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Ganzheitliche Therapieoptionen bei akuten Atemwegsinfekten

Holistic therapeutic options for the common cold

Zusammenfassung

Hintergrund

„Erkältungen“ sind ein Hauptgrund für ärztliche Inanspruchnahme. Sie sind meist durch Viren verursacht, werden symptomatisch behandelt und Antibiotika sind zu vermeiden.

Ziel der Arbeit

Übersicht zu konventionellen und alternativmedizinischen Therapien akuter Atemwegsinfektionen.

Material und Methoden

Systematische Suche von Medline, eMbase und der Cochrane-Datenbank von Januar 1985 bis Dezember 2015 mit den Schlüsselwörtern „Erkältung“, „akute Atemwegsinfektion“ und „Therapie“.

Ergebnisse

Bei Kindern gibt es für häufig als Erkältungsmittel angewandte Substanzen wie Hustensäfte oder Echinaceapräparate keine konsistente Datenlage. Potenziell nützlich sind ätherische Einreibungen (Vapor rub, cave: Reizungen), Zink, Pelargonium sidoides und Honig. Bei Erwachsenen besteht für Antihistaminika, intranasale Steroide, Codein, nasale Salzwasserspülungen und Dampfbäder keine konsistente positive Empfehlungssituation. Topische Dekongestiva, intranasales Ipratropium und Zink konnten leicht die Symptomschwere und -dauer vermindern. Nichtsteroidale Antiphlogistika und einige Phytotherapeutika milderten geringfügig die Symptome. Konsequente Hygiene vermindert die Übertragung der ursächlichen Viren.

Diskussion

Bei Kindern haben Selbstmedikationspräparate gegen Husten und Erkältung keine belegten Wirkungen, aber Potenzial für erhebliche Nebenwirkungen und sollten daher v. a. bei Jüngeren vermieden werden. Nützen können Paracetamol und nichtsteroidale Antiphlogistika sowie evtl. Antihistiminika-Dekongestiva-Kombinationen und intranasales Ipratropium. Ibuprofen scheint bei Kindern stärker antipyretisch zu wirken als Paracetamol. Zu den ganzheitlichen Ansätzen gibt es moderate Nutzenevidenz für Nahrungsergänzung mit Zink und Probiotika bei Erwachsenen sowie bei Kindern ebenfalls für Probiotika und jenseits des Säuglingsalters Honig zur Nacht. Hausmittel, wie z. B. Knoblauch oder Gurgeln, verdienen gut geplante, prospektive Studien.

Abstract

Background

Common colds are a major reason for physician visits. Being mainly of viral origin, treatment is symptomatic and antibiotics should be avoided.

Objectives

To review the evidence for conventional and alternative treatments of the common cold.

Material and Methods

Medline, eMbase, and the Cochrane database were searched from January 1985 to December 2015 combining the keywords “common cold” or “acute respiratory tract infection” with “treatment”.

Results

In children, commonly used medications such as cough syrups or Echinacea have not consistently been proven to be efficacious as treatment for the common cold. Products that potentially improve symptoms in children include vapour rub, zinc sulphate, pelargonium sidoides extract, and buckwheat honey. For adults, antihistamines, intranasal corticosteroids, codeine, nasal saline irrigation, and steam inhalation could not consistently proove efficacy at relieving cold symptoms. Topical decongestants, intranasal ipratropium, and zinc modestly reduced symptom severity and duration. NSAIDs and some herbal preparations slightly improved symptoms. Hand hygiene reduces the spread of viruses that cause cold illnesses.

Conclusions

In children, there is a potential for harm and no benefits with over-the-counter cough and cold medications; therefore, they should not be used, especially in the young. Beneficial effects exist for paracetamol and NSAIDS and potentially for antihistamine-decongestive combinations and intranasal ipratropium. Ibuprofen seems to be stronger antipyretic than paracetamol in paediatric patients. Among holistic strategies, there is moderate evidence for beneficial effects of zinc and probiotics in adults. In children, probiotics are also beneficial and – beyond the first year of life – honey at night. Commonly used strategies (e. g., garlic, gargling) warrant further research.

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Correspondence to M. A. Rose.

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M. Croessmann und M. A. Rose geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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M. Gappa, Wesel

M. Rose, Frankfurt/Main

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Croessmann, M., Rose, M.A. Ganzheitliche Therapieoptionen bei akuten Atemwegsinfekten. Pneumologe 13, 262–273 (2016). https://doi.org/10.1007/s10405-016-0052-3

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Schlüsselwörter

  • Akute Atemwegsinfektionen
  • Erkältungen
  • Therapie
  • Evidenzbasierte Medizin
  • Selbstmedikation

Keywords

  • Acute respiratory infections
  • Common cold
  • Therapy
  • Evidence based medicine
  • OTC