Ohnishi Hiroki, Jinnouchi Osamu, Agawa Seiji, Kondo Eiji, Kawata Ikuji, Okamoto Hidehiko, Azuma Takahiro, Sato Go, Kitamura Yoshiaki, Abe Koji, Takeda Noriaki
Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
Department of Otolaryngology, Anan Kyoei Hospital, Tokushima, Japan.
Acta Otolaryngol. 2020 Mar;140(3):249-253. doi: 10.1080/00016489.2020.1716993. Epub 2020 Feb 5.
In our previous study, a single auricular application of capsaicin ointment, but not placebo improved cough reflex in elderly patients with dysphagia. In the present study, we examined whether daily auricular application of capsaicin ointment continued to improve cough reflex in similar patients. With a cotton swab, 0.025% capsaicin ointment was applied in each external auditory canal alternately once a day for 2 weeks. The cough reflex sensitivity was evaluated on videoendoscopy using a numerical score and inhalation cough challenge test using citric acid in elderly dysphagic inpatients. After daily auricular application of capsaicin ointment for 2 weeks, the endoscopic score of glottal closure and cough reflexes significantly improved, and the citric acid cough threshold significantly decreased. There was a significant correlation between the endoscopic score and the citric acid cough threshold before and after daily capsaicin application in the patients.: Daily auricular stimulation with capsaicin ointment for 2 weeks continued to improve the cough reflex sensitivity in elderly patients with dysphagia. Daily auricular stimulation with capsaicin ointment would be a safe and effective intervention to prevent pneumonia in elderly with a risk of aspiration.
在我们之前的研究中，对吞咽困难的老年患者单次耳部涂抹辣椒素软膏可改善咳嗽反射，而涂抹安慰剂则无此效果。在本研究中，我们探讨了对类似患者每日耳部涂抹辣椒素软膏是否能持续改善咳嗽反射。用棉签将0.025%的辣椒素软膏交替涂抹于每个外耳道，每天1次，持续2周。对老年吞咽困难住院患者通过视频内镜检查采用数字评分法评估咳嗽反射敏感性，并采用柠檬酸吸入咳嗽激发试验进行评估。每日耳部涂抹辣椒素软膏2周后，声门关闭的内镜评分和咳嗽反射显著改善，柠檬酸咳嗽阈值显著降低。患者每日涂抹辣椒素前后，内镜评分与柠檬酸咳嗽阈值之间存在显著相关性。每日用辣椒素软膏进行耳部刺激2周可持续改善吞咽困难老年患者的咳嗽反射敏感性。每日用辣椒素软膏进行耳部刺激将是预防有误吸风险老年人肺炎的一种安全有效的干预措施。
