兒童咳嗽問題

02-09

兒童的免疫系統是不健全的，很多在成人身上有用的葯，在兒童身上是有很高危險性，且正作用效果打折扣的。

通用止咳藥品都是以中樞神經系統抑製為切入點，但是因為耐受度不一樣，這種方式在兒童身上是毒副作用超過收益的。

因此，FDA禁向4歲以下兒童使用止咳藥品。

Over-the-counter (OTC) cough and cold medicines can cause serious side effects in young children. The risks of using these medicines outweigh any benefits from reducing symptoms. Therefore, in October 2008, the Food and Drug Administration recommended that OTC cough and cold medicines never be used in children younger than 4 years.

From ages 4 to 6 years, they should be used only if recommended by your child』s doctor. After age 6 years, the medicines are safe to use, but follow the dosage instructions on the package. Fortunately, you can easily treat coughs and colds in young children without these nonprescription medicines.

也即：這個客觀現狀是嬰幼兒止咳處在「無葯可用」的狀態。

事實上，咳嗽是一種自我保護機制，是排除異物、自身分泌物的唯一方式。盲目止咳是不科學的。絕大部分咳嗽都是自限性的，除了純粹的非常高頻影響到正常作息的乾咳以外，都是不需要治療也會逐漸減輕至消除的。

因此，在兒童止咳的可行性建議里，一切能使氣管濕潤的手段，都在被推薦之列。包括溫水、蘋果汁、蜜水、糖水、甚至把孩子暫時放到溫濕的環境（Expose your child to warm mist from a shower）。

理解這些背景知識之後，你再審視一下這件事就會明白，為什麼一份不嚴謹的研究也會出現在兒科協會的推薦方案里。因為這個操作不會帶來副作用，而且如其它糖水一樣有著收益的正向價值。

Coughing: Use homemade cough medicines.

For Children 3 Months to 1 Year of Age: Give warm, clear fluids (eg, warm water, apple juice). Dosage is 5 to 15 mL 4 times per day when coughing. Avoid honey because it can cause infantile botulism. If your child is younger than 3 months, see your child』s doctor.

For Children 1 Year and Older: Use HONEY, 2 to 5 mL, as needed. It thins secretions and loosens the cough. (If honey is not available, you can use corn syrup.) Recent research has shown that honey is better than drugstore cough syrups at reducing the frequency and severity of nighttime coughing.

Coughing Spasms: Expose your child to warm mist from a shower.

有多少證據，說多少話。那些聲稱蜂蜜的「止咳作用」力壓止咳類藥物的研究，都是不足立論的。無論是樣本規模，還是適用人群。

但是我們看到，很多人用這些似是而非的概念包裝成神功異效，做顛覆基本用藥規律之事。這是不能容忍的，見一次，打一次。