肺癌病患化療期間接受蜂膠照護措施對改善口腔狀態之成效探討

本研究目的為探討肺癌病患化學治療期間接受蜂膠照護措施對口腔黏膜狀態、牙菌斑控制之成效，採實驗設計將受試者隨機分派為實驗組（n＝30）與控制組（n＝31），以住院接受第一次化學治療的肺癌患者為對象，參與14天之口腔照護措施。口腔照護措施包括1.一天刷牙兩次在早餐後與睡前，一次90秒。2.使用牙線3.一天漱口兩次控制組用蒸餾水，實驗組用蜂膠漱口。在住院期間及化療後14天以世界衛生組織量表（World health organization, WHO），口腔評估量表（Oral assessment guide, OAG）、牙菌斑指數來評估實行成效。研究結果發現接受口腔照護措施後發生WHO量表等級≧2風險上實驗組較控制組少但未達統計上顯著差異。措施介入後口腔評估量表（OAG）大於10分控制組與實驗組有下降，並且達顯著差異（p＜0.001）。牙菌斑指數在措施介入後實驗組較控制組有明顯下降，且達顯著差異（p＝0.002）。研究結果支持蜂膠口腔照護措施對改善肺癌病患化療期間口腔黏膜狀態具有成效，建議臨床人員可將口腔照護措施列為肺癌病患化學治療期間護理活動之選擇。

關鍵字

肺癌；化學治療；口腔炎；口腔護理；蜂膠

並列摘要

The purpose of this study was to determine the effects of oral care intervention on the incidence of mucositis and dental plaque in lung cancer patients receiving chemotherapy. An experimental design was conducted in this study and 61 patients were randomly assigned to a treatment group (n=30) or control group (n=31). All patients receiving standard protocol of oral care included (1) 90 seconds tooth brush after breakfast and before bed, (2) dental floss use after tooth brush, and (3) 2 times daily rinsing. The major difference between control group and treatment group was 2 times daily rinsing with sterile water and propolis, respectively. The World Health Organization (WHO) mucositis grading system and Oral Assessment Guide (OAG) were used to assess oral status every day during hospitalization and 14 days after chemotherapy. A statistical difference was not found between 2 groups measured by WHO scales. However, OAG score was significantly lower in treatment group (p ＜ 0.001). Plaque significantly reduced in the treatment group (p = 0.002). The result supports the application of propolis oral intervention an effective method for improving mucositis in lung cancer patients receiving chemotherapy.