Prevenstion of aspiration pneumonia and Research of the clinical application by VR1 and CMR1 agonists.

老年人的复发性肺炎是由于吞咽抑制和咳嗽反射引起的无声吸入所致，因为P物质释放不足。直接将辣椒素注射到咽部可以改善老年人的吞咽反射。然而，每天补充辣椒素是否会影响老年人反复吸入性支气管炎和肺炎的危险因素还没有被调查。为了确定每餐口服辣椒素片剂是否上调了上呼吸道保护反射的损害，如吞咽反射和咳嗽反射。2002年9月至2003年12月通过日本仙台疗养院招募的随机对照研究。养老院64人，平均年龄81.9±1.0岁，有慢性身体状况。参与者被随机分配到每餐前补充辣椒素或安慰剂的计划中，共4周…还有更多的鸡眼。个体吞咽反射潜伏期(LTSR)和咳嗽反射敏感性的评估。在本研究开始之前，干预组和对照组在多个参数上没有显著的基线差异。与对照组相比，干预组受试者的LTSR显著缩短(P&lt；0.05)。干预组LTSR缩短1分钟以上的优势比(OR)为3.4[95%可信区间(CI)1.1~10.4]，与对照组比较差异有统计学意义(P=0.03)。特别是，与低风险组(基线LTSR&lt；3.0秒)和中危组(基线LTSR&lt；6.0秒)相比，每日补充辣椒素显著增加了研究后4周高危组LTSR降低与基线LTSR的比率(P&lt；6.0秒)(P&lt；0.005)。干预组有17例(52.1%)咳嗽反射阈值降低，而对照组仅有7例(21.9%)咳嗽反射阈值降低(OR：4.1，[95%CI：1.4~12.2]，P&lt；0.01)。每日补充辣椒素显示，上呼吸道保护性反射有显著改善，特别是在吸入风险较高的老年人。较少

Recurrent pneumonia in older people is due to silent aspiration caused by depressed swallowing and cough reflexes because of an insufficient release of substance P.Direct administration of capsaicin to the pharynx can improve the swallowing reflex in older people. However, whether the daily capsaicin supplementation affects those risk factors for recurrent aspiration bronchitis and pneumonia in older people has not been investigated. To determine whether oral capsaicin troche supplementation every meal upregulates the impairment of upper respiratory protective reflexes such as the swallowing reflex and the cough reflex. Randomized-controlled study with recruitment through nursing homes in Sendai, Japan from September 2002 to December 2003. Sixty-four participants in nursing homes aged mean 81.9 ± 1.0 year old with chronic physical status. Participants were randomly assigned to the program for the supplementation of capsaicin trochisci or placebo trochisci soon before every meal for 4 w … More eeks. Assessment of individual latency of the swallowing reflex (LTSR) and cough reflex sensitivity. Before the commencement of this study, there were no significant baseline differences in multiple parameters between the intervention group and control group. LTSR in participants in the intervention group was significantly shortened, compared with the control group (P<.05). The odds ratio (OR) of the shortening of the LTSR of more than 1 minute in the intervention group was 3.4 [95% confidence interval (CI), 1.1-10.4], compared with the control group (P=.03). Particularly, daily capsaicin supplementation significantly increased the ratio of LTSR reduction at 4 weeks after the study to baseline LTSR in the high risk group (baseline LTSR>6.0sec) compared with the low risk group (baseline LTSR<3.0sec) and the intermediate group (3.0sec<baseline LTSR<6.0sec)(P<.005). The participants whose cough reflex sensitivity showed a decrease of the cough reflex threshold was observed in 17 participants (52.1%) in the intervention group but in only 7 participants (21.9%) in the control group after this study (OR : 4.1, [95% CI : 1.4-12.2], P<.01). Daily capsaicin supplementation showed a significant improvement in upper protective respiratory reflexes, particularly in older people with a high risk for aspiration. Less