1 Department of Otorhinolaryngology-Head and Neck Surgery, Inha University School of Medicine , Incheon, Republic of Korea.
2 Department of Internal Medicine, Inha University School of Medicine , Incheon, Republic of Korea.
Thyroid. 2015 Jul;25(7):839-45. doi: 10.1089/thy.2014.0525. Epub 2015 Apr 20.
The aim of this prospective study was to investigate the effect of salivary stimulation therapy using pilocarpine (a cholinergic agent) on chronic radioactive iodine (RAI)-induced sialadenitis.
Sixty-one patients with a diagnosis of chronic RAI-induced sialadenitis after thyroidectomy and RAI therapy were enrolled in this prospective study. Patients received salivary stimulation therapy with pilocarpine (5 mg, 3 times daily) over a 3-month period. Subjective symptom scores were assessed using self-reported questionnaires. Salivary flow rates (SFRs) were measured and salivary gland scintigraphy (SGS) was performed to evaluate objective salivary gland functions.
After salivary stimulation therapy, subjective symptom scores were significantly improved (p=0.002), but posttreatment unstimulated and stimulated SFRs did not differ significantly from pretreatment values. SGS parameters, that is, uptake ratio (UR), maximum accumulation (MA), Tmin, and maximum secretion (MS) of parotid and submandibular glands were nonsignificantly different after salivary stimulation therapy.
The study shows that salivary stimulation therapy may reduce the subjective symptoms of RAI-induced chronic sialadenitis but does not significantly induce functional restoration.
本前瞻性研究旨在探讨使用毛果芸香碱（一种拟胆碱能药物）进行唾液刺激疗法对慢性放射性碘（RAI）诱导的唾液腺炎的影响。
本前瞻性研究纳入了 61 例甲状腺切除和 RAI 治疗后诊断为慢性 RAI 诱导的唾液腺炎的患者。患者接受毛果芸香碱（5mg，每日 3 次）唾液刺激治疗 3 个月。使用自我报告问卷评估主观症状评分。测量唾液流量（SFR）并进行唾液腺闪烁显像（SGS）以评估客观唾液腺功能。
唾液刺激治疗后，主观症状评分显著改善（p=0.002），但治疗后未刺激和刺激 SFR 与治疗前值无显著差异。唾液刺激治疗后，腮腺和颌下腺的摄取比（UR）、最大积聚（MA）、Tmin 和最大分泌（MS）等 SGS 参数无显著差异。
该研究表明，唾液刺激疗法可能减轻 RAI 诱导的慢性唾液腺炎的主观症状，但不能显著诱导功能恢复。
