Effects of steam inhalation on nasal patency and nasal symptoms in patients with the common cold. Effect of inhaling heated vapor on symptoms of the common cold. Effect of inhaling heated vapor on symptoms of the common cold. Local hyperthermia benefits natural and experimental common colds. Therapeutic approaches to the common cold in children. Effect of inhalation of hot humidified air on experimental rhinovirus infection. Evaluation of the efficacy of a combined formulation (Grippostad-C) in the therapy of symptoms of common cold: a randomized, double-blind, multicenter trial. Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial. Cough and the common cold.
The effects of steam inhalation on nasal patency and on nasal symptoms were studied in 62 patients with the common cold by a double-blind, randomized, placebo-controlled clinical trial. Treatment consisted of two 20-minute sessions, during which the patient inhaled saturated, hot (42 degrees to 44 degrees C) air through the nose. The subjective response was recorded by each patient during the week following treatment on a daily symptom score card. Nasal patency was determined before treatment, the following day, and 1 week later by measuring peak nasal expiratory and inspiratory air flow. Highly reproducible results were obtained by using these objective methods. Steam inhalation resulted in alleviation of cold symptoms and increased nasal patency in a significantly higher percentage of patients in the actively treated group than in the placebo-treated group. Possible explanations for the effectiveness of treatment are discussed. To test the efficacy of steam inhalation in treating common cold symptoms.
                An in vitro study determined the temperature that inactivated rhinovirus: a temperature of 43 degrees C lasting at least 1 hour was needed. We then conducted a double-blind, placebo-controlled, randomized in vivo study.
                The virology laboratory and the outpatient department of the Cleveland (Ohio) Clinic Foundation.
                Sixty-eight Cleveland Clinic employee volunteers with symptoms of the common cold at the time of enrollment.
                A single 60-minute treatment was given to the volunteers. The steam treatment group (n = 32) received 40 L/min of heated saturated air that raised the intranasal temperature to 43 degrees C. The placebo group (n = 36) received 2 L/min of ambient air at 20 degrees C to 24 degrees C.
                Subjective symptom scores for nasal congestion, nasal drainage, and sneezing and objective measures of nasal resistance were studied during a 7-day follow-up observation period.
                There were no significant differences in daily symptom scores between the groups (P = .59 to .83). The only statistically significant differences between the groups were lower nasal resistances at baseline in the steam group (P = .04) and percent improvement in nasal resistance favoring the placebo group on day 7 (P = .01). However, these differences were of questionable clinical significance.
                We conclude that steam inhalation treatment had no beneficial effect on the cold symptoms of our volunteers. A double-blind, randomized study tested the efficacy of steam (technically, heated, humidified air) inhalation in the treatment of common cold symptoms. Two 20-minute treatments spaced 60 to 90 minutes apart were given at the time of enrollment. The active device (Rhinotherm, Netzer-Sereni, Beer Yaacov, Israel) delivered 40 L/min of saturated air at 40 degrees C to 42 degrees C, while the identical-appearing placebo delivered 2 L/min of ambient air at 20 degrees C to 24 degrees C. There were 34 patients in the placebo group and 32 in the active group. Significant improvements in the placebo-treated group were obtained on subjective symptom scores for nasal congestion, nasal drainage, and sneezing on isolated days during the treatment period (40%, vs 25% on day 3, 71% vs 60% on day 6, and 100% vs 67% on day 7). Improvement in nasal resistance as measured by rhinomanography was better in the placebo group than in the active group on day 7 (11% vs -6%). Our study demonstrated no beneficial effects of steam inhalation on common cold symptoms. To determine whether inhaling fully humidified air at 43 degrees C gave more benefit to cold sufferers than inhaling air at 30 degrees C.
                Randomised double blind trial. Setting--General practice and the common cold research unit.
                87 Unselected patients with typical acute nasal and upper respiratory symptoms (general practice study), and 84 volunteers aged 18-50 without a history of chronic or allergic diseases.
                Subjects breathed from apparatus delivering 40 litres of room air heated to 43 degrees C or 30 degrees C and fully humidified (relative humidity 100%) per minute. End point--Reduction in severity of disease. MEASUREMENTS and main results--Patients recorded their symptoms (general practice study) and observers recorded symptoms and signs, weight of nasal secretions, isolation of virus, and antibody responses in volunteers. Patients treated for 20 minutes at 43 degrees C had in the succeeding days roughly half the score for symptoms of those treated at 30 degrees C. Volunteers treated for 30 minutes on three occasions when they were starting a cold showed an 18% [corrected] reduction in symptoms. Treatment of volunteers for 20 minutes at the onset of the cold and for 10 minutes on succeeding days showed no difference between 43 degrees C and 30 degrees C.
                Nasal hyperthermia can improve the course of a common cold and also give immediate relief of symptoms. In a five-day, randomized, double-blind study, the efficacy and safety of a syrup containing a combination of azatadine maleate, pseudoephedrine sulfate, and dextromethorphan hydrobromide (SCH 399 syrup) were compared with those of an expectorant containing the antihistamine diphenhydramine hydrochloride in 60 children with symptoms of the common cold and associated cough. One-half teaspoonful of assigned medication was administered three or four times daily. The severity of signs and symptoms was graded on days 0, 3, and 5. At days 3 and 5, patients treated with SCH 399 experienced a significantly greater degree of relief (P less than 0.001) than did patients treated with the expectorant product. Differences between treatment groups in overall therapeutic response, as evaluated by the physician, were statistically significant (P less than 0.001) at each visit, favoring patients treated with SCH 399. More than 75% of the patients treated with SCH 399 demonstrated an excellent therapeutic response. Tolerance to both study medications was excellent. Nasal inhalation of steam has been proposed as treatment of viral colds on the assumption that increased intranasal temperature will inhibit replication of rhinovirus (RV). The effect of steam inhalation on RV shedding by infected volunteers was examined in this study.
                Randomized controlled trial. Volunteers experimentally infected with RV were treated with machine-generated humidified air, which was either hot (active) or at room temperature (placebo). Viral shedding was assessed over the 4 days following treatment.
                Local hotel.
                Twenty volunteers from the university community who were susceptible to the challenge virus.
                Two 30-minute intranasal treatments, the first at 24 hours after inoculation and the second at 48 hours. The temperature of active vapor was 42 degrees C to 44 degrees C and of placebo vapor was 22 degrees C.
                Viral titers in nasal washings on each of 5 days following inoculation.
                Mean viral titers prior to the first treatment were 10(1.7) tissue culture infectious doses per milliliter in the active group and 10(1.5) in the placebo group. Mean titers for the next 4 days were 10(1.7), and 10(1.7), 10(1.2), and 10(0.9)/mL in the active group and 10(1.8), 10(1.9), 10(1.6), and 10(0.7)/mL in the placebo group (no significant difference). The proportion of volunteers who shed virus on each day was also similar in the two groups.
                Two nasal inhalation treatments with steam had no effect on viral shedding in volunteers with experimental RV colds. The aim of the present trial was to evaluate the efficacy of a combined product in the treatment of common cold and to examine the contribution of the separate components. In the published literature there is conflicting data on the efficacy of agents used in the treatment of common cold, especially when given in drug combinations.
                A prospective, randomized, double-blind, multicenter, 4-arm, controlled trial was carried out in 1,167 patients with common cold treated with one of the following medications: Grippostad-C, a combination of acetaminophen, caffeine, chlorpheniramine and ascorbic acid (verum), ascorbic acid (control), chlorpheniramine and ascorbic acid (reference 1), as well as acetaminophen, caffeine, and ascorbic acid (reference 2). A score of common cold symptoms (headache, throat pain, extremities and joint pain, cough, blocked nose, and disturbances of sleep quality) was the primary outcome. The test drug was first compared with the control using a hierarchic test strategy, then with reference 1, followed by reference 2 with the aim of proving superiority.
                A clinically relevant and statistically significant difference was demonstrated at each level of the hierarchy. Grippostad-C was significantly superior to all other treatment groups, the combination of acetaminophen, caffeine, and ascorbic acid was significantly superior to the control, and the combination of chlorpheniramine and ascorbic acid was not statistically different from the control.
                The efficacy of Grippostad-C for the treatment of common cold was proven. The findings demonstrate that the combination is superior to each of its separate components and each of the components has its own distinctive contribution to the efficacy of the combination product. Echinacea purpurea stimulates the immune response and is promoted to reduce symptom severity and the duration of upper respiratory tract infections. We sought to determine the efficacy of a standardized preparation of E purpurea in reducing symptom severity and duration of the common cold.
                A randomized, double-blind, placebo-controlled design was used. Patients received either 100 mg of E purpurea (freeze-dried pressed juice from the aerial portion of the plant) or a lactose placebo 3 times daily until cold symptoms were relieved or until the end of 14 days, whichever came first. Symptoms (sneezing, nasal discharge, nasal congestion, headache, sore or scratchy throat, hoarseness, muscle aches, and cough) were scored subjectively by the patient and recorded daily in a diary. Kaplan-Meier curves were used to estimate the survival function of time to resolution in each group. The Wilcoxon rank sum test was used to compare time to resolution between the 2 groups.
                One hundred twenty-eight patients were enrolled within 24 hours of cold symptom onset. Group demographic distribution was comparable for sex, age, time from symptom onset to enrollment in the study, average number of colds per year, and smoking history. No statistically significant difference was observed between treatment groups for either total symptom scores (P range,.29-.90) or mean individual symptom scores (P range,.09-.93). The time to resolution of symptoms was not statistically different (P =.73).
                Some studies have concluded that Echinacea effectively reduces the symptoms and duration of the common cold. We were unable to replicate such findings. Further studies using different preparations and dosages of E purpurea are necessary to validate previous claims. To determine whether the cough of the common cold arises from upper respiratory stimuli and whether antihistamine-decongestant therapy is an effective treatment for this cough, we prospectively evaluated volunteers with uncomplicated common colds in a randomized, double-blind, placebo-controlled study. After completing a standardized questionnaire and undergoing a physical examination, throat-culturing, and pulmonary function testing, subjects took the active drug or identical-appearing placebo for 7 days while they kept a diary in which they ranked the severity of 17 symptoms for 14 days. Pulmonary function testing was repeated, on average, on Days 4, 8, and 14. Forty-six percent of the variation in cough severity could be explained by throat-clearing and 47% of the variation in throat-clearing severity by postnasal drip. FIF50%, the only physiologic parameter that significantly correlated with cough, rose as cough severity fell. Antihistamine-decongestant therapy reduced postnasal drip and significantly decreased the severity of cough, nasal obstruction, nasal discharge, and throat-clearing during the first few days of the common cold. In addition, cough was 20 to 30% less prevalent in the active drug group within 3 days of starting therapy. We conclude that the cough of the common cold arose from upper respiratory tract stimuli and that cough and other cardinal symptoms of the common cold were reduced with antihistamine-decongestant therapy when these symptoms were at their worst.
Steam inhalation has not shown any consistent benefits in the treatment of the common cold, hence is not recommended in the routine treatment of common cold symptoms until more double-blind, randomised trials with a standardised treatment modality are conducted.