哮喘联盟

   摘要
   环境刺激物引起的原因未明的慢性咳嗽以咳嗽反射敏感性增加为特点，这可以通过吸入辣椒素的方法得以论证。局部使用辣椒素可以改善非过敏性鼻炎和肠道过敏并能减轻神经性疼痛。
   目标：本文旨在研究口服天然辣椒素（辣椒） 是否能降低咳嗽反射的敏感性及改善原因不明的咳嗽。
   方法： 研究纳入24例刺激引起的、原因未明的慢性咳嗽病例及15例对照。受试者服用纯辣椒素胶囊4周并服用安慰剂胶囊4周。实验方案为交叉、随机、双盲。研究中，咳嗽敏感性由一项标准化的辣椒素吸入咳嗽试验来评估，该试验评估造成2次咳嗽（C2）及5次咳嗽（C5）所需要的辣椒素浓度。受试者也接受关于咳嗽及咳嗽相关症状的问卷调查。
   结果： 3名患者在研究结束前退出，其中1名患者在积极治疗阶段退出，2名患者在安慰剂阶段退出。相较安慰剂治疗，经过辣椒素治疗后，患者组（p < 0.020）及对照组(p < 0.0061)C2的阈值均有提高。患者组在经过活性物质治疗后，达到C2(p < 0.0004) 及C5(p < 0.0009)所需的辣椒素浓度与基线咳嗽阈值相比均有提高。在经过4周积极治疗后，咳嗽症状评分相较于基线评分也有所提高(p < 0.0030) 。
   结论: 口服辣椒素粉末能够降低辣椒素引起咳嗽的敏感性、减轻咳嗽症状。研究结果揭示了咳嗽敏感性瞬时电位香草酸受体1(TRPV1)的脱敏作用。

 

（刘国梁 审校）
Respir Med. 2015 Jan;109(1):27-37. doi: 10.1016/j.rmed.2014.11.001. Epub 2014 Nov 12.
 

Cough reduction using capsaicin.
 

Ternesten-Hasséus E1, Johansson EL2, Millqvist E3.
 

Abstract
Chronic unexplained cough triggered by environmental irritants is characterized by increased cough reflex sensitivity, which can be demonstrated by means of inhaled capsaicin. Topical capsaicin can be used to improve non-allergic rhinitis and intestinal hypersensitivity and to reduce neuropathic pain.
OBJECTIVES: We established whether an oral intake of natural capsaicin (chilli) could desensitize the cough reflex and improve unexplained coughing.
METHODS: Twenty-four patients with irritant-induced, unexplained chronic cough and 15 controls were included in the study. For 4 weeks, the participants took capsules with pure capsaicin, and for 4 weeks, they took placebo capsules. The protocol was crossover, randomized, and double blind. Cough sensitivity during the study was evaluated by a standardized capsaicin inhalation cough test that assessed the capsaicin concentration required to reach two coughs (C2) and five coughs (C5). Participants were also administered questionnaires on cough and cough-related symptoms.
RESULTS: Three patients withdrew before the study end, one during the active treatment period and two during the placebo period. After treatment with capsaicin, the thresholds for C2 were higher (improved) both in patients (p < 0.020) and in controls (p < 0.0061) compared to after the placebo period. Among patients, the concentration needed to reach C2 (p < 0.0004) and C5 (p < 0.0009) increased after the period with the active substance compared to cough thresholds at baseline. The cough symptom scores improved after 4 weeks of active treatment (p < 0.0030) compared to the baseline scores.
CONCLUSION: Capsaicin powder taken orally decreased capsaicin cough sensitivity and cough symptoms. The findings suggest a desensitization of the cough-sensitive transient receptor potential vanilloid-1 (TRPV1).
 

Respir Med. 2015 Jan;109(1):27-37. doi: 10.1016/j.rmed.2014.11.001. Epub 2014 Nov 12.