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ペルシカとクロルヘキシジン洗口剤の口腔内健康状態への付加的効果の評価。無作為化臨床試験
Evaluating the additive effect of Persica and chlorhexidine mouthwashes on oral health status of children receiving chemotherapy for their hematomalignancy: A randomized clinical trial.
PMID: 32665817 PMCID: PMC7335609. DOI: 10.4317/jced.56104.
抄録
背景:
化学療法誘発性粘膜炎の治療や予防のための決定的なプロトコルは導入されていない。本研究の目的は、小児の造血器腫瘍患者の化学療法誘発性粘膜炎に対するペルシカとクロルヘキシジンの相加的効果を評価することであった。
Background: No definitive protocol has been introduced for treatment or prevention of chemotherapy induced mucositis. The aim of this study was to assess the additive effect of Persica and chlorhexidine on chemotherapy induced mucositis of children with hematomalignancies.
材料と方法:
この無作為化臨床試験は、血球腫瘍に対して同様の維持化学療法を受けている6歳から12歳までの44名の小児を対象に実施された。臨床医が患者とその保護者に口腔衛生管理を指導し、口腔評価ガイド指標に基づいて患者の粘膜炎の重症度と口腔内の健康状態を評価した。その後、患者を2つの実験群のいずれかに無作為に割り付け、ペルシカ点滴または通常の生理食塩水で1日2回、2週間のすすぎを指示した。その後、両群の患者には、クロルヘキシジンで30秒のすすぎを行い、1時間は食事を控えるように教育した。2回目と3回目の口腔内検査は8日目と15日目に同じ問診票を用いて行った。
Material and Methods: This randomized clinical trial was performed on 44 children aged 6 to 12 years who were under a similar maintenance chemotherapy protocol for their hematomalignancies. The clinician instructed oral hygiene cares to the patients and their parents and the severity of the mucositis and oral health status of patients were evaluated according to Oral Assessment Guide index. Then, the patients were randomly assigned to one of two experimental groups and were instructed to rinse either with Persica oral drops or normal saline, twice a day for two weeks. Subsequently, the patients in both groups were educated to rinse with chlorhexidine for 30 seconds and avoid eating for an hour. Second and third oral examinations were performed on the 8th and 15th day using the same questionnaire.
結果:
患者の粘膜炎の重症度と口腔内の健康状態を比較しても、いずれの診察回においても治療群間で有意な差は認められなかった(>0.05)。しかし、両治療群ともマウスリンセス投与後14日目には、粘膜炎、プラーク蓄積、歯肉状態ともに統計学的に有意な口腔内健康状態の改善が認められた(<0.05)。
Results: Comparing severity of mucositis and oral health status of patients did not show any significant difference between treatment groups in either of examination sessions (>0.05). However, both treatment groups showed statistically significant oral health improvement, in terms of mucositis, plaque accumulation and gingival condition, in 14 days following mouthrinses administration (<0.05).
結論:
化学療法を受けている子供の粘膜炎、歯垢、歯肉の状態には、どちらのマウスリンスも有効であった。しかし、Persicaは化学療法で誘発された粘膜炎の重症度を低下させるという点では、クロルヘキシジンに追加の効果はないようであった。粘膜炎、化学療法、小児、クロルヘキシジン、Persica。
Conclusions: Both mouth-rinse combinations were effective on mucositis, plaque and gingival status of children receiving chemotherapy. However, Persica does not seem to pose additional effect on chlorhexidine in decreasing severity of chemotherapy induced mucositis. Mucositis, chemotherapy, children, chlorhexidine, Persica.
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