唾液腺灌洗缓解干燥综合征患者口干:随访40周的单盲随机对照临床试验  

Salivary gland irrigation relieves xerostomia in patients with Sjogren's syndrome:A single-blind randomized controlled clinical trial with 40-week follow-up

作　　者：杜洪明 朱晓东 赵静[1] 肖珊珊 傅振[2] DU Hongming;ZHU Xiaodong;ZHAO Jing;XIAO Shanshan;FU Zhen(Department of Oral and Maxillofacial Surgery,Affiliated Stomatological Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属口腔医院口腔颌面外科,江苏南京210029 [2]南京医科大学第四附属医院口腔科,江苏南京210031

出　　处：《口腔医学》2023年第11期996-1001,共6页Stomatology

基　　金：国家自然科学基金(81600908);江苏省科教能力提升工程——江苏省研究型医院(YJXYYJSDW4);江苏省医学创新中心(CXZX202227)。

摘　　要：目的验证曲安奈德(TA)和生理盐水(NS)灌洗唾液腺长期缓解干燥综合征(SS)患者口干症的效果。方法将纳入的49例SS患者随机分为对照组(不灌洗,n=16)、NS组(NS灌洗,n=17)和TA组(TA灌洗,n=16)。在灌洗前1周(0W)和灌洗后8周(8W)、16周(16W)、32周(32W)和40周(40W)检查未刺激的全唾液流(unstimulated whole salivary flow,UWS)、咀嚼刺激的全唾液流(chewing-stimulated whole saliva flow,SWS)、柠檬酸刺激的腮腺流(citric acid-stimulated parotid flow,SPF)、临床口腔干燥评分(CODS)、口干量表(XI)和EULAR SS患者报告指数(ESSPRI)。结果每组14例患者完成随访。与0W相比,经TA和NS灌洗后8W、16W、24W和32W的SWS和SPF增高(P<0.05),而40W无显著差异(P>0.05)。与0W相比,TA和NS组8W、16W、24W和32W的ESSPRI(口干症状)降低(P<0.05)。TA组16W、24W和32W的SWS和SPF均高于对照组(P<0.05)。TA组8W、24W和32W的CODS低于对照组(P<0.05)。结论TA和NS灌洗大唾液腺可以持续32周缓解SS患者口干。Objective To verify the effect of triamcinolone acetonide(TA)and normal saline(NS)irrigating salivary glands on longterm relief of xerostomia in patients with Sjogren's syndrome(SS).Methods A total of 49 SS patients were randomly divided into control group(no irrigation,n=16),NS group(NS irrigation,n=17)and TA group(TA irrigation,n=16).The examinations of the unstimulated whole salivary flow(UWS),chewing-stimulated total salivary flow(SWS),citric acid-stimulated parotid flow(SPF),clinical xerostomia score(CODS),xerostomia scale(XI)and EULAR SS patient-reported index(ESSPRI)were conductedat 1 week before irrigation(0W)and 8 weeks(8W),16 weeks(16W),32 weeks(32W)and 40 weeks(40W)after irrigation.Results The follow-up of 14 cases in each group was completed.Compared with 0W,the SWS and SPF of 8W,16W,24W and 32W were increased after TA and NS irrigation(P<0.05),but there was no significant difference at 40W(P>0.05).Compared with 0W,ESSPRI(oral dryness domain)was decreased in TA and NS groups at 8W,16W and 24W and 32W(P<0.05).The SWS and SPF of the TA group at 16W,24W and 32W were higher than those of the control group(P<0.05).The CDOS in the NS group at 8W,24W,and 32W were lower than those of the control group(P<0.05).Conclusion TA and NS irrigation of the major salivary glands can continuously relieve xerostomia in SS patients for 32 weeks.

关 键 词：灌洗 唾液 唾液腺 干燥综合征 口干症 

分 类 号：R781.71[医药卫生—口腔医学]