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1.
目的 评价愈酚伪麻口服溶液治疗儿童咳嗽、咯痰和鼻塞、流涕等症状的有效性和安全性.方法 采用前瞻性、多中心、随机、单盲、平行对照临床研究.共10个中心参与本研究,实际符合方案入选病例数412例,其中试验组205例,口服愈酚伪麻溶液,对照组207例,口服盐酸氨溴索溶液,疗程均为7 d.比较两组鼻塞、流涕、咳嗽、咯痰和痰液黏稠度等各单个症状改善率、综合症状改善率、总有效率,并观察药物不良反应和依从性.结果 两组均有显效,但试验组在疗程第3天,除痰液黏稠度外,症状改善优于对照组(P<0.05).第7天,除鼻塞症状外,其余症状改善也优于对照组(P<0.01).愈酚伪麻口服溶液组综合症状改善率82.90%,总有效率89.30%,药物接受度高,不良事件发生率0.92%.结论 愈酚伪麻口服溶液治疗小儿由普通感冒、急性气管支气管炎等引起的咳嗽、咯痰、鼻塞、流涕等症状有显著疗效,且安全性好.  相似文献   

2.
Aims: To evaluate ethnic differences in the prevalence of respiratory and skin symptoms in the first two years of life. Methods: A total of 4146 children participated in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study. Parents completed questionnaires on respiratory and skin symptoms, ethnic background, and other potential confounders during pregnancy, and at 3 months, 1 year, and 2 years of age. Results: In the first year, "non-Dutch" children (compared with "Dutch" children) had a higher prevalence of runny nose with itchy/watery eyes (11.0% versus 5.0%). In the second year, a higher prevalence of wheeze at least once (26.7% versus 18.5%), night cough without a cold (24.6% versus 15.5%), runny nose without a cold (34.1% versus 21.3%), and runny nose with itchy/watery eyes (13.7% versus 4.6%) was found. Adjustment for various confounders, especially adjustment for socioeconomic factors, reduced most associations between ethnicity and respiratory symptoms. Only runny nose with itchy/watery eyes in the second year of life was independently associated with non-Dutch ethnicity (adjusted odds ratio 2.89, 95% CI 1.3–6.4). Conclusions: Non-Dutch children more often had respiratory symptoms in the first two years of life than Dutch children. This could largely be explained by differences in socioeconomic status. Follow up of the cohort will determine whether this higher prevalence of respiratory symptoms in children with non-Dutch ethnicity represents an increased risk of developing allergic disease rather than non-specific or infection related respiratory symptoms.  相似文献   

3.
AIMS: To evaluate ethnic differences in the prevalence of respiratory and skin symptoms in the first two years of life. METHODS: A total of 4146 children participated in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study. Parents completed questionnaires on respiratory and skin symptoms, ethnic background, and other potential confounders during pregnancy, and at 3 months, 1 year, and 2 years of age. RESULTS: In the first year, "non-Dutch" children (compared with "Dutch" children) had a higher prevalence of runny nose with itchy/watery eyes (11.0% versus 5.0%). In the second year, a higher prevalence of wheeze at least once (26.7% versus 18.5%), night cough without a cold (24.6% versus 15.5%), runny nose without a cold (34.1% versus 21.3%), and runny nose with itchy/watery eyes (13.7% versus 4.6%) was found. Adjustment for various confounders, especially adjustment for socioeconomic factors, reduced most associations between ethnicity and respiratory symptoms. Only runny nose with itchy/watery eyes in the second year of life was independently associated with non-Dutch ethnicity (adjusted odds ratio 2.89, 95% CI 1.3-6.4). CONCLUSIONS: Non-Dutch children more often had respiratory symptoms in the first two years of life than Dutch children. This could largely be explained by differences in socioeconomic status. Follow up of the cohort will determine whether this higher prevalence of respiratory symptoms in children with non-Dutch ethnicity represents an increased risk of developing allergic disease rather than non-specific or infection related respiratory symptoms.  相似文献   

4.
??Abstract??Objective??To evaluate the effectiveness of Jin-Zheng oral solution expectorant cough?? safety and compliance. Methods??A prospective multicenter randomized double-blind?? parallel-controlled clinical study. A total of four centers participated in this study?? the actual number of cases in line with the program selected 239 cases?? of which 120 cases trial group using Jin-Zheng oral solution?? the control group of 119 cases?? oral Ji-Zhi syrup?? treatment both for 5 days. The improve rate of each single symptom of cough?? sputum?? wheezing?? pulmonary symptoms?? fever?? stuffy nose?? runny nose?? throat congestion etc. and the comprehensive symptoms?? the total effective rate were compared between two groups. The adverse drug reactions and compliance were assessed as well. Results??The efficacy was showed in both groups but the trial group in the course of the 3 rd day and the 5 th day except pharyngeal congestion?? the other symptoms improve markedly compared with the control group ??P < 0.0001??. The integrated improving rate of Jin-Zheng oral solution was 60% on the 3rd day and 90% on the 5th day respectively?? significantly better than the control group. The total efficiency of Jin-Zheng oral group after 5 days treatment was 96.67% and the Ji-Zhi syrup group was 64.71 %?? there was significant difference statistically between the two groups ??P = 0.0000??. Jin-Zheng oral group had good compliance up to 98.33%?? no adverse events during the trial period. Conclusion??Jin-Zheng oral solution has significant efficacy and safety as well in children for treatment of cough?? sputum?? wheezing?? fever?? stuffy nose?? runny nose etc. caused by acute upper respiratory tract infections?? tracheo-bronchitis and mild pneumonia. Its compliance is high. Jin-Zheng oral solution is an expectorant cough for proprietary Chinese medicine in children.  相似文献   

5.
Parenting books often provide advice for common medical ailments of infants and toddlers. However, the accuracy of such advice has never been evaluated. The purpose of this study is to survey the informational content of a sample of parenting books. Fifty general parenting books were identified and reviewed for the informational content on the following topics: common colds, diarrhea, and otitis media. When covered by the book, accurate and consistent information was generally provided in the following topic areas: non-medicated nose drops for nasal congestion, upright positioning for children with colds, breastfeeding infants with diarrhea, electrolyte solutions for diarrhea, and feeding practices as they relate to otitis media. The following topic areas displayed significant inconsistency: the use of decongestants, antihistamines, expectorants, cough suppressants, and decongestant nose drops for colds; antidiarrheal medications; soft drinks and juice for diarrhea; home recipes for oral hydration solutions; and the usefulness of pressure equalization tubes for refractory otitis media. Practitioners should be aware that parents may be misinformed by some parenting books and take measures to educate parents.  相似文献   

6.
The role of histamine in the pathogenesis of infectious rhinitis is unclear, as is the efficacy of antihistaminic drugs in the treatment of the common cold. This study evaluated the short-term efficacy of oral terfenadine (Seldane) in the treatment of the common cold. Over a 5-week period, the authors recruited 250 adults who had developed cold symptoms within 6 to 48 hours prior to enrollment. Volunteers had a primary complaint of runny or stuffy nose; at least one other respiratory symptom; no fever or exudative pharyngitis; and no history of atopy, sinusitis, or use of cold preparations within 1 week of enrollment. Out of the eligible subjects, 126 were randomly assigned terfenadine (60 mg), and 124 received placebo. Volunteers self-administered either terfenadine or placebo twice a day on Days 1, 2 and 3, and a final dose on the morning of Day 4. They also recorded the severity of their clinical symptoms (runny nose, sniffles, sneezing, postnasal drip, cough and sore throat) on symptom cards. Both groups reported similar severity scores throughout the treatment period. Average symptom burdens declined at almost identical rates for both groups. Terfenadine was well tolerated and had a low incidence of side effects. According to subject evaluation, terfenadine was no more effective than placebo. The mean +/- SD score of global efficacy was 2.2 +/- 1.1 in the terfenadine group and 2.1 +/- 1.3 in the placebo group (P = NS). Slightly fewer terfenadine recipients (41%) than placebo recipients (48%) said they would use the study medication again for treating cold symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

7.
Allergic rhinitis (AR) is a common condition among schoolchildren. The prevalence rate of AR differs among countries and even among regions within the same country. The objective of this study was to determine the prevalence of nasal symptoms and signs of AR and nasal smear eosinophilia in 11- to 15-yr-old children in Shiraz. A total of 4584 children aged 11-15 yr of both sexes were surveyed from May 1995 to April 1996, and nasal symptoms and signs of AR (sneezing, rhinorrhea, nasal blockage, itching, color change, mucosal swelling, nasal wetness, and nasal crease), based on questionnaire and ear, nose and throat (ENT) examination were recorded. In addition, smears were taken from nasal secretions and stained. The results compared with nasal smears related to 340 healthy children. 1008 (22%) schoolchildren had nasal symptoms of AR (based on the questionnaire), 445 (9.7%) were identified as having nasal symptoms and signs of AR (based on the questionnaire and ENT specialist examination), and 226 (5.8%) had nasal symptoms and signs of AR associated with nasal eosinophilia (based on the questionnaire, ENT specialist examination and positive nasal smear for eosinophilia). Nasal eosinophilia was present in 274 (62%) children with nasal symptoms and signs of AR. This survey showed that prevalence of nasal symptoms and signs of AR was high in schoolchildren in Shiraz. Nasal smear eosinophilia had a diagnostic specificity of 96% and sensitivity of 62% and seems to be a potentially valuable test for AR.  相似文献   

8.
This paper presents the results of a randomized, double-blind, placebo-controlled study of the efficacy of chlorpheniramine in relieving the symptoms and attenuating the pathophysiologic correlates of a rhinovirus "common cold." Forty healthy, adult, nonatopic subjects were randomly assigned to one of two treatment groups: active drug and placebo. On study Day 0, all subjects were challenged intranasally with rhinovirus type 39 (dose = 100 TCID50). Subjects were cloistered from Day 2 to Day 7, at which time they were treated with either chlorpheniramine or placebo. From 3 days before challenge to study Day 19, subjects had nasal patency assessed by rhinomanometry, eustachian tube function assessed by the 9-step test and sonotubometry, middle ear pressure assessed by tympanometry and nasal clearance assessed by the dyed-saccharin technique. Symptom diaries were maintained throughout the period of follow-up. During cloister, symptoms also were scored by interview, nasal secretions were quantified and nasal washings were performed for viral culture. Results showed that 19 (95%) subjects in the active-treatment group and 18 (90%) subjects in the placebo-treatment group shed virus. Symptomatic colds were observed in 63% of the active-treated and 83% of the placebo-treated subjects. Symptoms increased on Day 1 and peaked at Days 4 to 5. Detrimental changes in other measured functions consistent with those previously reported were observed. During the period of treatment, significant differences in the average symptom scores favoring the active-treatment group were observed for sneezing. Also, weight of expelled secretions was greater and mucociliary clearance rate less on some cloister days for the placebo-treated group. No significant differences between treatment groups in the objective measures of nasal congestion or the response of the middle ear and eustachian tube were documented.  相似文献   

9.
10.
Background: Collecting information on subjective symptoms in children by parental reports or physician’s interview is indirect and not suited for prospective data collection over extended time periods. Aim: To examine the reliability of a diary for symptom self‐reports by primary school children. Methods: Children aged 7–8 or 11–12 were recruited from primary school and a paediatric outpatient department. A picture‐based symptom diary was completed individually. Children were asked about presence of 10 specified subjective symptoms for five time periods covering the previous 24 h. The diary was completed twice for test–retest and answers were compared with semi structured physician’s interviews. Results: Test–retest reliability for reporting a symptom during the previous 24 h gave reliable kappa values of 0.64–0.91. Comparison with physician’s interview gave kappas of 0.18–0.68. Requiring correct time of day for each symptom reduced reliability and validity. Kappa values for test–retest and child‐physician agreement for the individual symptoms were respectively: sneezing, 0.80 and 0.30; sore throat, 0.89, 0.30; tiredness, 0.88, 0.65; headache, 0.64, 0.66; runny nose, 0.91, 0.68; sore eyes, 0.67, 0.18; cough, 0.73, 0.58; stomach ache, 0.69, 0.45. Conclusion: Our symptom diary gives reliable self‐report data from primary school children. It may be used for prospective symptom monitoring.  相似文献   

11.
目的探讨新生儿百日咳的临床表现、诊断、治疗及预后。方法回顾性分析经百日咳鲍特菌聚合酶链反应确诊为百日咳的17例新生儿患者的临床资料。结果 17例患儿中,男8例、女9例,早产儿2例,发病日龄15~27 d。13例患儿有咳嗽患者接触史,4例早期有鼻塞、流涕等症状,5例有典型痉挛性咳嗽,1例咳嗽伴有鸡鸣样回声,6例咳嗽剧烈有面色通红,7例咳嗽剧烈时伴口唇发绀,2例住院前曾出现全身青紫,7例咳嗽后有吐奶,3例有发热。15例患儿外周血白细胞计数升高,为(12.57~79.63)×109/L,淋巴细胞比例为45.1%~75.2%。百日咳PCR拷贝数为7.12×10~2~1.04×10~8/m L。17例患儿均予静脉滴注红霉素治疗,均有明显好转,无死亡病例。结论对于有明确咳嗽患者接触史、出现阵发性咳嗽,外周血白细胞升高,并以淋巴细胞为主的新生儿需警惕百日咳可能,应及早行相关检查。  相似文献   

12.
不同年龄儿童肺炎支原体肺炎临床特征的差异   总被引:1,自引:0,他引:1  
目的:了解不同年龄儿童肺炎支原体肺炎(MPP)的临床特征。方法:收集2010年1月至2011年12月因确诊MPP的住院患儿112例,对其临床资料进行回顾性总结分析。将所有入选患儿按年龄分为婴幼儿组(< 3岁)20例、学龄前儿童组(3岁~)41例、学龄儿童组(6~15.2岁)51例。比较不同年龄段儿童MPP的临床表现、肺部体征、全胸片及实验室检查等方面的差异。结果:婴幼儿组MPP患儿咳痰与喘息症状相对明显,发热多以低热为主,肺外表现以胃肠道症状为主,肺部体征较明显;学龄儿童组MPP患儿多表现为高热,干咳明显,多不伴喘息,肺外表现以皮损多见,肺部体征轻;学龄前组患儿临床表现介于两者之间。婴幼儿组、学龄前儿童组MPP患儿全胸片以支气管肺炎为主要表现,而学龄儿童全胸片以肺段实质浸润为主;婴幼儿组淋巴细胞计数高于学龄儿童组,学龄儿童组血CRP水平高于婴幼儿组。结论:不同年龄阶段的儿童MPP临床特征不同,尤其是婴幼儿与学龄儿童之间差异更明显。  相似文献   

13.
Live attenuated influenza vaccine (LAIV) offers a novel approach to influenza vaccination and is approved for healthy individuals 5 to 49 years of age. In placebo-controlled studies in children, LAIV was 73 to 93 percent efficacious, and protection lasted more than 12 months. In head-to-head studies in children, LAIV demonstrated a 35 to 53 percent reduction in influenza attack rates compared with injectable influenza vaccine (TIV) for matched strains. Compared with TIV, LAIV has demonstrated broader serum antibody responses, particularly against mismatched influenza A. The most common adverse events are runny nose and nasal congestion. Increased rates of asthma events were observed in young children. Additional large-scale safety and efficacy studies in young children, including a formal risk-benefit assessment, are ongoing. The results of these analyses will guide potential future use in young children.  相似文献   

14.
Since typical inflammatory responses may be diminished in children following bone marrow transplant (BMT), computed tomography (CT) imaging of the sinuses has been increasingly ordered to diagnose sinusitis in this group. The objective of this study was to determine the association between clinical sinusitis symptoms and sinus opacification on CT scans in post BMT versus immunocompetent children. Our sample was comprised of 64 post BMT and 86 immunocompetent children with sinus CT scans. CT sinus opacification was scored using the modified Lund–Mackay staging system. The relationship between clinical sinusitis symptoms (rhinorrhea, nasal congestion, cough, headache, and facial pain) and opacification was compared for the two groups. The severity of sinus opacification in the BMT group was significantly higher compared to the immunocompetent group. In combined patient groups the odds ratio (OR) for moderate/severe sinusitis was significantly elevated for rhinorrhea (OR = 3.00; 95% confidence interval [CI], 1.27–7.12), cough (OR = 2.80; 95% CI, 1.22–6.42), and having either rhinorrhea, nasal congestion, or cough (OR = 4.76; 95% CI, 1.71–13.24). While the immunocompetent group had a greater number of sinusitis symptoms compared to the post BMT group, both groups had a significant increase in the severity on CT with increasing number of symptoms. Conclusion: In post BMT patients, our data demonstrated higher odds of moderate/severe sinusitis on CT scans associated with rhinorrhea, cough or nasal congestion. These finding suggest that in post BMT children, detailed sinus history may still play a vital role in the diagnosis of sinusitis.  相似文献   

15.
OBJECTIVE: Constitutional factors might play a role in the susceptibility to clinical illness during the common cold. This study seeks to determine if the likelihood of developing frequent common colds persists during childhood. DESIGN: The Tucson Children's Respiratory Study involves 1246 children enrolled at birth and followed prospectively since 1980 and 1984. Parents reported the occurrence of frequent (> or =4) colds during the past year by questionnaire at 2, 3, 6, 8, 11, and 13 years of age. Blood for ex vivo interferon-gamma responses was obtained at 9 months and 11 years of age. RESULTS: After adjustment for potential confounding variables, children with frequent colds at year 2 or 3 were twice as likely to experience frequent colds at year 6 (relative risk [RR], 2.8; 95% confidence interval [CI], 2.1-3.9), year 8 (RR, 2.6; 95% CI, 2.1-3.3), year 11 (RR, 2.4; 95% CI, 1.8-3.1), and year 13 (RR, 2.1; 95% CI, 1.4-3.3) compared with children who had infrequent colds at years 2 and 3. At 9 months of age, children who ultimately experienced persistent frequent colds had lower interferon-gamma titers than children without persistent frequent colds (3.05 +/- 1.61 vs 3.74 +/- 1.39, P =.016); this finding persisted at 11 years of age. CONCLUSION: These data suggest the existence of a common cold constitution, whereby some children are more susceptible to infection and/or the expression of clinical symptoms when infected than are other children.  相似文献   

16.
BACKGROUND: This study was designed to evaluate the efficacy and safety of cold-adapted influenza vaccine, trivalent (CAIV-T) against culture-confirmed influenza in children 12 to <36 months of age during 2 consecutive influenza seasons at multiple sites in Asia. METHODS: In year 1, 3174 children 12 to <36 months of age were randomized to receive 2 doses of CAIV-T (n = 1900) or placebo (n = 1274) intranasally > or =28 days apart. In year 2, 2947 subjects were rerandomized to receive 1 dose of CAIV-T or placebo. RESULTS: Mean age at enrollment was 23.5 +/- 7.4 months. In year 1, efficacy of CAIV-T compared with placebo was 72.9% [95% confidence interval (CI): 62.8-80.5%] against antigenically similar influenza subtypes, and 70.1% (95% CI: 60.9-77.3%) against any strain. In year 2, revaccination with CAIV-T demonstrated significant efficacy against antigenically similar (84.3%; 95% CI: 70.1-92.4%) and any (64.2%; 95% CI: 44.2-77.3%) influenza strains. In year 1, fever, runny nose/nasal congestion, decreased activity and appetite, and use of fever medication were more frequent with CAIV-T after dose 1. Runny nose/nasal congestion after dose 2 (year 1) and dose 3 (year 2) and use of fever medication after dose 3 (year 2) were the only other events reported significantly more frequently in CAIV-T recipients. CONCLUSIONS: CAIV-T was well tolerated and effective in preventing culture-confirmed influenza illness over multiple and complex influenza seasons in young children in Asia.  相似文献   

17.
Acute bacterial rhinosinusitis is an infection of the nasal epithelium and paranasal sinus mucosa, usually caused in children by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and, less frequently, group A Streptococcus species. The clinical diagnosis is based on daytime cough that may be worse at night or purulent rhinorrhea, or both, lasting at least 10 days, often worsening after a period of initial improvement after initial symptoms of the common cold, and often associated with facial or dental pain, facial fullness, or swelling, headache, and fever. Sinusitis is diagnosed clinically; radiographic evaluation is not indicated for diagnosis. When the disease persists despite treatment, or is complicated by potential intracranial or orbital extension, CT is the preferred imaging modality. Initial therapy should be amoxicillin in a high dosage (80-90 mg/kg/day). Treatment is generally for 10 to 14 days and for at least 7 days beyond the time of substantial improvement in symptoms. Complications of acute bacterial rhinosinusitis in children are rare.  相似文献   

18.
The aims of this study were to assess whether sodium cromoglycat (SCG) was an effective prophylaxis against both upper and lowr respiratory tract signs and to determine factors which affected the site and magnitude of the response to SCG. Sixteen children born prematurely were entered into a randomised placebocontrolled trial at 15 months of age (range 4–31 months). The patients received, in random order, either 3 weeks' treatment with SCG (5 mg) or placebo, both given four times a day by inhalation via a spacer device. Parents were asked to record the occurrence and severity of their child's upper respiratory tract signs; sneezing and runny nose and lower respiratory tract signs; day and night time cough and wheeze. During the active compared to the placebo period there was an overall reduction of 47% and 53% in upper and lower respiratory tract signs, respectively. The magnitude of response to SCG as assessed by either the change in upper or lower respiratory tract signs was not significantly related to the patient's gestational or postnatal age, the occurrence of neonatal chronic lung disease, family history of atopy or the order in which the therapy was administered. We conclude that inhaled SCG may be a useful prophylaxis for both upper and lower respiratory tract signs for children born prematurely and less than 3 years of age.  相似文献   

19.
目的 评价利巴韦林气雾剂治疗手足口病(HFMD)患儿的有效性和安全性。方法 采用随机、双盲、对照研究方法。119 例轻症HFMD 患儿随机分为试验组(59 例)和对照组(60 例)。试验组应用利巴韦林气雾剂治疗,首次使用1 h 内喷4 次,以后每隔1 h 喷1 次;2 日以后,一日4 次,每次2~3 揿,连续用药7 d。对照组采用安慰剂,用法同试验组。两组均加用“抗病毒口服液”口服。记录治疗前和治疗后口腔溃疡、皮疹、鼻塞、流涕、喷嚏、咳嗽、发热等临床症状评分,评价治疗效果;分别于治疗前、治疗后5~7 d 取咽拭子,用RT-PCR 法检测病毒载量以评价两组阴转率。结果 完成研究报告表规定内容的受试者试验组有57 例,对照组56 例。用药5~7 d 后,试验组肠道病毒总阴转率高于对照组(P<0.01);试验组和对照组的综合疗效评价总显效率分别为89%、29%,总有效率分别为89%、43%,试验组的总显效率和总有效率均高于对照组。用药后两组均无头晕、呕吐等不良反应发生,外周血三系指标均无明显下降。结论 利巴韦林气雾剂治疗轻症HFMD 疗效确切,用药剂量小、不良反应轻,值得临床推广应用。  相似文献   

20.
AIM: To determine the efficacy of prophylactic administration of zinc sulphate in reducing the occurrence of the common cold in children, and to evaluate the efficacy of zinc sulphate in reducing the duration and severity of cold symptoms. METHODS: A total of 200 healthy children were randomly assigned to receive oral zinc sulphate (zinc group, n=100) or placebo (placebo group, n=100). Zinc sulphate (15 mg of zinc) or placebo syrup were administered for prophylaxis once daily during a 7-mo study period. The dose was increased to two times per day (30 mg of zinc) at the onset of cold, until symptoms resolved. RESULTS: The mean number of colds in the zinc group was significantly less than in the placebo group (1.2 vs 1.7 colds per child; p=0.003). The mean cold-related school absence was 0.9 d per child in the zinc group versus 1.3 d in the placebo group (p=0.04). Compared to the placebo group, the zinc group had shorter mean duration of cold symptoms and decreased total severity scores for cold symptoms (p<0.0001). Adverse effects were mild and similar in both groups. CONCLUSION: Zinc sulphate appears to be an easily administered, safe and well-tolerated alternative for the prevention and treatment of the common cold in children.  相似文献   

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