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唾液替代物缓解口干症状可改善头颈部放疗后患者的吞咽能力和临床营养状况:一项随机对照试验。

Alleviation of dry mouth by saliva substitutes improved swallowing ability and clinical nutritional status of post-radiotherapy head and neck cancer patients: a randomized controlled trial.

机构信息

Master of Science Program in Nutrition and Dietetics, Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand.

Faculty of Dentistry, Srinakarinwirot University, Bangkok, Thailand.

出版信息

Support Care Cancer. 2020 Jun;28(6):2817-2828. doi: 10.1007/s00520-019-05132-1. Epub 2019 Nov 15.

Abstract

PURPOSE

The aim of this study is to investigate the effect of an edible saliva substitute, oral moisturizing jelly (OMJ), and a topical saliva gel (GC) on dry mouth, swallowing ability, and nutritional status in post-radiotherapy head and neck cancer patients.

METHODS

Sixty-two post-radiation head and neck cancer patients with xerostomia completed a blinded randomized controlled trial. They were advised to swallow OMJ (n = 31) or apply GC orally (n = 31) for 2 months. Outcome measures were assessed at baseline, 1, and 2 months, including subjective and objective dry mouth (Challcombe) scores, subjective swallowing problem scores (EAT-10), water swallowing time, clinical nutritional status (PG-SGA), body weight, and dietary intake.

RESULTS

After 1 and 2 months of interventions, subjective and objective dry mouth scores, subjective swallowing problem scores, swallowing times, and clinical nutritional status in both groups were significantly improved (p < 0.0001). Compared to GC, OMJ group had higher percent improvement in all outcome measures (p < 0.001) except swallowing time and clinical nutritional status. Interestingly, subjective dry mouth scores were significantly correlated with subjective swallowing problem scores (r = 0.5321, p < 0.0001).

CONCLUSIONS

Continuous uses of saliva substitutes (OMJ or GC) for at least a month improved signs and symptoms of dry mouth and enhanced swallowing ability. An edible saliva substitute was superior to a topical saliva gel for alleviating dry mouth and swallow problems. These lead to improved clinical nutritional status. Thus, palliation of dry mouth may be critical to support nutrition of post-radiotherapy head and neck cancer patients.

CLINICAL TRIAL REGISTRY

Clinicaltrials.gov NCT03035825.

摘要

目的

本研究旨在探讨一种可食用唾液替代品(口腔保湿凝胶,OMJ)和一种局部唾液凝胶(GC)对放疗后头颈部癌症患者口干、吞咽能力和营养状况的影响。

方法

62 例放疗后口干的头颈部癌症患者完成了一项双盲随机对照试验。他们被建议吞咽 OMJ(n = 31)或口服 GC(n = 31),持续 2 个月。在基线、1 个月和 2 个月时评估结局指标,包括主观和客观口干(Challcombe)评分、主观吞咽问题评分(EAT-10)、水吞咽时间、临床营养状况(PG-SGA)、体重和饮食摄入。

结果

干预 1 个月和 2 个月后,两组的主观和客观口干评分、主观吞咽问题评分、吞咽时间和临床营养状况均显著改善(p < 0.0001)。与 GC 相比,OMJ 组在所有结局指标上的改善百分比均较高(p < 0.001),除吞咽时间和临床营养状况外。有趣的是,主观口干评分与主观吞咽问题评分呈显著相关(r = 0.5321,p < 0.0001)。

结论

连续使用唾液替代品(OMJ 或 GC)至少 1 个月可改善口干的症状和吞咽能力。可食用唾液替代品在缓解口干和吞咽问题方面优于局部唾液凝胶。这导致临床营养状况得到改善。因此,缓解口干可能对头颈部癌症患者放疗后的营养支持至关重要。

临床试验注册

Clinicaltrials.gov NCT03035825。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5a4/7181446/2db9e0539a31/520_2019_5132_Fig1_HTML.jpg

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