Jefferson T O, Tyrrell D
Cochrane Database Syst Rev. 2007 Jul 18;2001(3):CD002743. doi: 10.1002/14651858.CD002743.pub2.
The common cold is a ubiquitous short and usually mild illness for which preventive and treatment interventions have been under development since the mid-40s. As our understanding of the disease has increased, more experimental antivirals have been developed. This review attempts to draw together experimental evidence of the effects of these compounds.
To identify, assemble, evaluate and (if possible) synthesise the results of published and unpublished randomised controlled trials of the effects of antivirals to prevent or minimise the impact of the common cold.
We searched electronic databases, corresponded with researchers and handsearched the archives of the MRC's Common Cold Unit (CCU).
We included original reports of randomised and quasi-randomised trials assessing the effects of antivirals on volunteers artificially infected and in individuals exposed to colds in the community.
We included 241 studies assessing the effects of Interferons, interferon-inducers and other antivirals on experimental and naturally occurring common colds, contained in 230 reports. We structured our comparisons by experimental or community setting.
Although intranasal interferons have high preventive efficacy against experimental colds (protective efficacy 46%, 37% to 54%) and to a lesser extent against natural colds (protective efficacy 24%, 21% to 27%) and are also significantly more effective than placebo in attenuating the course of experimental colds (WMD 15.90, 13.42 to 18.38), their safety profile makes compliance with their use difficult. For example, prolonged prevention of community colds with interferons causes blood-tinged nasal discharge (OR 4.52, 3.78 to 5.41). Dipyridamole (protective efficacy against natural colds 49%, 30% to 62%), ICI 130, 685 (protective efficacy against experimental colds 58%, 35% to 74% ), Impulsin (palmitate) (protective efficacy against natural colds 44%, CI 35% to 52% ) and Pleconaril (protective efficacy against experimental colds 71%, 15% to 90% ) appear to have important antiviral properties and are well-tolerated. The evidence of effectiveness of other compounds in the treatment of experimental or natural colds is sparse.
AUTHORS' CONCLUSIONS: There are no licensed effective antivirals for the common cold. Because prolonged intranasal administration causes a clinical picture which is not distinguishable from the common cold, interferons have no place in everyday use. Further assessment of the effects of dipyridamole, ICI 130, 685, Impulsin (palmitate) and Pleconaril in preventing the common cold should be carried out. Given the multi-agent nature of the causes of the common cold, future research efforts should focus on non virus-specific compounds.
普通感冒是一种普遍存在的短期疾病，通常症状较轻。自40年代中期以来，人们一直在研发针对它的预防和治疗干预措施。随着我们对该疾病认识的增加，更多的实验性抗病毒药物被开发出来。本综述旨在汇总这些化合物作用的实验证据。
识别、收集、评估并（如有可能）综合已发表和未发表的关于抗病毒药物预防或减轻普通感冒影响的随机对照试验结果。
我们检索了电子数据库，与研究人员进行了通信，并手工检索了医学研究委员会普通感冒研究室（CCU）的档案。
我们纳入了评估抗病毒药物对人工感染志愿者和社区中接触感冒者影响的随机和半随机试验的原始报告。
我们纳入了230篇报告中的241项研究，这些研究评估了干扰素、干扰素诱导剂和其他抗病毒药物对实验性和自然发生的普通感冒的影响。我们按实验或社区环境进行比较。
尽管鼻内干扰素对实验性感冒具有较高的预防效果（保护效果46%，37%至54%），对自然感冒的预防效果稍低（保护效果24%，21%至27%），并且在减轻实验性感冒病程方面也比安慰剂显著更有效（加权均数差15.90，13.42至18.38），但其安全性使得难以坚持使用。例如，用干扰素长期预防社区感冒会导致鼻衄（比值比4.52，3.78至5.41）。双嘧达莫（对自然感冒的保护效果49%，30%至62%）、ICI 130,685（对实验性感冒的保护效果58%，35%至74%）、Impulsin（棕榈酸酯）（对自然感冒的保护效果44%，可信区间35%至52%）和普来可那立（对实验性感冒的保护效果71%，15%至90%）似乎具有重要的抗病毒特性且耐受性良好。其他化合物治疗实验性或自然感冒有效性的证据很少。
目前尚无获批用于普通感冒的有效抗病毒药物。由于长期鼻内给药会导致与普通感冒难以区分的临床表现，干扰素不适用于日常使用。应进一步评估双嘧达莫、ICI 130,685、Impulsin（棕榈酸酯）和普来可那立预防普通感冒的效果。鉴于普通感冒病因的多因素性质，未来的研究应集中于非病毒特异性化合物。
