Sensory Stimulation to Improve Swallowing Reflex and Prevent Aspiration Pneumonia in Elderly Dysphagic People
Sensory Stimulation to Improve Swallowing Reflex and Prevent Aspiration Pneumonia in Elderly Dysphagic People
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DOI：
10.1254/jphs.10r05cp
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发表时间：
2011-02-01
影响因子：
3.5
通讯作者：
Ebihara, Takae
中科院分区：
文献类型：
--
作者：
Ebihara, Satoru;Kohzuki, Masahiro;Ebihara, Takae
吸入性肺炎的发病率和死亡率仍然是老年人的一个主要健康问题。吸入性肺炎患者存在吞咽障碍，如吞咽反射延迟触发。我们发现老年人的吞咽反射对温度敏感。当食物的温度接近体温时，吞咽反射延迟。实际吞咽时间随温差的增大而缩短。温度刺激对吞咽反射的改善可能是通过温度敏感的瞬时受体电位（TRP）通道介导的。辣椒素作为TRPV1（一种温热感受器）的激动剂刺激物的锭剂的给药减少了吞咽反射的延迟。含有薄荷醇的食物，一种TRPM8的激动剂，一种冷温度受体，也减少了吞咽反射的延迟。嗅觉刺激，如黑胡椒是有用的，以改善吞咽反射的人与日常生活活动（ADL）水平低或意识下降。口腔护理还缩短了吞咽反射的潜伏时间，可能是由于刺激了口腔的伤害性感受。这些感觉刺激的组合可以改善吞咽障碍并预防吸入性肺炎。
Morbidity and mortality from aspiration pneumonia continues to be a major health problem in the elderly. A swallowing disorder, such as a delayed triggering of the swallowing reflex, exists in patients with aspiration pneumonia. We found that the swallowing reflex in elderly people was temperature-sensitive. The swallowing reflex was delayed when the temperature of the food was close to body temperature. The actual swallowing time shortened when the temperature difference increases. The improvement of swallowing reflex by temperature stimuli could be mediated by the temperature-sensitive transient receptor potential (TRP) channel. The administration of a pastille with capsaicin as an agonist stimulus of TRPV1, a warm-temperature receptor, decreased the delay in swallowing reflex. Food with menthol, an agonist of TRPM8, a cold-temperature receptor, also decreased the delay in swallowing reflex. Olfactory stimulation such as black pepper was useful to improve the swallowing reflex for people with low activity of daily living (ADL) levels or with decreased consciousness. Oral care also shortened the latent time of swallowing reflex presumably due to stimulating the nociception of the oral cavity. A combination of these sensory stimuli may improve the swallowing disorders and prevent aspiration pneumonia.