What helps with coughing
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Effective Remedies for Cough Relief
Coughing is a common symptom that can significantly impact quality of life, causing discomfort, anxiety, and sleep disturbances. Various remedies have been explored to alleviate cough symptoms, ranging from natural substances like honey to traditional herbal medications and over-the-counter (OTC) drugs. This article synthesizes the findings from multiple studies on effective treatments for cough.
Honey for Cough Relief
Honey vs. No Treatment and Placebo
Several studies have evaluated the effectiveness of honey in treating acute cough, particularly in children. Honey has been found to be more effective than no treatment and placebo in reducing the frequency and severity of cough. Moderate to high-quality evidence suggests that honey can significantly reduce cough frequency compared to no treatment (mean difference (MD) -1.05; 95% confidence interval (CI) -1.48 to -0.62) and placebo (MD -1.85; 95% CI -3.36 to -0.33) .
Honey vs. OTC Medications
When compared to OTC medications like dextromethorphan and diphenhydramine, honey showed mixed results. Honey was found to be as effective as dextromethorphan in reducing cough frequency (MD -0.07; 95% CI -1.07 to 0.94) but slightly better than diphenhydramine (MD -0.57; 95% CI -0.90 to -0.24) . However, the evidence is not strong enough to conclusively recommend honey over these medications.
Safety and Adverse Effects
Honey is generally safe for children over one year of age, with mild adverse effects such as nervousness, insomnia, and hyperactivity reported in a small percentage of cases. These side effects were not significantly different from those observed with dextromethorphan or diphenhydramine .
Herbal Medications for Cough
Maekmoondong-tang (MMDT)
Maekmoondong-tang (MMDT), a traditional herbal medication, has been used in Korea, Japan, and China to treat cough. A systematic review and meta-analysis of nine randomized controlled trials (RCTs) involving 2,453 participants found that MMDT significantly reduced cough severity by 74% compared to conventional antitussive medications (RR of cough persisting after treatment=0.26; 95% CI, 0.19-0.34). However, the evidence is inconsistent for its effectiveness in conditions like chronic obstructive pulmonary disease (COPD), lung cancer surgery, and asthma.
General Herbal Medicine
A broader review of herbal medicine (HM) for chronic cough included 80 RCTs with 7,573 patients. The study found that HM significantly improved cough-related quality of life, reduced cough recurrence rates, and had a lower incidence of adverse events compared to conventional medications. However, the high risk of bias and clinical heterogeneity in the included studies call for more rigorous trials.
Capsaicin for Cough
Capsaicin, the active component in chili peppers, has been studied for its potential to desensitize the cough reflex. A study involving 24 patients with chronic unexplained cough found that oral intake of capsaicin significantly increased the thresholds for cough reflex sensitivity and improved cough symptoms. This suggests that capsaicin may help reduce cough sensitivity and provide symptomatic relief.
Over-the-Counter Medications
Effectiveness in Adults and Children
The effectiveness of OTC medications for acute cough remains inconclusive. A review of 22 trials involving 4,199 participants found mixed results. While some studies showed that antitussives like dextromethorphan and expectorants like guaifenesin were effective, others did not find significant differences compared to placebo. The evidence for the effectiveness of antihistamines and mucolytics was also inconsistent.
Safety and Adverse Effects
OTC medications generally have a low incidence of adverse effects, but their effectiveness varies widely. The review concluded that there is no strong evidence for or against the use of OTC medications for acute cough, highlighting the need for more consistent and high-quality studies.
Conclusion
Honey appears to be a safe and effective remedy for reducing cough frequency and severity, particularly in children. Traditional herbal medications like Maekmoondong-tang and general herbal medicine show promise but require more rigorous studies to confirm their effectiveness. Capsaicin may offer relief for chronic unexplained cough by desensitizing the cough reflex. The effectiveness of OTC medications remains uncertain, with mixed results across different studies. Further high-quality research is needed to establish the most effective treatments for cough.
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