Dodd M J, Larson P J, Dibble S L, Miaskowski C, Greenspan D, MacPhail L, Hauck W W, Paul S M, Ignoffo R, Shiba G
University of California, San Francisco School of Nursing, USA.
Oncol Nurs Forum. 1996 Jul;23(6):921-7.
PURPOSE/OBJECTIVES: To test the effectiveness of a nurse-initiated systematic oral hygiene teaching program-PRO-SELF: Mouth Aware (PSMA)-in conjunction with two mouthwashes (0.12% chlorhexidine or sterile water) in preventing chemotherapy-induced oral mucositis.
Randomized, double-blind, placebo-controlled, clinical trial.
23 outpatient clinics and office practices in California.
222 patients who were starting a cycle of mucositis-inducing chemotherapy.
Participants were followed over three chemotherapy cycles. All patients were provided the PSMA program. Random assignment to a mouthwash occurred prior to the development of oral mucositis. Researchers used the Oral Assessment Guide to assess the patients oral cavities monthly (with the patients cycles of chemotherapy) and when patients reported any oral changes between cycles.
Type of mouthwash, incidence, days to onset, and severity of chemotherapy-induced oral mucositis.
No significant differences existed between the two mouthwashes in regard to incidence, days to onset, and severity of mucositis.
Because chlorhexidine (S20 per pint) was no more effective than water, a substantial cost savings can be realized by rinsing with water. Interestingly, the PSMA program appeared to reduce the incidence of mucositis from on a prior estimate of 44% to less than 26%.
A nursing prescription of a systematic oral hygiene program using water as a mouth rinse is cost efficient and may be effective in preventing oral mucositis.
目的/目标：检验由护士发起的系统性口腔卫生教育项目——“自我防护：口腔关爱”（PSMA），联合两种漱口水（0.12%氯己定或无菌水）预防化疗所致口腔黏膜炎的效果。
随机、双盲、安慰剂对照临床试验。
加利福尼亚州的23家门诊诊所及办公室。
222例即将开始一轮可诱发口腔黏膜炎化疗的患者。
对参与者进行三个化疗周期的随访。所有患者均接受PSMA项目。在口腔黏膜炎发生之前随机分配漱口水。研究人员每月（随患者化疗周期）以及患者报告周期之间有任何口腔变化时，使用口腔评估指南评估患者口腔。
漱口水类型、化疗所致口腔黏膜炎的发生率、发病天数及严重程度。
两种漱口水在黏膜炎的发生率、发病天数及严重程度方面无显著差异。
由于氯己定（每品脱20美元）并不比水更有效，用水漱口可大幅节省成本。有趣的是，PSMA项目似乎将黏膜炎的发生率从之前估计的44%降低至不到26%。
采用水漱口的系统性口腔卫生项目的护理处方具有成本效益，可能对预防口腔黏膜炎有效。
