Koray M, Ak G, Kurklu E, Issever H, Tanyeri H, Kulekci G, Guc U
Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Istanbul University, Turkey.
Oral Dis. 2005 Sep;11(5):309-13. doi: 10.1111/j.1601-0825.2005.01124.x.
The aim of the present study was to compare the influence of fluconazole capsules and/or hexetidine mouthrinses for the management of oral candidiasis associated with denture stomatitis. DESIGN RELEVANT: Sixty-one patients (ages 43-76 years, mean: 61) admitted to the Department of Oral Surgery and Medicine and diagnosed as suffering from oral candidiasis associated with denture stomatitis by microbiological examination were involved.
Patients in group 1 (n = 21) were given only fluconazole capsules (Zolax 50 mg once a day), those in group 2 (n = 18) were given only hexetidine mouthrinses (Heksoral 0.1%, twice daily), whereas those in group 3 (n = 22) were given both fluconazole capsules and hexetidine mouthrinses for 14 days. The yeast colonies of the saliva samples were counted and calculated as the number of colony forming units per milliliter. The presence of yeasts in the lesion and denture samples were evaluated as present/absent according to their growth on cultures. Candida albicans was identified by means of germ tube analysis.
Patients in groups 1, 2 and 3 had a statistically significant decrease in the amount of C. albicans in saliva, lesions and dentures after treatment, when compared with pretreatment results (P < 0.05). Candida albicans counts in saliva, lesion and denture after treatment detected no statistically significant difference when the three groups were compared.
Of the three study groups, group 2, where hexetidine was the only medication prescribed, was found to be superior on account of fewer potential complications. We conclude that dentists should employ a more conservative intervention with oral mouthrinses rather than risk adverse effects and complications of systemic drugs for the management of oral candidiasis.
本研究旨在比较氟康唑胶囊和/或洗必泰漱口水对义齿性口炎相关口腔念珠菌病的治疗效果。设计相关性:纳入61例患者(年龄43 - 76岁,平均61岁),这些患者因微生物学检查确诊为义齿性口炎相关口腔念珠菌病而入住口腔外科和内科。
第1组(n = 21)患者仅服用氟康唑胶囊(卓乐新50毫克,每日一次),第2组(n = 18)患者仅使用洗必泰漱口水(0.1%的海克索罗,每日两次),而第3组(n = 22)患者同时服用氟康唑胶囊和使用洗必泰漱口水,疗程均为14天。对唾液样本中的酵母菌落进行计数,并计算为每毫升菌落形成单位数。根据病变和义齿样本在培养物上的生长情况评估酵母菌的存在与否,通过芽管分析鉴定白色念珠菌。
与治疗前结果相比,第1、2和3组患者治疗后唾液、病变部位和义齿中的白色念珠菌数量均有统计学意义的下降(P < 0.05)。三组比较时,治疗后唾液、病变部位和义齿中的白色念珠菌计数无统计学显著差异。
在三个研究组中,仅开具洗必泰作为唯一药物的第2组,因其潜在并发症较少而被认为更优。我们得出结论,对于口腔念珠菌病的治疗,牙医应采用更保守的口腔漱口水干预措施,而非冒险使用全身药物的不良反应和并发症。