生津活血中药在头颈部放疗中对涎腺功能影响的研究

目的探讨生津活血中药在头颈部肿瘤患者放疗过程中对涎腺功能的影响。方法将38例首程放疗的患者随机分为实验组(中药加放疗)18例和对照组(单纯放疗)20例。对放疗前及放疗不同剂量时的口干程度、pH值、唾液流率及淀粉酶浓度进行比较。结果随放疗剂量的增加,2组患者口干程度增加,唾液流率与淀粉酶浓度均降低。在放疗至20、40 Gy时实验组的唾液流率和淀粉酶浓度均较对照组高。但在达到60 Gy时,2组数据则趋于接近。另外,患者的主观口干程度与客观的唾液流率下降程度之间并不直接对应。结论①头颈部肿瘤患者在放疗过程中辅以生津活血中药,可在一定程度上改善口干症状,但并不足以预防放射性口干症的发生。②患者的口干严重程度和唾液流率下降程度之间并不严格对应,患者主观的口干程度并不能作为反映唾液腺功能受损程度的可靠指标。     

改良人工唾液对鼻咽癌放疗患者唾液pH值和缓冲能力的影响

目的:探讨改良人工唾液对鼻咽癌放疗患者全唾液pH值和缓冲能力的影响。方法:选择8例因鼻咽癌放疗并伴有口干症的患者为受试者,收集唾液时间为上午9点至11点。用改良人工唾液含漱1 m in,收集基线时及含漱后2分钟静止性及刺激性全唾液,对含漱前后静止性唾液的pH值和含漱前后刺激性唾液的缓冲能力进行测定。结果:经改良人工唾液含漱后,患者静止性全唾液pH值较含漱前为高,经统计学检验其差异具有显著性(P<0.05);患者刺激性全唾液缓冲能力大于含漱前,经统计学检验其差异具有高度显著性意义(P<0.01)。结论:改良人工唾液具有改善鼻咽癌放疗患者全唾液pH值和缓冲能力的作用。     

高血压伴有涎腺肿大患者的涎腺表现(附17例报告)

高血压患者全身各系统均有相应的变化 ,特别是中老年人 ,如高血压性心血管病 ,眼病等。在口腔颌面部常引起涎腺退行性肿大 ,本研究通过临床 ,唾液总流率检查及腮腺造影对 15例高血压患者进行了系统观察。发现 15例病例临床上的腮腺肿大为特点占 87% ,腮腺造影示除腺体体积增大外主导管扩张较为常见 ,认为与主导管发生逆行性感染有关 ,可能与静止唾液流率减低有关。使用促唾剂保持静止唾液总流率在正常范围内是防止逆行感染的必要治疗手段。有 4例静止唾液总流率低于正常有明显口干症状。而动态唾液总流率未见明显异常 ,提示高血压患者涎腺贮备功能尚未明显受累 ,说明口干症状主要是静止唾液总流率下降所致     

胃食管反流病患者唾液腺功能的变化

目的探讨胃食管反流病（gastroesophageal reflux disease,GERD）患者的非刺激性唾液（unstimulated whole saliva,UWS）和刺激性唾液（stimulated whole saliva,SWS）初始pH值、唾液缓冲能力和唾液流率等唾液腺功能的改变。方法收集57例确诊的GERD住院患者和24名健康人的非刺激性唾液、刺激性唾液各2ml,测定唾液的pH值、唾液缓冲能力和唾液流率。结果①GERD组刺激性唾液的初始pH值极显著高于非刺激性唾液（P〈0.001）;②对照组非刺激性唾液的缓冲能力显著高于GERD组非刺激性唾液的缓冲能力（P〈0.01）,对照组刺激性唾液的缓冲能力高于GERD组刺激性唾液的缓冲能力（P〈0.05）;③对照组非刺激性唾液的流率极显著高于GERD组非刺激性唾液的流率（P〈0.001）,对照组刺激性唾液的流率显著高于GERD组刺激性唾液的流率（P〈0.01）。结论GERD患者唾液腺功能降低。     

咀嚼口香糖对唾液流率和pH值的影响

目的 观察咀嚼口香糖后唾液流率和pH值的变化规律。方法 30名志愿者，平均年龄23．9岁。分别检测咀嚼口香糖前后不同时间段混合唾液流率和pH值。结果 咀嚼口香糖20分钟内，唾液流率显著增加，唾液pH值明显升高。结论 咀嚼无糖口香糖有助于预防和治疗龋齿，有助于缓解口干症状。     

可摘局部义齿患者口腔内环境变化的动态观察

目的：观察和探讨可摘局部义齿对口腔唾液流率、pH值及变链菌数的影响机制和特点。方法：收集28例患者戴用可摘局部义义齿前及戴用后2周、3月、6月、1年、2年、4年的5min非刺激性全唾液，计算单位时间内唾液分泌总量（流率，ml/min）；用精密pH试纸测定唾液pH值；采用塑料条法测定唾液中变链菌数。结果：①患者戴用可摘除局部义齿后，唾液流率有所降低，唾液pH值有所升高。但随着戴用时间延长，它们又逐渐恢复正常。②患者戴用可摘局部义齿后唾液中变形链球菌数量增加。结论：戴用可摘局部义齿可导致患者唾液分泌减少；酸碱平衡改变及变形链球菌数量增加。     

小型猪腮腺放射损伤唾液流率和血常规及生化动态观察

目的 :动态观察小型猪腮腺放射损伤前后腮腺流率、血常规及血生化变化 ,为建立小型猪腮腺放射损伤动物模型 ,及基因治疗涎腺放射损伤奠定基础。方法 :试验组 8只小型猪 ,1 5Gy单侧腮腺放射损伤 ,对侧腮腺做对照 ,2只 0Gy放射做空白对照。放疗前、放疗后 4周、8周和 1 6周 ,用吸盘法收集唾液 ,前腔静脉取血 ,观察唾液流率、血常规和血生化改变。结果 :放疗后 8周唾液流率下降 ,1 6周唾液流率下降明显并与放疗前有显著性差别。随着放射后的时间延长 ,白细胞计数下降越来越明显 ,第 8周和 1 6周与放疗前有显著性差别。红细胞在放疗后第 8周及第 1 6周稍有增加但没有显著性差别 ,血小板在 4周下降 ,第 8周及第 1 6周增高超出放射前水平。乳酸脱氢酶血清含量放疗后呈持续下降趋势 ,与放疗前有显著性差别(P <0 0 5 )。血清淀粉酶在放疗后 1周增高 ,第 4周显著下降 ,与放疗前相比差别有显著性 ,随后缓慢回升。结论 :1 5Gy放疗1 6周时放疗侧腮腺唾液流率明显下降 ,血液常规白细胞计数和血清乳酸脱氢酶、淀粉酶改变     

头颈癌患者放疗期混合唾液质和量的变化

选择26例头颈部癌患者，对其放疗前、放疗中及放疗后刺激性混合唾液流率、乳铁素、溶菌酶、淀粉酶与白蛋白的含量进行分析，结果显示：唾液流率和淀粉酶含量在放疗开始后即明显下降，并一直维持在较低水平，半年后更低；唾液乳铁素、溶菌酶与白蛋白的含量在放疗早期明显升高，累积量达40Gy时稍有回落，当累积量达60Gy时，又明显升高，半年后基本恢复到治疗前水平。提示：唾液流率和淀粉酶含量的变化是反映放疗期唾液腺功能受损程度的可靠指标，而乳铁质、溶菌酶与白蛋白的变化是与放疗有关的炎症反应的指标。     

唾液总流率的临床意义探讨

目的探讨唾液总流率的临床意义。方法对６２例有口干症状的患者［其中舍格伦综合征（Ｓｊ¨ｏｇｒｅｎ＇ｓｓｙｎｄｒｏｍ，ＳＳ）３０例，涎腺良性肥大３２例］及正常对照组２３例，空腹下测定静止唾液总流率及咀嚼白蜡动态唾液总流率，将口干症状分级与唾液总流率进行相关性分析。口干症状根据治疗意外症状量表（ｔｒｅａｔｍｅｎｔｅｍｅｒｇｅｎｔｓｙｍｐｔｏｍｓｃａｌｅ，ＴＥＳＳ）分为０、１、２、３、４级。结果静态唾液总流率：ＳＳ组为（００７０±００８９）ｍｌ／ｍｉｎ，良性肥大组为（０１７５±０１１５）ｍｌ／ｍｉｎ，对照组为（０３３０±０１８８）ｍｌ／ｍｉｎ。动态唾液总流率：ＳＳ组为（０７０９±０７２０）ｍｌ／ｍｉｎ，良性肥大组为（１５６１±０８６７）ｍｌ／ｍｉｎ，对照组为（１８９４±０６６１）ｍｌ／ｍｉｎ。ＴＥＳＳ值与静态及动态唾液总流率有高度相关性。ＴＥＳＳ值为１，２时，只有静态唾液总流率下降，ＴＥＳＳ值为３，４时，静、动态唾液总流率均明显减低。结论静态唾液总流率较动态唾液总流率在口干评价中更为敏感。轻度口干症状只有静止流率降低。     

咀嚼麦芽糖醇口香糖对唾液流率及pH值的影响

目的 探讨咀嚼麦芽糖醇口香糖对唾液流率与pH值的影响.方法 选10例志愿者,分别检测咀嚼麦芽糖醇口香糖或木糖醇口香糖前后不同时间段唾液的流率和pH值.应用SPSS 12.0软件分析.结果 咀嚼2种口香糖10 min内,唾液流率显著增加,在2～4 min时达到峰值,实验组和对照组分别为(4.24±0.30)mg/min和(4.53±0.19)mg/min.唾液pH值在2～4 min时上升至(7.16±0.15)和(7.02±0.20).两组的唾液流率与pH值之间差异均无统计学意义(P>0.05).结论 咀嚼麦芽糖醇口香糖也能促进唾液分泌,提高唾液pH值.     

A prospective study of salivary gland function in patients undergoing radiotherapy for squamous cell carcinoma of the oropharynx

OBJECTIVE: We sought to investigate the impact of head and neck cancer treatment on salivary function. STUDY DESIGN: The study was conducted on 54 patients with advanced squamous cell carcinoma with confirmed (n = 50) or suspected (n = 4) primary oropharyngeal localization who were treated with radiation alone or in combination with surgery or chemotherapy, or both. The following groups were considered in the evaluation: 1, the entire pool of patients; 2, those undergoing surgery and those not undergoing surgery before radiation; 3, those undergoing resection and those not undergoing resection of the submandibular gland. The flow rates, pH, and buffering capacity were determined before, during, and up to 12 months after the completion of radiation. RESULTS: Head and neck surgery, particularly when submandibular gland resection was performed, had a negative impact on salivary flow rates but did not influence pH or buffering capacity. Nonetheless, the effect of surgery on salivary flow rates decreased progressively and disappeared at 3 to 6 months after radiotherapy. More than two thirds of the salivary output was lost during radiation treatment. All patients were experiencing salivary dysfunction at 1 year after completion of radiotherapy, with average decreases of 93% (P < .0001) and 95% (P < .0001) for whole resting salivary flow and whole stimulated salivary flow, respectively, compared with the preradiotherapy values. The buffering capacity decreased to 67% of its preradiotherapy value, and whole stimulated saliva became acidic. CONCLUSIONS: The result of this study confirms that cancer treatment involving full-dose radiotherapy (RTH) to all major salivary glands for locally advanced squamous cell carcinoma of the oropharynx induces severe hyposalivation with alteration of salivary pH and buffering capacity. Head and neck surgery has a negative impact on salivary flow rates, especially when the submandibular gland is removed. However, surgery before irradiation is not a factor aggravating hyposalivation when postoperative radiotherapy includes all the major salivary glands.     

Pilocarpine treatment in a mixed cohort of xerostomic patients

Objective: To compare the effect of a single 5‐mg dose of pilocarpine hydrochloride on the salivary flow rate in three groups of xerostomic patients. Subjects and methods: Forty‐five patients were divided into three groups according to the etiology of their xerostomia: (i) radiotherapy; (ii) Sjögren's syndrome; and (iii) sialosis and xerogenic medications. Following the oral administration of a 5‐mg pilocarpine hydrochloride tablet blood pressure, heart rate, body temperature and saliva secretion rates were monitored hourly for 3 h and adverse events were reported. Results: The most significant and persistent elevation of salivary flow rate was observed in the sialosis/drug‐induced group followed by the Sjögren's syndrome group. The radiotherapy group presented a significant elevation of salivary secretion rate after 1 and 2 h, but returned to baseline at 3 h. No significant changes in vital signs were reported, except for low diastolic pressure measured at 1 h in the radiotherapy group. Several adverse events were recorded throughout the trial; however, only one patient withdrew from the study. Conclusion: Treatment with pilocarpine hydrochloride tablets may improve saliva secretion in patients taking xerogenic medications and/or suffering from metabolic sialosis expanding the beneficial potential of this sialogogue.     

Salivary flow rate and pH during prolonged gum chewing in humans

Gum chewing for 20 min causes an increase in salivary flow rate and salivary pH. Most people chew gum for longer than 20 min, and our aim was to determine how whole mouth salivary flow rate and pH might adapt during prolonged gum chewing. Resting saliva was collected over 5 min; gum-stimulated saliva was collected at intervals during 90 min, chewing a single pellet (1.5 g) of mint-flavoured, sugar-free gum (n = 19). Subjects chewed at their own preferred rate and style. Both salivary flow rate and pH were increased above resting levels for the entire 90 min. The salivary flow was significantly greater (anovaP < 0.05) than resting flows up to 55-min chewing. The saliva pH remained significantly higher (P < 0.0001) than the resting pH even after 90-min chewing. When the experiment was repeated with the gum pellets replaced at 30 and 60 min (n = 9), similar increases in salivary flow rate and pH were found. In the latter experiment, there was no evidence of any cumulative effects on flow or pH. The persistent increase in salivary pH in particular could be beneficial to oral and dental health.     

非刺激性混合睡液对全口义齿着色影响的实验研究

目的:本研究通过检测牙列缺失的患者全口义齿配戴前后非刺激性混合唾液的流率、pH值以及Ca2+、Na+、K+离子的浓度,探讨非刺激性混合唾液对全口义齿着色的影响.方法:按全口义齿着色程度的不同,将90例全口义齿配戴者分成轻、中、重度3组.对各组患者全口义齿配戴前和配戴3个月后非刺激性混合唾液的流率、pH值以及Ca2+、Na+、K+离子浓度进行检测.采用单因素方差分析和配对样本资料的t检验进行统计学分析.结果:(1)全口义齿配戴前与配戴后,轻度组的唾液流率以及pH值高于中度组和重度组,Ca2+、Na+、K+离子浓度则低于中度组和重度组,差别有统计学意义(P<0.01).(2)全口义齿配戴后唾液流率0.66±0.17mL/min高于配戴前0.50±0.20mL/min,配戴后pH值6.48±0.22低于配戴前6.71±0.18,Ca2+、Na+、K+离子浓度升高,差别均有统计学意义(P<0.01).结论:非刺激性混合唾液的流率、PH值以及Ca2+、Na+、K+离子浓度的变化影响全口义齿着色的严重程度;全口义齿修复前后唾液的分泌也有所改变.     

The persistence of Streptococcus mutans in nasopharyngeal carcinoma patients after radiotherapy

The aim of the study was to examine the persistence of oral Streptococcus mutans in nasopharyngeal carcinoma patients after radiotherapy. Ten subjects, ranging in age from 20 to 67 years, participated. DMFT/DMFS, salivary level of mutans streptococci and oral health status were recorded. Pooled plaque samples were obtained from the cervical margins and the interproximal regions of all the teeth and the occlusal surfaces of the molars prior to, immediately after, 3 and 6 months after the completion of radiotherapy. At least 10 colonies of S. mutans were isolated from each subject and totally 645 isolates were genotyped by restriction endonuclease analysis. The results showed that the salivary level of S. mutans increased significantly with the reduction of salivary flow rate after radiotherapy. Each subject had at least 1 genotype of S. mutans isolated throughout the follow-up period. In 3 subjects who initially carried 2 or more genotypes, 1 or 2 genotypes of S. mutans could not be detected 3 months after treatment. Moreover, the genotypes that became undetectable were predominant bacteria in the first sampling. The result indicated that most S. mutans genotypes were persistent after radiotherapy but some genotypes that might not adapt to the alteration of oral environment became undetectable.     

The effects of heparan sulphate mimetic RGTA-OTR4120 on irradiated murine salivary glands

J Oral Pathol Med (2012) 41 : 477–483 Background: This study focuses on the potential of ReGeneraTing Agent OTR4120 (RGTA‐OTR4120) to treat radiation‐induced damage of salivary glands. RGTAs are biopolymers designed to mimic the effects of heparan sulphate, thereby stimulation tissue repair and regeneration. Methods: C3H mice were irradiated with a single dose of 15 Gy in the head and neck region. RGTA‐OTR4120 was injected 24 h after radiotherapy, followed by weekly injections. At 2, 6 and 10 weeks after radiotherapy, salivary flow rates were measured and animals were sacrificed to obtain parotid and submandibular glands for histology. Periodic acid Schiff stain was performed to visualize mucins that are produced by acinar cells. Amylase and total protein content were measured in saliva samples. Results: Salivary flow rates were increased at 2 weeks, but not at 6 and 10 weeks after radiotherapy with RGTA‐OTR4120 administration, compared to irradiated controls. Two and 10 weeks after radiotherapy, the mucin production activity of acinar cells was increased under influence of RGTA administration. RGTA‐OTR4120 did not influence amylase or total protein secretion. Conclusion: RGTA‐OTR4120 administration has a positive effect on salivary flow rates in irradiated mice on the short term. The effect was absent 10 weeks after radiotherapy, while at that time point, mucin producing activity of acinar cells was elevated by RGTA‐OTR4120 administration. Given these results and the advantages of RGTA use in irradiated patients, further investigation on the potential of this drug to treat radiation‐induced salivary gland damage, alone or in combination with other drugs, such as amifostine, is suggested.     

Salivary buffer capacity,pH, and stimulated flow rate of crack cocaine users

Aim: Crack cocaine is the freebase form of cocaine that can be smoked. The use of this drug has been considered a public health problem in many countries. The aim of this study was to assess the stimulated salivary flow rate (SSFR), pH, and the buffer capacity of saliva in crack cocaine users. Methods: Stimulated whole saliva was collected from 54 selected crack cocaine users and 40 non‐users. All samples were analyzed for SSFR, pH, and buffer capacity. SSFR was analyzed by gravimetric method. The buffer capacity and pH were determined using a digital pH meter. Results: The crack cocaine users demonstrated higher buffer capacity than the control group (P > 0.05). Salivary pH was lower in crack cocaine users (P < 0.05). Mean values of the SSFR for the experimental and control groups were 1.1 and 1.3 mL/min, respectively (P > 0.05). Conclusion: Crack cocaine users might exhibit a significant decrease in salivary pH, but not in salivary flow rate or buffer capacity.     

放射性龋发病因素的初步研究

为探讨放射性龋发病的相关因素和防治措施。方法,本文共收集２２例头颈部放疗患者,对其中的１０例分别于放疗前和放疗后二个月进行唾液流速和离体菌斑产酸性的检测,并比较了放疗患者与正常人唾液缓冲能力的差别。