麩醯胺酸是否可有效改善癌症患者放化療後造成之口腔黏膜炎

口腔黏膜炎是癌症患者在接受化學治療和放射線治療時常見的併發症之一。該病症發生率會因不同癌症治療方法而有所影響，大部分口腔黏膜炎在治療後數週內逐漸改善。嚴重的口腔黏膜炎可能會導致病人疼痛、進食困難、營養不良、體力虛弱、睡眠障礙、情緒不佳以及溝通困難等問題，可能迫使患者中斷治療、增加住院天數、對患者生活造成嚴重影響。臨床上常採用各種護理措施來幫助管理口腔黏膜炎的症狀，包括使用含冰塊、蜂蜜、茶葉、小蘇打水、或含有抗微生物成分的漱口水，甚至是人工唾液漱口水以及麩醯胺酸等。麩醯胺酸是一種胺基酸，通常被認為對細胞修復和生長有益，本文藉由文獻探討麩醯胺酸是否能有效緩解化放療後的口腔黏膜炎，評讀文獻結果發現麩醯胺酸可預防和治療癌症患者放化療後引起的口腔黏膜炎，對於3-4級口腔黏膜炎有顯著改善；但在接受高劑量的放射線治療所引起口腔黏膜炎成效較不明顯。臨床上應注重患者對於口腔護理的認知及護理技巧，正確的口腔護理能預防且及早發現黏膜炎發生。

關鍵字

麩醯胺酸；癌症；口腔黏膜炎

並列摘要

Oral mucositis is one of the common complications in cancer patients undergoing chemotherapy and radiation therapy. The incidence of this condition can vary depending on the cancer treatment methods, with most cases of oral mucositis gradually improving within a few weeks after treatment. Severe cases of oral mucositis can lead to issues such as pain, difficulty eating, malnutrition, physical weakness, sleep disturbances, emotional distress, and communication difficulties. This may force patients to interrupt their treatment, extend hospital stays, and significantly impact their quality of life. Various care measures are often used in clinical practice to help manage the symptoms of oral mucositis, including the use of ice chips, honey, tea leaves, baking soda water, or mouthwashes containing antimicrobial ingredients, as well as artificial saliva mouthwashes and glutamine, among others. Glutamine is an amino acid that is generally believed to be beneficial for cell repair and growth. This study explores whether glutamine can effectively alleviate oral mucositis following radiotherapy and chemotherapy. The literature review suggests that glutamine can prevent and treat oral mucositis in cancer patients resulting from chemotherapy, particularly for cases classified as grade 3-4 mucositis. However, its efficacy is less clear in cases of oral mucositis induced by high-dose radiation therapy. Clinical attention should be given to patients' awareness of oral care and proper care techniques, as correct oral care can prevent and detect mucositis early.

並列關鍵字

glutamine ； cancer ； oral Mucositis

參考文獻

周繡玲、謝嘉芬、李佳諭、江孟冠、紀雯真(2011)．癌症病人口腔黏膜炎臨床照護指引．腫瘤護理雜誌，11(1)，61-85。https://doi. org/10.6880/TJON.201112/SP_11.05

Daugėlaitė, G., Užkuraitytė, K., Jagelavičienė, E., & Filipauskas, A. (2019). Prevention and treatment of chemotherapy and radiotherapy induced oral mucositis. Medicina (Kaunas), 55(2), 25. https://doi. org/10.3390/medicina55020025

Huang, C. J., Huang, M. Y., Fang, P. T., Chen, F., Wang, Y. T., Chen, C. H., Yuan, S. S., Huang, C. M., Luo, K. H., Chuang, H. Y., Wang, Y. Y., & Lee, H. H. (2019). Randomized double-blind, placebo-controlled trial evaluating oral glutamine on radiation-induced oral mucositis and dermatitis in head and neck cancer patients. American Journal of Clinical Nutrition, 109(3), 606-614. https://doi.org/10. 1093/ajcn/nqy329

Kusiak, A., Jereczek-Fossa, B. A., Cichońska, D., & Alterio, D. (2020). Oncological-therapy related oral mucositis as an interdisciplinary problem-literature review. International Journal of Environmental Research and Public Health, 17(7), 2464. https://doi.org/10.3390/ ijerph17072464

Pengm, T. R., Lin, H. H., Yang, L. J., & Wu, T. W. (2021). Effectiveness of glutamine in the management of oral mucositis in cancer patients: a meta-analysis of randomized controlled trials. Support Care in Cancer, 29(8), 4885-4892. https://doi.org/10.1007/s00520-021-06060-9

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