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根据严重程度量表进行口腔黏膜炎的疼痛控制:一项叙述性文献综述

Pain Control in Oral Mucositis According to the Severity Scale: A Narrative Literature Review.

作者信息

Suhaimi Nawal, Abdul Razak Noor Azura Hani, Ramli Roszalina

机构信息

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia.

Department of Oral and Maxillofacial Surgery, Hospital Umum Sarawak, Kuching 93586, Malaysia.

出版信息

J Clin Med. 2025 Jun 24;14(13):4478. doi: 10.3390/jcm14134478.


DOI:10.3390/jcm14134478
PMID:40648851
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12249691/
Abstract

BACKGROUND: Oral mucositis (OM) is a painful and debilitating stomatitis that often arises following head and neck radiotherapy, chemotherapy, or stem cell transplant, leading to treatment delays and potential patient intervention interruption. The aim of this narrative review was to explore the modalities in the management of OM. When supported by evidence, treatment is customized according to its severity. METHOD: A literature search was performed using the PubMed database. The search strategy consists of keywords such as "pain management", "pain control", and "oral mucositis". Literature references from 1997 to 2024 were selected by the authors based on relevance to the current practice of oral mucositis pain management. RESULTS: Fourteen studies were included in this review. Interventions were classified into pharmacological and non-pharmacological modalities. In relation to pain measurement, for grade 1 OM, topical treatments are the primary recommendation. For grades 2 to 4, where pain is moderate to severe, systemic analgesia should be administered. Honey and oral care are beneficial for OM with grades 2 to 4. CONCLUSIONS: Effective management of OM should be tailored to the severity of the condition, incorporating both pharmacological and non-pharmacological strategies. While various modalities have shown promise in relieving symptoms and enhancing the quality of life, a multifaceted, patient-centered approach remains essential. Advancing high-quality clinical trials, particularly those evaluating non-pharmacological interventions will be crucial to expanding treatment options. Future efforts should focus on personalized therapies, integration of combination treatments, adoption of standardized pain assessment tools, and long-term outcome studies to improve clinical effectiveness and optimize patient care.

摘要

背景:口腔黏膜炎(OM)是一种疼痛且使人虚弱的口腔炎,常发生于头颈部放疗、化疗或干细胞移植后,导致治疗延迟并可能中断患者干预。本叙述性综述的目的是探讨口腔黏膜炎的管理模式。如有证据支持,治疗将根据其严重程度进行定制。 方法:使用PubMed数据库进行文献检索。检索策略包括“疼痛管理”“疼痛控制”和“口腔黏膜炎”等关键词。作者根据与口腔黏膜炎疼痛管理当前实践的相关性,选择了1997年至2024年的文献参考。 结果:本综述纳入了14项研究。干预措施分为药物和非药物模式。在疼痛测量方面,对于1级口腔黏膜炎,局部治疗是主要推荐。对于2至4级,疼痛为中度至重度时,应给予全身镇痛。蜂蜜和口腔护理对2至4级口腔黏膜炎有益。 结论:口腔黏膜炎的有效管理应根据病情严重程度进行调整,结合药物和非药物策略。虽然各种模式在缓解症状和提高生活质量方面已显示出前景,但多方面、以患者为中心的方法仍然至关重要。推进高质量的临床试验,特别是那些评估非药物干预措施的试验,对于扩大治疗选择至关重要。未来的努力应集中在个性化治疗、联合治疗的整合、采用标准化疼痛评估工具以及长期结局研究,以提高临床疗效并优化患者护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d2c/12249691/226f023c0b14/jcm-14-04478-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d2c/12249691/226f023c0b14/jcm-14-04478-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d2c/12249691/226f023c0b14/jcm-14-04478-g001.jpg

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本文引用的文献

[1]
Efficacy of topical agents in oral mucositis prevention: Systematic review and network meta-analysis.

Oral Dis. 2024-10

[2]
High molecular weight hyaluronic acid drastically reduces chemotherapy-induced mucositis and apoptotic cell death.

Cell Death Dis. 2023-7-21

[3]
The quality of life in nasopharyngeal carcinoma radiotherapy: A longitudinal study.

Asia Pac J Oncol Nurs. 2023-5-26

[4]
Multimodal Data Integration to Predict Severe Acute Oral Mucositis of Nasopharyngeal Carcinoma Patients Following Radiation Therapy.

Cancers (Basel). 2023-3-29

[5]
Mucoadhesive drug delivery systems: a promising noninvasive approach to bioavailability enhancement. Part II: formulation considerations.

Expert Opin Drug Deliv. 2023-3

[6]
Impact of systemic dexamethasone administration on oral mucositis induced by anthracycline-containing regimens in breast cancer treatment.

Sci Rep. 2022-7-22

[7]
A randomized clinical trial of granulocyte macrophage colony stimulating factor mouthwash for oral mucositis in head and neck cancer.

Eur J Oncol Nurs. 2022-2

[8]
Intravenous fluids for pain management in head and neck cancer patients undergoing chemoradiation.

Ann Transl Med. 2021-5

[9]
The role of benzydamine in prevention and treatment of chemoradiotherapy-induced mucositis.

Support Care Cancer. 2021-10

[10]
Mechanisms and Pathways of Pain Photobiomodulation: A Narrative Review.

J Pain. 2021-7

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