Lakshman Anusha Rangare, Babu G Subhas, Rao Suresh
Department of Oral Medicine and Radiology, Century International Institute of Dental Science and Research Centre, Poinachi, Kasaragod, Kerala, India.
J Cancer Res Ther. 2015 Jan-Mar;11(1):229-33. doi: 10.4103/0973-1482.138008.
Xerostomia is a common sequel in patients undergoing irradiation of malignant tumors of the head and neck. Palliative treatments of xerostomia like topical agents such as ice-chips, saliva substitutes, systemic sialogogues like pilocarpine and cevimeline work well for some patients. Electrostimulation was studied in the past and showed moderate promise but never became part of the mainstream therapy for better management of xerostomia patients.
The aim of the following study is to evaluate the effectiveness of a transcutaneous electrical nerve stimulation (TENS) unit in stimulating the whole salivary flow rate in radiation induced xerostomia patients.
A total of 40 subjects were included in the study. The study group consisted of 30 individuals and was divided into Group S1 (n = 20), which was further subdivided into Group S1A (n = 10) subjects complaining of dry mouth who were undergoing head and neck radiotherapy with TENS stimulation during the commencement of radiotherapy, on the 3 rd , 6 th week and after a month of completion of radiotherapy and Group S1B (n = 10) with TENS stimulation daily during the full course of radiotherapy and Group S2 (n = 10) subjects complaining of dry mouth who had undergone head and neck radiotherapy that ended 1 month prior to their entry into the study. The control group (n = 10) consisted of healthy individuals not complaining of dry mouth and who have not undergone head and neck radiotherapy. Whole saliva was collected without stimulation for 10 min and after electrostimulation with TENS unit for additional 10 min in a graduated test tube. The results were statistically analyzed using Mann-Whitney U-test and Kruskal-Wallis's test.
The data analysis revealed that control and S1B group showed increased salivary flow rate after stimulation by TENS therapy compared with the unstimulated salivary flow, whereas in S1A and S2 group it was found to be statistically non-significant.
The present study gave us an insight about the effectiveness of TENS therapy in stimulating salivary flow in healthy subjects and it is very effective when used in conjunction with radiation therapy by reducing the side-effects of radiation therapy. Hence, TENS therapy can be used as an adjunctive method for the treatment of xerostomia along with other treatment modalities.
口干症是头颈部恶性肿瘤患者接受放疗后的常见后遗症。口干症的姑息治疗方法，如局部用药（如冰片、唾液替代品）、全身性催涎剂（如毛果芸香碱和西维美林）对部分患者效果良好。过去曾对电刺激进行过研究，显示出一定前景，但从未成为改善口干症患者管理的主流治疗方法。
以下研究的目的是评估经皮电神经刺激（TENS）装置对放疗引起的口干症患者刺激全唾液流速的有效性。
共有40名受试者纳入本研究。研究组由30名个体组成，分为S1组（n = 20），S1组又进一步细分为S1A组（n = 10），该组为正在接受头颈部放疗且在放疗开始时、第3周、第6周以及放疗结束后1个月接受TENS刺激的主诉口干的受试者，以及S1B组（n = 10），该组在放疗全过程中每天接受TENS刺激；S2组（n = 10）为在进入本研究前1个月已完成头颈部放疗的主诉口干的受试者。对照组（n = 10）由无口干主诉且未接受过头颈部放疗的健康个体组成。在刻度试管中，先在无刺激的情况下收集10分钟全唾液，然后用TENS装置进行电刺激后再收集额外10分钟的全唾液。结果采用曼-惠特尼U检验和克鲁斯卡尔-沃利斯检验进行统计学分析。
数据分析显示，与未刺激时的唾液流速相比，对照组和S1B组在接受TENS治疗刺激后唾液流速增加，而在S1A组和S2组中，发现差异无统计学意义。
本研究让我们了解了TENS治疗对刺激健康受试者唾液分泌的有效性，并且在与放疗联合使用时，通过减少放疗副作用，效果非常显著。因此，TENS治疗可作为一种辅助方法，与其他治疗方式一起用于治疗口干症。
