Spijkervet F K, van Saene H K, Panders A K, Vermey A, van Saene J J, Mehta D M, Fidler V
Department of Oral and Maxillofacial Surgery, University Hospital Groningen, The Netherlands.
Oral Surg Oral Med Oral Pathol. 1989 Feb;67(2):154-61. doi: 10.1016/0030-4220(89)90321-6.
Oral flora is thought to contribute to irradiation mucositis in patients with head and neck cancer. Neglect of oral hygienic care may also contribute to mucositis. The purpose of this prospective, randomized, placebo-controlled, double-blind study was to evaluate the effect of chlorhexidine 0.1% mouthrinses on oral flora and irradiation mucositis. This study included 30 patients with head and neck cancer who had comparable irradiation portals. One group (N = 15) rinsed four times daily with chlorhexidine 0.1%, the other group (N = 15) with a placebo. The oral flora was cultured (oral washing technique) twice before and three times per week during the period of radiotherapy. On the same days, the severity of mucositis was determined. The colonization index of viridans streptococci was significantly reduced only after 5 weeks of chlorhexidine 0.1% treatment. The colonization patterns of Candida species, Streptococcus faecalis, staphylococci, and Enterobacteriaceae, Pseudomonadaceae, and Acinetobacter species were not influenced by 5 weeks of use of chlorhexidine rinses when compared with the placebo. No differences were seen between the two study groups in the development and severity of mucositis. In conclusion, suppression of oral flora and a lowering of the severity of mucositis by means of disinfecting mouthrinses were not successful.
口腔菌群被认为与头颈癌患者的放射性粘膜炎有关。忽视口腔卫生护理也可能导致粘膜炎。这项前瞻性、随机、安慰剂对照、双盲研究的目的是评估0.1%洗必泰漱口水对口腔菌群和放射性粘膜炎的影响。本研究纳入了30名头颈癌患者，他们具有可比的放射野。一组（N = 15）每天用0.1%洗必泰漱口4次，另一组（N = 15）用安慰剂漱口。在放疗前两次及放疗期间每周三次采用口腔冲洗技术培养口腔菌群。在同一天，确定粘膜炎的严重程度。仅在0.1%洗必泰治疗5周后，草绿色链球菌的定植指数才显著降低。与安慰剂相比，念珠菌属、粪肠球菌、葡萄球菌以及肠杆菌科、假单胞菌科和不动杆菌属的定植模式在使用洗必泰漱口水5周后未受影响。在两个研究组之间，粘膜炎的发生和严重程度未见差异。总之，通过消毒漱口水抑制口腔菌群并降低粘膜炎严重程度的方法未取得成功。
