TY - JOUR T1 -疼痛条件反射对实验性诱发咳嗽的影响:内源性抑制控制机制受损的证据在难治性慢性咳嗽JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.01387 -2020欧元六世- 56 - 6 SP - 2001387 AU -希尔顿,艾玛盟——Satia伊姆兰AU -霍尔特,金伯利AU -丘鹬,阿什利·a . AU -贝尔彻,约翰AU -史密斯,Jaclyn A. Y1 - 2020/12/01 UR - //www.qdcxjkg.com/content/56/6/2001387.abstract N2 -难治性慢性咳嗽(RCC)的病理生理机制尚不清楚。我们假设，内源性抑制控制机制，如那些由引起疼痛的有害刺激激活的(条状疼痛调节)可能能够抑制咳嗽和吸入辣椒素诱发的咳嗽冲动。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肾细胞癌患者咳嗽和催咳的影响。健康志愿者和RCC患者进行了一项随机、对照、四种交叉研究，比较了四种干预措施对辣椒素诱发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，但受试者被要求自愿抑制咳嗽; 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 ER -