Maranta C A, Simmen D
HNO-Klinik, Kantonsspital Aarau.
Schweiz Med Wochenschr. 1996 Nov 2;126(44):1875-80.
Between november 1993 and july 1995 60 patients with a common cold underwent randomized and double-blind testing of 3 commercial nasal sprays-benzydamine, xylometazoline combined with the secretolytic S-carboxymethylcysteine, and phenylephrine combined with the antihistaminic dimethindene maleate. After prior active rhinomanometric measurement of the untreated nose, the test substance was applied. The change of nasal patency was registered after 3 and 10 minutes and then after 2, 4, 6 and 8 hours. At the end the patient gave a subjective evaluation of the used spray. There was no change in nasal obstruction following application of NaCl or benzydamine. Xylometazoline/S-carboxymethylcysteine (+87%) or phenylephrine/ dimethindene maleate (+113%) augmented nasal patency within minutes. Using phenylephrine/dimethindene maleate the effect lasted less than 2 hours, while after xylometazoline/S-carboxymethylcysteine decongestion lasted more than 6 hours. The patients also subjectively reported an increase in nasal patency after the use of benzydamine and placebo. But only phenylephrine/ dimethindene maleate or xylometazoline/S-carboxymethylcysteine were judged good. Using benzydamine or phenylephrine + dimethindene maleate, more side-effects (mainly dryness and burning) were mentioned. Considering the subjective assessment of side-effects and duration of action, as well as objective parameters, derivatives of imidazole (oxymetazoline and xylometazoline) are first choice in treatment of the common cold.
1993年11月至1995年7月期间,60名患普通感冒的患者接受了3种市售鼻喷雾剂的随机双盲测试,这3种鼻喷雾剂分别是:苄达明、赛洛唑啉与黏液溶解剂S-羧甲基半胱氨酸的组合,以及去氧肾上腺素与抗组胺药马来酸氯苯那敏的组合。在对未治疗的鼻子进行主动鼻测压测量后,应用测试物质。分别在3分钟和10分钟后,以及2、4、6和8小时后记录鼻腔通畅度的变化。最后,患者对所使用的喷雾剂进行主观评价。应用氯化钠或苄达明后鼻塞无变化。赛洛唑啉/S-羧甲基半胱氨酸(+87%)或去氧肾上腺素/马来酸氯苯那敏(+113%)在数分钟内即可增强鼻腔通畅度。使用去氧肾上腺素/马来酸氯苯那敏,效果持续不到2小时,而使用赛洛唑啉/S-羧甲基半胱氨酸后,鼻充血缓解持续超过6小时。患者在使用苄达明和安慰剂后也主观报告鼻腔通畅度有所增加。但只有去氧肾上腺素/马来酸氯苯那敏或赛洛唑啉/S-羧甲基半胱氨酸被评价为良好。使用苄达明或去氧肾上腺素+马来酸氯苯那敏时,提及的副作用更多(主要是干燥和烧灼感)。综合考虑副作用的主观评估、作用持续时间以及客观参数,咪唑衍生物(羟甲唑啉和赛洛唑啉)是治疗普通感冒的首选药物。