感染指征,试验组为89.9%,对照组为93.1%。总体而言,试验组症状评分的平均降低值为85.3%,对照组为85.7%((p = 0.828))。试验组和对照组预期降低值差异的95%置信区间为(-3.87%)至(3.10%)。两组平均降低值在(\pm 10%)范围内相当,更重要的是,试验组与对照组相比不差。试验组有3例患者(0.6%)记录了不良事件,对照组有14例患者(3.9%)记录了不良事件((p = 0.001))。总之,结果表明,草药制剂在急性鼻窦炎、急性支气管炎和急性尿路感染的治疗中,在疗效方面与标准抗生素治疗相当。与标准抗生素治疗相比,试验制剂在所有指征中显示出显著更低的不良事件发生可能性,因此,可以得出更好的安全性结论。

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