Assessment of antitussive efficacy of dextromethorphan in smoking related cough:: objective vs. subjective measures
Assessment of antitussive efficacy of dextromethorphan in smoking related cough:: objective vs. subjective measures
复制标题
DOI：
10.1111/j.1365-2125.2008.03115.x
复制
发表时间：
2008-05-01
影响因子：
3.4
通讯作者：
Morice, Alyn H.
中科院分区：
文献类型：
--
作者：
Ramsay, James;Wright, Caroline;Morice, Alyn H.
目的：使用一个建立的吸烟者咳嗽模型，我们测量了美沙芬与安慰剂相比的止咳作用。方法：本研究是一项随机、双盲、安慰剂对照、交叉比较的研究，22 mg 0.8 ml（-1）美沙芬与匹配的安慰剂进行胃前给药。记录咳嗽的客观和主观测量值。主观测量包括咳嗽症状的每日日记记录和莱斯特生活质量问卷。使用手动咳嗽计数器记录咳嗽频率。咳嗽反射敏感性的客观测量是柠檬酸，剂量-反应咳嗽challenge.结果与安慰剂相比，右美沙芬与柠檬酸浓度的增加显著相关，在剂量后1小时增加0.49 mM，（95% CI 0.05，0.45，几何平均值3.09）与安慰剂0.24 mM相比（几何平均值1.74）P < 0.05，2 h时为0.57 mM（95%CI 0.01，0.43，几何平均值3.75）与安慰剂0.34 mM（几何平均值2.19）P < 0.05）相比。与基线相比，主观数据有非常显著的改善。但是，安慰剂和活性药物治疗之间无显著差异。对柠檬酸的咳嗽敏感性与记录的咳嗽计数或症状之间没有相关性。当主观和客观的数据与筛选数据进行比较，有证据表明，一个显着的“安慰剂”effects.CONCLUSIONS咳嗽敏感性的客观措施表明，美沙芬有效地减少了咳嗽反射的敏感性。然而，主观的衡量标准并不支持这一点。其他研究支持这些发现，这可能代表了咳嗽反射对更高影响的深刻敏感性。
AIMS Using an established model of smokers cough we measured the antitussive effects of dextromethorphan compared with placebo.METHODS The study was a randomized, double-blind placebo controlled, crossover comparison of 22 mg 0.8 ml(-1) dextromethorphan delivered pregastrically with matched placebo. Objective and subjective measurements of cough were recorded. Subjective measures included a daily diary record of cough symptoms and the Leicester quality of life questionnaire. Cough frequency was recorded using a manual cough counter. The objective measure of cough reflex sensitivity was the citric acid, dose-response cough challenge.RESULTS Dextromethorphan was significantly associated with an increase in the concentration of citric acid eliciting an average of two coughs/inhalation (C2) when compared with placebo, 1 h post dose by 0.49 mM (95% CI 0.05, 0.45, geometric mean 3.09) compared with placebo 0.24 mM (geometric mean 1.74) P < 0.05 and at 2 h 0.57 mM (95% CI 0.01, 0.43, geometric mean 3.75) compared with placebo 0.34 mM (geometric mean 2.19) P < 0.05). There was a highly significant improvement in the subjective data when compared with baseline. However, there was no significant difference between placebo and active treatment. No correlation was seen between cough sensitivity to citric acid and recorded cough counts or symptoms. When both subjective and objective data were compared with screening data there was evidence of a marked 'placebo' effect.CONCLUSIONS The objective measure of cough sensitivity demonstrates dextromethorphan effectively diminishes the cough reflex sensitivity. However, subjective measures do not support this. Other studies support these findings, which may represent a profound sensitivity of the cough reflex to higher influences.