Mohandas Rahul, Mohapatra Subhashree
Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India.
Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India.
Evid Based Dent. 2025 Feb 13. doi: 10.1038/s41432-025-01117-8.
Benzydamine mouthwash is beneficial in avoiding radiation-induced oral mucositis (RIOM) in patients with head and neck cancer, but it is also expensive and has negative side effects, while herbal mouthwashes offer a potential, easily accessible alternative with less side effects and bioactive characteristics. Hence, the aim of the systematic review and network meta-analysis was to assess and compare the efficacy of herbal mouthwash and benzydamine mouthwash in preventing RIOM among head and neck cancer patients.
After searching Scopus, PubMed, Cochrane, Science Direct, EBSCO Host, Lilacs, Science Direct, Web of Science, and Google Scholar from the earliest available year till July 15, 2024, 79 articles were obtained. Four full-text publications met the eligibility requirements and underwent additional processing for data extraction. PICO Strategy: P: Head and neck cancer patients, I: Herbal mouthwash, C: Benzydamine mouthwash, O: Reduction in radiation-induced oral mucositis. The review only comprised randomised controlled trials. The risk of bias assessment and quality of evidence were assessed using the RoB-2 Tool and GRADE Tool respectively.
Curcumin mouthwash was most effective in reducing the incidence of oral mucositis followed by sumac-rose and turmeric mouthwash. Curcumin, turmeric, and sumac-rose mouthwashes were found to be effective in delaying the onset of oral mucositis as compared to the benzydamine group. Turmeric mouthwash followed by curcumin and sumac-rose mouthwash were found to be more effective in reducing the severity of oral mucositis.
The current review concludes that curcumin, turmeric, and sumac-rose mouthwashes are more effective than benzydamine mouthwash in preventing RIOM. These natural alternatives show promising results for improving patient outcomes and should be investigated further to be used clinically.
CRD42024570913.
苄达明漱口水有助于预防头颈癌患者的放射性口腔黏膜炎（RIOM），但价格昂贵且有副作用，而草药漱口水是一种潜在的、易于获取的替代品，副作用较小且具有生物活性。因此，本系统评价和网状Meta分析的目的是评估和比较草药漱口水和苄达明漱口水在预防头颈癌患者RIOM方面的疗效。
在检索了Scopus、PubMed、Cochrane、Science Direct、EBSCO Host、Lilacs、Science Direct、Web of Science和Google Scholar从最早可获取年份至2024年7月15日的文献后，共获得79篇文章。4篇全文出版物符合纳入标准，并进行了额外的数据提取处理。PICO策略：P：头颈癌患者，I：草药漱口水，C：苄达明漱口水，O：放射性口腔黏膜炎的减轻。本评价仅纳入随机对照试验。分别使用RoB-2工具和GRADE工具评估偏倚风险和证据质量。
姜黄素漱口水在降低口腔黏膜炎发生率方面最有效，其次是漆树玫瑰漱口水和姜黄漱口水。与苄达明组相比，姜黄素、姜黄和漆树玫瑰漱口水在延迟口腔黏膜炎发作方面有效。姜黄漱口水在降低口腔黏膜炎严重程度方面最有效，其次是姜黄素漱口水和漆树玫瑰漱口水。
本评价得出结论，姜黄素、姜黄和漆树玫瑰漱口水在预防RIOM方面比苄达明漱口水更有效。这些天然替代品在改善患者预后方面显示出有前景的结果，应进一步研究以用于临床。
PROSPERO注册号：CRD42024570913。
