口服冷冻疗法对接受自体造血干细胞移植患者化疗所致口腔黏膜炎的影响：一项临床试验
The Effects of Oral Cryotherapy on Chemotherapy-Induced Oral Mucositis in Patients Undergoing Autologous Transplantation of Blood Stem Cells: A Clinical Trial.
作者信息
Askarifar Marzieh, Lakdizaji Sima, Ramzi Mani, Rahmani Azad, Jabbarzadeh Faranak
机构信息
Tabriz University of Medical Sciences, Tabriz, IR Iran.
Medical-Surgical Nursing Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, IR Iran.
出版信息
Iran Red Crescent Med J. 2016 Feb 7;18(4):e24775. doi: 10.5812/ircmj.24775. eCollection 2016 Apr.
BACKGROUND
Oral mucositis is one of the irritating side effects of chemotherapy in patients undergoing bone marrow transplantation. However, up until now, the common methods of oral mucositis therapy have failed to show significant effects.
OBJECTIVES
The aim of this study was to investigate the effects of local cryotherapy on the intensity of chemotherapy-induced oral mucositis in autologous bone marrow transplantation patients.
PATIENTS AND METHODS
In this single, blinded, randomized clinical trial, 29 patients undergoing stem cell transplantation in Iran were selected by convenience sampling, and randomly allocated to control (n = 13) and intervention groups (n = 16). In the intervention group, cryotherapy was applied, while the control group received a normal saline mouthwash. The severity of the mucositis and neutrophil rate were investigated in five periods, based on the world health organization (WHO) scales. The data were analyzed using descriptive statistics, the Mann-Whitney test, repeated measures analysis of variance (ANOVA), and linear regression.
RESULTS
In both groups, the mucositis reached its peak intensity on the 7th day, and the least intensity was obtained on the 21st day. The neutrophil rate reached the minimum value on the 7th day, then increased up to the 21st day. The two groups showed no significant differences between the mucositis severity on the 14th and 21st days (P = 0.164), while the severity of the mucositis in the cryotherapy group was significantly less than that in the saline mouthwash group (1.81 < 2.54 and 0.13 < 0.92, respectively) on the 7th and 14th days (P < 0.05). There was no significant difference in the neutrophil rate between the groups.
CONCLUSIONS
The results showed that cryotherapy is more effective than the saline mouthwash in reducing the severity of mucositis. This method is recommended for the prevention of mucositis in bone marrow transplantation.
背景
口腔黏膜炎是接受骨髓移植患者化疗的刺激性副作用之一。然而，到目前为止，口腔黏膜炎的常见治疗方法尚未显示出显著效果。
目的
本研究旨在探讨局部冷冻疗法对自体骨髓移植患者化疗所致口腔黏膜炎严重程度的影响。
患者与方法
在这项单盲随机临床试验中，通过便利抽样选取了29例在伊朗接受干细胞移植的患者，并随机分为对照组（n = 13）和干预组（n = 16）。干预组采用冷冻疗法，而对照组接受生理盐水漱口。根据世界卫生组织（WHO）标准，在五个时间段内调查黏膜炎的严重程度和中性粒细胞率。使用描述性统计、曼-惠特尼检验、重复测量方差分析（ANOVA）和线性回归对数据进行分析。
结果
两组患者的黏膜炎在第7天达到峰值强度，在第21天达到最低强度。中性粒细胞率在第7天达到最小值，然后上升至第21天。两组在第14天和第21天的黏膜炎严重程度无显著差异（P = 0.164），而在第7天和第14天，冷冻疗法组的黏膜炎严重程度明显低于生理盐水漱口组（分别为1.81 < 2.54和0.13 < 0.92）（P < 0.05）。两组之间的中性粒细胞率无显著差异。
结论
结果表明，冷冻疗法在减轻黏膜炎严重程度方面比生理盐水漱口更有效。推荐该方法用于预防骨髓移植中的黏膜炎。
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