头颈部肿瘤放疗后口腔干燥治疗研究进展

目的 综合目前头颈部肿瘤放疗后口腔干燥治疗研究现状，分析目前口腔干燥治疗方法的优缺点以及将来研究方向。方法 查询多种相关治疗资料，根据唾液分泌生理学机制和目前放射性损伤机理，分析各种治疗可能存在的缺陷，引发相关医务人员在治疗方面更好开发新的治疗方法。结果 唾液的生理性分泌是完全神经反射性的，头颈部肿瘤放疗后口腔干燥涉及感受器、传入神经、传出神经、效应器损伤，目前主要针对效应器的治疗，反射弧其余部位的损伤靠自行修复，难以短时间达到应有的疗效。结论 减少射野内反射弧照射剂量是有效的预防措施，已形成的口腔干燥需要针对反射弧多环节综合治疗。     

硝酸毛果芸香碱治疗精神药物所致口干的临床对照

为了解硝酸毛果芸香碱(瑞尔欣)治疗精神药物所致口干的疗效和不良反应,对精神药物所致口干75例,前60例病人分为两组,每组男女病人各15例,采用随机双盲对照方法分别给于瑞尔欣片(2.5mg/片)或外形相同的安慰剂(淀粉)2片,口服Tid,连用28天。另15例病人同样方法予瑞尔欣片开放治疗。结果,瑞尔欣总有效率为77.8％,安慰剂组自然有效率为26.7％,组间比较P<0.01。不良反应有窦性心动过缓、出汗、流泪和视物模糊。说明,瑞尔欣对精神药物所致口干安全有效。     

Translation and validation of a Turkish version of the Xerostomia Inventory XI in patients with primary Sjögren’s syndrome

Background/aim The aim of this study was to assess the reliability and validity of Turkish version of the Xerostomia Inventory XI in patients with primary Sjögren’s syndrome (pSS).Materials and methods A cross-sectional survey study design and analysis were used to assess the reliability and validity of the Xerostomia Inventory XI. A total of 69 patients with pSS (5 males, 64 females; mean age = 54.81 ± 8.77 years) were included. The Xerostomia Inventory XI (TR) was applied twice at an interval of 15 days. The test-retest reliability was assessed with the intraclass correlation coefficient (ICC), and the internal consistency of multiitem subscales by calculating Cronbach’s alpha values. The correlations between ESSPRI, basal and stimulated salivary flow (BSF-SSF), Oral Health Impact Profile-14 (OHIP-14) and Oral Health-Related Quality of Life-UK (OHRQoL-UK) Questionnaire were evaluated to determine the construct validity.Results The ICC value for test/retest reliability of the Xerostomia Inventory XI (TR) was 0.993. The internal consistency was 0.869. There were low to high correlations between Xerostomia Inventory XI (TR) and ESSPRI, BSF, SSF, OHIR-14 total and OHRQoL-UK total.Conclusion The Turkish version of the Xerostomia Inventory XI was found to be clinically valid and reliable to be used in clinical evaluations and rehabilitation interventions in patients with pSS.     

口干问卷中文版对鼻咽癌放疗患者评价效度和信度调查

目的 评价口干问卷中文版(XQ-C)对鼻咽癌放疗患者的效度和信度。方法 根据国际生命质量评价项目的标准程序进行XQ-C的制作,对不同放疗阶段的鼻咽癌患者进行问卷调查,对问卷结果进行效度和信度检验,内容效度采用专家评价法,结构效度采用探索性因子分析,区分效度采用非参数检验,信度检验采用克朗巴赫系数(Cronbach′s α)和分半信度进行内部一致性评价。结果回收有效问卷212份,内容效度I-CVI均≥0.80,S-CVI/Ave=0.97,Kendall′s W一致性检验P=0.701;探索性因子分析显示XQ-C为单一维度量表;不同放疗阶段患者的量表评分不同即区分效度良好;信度检验示Cronbach′s α系数=0.951,Guttman分半信度系数为0.940。方法 中文版口干问卷具有良好的效度和信度,可推广用于我国鼻咽癌患者放疗后口腔干燥症的临床诊疗和研究中。     

头颈部肿瘤涎腺放射性损伤的防治研究进展

放射性涎腺损伤是头颈部肿瘤患者放射治疗后最常见的并发症之一,表现为口腔疼痛,说话、吞咽困难等症状,严重影响患者的生存质量。因此,涎腺放射性损伤的防治十分重要。本文从放疗保护药物、放疗技术、分子生物学等方面,针对头颈部肿瘤涎腺放射性损伤的预防与治疗予以综述。     

MR涎管成像对鼻咽癌放疗患者涎腺功能

目的 探究MR涎管成像用于评价鼻咽癌调强放疗患者涎腺功能的可行性。方法在放疗前、放疗结束时分别采集32例鼻咽癌患者腮腺和下颌下腺在静息及酸刺激下MR涎管成像图像,同时对涎管可见性及放射性口干进行评价,Spearman相关分析用于急性放射性口干评级与MR涎管成像评分关系的研究。结果 放疗后涎腺导管可见性、MR涎管成像评分均较放疗前降低(P=0.000、0.000)。非重度口干与重度口干相比,腮腺导管静息与刺激下MR涎管成像评分差值不同(P=0.009),下颌下腺导管静息与刺激下MR涎管成像评分差值也不同(P=0.005);腮腺导管静息与刺激下,以及下颌下腺导管静息与刺激下得分均相近(P=0.881、0.305、0.327、0.229)。Spearman相关分析显示急性口干与腮腺导管静息与刺激得分差值,以及下颌下腺导管静息与刺激得分差值均呈负相关(R=－0.472,P=0.006;R=－0.482,P=0.005)。结论 MR涎管成像评分与口干具有相关性,MR涎管成像可用于评价鼻咽癌放疗患者的涎腺功能。     

颌下腺移位术预防鼻咽癌放疗后口干燥症的近期效果

背景与目的:口干燥症是鼻咽癌放疗后最常见的后遗症之一,它严重影响患者放疗后的生存质量。本研究旨在探讨颌下腺移位术预防鼻咽癌放疗后口干燥症的临床效果。方法:共选择70例病例进行前瞻性非随机临床对照研究。试验组选择符合入选标准的鼻咽癌患者36例,在放疗前将颌下腺移位至颏下区,术后接受常规放疗,放疗时颏下区设置挡块。观察放疗中急性口腔粘膜反应,应用锝-99核素扫描检测放疗前后颌下腺功能的变化,测定放疗前后唾液分泌量的变化,放疗后3个月进行口干程度问卷调查。对照组(34例)不行颌下腺移位术,其余处理方法同试验组。将试验组的术侧与非术侧以及试验组与对照组的上述观察指标进行比较。结果:试验组急性口腔粘膜反应明显轻于对照组(P=0.007)。试验组放疗后3个月移位术侧颌下腺摄取、排泌功能均明显较未移位术侧者好,两者之间有非常显著性差异(P值分别为0.001和0.000);试验组颌下腺摄取、排泌功能均明显较对照组者好,两者之间有非常显著性差异(P值分别为0.004和0.000)。试验组放疗后唾液分泌量的平均值为1.41g,而对照组放疗后唾液分泌量平均值为0.71g。对照组76.5%的患者有中度至重度的口干燥症,试验组仅13.9%的患者有中度至重度的口干燥症,两者之间有非常显著性差异(P=0.000)。结论:颌下腺移位     

针刺治疗原发性口干燥症疗效观察(英文)

目的:观察针刺治疗原发性口干燥症的临床疗效。方法:将46例患者按随机字母表随机分入针刺组和药物组。针刺组予以滋阴补肾针刺治疗,药物组口服知柏地黄丸治疗。对两组患者治疗前后静态唾液总流率及方糖试验计分变化进行比较分析。结果:针刺组总有效率87.0%,药物组总有效率60.9%,两组总有效率比较,差异有统计学意义(P<0.05)。治疗后,两组静态唾液总流率测定、方糖试验计分均明显改善,同组治疗前后比较差异均有统计学意义(P<0.05或P<0.01);治疗后,针刺组静态唾液总流率、方糖试验计分与药物组比较差异均有统计学意义(P<0.01)。结论:滋阴补肾针刺疗法治疗原发性口干燥症疗效优于口服知柏地黄丸,且无不良反应。     

The efficacy of Xialine<Superscript>®</Superscript> in patients with Sjögren’s syndrome: a single-blind,cross-over study

Sjögren syndrome (SS) is a chronic inflammatory autoimmune disease of unknown cause whose main characteristic is severe dryness of the eyes and the mouth. The decreased functional capacity of the lacrimal and salivary glands which is the result of the inflammatory process and lymphocytic infiltration observed in SS is accountable for this complication. Twenty-nine patients with SS whose ages were ranging between 24–77, who were under treatment in Ege University Faculty of Medicine Department of Rheumatology, participated in the study, and their informed consents were obtained upon enrollment. Each patient recorded their subjective complaints on a separate questionnaire. The baseline and subsequent evaluation of the subjective findings on predetermined times (1 h after application of the material, at the end of the 1st, 7th, and 14th days) were also recorded on separate questionnaire sheets. Throughout the 14-day treatment period, no statistically significant differences were noted between the Xialine® and placebo groups with regard to burning tongue, diminished taste, and waking up at night to sip water (p?=?0.925, 0.527, and 0.066, respectively). However, patients’ satisfaction with placebo decreased by 25.63% at the end of the test period, whereas it increased by 16.37% after Xialine® administration. Overall, the patients preferred Xialine® at the end of the study (p?=?0.011). The main motive to administer saliva substitute is to improve lubrication and hydration of oral tissues. The results of this study indicated that Xialine® is helpful in the management of xerostomia-related symptoms of SS patients. However, further investigations in larger scale group of patients are recommended to provide the effects of these agents on various complaints of xerostomia.