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对乙酰氨基酚:对水痘弊大于利?

Acetaminophen: more harm than good for chickenpox?

作者信息

Doran T F, De Angelis C, Baumgardner R A, Mellits E D

机构信息

Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore.

出版信息

J Pediatr. 1989 Jun;114(6):1045-8. doi: 10.1016/s0022-3476(89)80461-5.

Abstract

STUDY OBJECTIVE

To determine whether acetaminophen affects the duration or severity of childhood varicella.

DESIGN

Randomized, double-blind, placebo-controlled trial.

SETTING

Office- and hospital-based pediatric practices.

PATIENTS

Seventy-two children between 1 and 12 years of age entered the study. One child was withdrawn because of high fever, and three children did not complete the study; 31 received placebo and 37 received acetaminophen.

INTERVENTIONS

Acetaminophen, 10 mg/kg/dose, was given at 8 AM, 12 PM, 4 PM, and 8 PM for 4 days. Placebo was given to the control group. Itching, appetite, activity, and overall condition were measured for 6 days. The time to last vesicle formation, time to total scabbing, and time to total healing were measured until complete resolution of the exanthem.

MEASUREMENTS AND MAIN RESULTS

The following results were better in the placebo group (p less than .05): time to total scabbing 5.6 days (SD 2.5) versus 6.7 days (SD 2.3) in the acetaminophen group, and itching on day 4 in the placebo group (symptom score 2.9 (SD 0.20) vs 2.2 (SD 0.26]. Activity was better in the acetaminophen group on day 2 (3.13 (SD 0.23) vs 2.82 (SD 0.24].

CONCLUSIONS

These results provide evidence that acetaminophen does not alleviate symptoms in children with varicella and may prolong illness.

摘要

研究目的

确定对乙酰氨基酚是否会影响儿童水痘的病程或严重程度。

设计

随机、双盲、安慰剂对照试验。

地点

基于办公室和医院的儿科诊所。

患者

72名1至12岁的儿童进入研究。一名儿童因高烧退出,三名儿童未完成研究;31名接受安慰剂,37名接受对乙酰氨基酚。

干预措施

对乙酰氨基酚,10mg/kg/剂量,于上午8点、中午12点、下午4点和晚上8点给药,共4天。对照组给予安慰剂。对瘙痒、食欲、活动和总体状况进行6天的测量。测量最后一个水疱形成的时间、完全结痂的时间和完全愈合的时间,直到皮疹完全消退。

测量结果与主要结果

以下结果在安慰剂组更好(p<0.05):完全结痂时间,安慰剂组为5.6天(标准差2.5),对乙酰氨基酚组为6.7天(标准差2.3);安慰剂组第4天的瘙痒(症状评分2.9(标准差0.20)对2.2(标准差0.26)。对乙酰氨基酚组在第2天的活动情况更好(3.13(标准差0.23)对2.82(标准差0.24)。

结论

这些结果表明,对乙酰氨基酚不能缓解水痘患儿的症状,可能会延长病程。

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