| Project/Area Number |
17K11387
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Otorhinolaryngology
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| Research Institution | The University of Tokushima |
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Principal Investigator |
KONDO Eiji 徳島大学, 病院, 助教 (50770434)
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| Co-Investigator(Kenkyū-buntansha) |
武田 憲昭 徳島大学, 大学院医歯薬学研究部(医学域), 教授 (30206982)
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2019: ¥260,000 (Direct Cost: ¥200,000、Indirect Cost: ¥60,000)
Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2017: ¥3,510,000 (Direct Cost: ¥2,700,000、Indirect Cost: ¥810,000)
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| Keywords | カプサイシン / 外耳道刺激 / 嚥下障害 / 誤嚥性肺炎 / 咳反射 / サブスタンスＰ / 嚥下性肺炎 / 高齢者 |
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| Outline of Final Research Achievements |
In our previous study, a single application of 0.025% capsaicin ointment in the external auditory canal improved cough reflexes, in elderly patients with dysphagia. In the present study, we examined the mechanism for improvement of cough reflex after aural stimulation with capsaicin and prophylactic effects of daily aural stimulation on the development of pneumonia in elderly dementia inpatients who are at high risk of aspiration, but cannot undergo swallowing exercises.
Aural stimulation with capsaicin increased the concentration of substance P in the sputum of healthy volunteers. This stimulation induced the retrograde release of substance P in the pharyngolaryngeal mucosa. Daily aural stimulation with capsaicin for 6 months enhanced the cough reflex as a glottis protective measure, resulting in the reduction of incidence of pneumonia in patients. The daily aural stimulation with capsaicin may be a new safe and effective option for prevention of pneumonia in elderly dysphagic people.
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| Academic Significance and Societal Importance of the Research Achievements |
近年、高齢者の嚥下性肺炎が急増し誤嚥を予防するために嚥下訓練など様々な介入が行われているがエビデンスは限られている。降圧剤であるACE阻害薬は副作用である咳反射の亢進により誤嚥を防止し嚥下性肺炎の罹患率を減少させる報告があるが、服薬により薬剤を誤嚥するリスクを伴う。
我々は、これまでの研究でカプサイシン軟膏による外耳道刺激が嚥下障害患者の咳反射を亢進させることを示し、本研究において誤嚥性肺炎の予防にも有用である可能性を示した。本法は誤嚥の危険性がない安全で新しい嚥下障害の治療法となる可能性があり、臨床への応用により超高齢化社会のニーズに応えることができると考えられる。
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