辣椒素雾化对出血性脑卒中患者咳嗽和吞咽功能的影响：一项随机对照试验。
Effect of Capsaicin Atomization on Cough and Swallowing Function in Patients With Hemorrhagic Stroke: A Randomized Controlled Trial.
机构信息
Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, China.
出版信息
J Speech Lang Hear Res. 2023 Feb 13;66(2):503-512. doi: 10.1044/2022_JSLHR-22-00296. Epub 2023 Jan 30.
BACKGROUND
Patients with hemorrhagic stroke have high mortality and disability rates. Nevertheless, early rehabilitation interventions can improve their outcomes. We aimed to apply capsaicin atomization as early intervention to patients with hemorrhagic stroke and explore improvements in cough and swallowing functions.
METHOD
Patients with hemorrhagic stroke were randomly divided into the control group, which received routine care, and the intervention group, which underwent the capsaicin solution nebulization scheme in addition to routine care. Differences in the presence/absence of cough reflex and number of coughs in response to capsaicin, the presence/absence of swallowing reflex in response to water, the presence/absence of postswallow residue, substance P (SP) concentration, and pulmonary inflammation between the two groups were determined before and after the intervention.
RESULTS
A total of 53 patients with hemorrhagic stroke were included. Results showed no statistically significant difference in cough reflex in both groups after the intervention ( > .05). The degree of cough in the intervention group was stronger than that in the control group ( = .046). No statistically significant difference was observed in the number of patients with swallowing reflex in response to water between the groups ( > .05). The presence/absence of postswallow residue of the intervention group was stronger than that of the control group ( = .032). No statistically significant difference was observed between the Glasgow Coma Scale scores of the groups after the intervention ( > .05). SP in the intervention group was significantly increased ( = .031). The Clinical Pulmonary Infection Score was significantly lower in the control group, and the difference was statistically significant ( = .028).
CONCLUSIONS
Capsaicin nebulization can help enhance the number of coughs in response to capsaicin, reduce postswallow residue, and increase the level of SP in patients with hemorrhagic stroke and has a positive effect on pulmonary inflammation. This study provides intervention points for cough and swallowing rehabilitation after a hemorrhagic stroke.
SUPPLEMENTAL MATERIAL
背景
出血性脑卒中患者的死亡率和致残率较高。然而，早期康复干预可以改善患者的预后。本研究旨在对出血性脑卒中患者应用辣椒素雾化治疗，并探讨其对咳嗽和吞咽功能的改善作用。
方法
将出血性脑卒中患者随机分为对照组和干预组，对照组接受常规护理，干预组在常规护理的基础上接受辣椒素溶液雾化方案。比较两组患者干预前后咳嗽反射存在/缺失、咳嗽次数、水吞咽反射存在/缺失、吞咽后残留物存在/缺失、P 物质（SP）浓度和肺部炎症情况。
结果
共纳入 53 例出血性脑卒中患者。结果显示，干预后两组咳嗽反射差异均无统计学意义（>0.05），但干预组咳嗽程度强于对照组（=0.046）。两组水吞咽反射存在的患者例数差异无统计学意义（>0.05），但干预组吞咽后残留物存在的患者例数强于对照组（=0.032）。干预后两组格拉斯哥昏迷量表评分差异无统计学意义（>0.05）。干预组 SP 显著增加（=0.031）。对照组临床肺部感染评分显著降低，差异有统计学意义（=0.028）。
结论
辣椒素雾化可以增加出血性脑卒中患者对辣椒素的咳嗽次数，减少吞咽后残留物，增加 SP 水平，对肺部炎症有积极作用。本研究为出血性脑卒中后咳嗽和吞咽康复提供了干预点。
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