Esfandiari Ebrahim, Feizi Awat, Heidari Zahra, Tabibian Seyed Reza, Shaabani Pooria, Iraj Bijan, Adibi Payman, Varzaneh Amrollah Ebrahimi
Department of Anatomical Sciences and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Prev Med. 2017 Jun 23;8:46. doi: 10.4103/ijpvm.IJPVM_174_16. eCollection 2017.
The aim of this study was to investigate the therapeutic effect of traditional wooden toothbrush usage on most severe constipation, which usually occurs in spinal cord injury (SCI) patients.
In a quasi-experimental study, 61 SCI patients were selected who had injuries in different spinal levels (cervical, thoracic, and lumbar), and severe constipation from one defection in a few days to 3 weeks. They were recommended to use traditional wooden toothbrush for 5 min twice a day, after breakfast and dinner, over a 6 weeks period. Two proper standard scales, called neurogenic bowel dysfunction (NBD), and "Constipation Assessment Scale (CAS)," were used for evaluating the changes in patients' gastrointestinal (GI) habits during the period of using the wooden toothbrush. Through these scales (NBD and CAS), the therapeutic effects of traditional wooden toothbrush usage on the severity of constipation before and after intervention were measured.
The mean of NBD and CAS scores were reduced significantly, from 8.95 ± 0.78 and 3.34 ± 0.28; respectively, to 3.03 ± 0.57 and 1.74 ± 0.25, after 6 weeks using traditional wooden toothbrush ( < 0.0001). There was a significant difference in terms of NBD scores in patients with different levels of injury ( < 0.01), particularly in patients with thoracic injury, before (10.52 ± 0.88) and after (3.13 ± 0.78) treatment, respectively ( < 0.0001). Eventually, all symptoms of bowel problems improved significantly after the intervention ( < 0.05).
The use of traditional wooden toothbrush lead to the improvement of bowel and defecation problems in SCI patients. Yet more studies, particularly randomized control clinical trials are needed to investigate the effect of using wooden toothbrush on other GI reflexes. In addition, if some clinical trials are devised to study the effects of wooden toothbrush on both conscious and unconscious patients in ICU, best results are expected to be found on keeping their mouth and teeth hygiene, as well as, getting rid of their constipations.
本研究旨在探讨使用传统木质牙刷对脊髓损伤（SCI）患者常出现的最严重便秘的治疗效果。
在一项准实验研究中，选取了61例脊髓损伤患者，这些患者脊髓损伤水平不同（颈髓、胸髓和腰髓），且存在严重便秘，排便间隔从几天一次到3周一次。建议他们在6周时间内，每天早餐和晚餐后使用传统木质牙刷，每次5分钟。使用两种合适的标准量表，即神经源性肠功能障碍（NBD）量表和“便秘评估量表（CAS）”，来评估患者在使用木质牙刷期间胃肠道（GI）习惯的变化。通过这些量表（NBD和CAS），测量使用传统木质牙刷前后便秘严重程度的治疗效果。
使用传统木质牙刷6周后，NBD和CAS评分均值显著降低，分别从8.95±0.78和3.34±0.28降至3.03±0.57和1.74±0.25（P<0.0001）。不同损伤水平患者的NBD评分存在显著差异（P<0.01），尤其是胸髓损伤患者，治疗前（10.52±0.88）和治疗后（3.13±0.78）差异显著（P<0.0001）。最终，干预后所有肠道问题症状均显著改善（P<0.05）。
使用传统木质牙刷可改善脊髓损伤患者的肠道和排便问题。然而，需要更多研究，特别是随机对照临床试验，来研究使用木质牙刷对其他胃肠反射的影响。此外，如果设计一些临床试验来研究木质牙刷对重症监护病房（ICU）有意识和无意识患者的影响，有望在保持口腔和牙齿卫生以及消除便秘方面取得最佳效果。
