Kittipanya-Ngam Pajeemas, Benjapornlert Paitoon, Rattanakanokchai Siwanon, Wattanapan Pattra
Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, 123 Mittraphap Rd., Nai Mueang, Mueang Khon Kaen District, Khon Kaen, 40000, Thailand.
Department of Rehabilitation Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd., Ratchathewi, Bangkok, 10400, Thailand.
Dysphagia. 2021 Aug;36(4):614-622. doi: 10.1007/s00455-020-10175-2. Epub 2020 Aug 31.
There is still controversy on evidence supporting compounds that stimulate the transient receptor potential cation channel (TRP) receptor, which can reduce the latency of swallowing reflex. This systematic review aims to evaluate the effectiveness of TRP-stimulating compounds to reduce swallowing reflex time in the elderly. We searched the following databases: PubMed, EMBASE, OVID, Central, Scopus, ISI, CINALH, LILACS, CRD database, and Open grey until June 1st, 2019. We included randomized controlled trials (RCTs) which compared swallowing time between TRP-stimulating compounds and placebo or no treatment in population aged more than 60 years old. We assessed bias using the Cochrane risk of bias tool. Three authors independently screened and selected studies. Quality assessment and data extraction were performed by two authors independently. Of 363 reviews, we included four RCTs. Two RCTs used black pepper, one RCT used capsaicinoids, and the other one used capsaicin ointment to stimulate the TRPV1 receptor. All of the studies were assessed at unclear bias except the study, which used capsaicin ointment with assessed as low risk of bias. Meta-analysis could not be done in this study due to the different baseline characteristics and definition of swallowing reflex time. This review demonstrates the potential effect of TRPV1-stimulating compounds to reduce swallowing response time in the elderly were remains unclear. Most studies had an unclear bias. Further larger and well-designed RCTs are needed to draw robust conclusions.
关于支持刺激瞬时受体电位阳离子通道(TRP)受体的化合物的证据仍存在争议,这类化合物可缩短吞咽反射的潜伏期。本系统评价旨在评估刺激TRP的化合物在减少老年人吞咽反射时间方面的有效性。我们检索了以下数据库:PubMed、EMBASE、OVID、Central、Scopus、ISI、CINALH、LILACS、CRD数据库和Open grey,检索截至2019年6月1日。我们纳入了比较刺激TRP的化合物与安慰剂或未治疗在60岁以上人群中的吞咽时间的随机对照试验(RCT)。我们使用Cochrane偏倚风险工具评估偏倚。三位作者独立筛选和选择研究。质量评估和数据提取由两位作者独立进行。在363篇综述中,我们纳入了四项RCT。两项RCT使用了黑胡椒,一项RCT使用了辣椒素类,另一项使用辣椒素软膏刺激TRPV1受体。除了使用辣椒素软膏且评估为低偏倚风险的研究外,所有研究的偏倚评估均为不清楚。由于基线特征和吞咽反射时间定义不同,本研究无法进行荟萃分析。本综述表明,刺激TRPV1的化合物在减少老年人吞咽反应时间方面的潜在效果仍不清楚。大多数研究的偏倚不清楚。需要进一步开展更大规模且设计良好的RCT以得出可靠结论。