Epstein J B, Truelove E L, Oien H, Allison C, Le N D, Epstein M S
Department of Dentistry, Vancouver Hospital and Health Sciences Centre, Vancouver, BC, Canada.
Oral Oncol. 2001 Dec;37(8):632-7. doi: 10.1016/s1368-8375(01)00005-7.
Oral mucositis is a treatment limiting toxicity of cancer therapy. The purpose of this study was to assess the impact of doxepin oral rinse in the management of oral mucosal pain in cancer patients. Forty-one cancer patients with oral mucosal pain were provided a solution of doxepin (0.5%) for oral rinsing. Oral pain was assessed prior to rinsing, and following rinsing for 4 h using a visual analogue scale (VAS). Adverse effects were recorded. Doxepin rinse resulted in a reduction of pain intensity of more than 50%, with pain relief extending for more than 3 h with pain not returning to baseline 4 h after rinsing. The rinse was tolerated by patients with mucosal damage, and had acceptable taste, and infrequent mucosal stinging with use. Some patients reported sedation after use, likely due to systemic absorption. The results of this single dose trial suggest that topical doxepin rinse has significant ability to provide clinically significant pain relief in patients with mucosal damage with an extended duration of effect.
口腔黏膜炎是癌症治疗中限制治疗的毒性反应。本研究的目的是评估多塞平口腔含漱液对癌症患者口腔黏膜疼痛管理的影响。41例患有口腔黏膜疼痛的癌症患者使用多塞平（0.5%）溶液进行口腔含漱。在含漱前以及含漱4小时后，使用视觉模拟量表（VAS）评估口腔疼痛情况。记录不良反应。多塞平含漱液使疼痛强度降低超过50%，疼痛缓解持续超过3小时，含漱4小时后疼痛未恢复至基线水平。黏膜受损的患者能够耐受该含漱液，其味道可接受，使用时黏膜刺痛不常见。一些患者使用后报告有镇静作用，可能是由于全身吸收所致。该单剂量试验的结果表明，局部使用多塞平含漱液有显著能力为黏膜受损患者提供具有临床意义的疼痛缓解，且作用持续时间延长。
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