舌清掃は高齢者の呼吸機能を維持する：1年間のランダム化比較試験

Tongue cleaning maintains respiratory function in older individuals: A 1-year randomised controlled trial.

抄録

目的:

この1年間の縦断的ランダム化比較試験の目的は、要介護高齢者の呼吸機能維持に対する舌清掃の有効性を評価することであった。

OBJECTIVE: The aim of this 1-year longitudinal randomised controlled trial was to evaluate the effectiveness of tongue cleaning on the maintenance of respiratory function in older adults requiring care.

方法:

参加者は、北九州市にある2つの特別養護老人ホームの入居者24名であった。参加者は、日常的な口腔ケアとともに舌清掃を受ける群（介入群、n=12）と、日常的な口腔ケアのみを受ける群（対照群、n=12）に無作為に割り付けられた。参加者のうち、介入群3人、対照群4人に脳血管疾患の既往歴があり、介入群4人、対照群4人に心疾患の既往歴があり、介入群5人、対照群4人に既往歴はなかった。呼吸機能はピーク呼気流量（PEFR）に基づいて評価された。舌圧、嚥下機能、口腔の健康状態、日常生活動作、栄養状態もベースライン時と1年間の追跡期間終了時に測定した。

METHODS: The participants included 24 residents of two nursing homes in Kitakyushu, Japan. The participants were randomised to receive tongue cleaning with routine oral care (intervention group, n = 12), or routine oral care alone (control group, n = 12). Among the participants, three in the intervention group and four in the control group had cerebrovascular disease history, four in the intervention group and four in the control group had a history of cardiac disease, and five in the intervention group and four in the control group were without medical history. Respiratory function was assessed on the basis of the peak expiratory flow rate (PEFR). Tongue pressure, swallowing function, oral health status, activities of daily living and nutritional status were also measured at baseline and at the end of the 1-year follow-up period.

結果:

各群の解析対象者数は12人であった。対照群では、1年後にPEFR（1.6 [0.4-4.2] Ls vs 1.4 [0.4-3.2] Ls、P=.034）と舌圧（16.4 [1.7-35.2] kPa vs 8.0 [1.4-38.6] kPa、P=.032）が有意に低下した。しかし、PEFR（1.5 [0.8-2.9] Ls vs 1.6 [0.7-4.2] Ls 、P=.366）と舌圧（18.1 [4.2-37.1] kPa vs 16.1 [5.2-41] kPa、P=.307）は介入群で維持された。PEFRの変化は、対照群と比較して介入群で有意に大きかった（0.130 [-0.45-1.70] Ls vs -1.70 [-10.00-10.00] Ls 、P=.028）。

RESULTS: The number of analysed participants in each group was 12. In the control group, the PEFR (1.6 [0.4-4.2] L s vs 1.4 [0.4-3.2] L s , P = .034) and tongue pressure (16.4 [1.7-35.2] kPa vs 8.0 [1.4-38.6] kPa, P = .032) significantly declined after 1-year. However, the PEFR (1.5 [0.8-2.9] L s vs 1.6 [0.7-4.2] L s , P = .366) and tongue pressure (18.1 [4.2-37.1] kPa vs 16.1 [5.2-41] kPa, P = .307) were maintained in the intervention group. The change in the PEFR was significantly greater in the intervention group compared with the control group (0.130 [-0.45-1.70] L s vs -1.70 [-10.00-10.00] L s , P = .028).

結論:

今回の結果から、舌清掃は要介護高齢者の舌機能と呼吸機能の維持に役立つ可能性が示唆された。

CONCLUSION: Our findings suggest that tongue cleaning may help maintain tongue and respiratory function in older adults requiring care.