Smith D S, Helzner E C, Nuttall C E, Collins M, Rofman B A, Ginsberg D, Goswick C B, Magner A
Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia 19104.
Antimicrob Agents Chemother. 1989 May;33(5):646-8. doi: 10.1128/AAC.33.5.646.
Zinc is a trace metal with in vitro activity against rhinovirus, the major etiologic agent in acute upper respiratory tract infections (URIs). A previous trial of zinc gluconate supported its efficacy in treating URIs, but the effectiveness of blinding was uncertain. We conducted a prospective randomized trial of zinc gluconate versus a taste-matched placebo of sucrose octaacetate. Lozenges containing either 23 mg of elemental zinc or placebo were taken every 2 h. Eleven URI symptoms were rated daily on a scale of 0 (not present) to 3 (severe). Duration of illness, reflected in the proportion of subjects remaining symptomatic on each day, was not significantly reduced (maximum difference of 12.6% on day 7, P = 0.09; 95% confidence interval, -6 to 31%) by either treatment. Severity of illness, assessed by using a summed severity score, was reduced incrementally by 7 to 8% on days 5 to 7 (P = 0.02) in subjects taking zinc. Adverse effects, mostly nausea and altered taste, were reported by 50% of subjects taking zinc. We conclude that while zinc gluconate may produce a small reduction in overall severity of symptoms, this is not clinically significant. Given the additional high incidence of adverse effects, zinc gluconate cannot be recommended for use in the treatment of acute URIs.
锌是一种对鼻病毒具有体外活性的痕量金属，鼻病毒是急性上呼吸道感染（URI）的主要病原体。先前一项关于葡萄糖酸锌的试验支持其在治疗URI方面的疗效，但盲法的有效性尚不确定。我们进行了一项前瞻性随机试验，比较葡萄糖酸锌与味觉匹配的蔗糖八乙酸酯安慰剂。每2小时服用含23毫克元素锌的含片或安慰剂。每天对11种URI症状按0（不存在）至3（严重）进行评分。两种治疗方法均未显著降低疾病持续时间，以每天仍有症状的受试者比例衡量（第7天最大差异为12.6%，P = 0.09；95%置信区间，-6至31%）。服用锌的受试者在第5至7天，通过综合严重程度评分评估的疾病严重程度逐渐降低7%至8%（P = 0.02）。服用锌的受试者中有50%报告了不良反应，主要是恶心和味觉改变。我们得出结论，虽然葡萄糖酸锌可能会使症状的总体严重程度略有降低，但这在临床上并不显著。鉴于不良反应的高发生率，不建议使用葡萄糖酸锌治疗急性URI。
