Ozen Nurten, Aydin Sayilan Aylin, Mut Dilek, Sayilan Samet, Avcioglu Zeynep, Kulakac Nursen, Ecder Tevfik, Akyolcu Neriman
Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University, Istanbul, Turkey.
Nursing Department, Kirklareli University School of Health Science, Kırklareli, Turkey.
Hemodial Int. 2021 Jan;25(1):94-103. doi: 10.1111/hdi.12878. Epub 2020 Sep 29.
The major salivary glands can be stimulated by chewing gum to increase saliva flow and decrease xerostomia. The aim of this study was to investigate the effect of chewing gum on dry mouth, interdialytic weight gain, and intradialytic symptoms in hemodialysis (HD) patients.
This prospective randomized controlled single-blind study was conducted with patients who had been treated for at least 6 months with sessions 3 days a week for 4 hours at two HD units. Patients were randomly allocated to chewing gum group or the control group. In the chewing gum group, gum was chewed for 10 minutes six times a day, and when the patients felt mouth dryness or were thirsty. In the nonchewing gum group, gum was not chewed. The patients were followed-up for 3 months. A total of three saliva samples were taken before starting treatment at the first, 12th, and 36th HD session. Data were collected with the "Visual Analogue Scale (VAS)," "Hemodialysis Patients Fluid Control Scale," "Dialysis Symptom Index," and "Hospital Anxiety and Depression Scale" at baseline, week 4, week 8, and week 12.
The study was completed with a total of 44 patients consisting of 22 patients in the each group. The second and third month VAS values (xerostomia) of the patients in the chewing gum groups were statistically significantly lower than those in the control group (P = 0.014, P < 0.001, respectively). The third month salivary flow rate in the chewing gum group was higher than the values in the control group patients (P < 0.001).
It is anticipated that this study will raise nurses' awareness of dry mouth and encourage future studies on interventions to increase the salivary flow rate to prevent or treat dry mouth.
咀嚼口香糖可刺激主要唾液腺增加唾液分泌，减轻口干症状。本研究旨在探讨咀嚼口香糖对血液透析（HD）患者口干、透析间期体重增加及透析期间症状的影响。
本前瞻性随机对照单盲研究在两家血液透析单位进行，研究对象为每周接受3次、每次4小时透析治疗至少6个月的患者。患者被随机分为咀嚼口香糖组和对照组。咀嚼口香糖组患者每天咀嚼口香糖6次，每次10分钟，感觉口干或口渴时也咀嚼。非咀嚼口香糖组患者不咀嚼口香糖。对患者进行3个月的随访。在第1次、第12次和第36次血液透析治疗开始前共采集3次唾液样本。在基线、第4周、第8周和第12周，使用“视觉模拟评分量表（VAS）”、“血液透析患者液体控制量表”、“透析症状指数”和“医院焦虑抑郁量表”收集数据。
本研究共纳入44例患者，每组22例。咀嚼口香糖组患者第2个月和第3个月的VAS值（口干）在统计学上显著低于对照组（分别为P = 0.014，P < 0.001）。咀嚼口香糖组第3个月的唾液流速高于对照组患者（P < 0.001）。
预计本研究将提高护士对口干的认识，并鼓励未来开展关于增加唾液流速以预防或治疗口干的干预措施的研究。
