Widdicombe John
Respir Physiol Neurobiol. 2009 May 30;167(1):2-8. doi: 10.1016/j.resp.2008.09.012. Epub 2008 Oct 5.
Stimuli within the lung can cause the sensations of pain, ache, irritation and urge-to-cough. In general these are abolished or inhibited by vagal section or vagal anaesthesia, or local anaesthesia within the airways. They are present in patients with functional high cervical spinal cord transaction and after general neuromuscular paralysis. There are at least nine sensors in the bronchopulmonary system, studied almost entirely in animals. It is at present impossible to link any one sensor with any one pattern of sensation. It is reasonable to suppose that urge-to-cough arises from sensors what mediate cough, but there are at least five sensors involved in this reflex, and how they relate to unpleasant sensation is unknown. The problem is that sensation can almost only be studied in humans, and the vagal neural mechanisms almost only in other species. Vagal sensors can also ameliorate the sensation of air hunger, and this is probably due to the action of slowly adapting pulmonary stretch receptors (SARs). The same sensors may give rise to the awareness of lung volume and its changes. Many sensors in the lungs can be sensitized or desensitized by natural or imposed conditions, and this could underlie the sensitization and desensitization of dyspnoeic sensations that have been described.
肺内的刺激可引起疼痛、酸痛、刺激感和咳嗽冲动等感觉。一般来说，这些感觉可通过迷走神经切断术、迷走神经麻醉或气道内局部麻醉而消除或受到抑制。在功能性高位颈脊髓横断的患者以及全身神经肌肉麻痹后，这些感觉依然存在。支气管肺系统中至少有九种感受器，几乎全部是在动物身上进行研究的。目前还无法将任何一种感受器与任何一种感觉模式联系起来。可以合理推测，咳嗽冲动源于介导咳嗽的感受器，但这种反射至少涉及五种感受器，它们与不适感之间的关系尚不清楚。问题在于，感觉几乎只能在人类身上进行研究，而迷走神经的神经机制几乎只能在其他物种身上进行研究。迷走神经感受器还可减轻空气饥饿感，这可能是由于慢适应性肺牵张感受器（SARs）的作用。同样的感受器可能会引起对肺容积及其变化的感知。肺内的许多感受器可因自然或人为条件而致敏或脱敏，这可能是已描述的呼吸困难感觉致敏和脱敏的基础。
