一级预防
通过物理防护措施可以减少向他人传播,包括洗手、打喷嚏或咳嗽时遮住口鼻、及时清理有鼻分泌物的纸巾、远离工作或学校。没有证据支持使用口罩。[15]Jefferson T, Del Mar CB, Dooley L, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev. 2020 Nov 20;(11):CD006207. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub5/full http://www.ncbi.nlm.nih.gov/pubmed/33215698?tool=bestpractice.com [16]Hübner NO, Hübner C, Wodny M, et al. Effectiveness of alcohol-based hand disinfectants in a public administration: impact on health and work performance related to acute respiratory symptoms and diarrhoea. BMC Infect Dis. 2010 Aug 24;10:250. http://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-10-250 http://www.ncbi.nlm.nih.gov/pubmed/20735818?tool=bestpractice.com [17]MacIntyre CR, Chughtai AA. Facemasks for the prevention of infection in healthcare and community settings. BMJ. 2015 Apr 9;350:h694. http://www.ncbi.nlm.nih.gov/pubmed/25858901?tool=bestpractice.com [18]Smith JD, MacDougall CC, Johnstone J, et al. Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis. CMAJ. 2016 May 17;188(8):567-74. http://www.cmaj.ca/content/188/8/567.long http://www.ncbi.nlm.nih.gov/pubmed/26952529?tool=bestpractice.com [ ] Can physical interventions help reduce the spread of respiratory viruses?/cca.html?targetUrl=https://www.cochranelibrary.com/cca/doi/10.1002/cca.4280/full展示答案
补剂
维生素 C:研究发现补充维生素 C 对预防感冒并无益处。[19]Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD000980. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000980.pub4/full http://www.ncbi.nlm.nih.gov/pubmed/23440782?tool=bestpractice.com [20]Gómez E, Quidel S, Bravo-Soto G, et al. Does vitamin C prevent the common cold?. Medwave. 2018 Aug 6;18(4):e7235. https://www.doi.org/10.5867/medwave.2018.04.7236 http://www.ncbi.nlm.nih.gov/pubmed/30113569?tool=bestpractice.com
维生素 D:维生素 D 缺乏可能与急性呼吸道感染病程较长有关,但关于它对健康成人发病率和严重程度的影响,尚无定论。[21]Wang MX, Koh J, Pang J. Association between micronutrient deficiency and acute respiratory infections in healthy adults: a systematic review of observational studies. Nutr J. 2019 Nov 30;18(1):80. https://www.doi.org/10.1186/s12937-019-0507-6 http://www.ncbi.nlm.nih.gov/pubmed/31785608?tool=bestpractice.com 研究已经发现,补充维生素 D3 并不能预防儿童或成人的上呼吸道感染,即使补充高剂量维生素 D3 也不能。[22]Martineau AR, Hanifa Y, Witt KD, et al. Double-blind randomised controlled trial of vitamin D3 supplementation for the prevention of acute respiratory infection in older adults and their carers (ViDiFlu). Thorax. 2015 Oct;70(10):953-60. http://www.ncbi.nlm.nih.gov/pubmed/26063508?tool=bestpractice.com [23]Aglipay M, Birken CS, Parkin PC, et al. Effect of high-dose vs standard-dose wintertime vitamin D supplementation on viral upper respiratory tract infections in young healthy children. JAMA. 2017 Jul 18;318(3):245-54. http://www.ncbi.nlm.nih.gov/pubmed/28719693?tool=bestpractice.com
锌:由于数据不充分,目前不能明确给出预防性补锌建议。有研究显示,在 <10 岁的健康儿童中,锌补剂可预防多达半数的普通感冒。然而,在健康成人中,即使使用更大的剂量,也未观察到这种效果。[24]Wang MX, Win SS, Pang J. Zinc supplementation reduces common cold duration among healthy adults: a systematic review of randomized controlled trials with micronutrients supplementation. Am J Trop Med Hyg. 2020 Jul;103(1):86-99. https://www.doi.org/10.4269/ajtmh.19-0718 http://www.ncbi.nlm.nih.gov/pubmed/32342851?tool=bestpractice.com 口服补锌剂对锌缺乏症患病率较高地区(例如发展中国家)的儿童可能有益。[25]Vakili R, Vahedian M, Khodaei GH, et al. Effects of zinc supplementation in occurrence and duration of common cold in school aged children during cold season: a double-blind placebo-controlled trial. Iranian J Pediatr. 2009;19(4):376-80.
紫锥菊:关于紫锥菊的预防性作用,尚无定论。[26]Karsch-Völk M, Barrett B, Kiefer D, et al. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2014 Feb 20;(2):CD000530. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000530.pub3/full http://www.ncbi.nlm.nih.gov/pubmed/24554461?tool=bestpractice.com
二级预防
应避免接触普通感冒患者的鼻黏液或咳出的痰液。饭前或接触鼻、眼或口腔部位之前均应洗手。避免接触其他感冒患者(尤其是在疾病最初的几天)可降低接触性传播的可能性。[15]Jefferson T, Del Mar CB, Dooley L, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev. 2020 Nov 20;(11):CD006207. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub5/full http://www.ncbi.nlm.nih.gov/pubmed/33215698?tool=bestpractice.com
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