AU - Hilton, Emma AU - Satia, Imran AU - Holt, Kimberley AU - Woodcock, Ashley A. AU - Belcher, John AU - Smith, Jaclyn A. TI -疼痛调节对实验诱发咳嗽的影响:难治性慢性咳嗽辅助药物内源性抑制控制机制的损伤证据- 10.1183/13993003.01387-2020 DP -2020年12月01日TA -欧洲呼吸杂志PG - 2001387 VI - 56 IP - 6 4099 - //www.qdcxjkg.com/content/56/6/2001387.short 4100 - //www.qdcxjkg.com/content/56/6/2001387.full SO - Eur Respir J2020年12月01日;56 AB -难治性慢性咳嗽(RCC)的病理生理学尚不清楚。我们假设内源性抑制控制机制，例如由诱导疼痛的有害刺激激活的机制(条件性疼痛调节)可能能够抑制吸入辣椒素引起的咳嗽和咳嗽冲动。此外，这些机制可能在RCC患者中受损。目的是研究疼痛对健康志愿者和RCC患者咳嗽和咳嗽冲动的影响。健康志愿者和RCC患者进行了一项随机、对照、四向交叉研究，比较了四种干预措施对辣椒素诱发的咳嗽和咳嗽冲动的影响。这些干预措施包括将一只手浸入有毒的冷水中;2)温水;3)温水，但受试者被指示自愿抑制咳嗽; and 4) no intervention. The co-primary outcomes were numbers of evoked coughs and urge to cough scores.20 healthy volunteers (mean±sd age 50.1±14.2 years, male:female 10:10) and 20 RCC patients (age 60.1±7.9 years, male:female 9:11) participated. Overall, noxious cold water reduced capsaicin-evoked urge-to-cough scores and cough numbers compared with warm water (1.6 (95% CI 1.3–2.0) versus 2.2 (1.8–2.6), p<0.001 and 4.8 (3.7–6.2) coughs versus 7.9 (6.7–9.5) coughs, p<0.001, respectively). Healthy volunteers and RCC patients demonstrated similar reductions in the urge to cough during noxious cold-water immersion, but noxious cold water and voluntary suppression interventions were less effective at reducing capsaicin-evoked cough in RCC patients than in healthy volunteers (p=0.041).Endogenous inhibitory control mechanisms, specifically those activated by pain, can reduce both coughing and the urge to cough. Impairment of endogenous inhibitory control mechanisms may contribute to excessive coughing in RCC.Painful cold-water hand immersion elicited a weaker inhibitory effect on cough in patients with refractory chronic cough than healthy volunteers, suggesting a relative deficiency in conditioned pain modulation https://bit.ly/3gedtjg