Effect of Olfactory Stimulation by L-Menthol on Laboratory-Induced Dyspnea in COPD
Effect of Olfactory Stimulation by L-Menthol on Laboratory-Induced Dyspnea in COPD
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DOI：
10.1016/j.chest.2019.12.028
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发表时间：
2020-06-01
期刊：
影响因子：
9.6
通讯作者：
Ebihara, Satoru
中科院分区：
文献类型：
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作者：
Kanezaki, Masashi;Terada, Kunihiko;Ebihara, Satoru
背景：吸入l -薄荷醇作为一种瞬时受体电位美拉他汀8激动剂可引起气道内的冷却感觉。这种由l -薄荷醇（OSM）的嗅觉刺激引起的凉爽感觉减轻了健康人的呼吸困难。因此，我们研究了OSM对慢性阻塞性肺病患者吸气阻力负荷呼吸引起的呼吸困难的神经呼吸驱动（NRD）和多维方面的影响。方法：这项随机、单盲、安慰剂对照的交叉研究共纳入了28名COPD患者和14名对照组。OSM使用l-薄荷醇气味贴片，而安慰剂使用草莓气味贴片进行嗅觉刺激：安慰剂（OSP）。假性条件通过不带OSP的口罩呼吸来测量。呼吸困难是通过呼吸阻力20或30 cm H2O/L/s引起的，并使用多维呼吸困难谱进行测量。使用胸骨旁肋间肌的肌电图活动来估计NRD。结果：与假手术和OSP相比，OSM未改变吸气阻力负荷时的呼吸方式/时间和NRD；但可显著缓解COPD患者吸气阻力负荷呼吸时的身心呼吸费力、空气饥饿、呼吸不适、焦虑和恐惧。然而，虽然OSM减少了空气饥饿、精神呼吸努力和不愉快，但在对照组中没有观察到OSM对呼吸困难的情感维度的显著改善。结论：我们的研究结果表明，OSM激活了COPD患者的吸气流感，从而缓解了呼吸困难。
BACKGROUND: Inhalation of L-menthol as a transient receptor potential melastatin 8 agonist induces a cooling sensation in the airway. This cooling sensation induced through olfactory stimulation by L-menthol (OSM) alleviates dyspnea in healthy humans. Therefore, we investigated effects of OSM on the neural respiratory drive (NRD) and multidimensional aspects of dyspnea induced by inspiratory resistive loaded breathing in COPD.METHODS: In total, 28 patients with COPD and 14 control participants were included in this randomized, single-blinded, placebo-controlled, crossover study. OSM was administered using an L-menthol-scented patch, whereas placebo was administered using olfactory stimulation by strawberry-scented patch: placebo (OSP). Sham condition was measured by breathing through a face mask without a OSP. Dyspnea was evoked by breathing through the inspiratory resistance of 20 or 30 cm H2O/L/s and measured using the Multidimensional Dyspnea Profile. NRD was estimated using the electromyogram activities of the parasternal intercostal muscles.RESULTS: Compared with sham and OSP, OSM did not alter the breathing pattern/timing and NRD during inspiratory resistive loading; however, it significantly alleviated the physical and mental breathing effort, air hunger, breathing discomfort, anxiety, and fear during inspiratory resistive loaded breathing in patients with COPD. However, although OSM reduced the air hunger, mental breathing effort, and unpleasantness, no significant improvement on affective dimension of dyspnea by OSM was observed in control participants.CONCLUSIONS: Our findings suggest that OSM activated the sense of inspiratory flow that achieved dyspnea relief in patients with COPD.