January 1998
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17 Citations
Atemwegs- und Lungenkrankheiten
In former controlled investigations Ambroxol and Cineol were shown to improve FEV1 and FVC in patients with COPD versus placebo. To compare the effects of oral therapy with Cineol (3 x 200 mg/day), a monoterpene of eucalyptus oil, and Ambroxol (3 x 30 mg/day) after a treatment over one week, a randomized double-blind, double-dummy, cross-over trial in 29 patients with COPD (which showed at least a 15% reversibility in FEV1 after 200 μg inhaled Fenoterol) was performed. The parameters of interest were lung function (including bodyplethysmography with Raw and sGaw), peak-flow protocol and a dyspnoe score. A constant co-therapy with inhaled steroids and with Theophyllin was allowed. Four patients had to be excluded from the study because of acute upper airway infections and one patient because of an allergic exanthem under therapy with Ambroxol. The lung function improved from day 1 (before therapy) to day 7 (2.5 hours after therapy) concerning VC (p < 0.05), Raw (p < 0.005) and sGaw (p < 0.005) statistically significant for both drugs - Cineol and Ambroxol. FEV1 also improved, but without significance. Only under therapy with Cineol ITGV was reduced from 4.41 to 4.20 (p < 0.05), without any change under Ambroxol. All parameters of lung- function, peak-flow (not significant) and the symptom-score (for dyspnoe at rest) showed better improvement under therapy with Cineol, but field to reach statistical significance in comparison with Ambroxol because of the small number of patients (for ITGV p-value 0.08). The cooperation-independant parameters of plethysmography showed higher p values than only VC and FEV1 indicating that plethysmography is a better instrument for studies comparing drugs. In summary, the expectorant Cineol seems to have an additional bronchodilator effect.