药物性口干的特征及治疗效果。
Characteristics of medication-induced xerostomia and effect of treatment.
机构信息
Oral Rehabilitation, Niigata University Medical and Dental Hospital, Niigata, Japan.
Medical Affairs, Internal Medicine, Pfizer Japan, Inc., Tokyo, Japan.
出版信息
PLoS One. 2023 Jan 12;18(1):e0280224. doi: 10.1371/journal.pone.0280224. eCollection 2023.
OBJECTIVE
Side-effects of medications cause xerostomia. There have been cases where a medication has been discontinued owing to its severe side-effects. Therefore, the xerostomia must be treated to ensure that the primary disease is managed effectively. This study analyzed the actual status of patients with medication-induced xerostomia and investigates factors associated with its improvement.
METHODS
This study assessed 490 patients diagnosed with medication-induced xerostomia who had an unstimulated salivary flow of ≤0.1 mL/min and received treatment for xerostomia at a xerostomia clinic. Patient age, sex, medical history, medications used, disease duration of xerostomia, and psychological disorders were recorded. The anticholinergic burden was assessed using the Anticholinergic Cognitive Burden scale. The unstimulated salivary flow was measured by the spitting method. According to their symptoms and diagnoses, the patients were introduced to oral lubricants, instructed on how to perform massage, and prescribed Japanese herbal medicines, and sialogogues. Factors associated with the subjective improvement of xerostomia and objective changes in the salivary flow rate were recorded at six months.
RESULTS
Xerostomia improved in 338 patients (75.3%). The improvement rate was significantly lower in patients with psychiatric disorders (63.6%) (P = 0.009). The improvement rate decreased as more anticholinergics were used (P = 0.018). However, xerostomia improved in approximately 60% of patients receiving three or more anticholinergics. The unstimulated salivary flow increased significantly more in patients who reported an improvement of xerostomia (0.033±0.053 mL/min) than in those who reported no improvement (0.013±0.02 mL/min) (P = 0.025).
CONCLUSION
Xerostomia treatment improved oral dryness in 75.3% of patients receiving xerogenic medications in this study. If xerostomia due to side-effects of medications can be improved by treatment, it will greatly contribute to the quality of life of patients with xerogenic medications and may reduce the number of patients who discontinue medications.
目的
药物的副作用会导致口干。有些情况下，由于药物的严重副作用，药物会被停用。因此，必须治疗口干症，以确保有效治疗原发性疾病。本研究分析了药物引起的口干症患者的实际状况，并调查了改善其症状的相关因素。
方法
本研究评估了 490 名在口干症诊所接受口干症治疗的药物引起的口干症患者，这些患者的非刺激性唾液流量≤0.1mL/min。记录了患者的年龄、性别、病史、使用的药物、口干症的病程以及心理障碍。使用抗胆碱能认知负担量表评估抗胆碱能负担。通过吐口水的方法测量非刺激性唾液流量。根据他们的症状和诊断，向患者介绍口腔润滑剂，指导他们进行按摩，并开出处方草药和唾液分泌剂。在六个月时记录与口干症主观改善和唾液流量客观变化相关的因素。
结果
338 名患者（75.3%）的口干症得到改善。有精神障碍的患者（63.6%）的改善率明显较低（P=0.009）。使用的抗胆碱能药物越多，改善率越低（P=0.018）。然而，接受三种或三种以上抗胆碱能药物的患者中有约 60%的口干症得到改善。报告口干症改善的患者的非刺激性唾液流量增加（0.033±0.053）mL/min，明显多于报告无改善的患者（0.013±0.02）mL/min（P=0.025）。
结论
在本研究中，接受致口干药物治疗的患者中有 75.3%的口干症状得到改善。如果因药物副作用引起的口干症可以通过治疗得到改善，这将极大地提高使用致口干药物患者的生活质量，并可能减少因药物副作用而停药的患者数量。
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