Fujimori K, Suzuki E, Arakawa M
Department of Internal Medicine, Niigata Prefectural Shibata Hospital.
Arerugi. 1998 Jan;47(1):48-53.
H1 antihistamines have been shown to have antitussive effects in patients with asthma and postnasal drip. In Japan, no study has been performed to determine whether orally administered oxatomide, H1 antihistamine, can reduce the chronic cough seen in patients with post-upper-airway infection (postinfection). Patients who had chronic cough of more than three weeks' duration and a history of post-upper-airway infection took part in the study. None had any history of nasal disease, gastroesophageal reflux, bronchial asthma, or other chronic pulmonary disease. All patients were non-smokers, and none used ACE inhibitors. They had normal CRP concentrations, peripheral white blood cell and eosinophil counts, serum IgE concentrations, titers of cold agglutinins and antibodies to Mycoplasma pneumoniae, chest roentgenograms, and respiratory function tests. A prospective randomized, open design was used. The effect of one week of treatment with dextromethorphan (D) or with D plus oxatomide (D + O) on the severity of cough, as estimated by cough diary, were examined. Twenty-two patients entered the study, and 20 were eligible for efficacy and side-effect analyses. Nine patients receiving D and 11 receiving D + O completed the protocol. Patients' characteristics before the start of the study, such as severity and duration of cough, and laboratory data, were not significantly different between the two groups. From trial day 5 to 7, improved rates of cough were significantly higher with D + O than with D alone (p < 0.05). Combination therapy with oxatomide and dextromethorphan reduces subjective perception of cough as estimated by cough diary. These results suggest that oxatomide, H1 antihistamine may improve chronic cough in patients with post-upper-airway infection.
H1抗组胺药已被证明对哮喘和鼻后滴漏患者有镇咳作用。在日本,尚未进行研究以确定口服H1抗组胺药奥沙米特是否能减轻上呼吸道感染后(感染后)患者出现的慢性咳嗽。持续咳嗽超过三周且有上呼吸道感染病史的患者参与了该研究。所有患者均无鼻部疾病、胃食管反流、支气管哮喘或其他慢性肺部疾病史。所有患者均不吸烟,且无人使用血管紧张素转换酶抑制剂。他们的C反应蛋白浓度、外周白细胞和嗜酸性粒细胞计数、血清IgE浓度、冷凝集素滴度和肺炎支原体抗体、胸部X线片以及呼吸功能测试均正常。采用前瞻性随机开放设计。通过咳嗽日记评估右美沙芬(D)或右美沙芬加奥沙米特(D + O)治疗一周对咳嗽严重程度的影响。22名患者进入研究,20名符合疗效和副作用分析条件。9名接受D治疗的患者和11名接受D + O治疗的患者完成了方案。两组在研究开始前患者的特征,如咳嗽的严重程度和持续时间,以及实验室数据,均无显著差异。从试验第5天到第7天,D + O组的咳嗽改善率显著高于单独使用D组(p < 0.05)。奥沙米特与右美沙芬联合治疗可降低咳嗽日记所估计的咳嗽主观感受。这些结果表明,H1抗组胺药奥沙米特可能改善上呼吸道感染后患者的慢性咳嗽。