Ferretti G A, Raybould T P, Brown A T, Macdonald J S, Greenwood M, Maruyama Y, Geil J, Lillich T T, Ash R C
Department of Oral Health Practice, University of Kentucky, Lexington.
Oral Surg Oral Med Oral Pathol. 1990 Mar;69(3):331-8. doi: 10.1016/0030-4220(90)90295-4.
Patients receiving cytotoxic antineoplastic therapy often have treatment-associated stomatitis. A 0.12% chlorhexidine digluconate mouthrinse was evaluated (15 ml, three times a day) in a prospective, double-blind randomized trial as prophylaxis against cytotoxic therapy-induced damage to oral soft tissues. Seventy subjects, forty inpatients receiving high-dose chemotherapy and thirty outpatients receiving high-dose head and neck radiation therapy, were evaluated. Chlorhexidine mouthrinse significantly reduced the incidence of oral mucositis in the chemotherapy group on day 14 (p less than 0.02) and at 1 week follow-up on day 28 (p less than 0.002). Mucositis in the patients undergoing chemotherapy who received chlorhexidine also resolved more rapidly. Mucositis severity was significantly less compared to the control chemotherapy group on day 14 (p less than 0.03), day 21 (p less than 0.04), and on 1 week follow-up (p less than 0.02). Concomitant trends in the reduction in oral streptococci and yeast were noted in the chemotherapy group receiving chlorhexidine mouthrinse. Although no differences were observed in oral mucositis between the control and chlorhexidine groups of patients undergoing high-dose radiotherapy, similar reductions of oral microflora to those seen in the chemotherapy population were also noted for patients undergoing radiation therapy who received chlorhexidine. Although generally not significant, some increase in gram-negative bacilli was noted in the chlorhexidine-treated patients in both the chemotherapy and radiotherapy groups, but there was no correlation with increased systemic infection. Prophylactic chlorhexidine mouthrinse reduces oral mucositis and microbial burden in patients with cancer undergoing intensive chemotherapy.
接受细胞毒性抗肿瘤治疗的患者常出现与治疗相关的口腔炎。在一项前瞻性、双盲随机试验中，对0.12%葡萄糖酸氯己定漱口水（15毫升，每日三次）进行了评估，以预防细胞毒性治疗引起的口腔软组织损伤。评估了70名受试者，其中40名接受高剂量化疗的住院患者和30名接受高剂量头颈放疗的门诊患者。葡萄糖酸氯己定漱口水显著降低了化疗组在第14天（p<0.02）和第28天1周随访时（p<0.002）口腔黏膜炎的发生率。接受氯己定治疗的化疗患者的黏膜炎也消退得更快。在第14天（p<0.03）、第21天（p<0.04）和1周随访时（p<0.02），与对照化疗组相比，黏膜炎严重程度明显更低。在接受葡萄糖酸氯己定漱口水的化疗组中，观察到口腔链球菌和酵母菌数量减少的伴随趋势。虽然在接受高剂量放疗的患者中，对照组和氯己定组之间在口腔黏膜炎方面未观察到差异，但接受氯己定治疗的放疗患者的口腔微生物群也有与化疗人群类似的减少。虽然一般不显著，但在化疗和放疗组接受氯己定治疗的患者中，革兰氏阴性杆菌有一些增加，但与全身感染增加无关。预防性使用葡萄糖酸氯己定漱口水可降低接受强化化疗的癌症患者的口腔黏膜炎和微生物负荷。
