Baradari A G, Khezri H D, Arabi S
Mazandaran University of Medical Sciences, Tehran, Iran.
Bratisl Lek Listy. 2012;113(9):556-60. doi: 10.4149/bll_2012_125.
Mouthwashes decrease the risk of VAP by reducing the number of microorganisms and their transmission and colonization in the lung. Among the oral rinses, chlorhexidine is considered as the gold standard but it has a variety of complications. The purpose of this study was to determine and compare anti-bacterial effects of the chlorhexidine gluconate and herbal mouthwashes in intensive care unit patients.
In this double blind randomized clinical trial, 60 patients who were admitted in ICU were divided into two equal 30 persons groups. In the first group Chlorhexidine gluconate 2 % mouthwash and in the second group herbal mouth wash was used. Just before and again after 6 min of oral rinsing, salivary samples were obtained without any stimulation in order to culture Staphylococcus aureus and Streptococcus pneumoniae. The data were processed in SPSS16 software and were analyzed by appropriate statistical tests.
Matrica® and chlorhexidine mouthwashes have significant antibacterial effects against Streptococcus pneumoniae and Staphylococcus aureus. Decreasing of the number of bacteria in samples after oral rinsing was significant in both groups (p <0.001) but chlorhexidine was significantly more effective than herbal mouth wash in reducing the number of colonies (p < 0.001).
The herbal mouth wash has significant antibacterial effects against Staphylococcus aureus and Streptococcus pneumoniae, but its efficacy is less than chlorhexidine, so after further investigation, it would be considered as an alternative to chlorhexidine in ICUs (Tab. 3, Ref. 33).
漱口水通过减少微生物数量及其在肺部的传播与定植来降低呼吸机相关性肺炎（VAP）的风险。在口腔冲洗液中，洗必泰被视为金标准，但它有多种并发症。本研究的目的是确定并比较葡萄糖酸氯己定和草药漱口水对重症监护病房患者的抗菌效果。
在这项双盲随机临床试验中，60名入住重症监护病房的患者被分为两组，每组30人。第一组使用2%葡萄糖酸氯己定漱口水，第二组使用草药漱口水。在口腔冲洗前及冲洗6分钟后，在无任何刺激的情况下采集唾液样本，以培养金黄色葡萄球菌和肺炎链球菌。数据在SPSS16软件中处理，并通过适当的统计检验进行分析。
Matrica®漱口水和洗必泰漱口水对肺炎链球菌和金黄色葡萄球菌均有显著的抗菌效果。两组口腔冲洗后样本中的细菌数量均显著减少（p<0.001），但在减少菌落数量方面，洗必泰比草药漱口水显著更有效（p<0.001）。
草药漱口水对金黄色葡萄球菌和肺炎链球菌有显著的抗菌效果，但其疗效低于洗必泰，因此在进一步研究后，它可被视为重症监护病房中洗必泰的替代品（表3，参考文献33）。
