Newall A R, Orser R, Hunt M
Faculty of Medicine, University of Ottawa, Canada.
J Neurol Sci. 1996 Aug;139 Suppl:43-4. doi: 10.1016/0022-510x(96)00104-9.
For the bulbar ALS/MND patient with dysphagia, the accumulation of oral secretions is a distressing problem. The control of these secretions, particularly the thick mucus form, is very difficult. In approaching this problem it is important to realise that the source of these secretions is not just from the oral salivary glands. The nose and lungs also contribute a constant flow of serous and particularly mucoid fluids. The neural control of these different forms of secretion is of importance in controlling them. Stimulation of cholinergic receptors produces thin serous secretions whereas beta adrenergic receptors produce thick protein and mucus-rich secretions. Therefore 16 bulbar ALS/MND patients were treated with beta antagonists after maximising other therapy. 75% of this group had fast and significant relief from their thick secretions. It is therefore proposed to perform a large controlled trial of beta blockers in the control of thick oral secretions in ALS/MND based on these promising pilot data.
对于患有吞咽困难的延髓性肌萎缩侧索硬化症/运动神经元病（ALS/MND）患者而言，口腔分泌物的积聚是一个令人苦恼的问题。控制这些分泌物，尤其是浓稠的黏液状分泌物，非常困难。在解决这个问题时，重要的是要认识到这些分泌物的来源不仅仅是口腔唾液腺。鼻子和肺部也会持续分泌浆液性液体，尤其是黏液状液体。对这些不同形式分泌物的神经控制对于控制它们很重要。刺激胆碱能受体会产生稀薄的浆液性分泌物，而刺激β肾上腺素能受体会产生浓稠的富含蛋白质和黏液的分泌物。因此，在将其他治疗方法最大化后，对16名延髓性ALS/MND患者使用了β受体拮抗剂进行治疗。该组中75%的患者浓稠分泌物迅速且显著减少。因此，基于这些有前景的试验数据，建议开展一项关于β受体阻滞剂控制ALS/MND患者浓稠口腔分泌物的大型对照试验。
