| Abjective: To research the efficacy of Qingshuyin combined with Recombinant human interleukin-11 mouthwash in prevention and treatment of oral mucositis(OM)in patients with allogeneic hematopoietic stem cell transplantation(allo-HSCT)from aspects of incidence rate,severity,duration,degree of pain,use of analgesic drugs,etc.And to provide new ideas and methods for the prevention and treatment of OM associated with allo-HSCT.Methods: Patients who met the inclusion criteria and received allo-HSCT in the laminar flow ward of the Hematology Department of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from September 2020 to January 2022 were selected as the research subjects and randomly divided into the control group and the experimental group.The two groups of patients were given oral health education before the start of pretreatment,and the importance of maintaining oral hygiene during allo-HSCT was fully emphasized.The experimental group was given Qingshuyin,which was uniformly prepared by the decoction room of the Affiliated Hospital of Shandong University of traditional Chinese medicine combined with Recombinant human interleukin-11 mouthwash(Recombinant human interleukin-11 3 mg + sodium bicarbonate 250 ml + normal saline 100 ml)to gargle.The specific method is: in the morning,after meals and within half an hour before going to bed,firstly put the frozen Qingshuyin liquid(10-15 m L each time)in the mouth,and do the mouthwash action to make the drug fully contact the oral mucosa.After 5 minutes Spit out.And then gargle with Recombinant human interleukin-11 mouthwash(10-15 m L each time)for5 minutes and spit it out.The control group was given Recombinant human interleukin-11 mouthwash,and the method was the same as that of the experimental group.The duration of intervention was 1 month(patients without OM)or continued until the oral mucositis healed(patients with OM).During the intervention period,the oral mucosa was observed every day,and the occurrence of oral mucositis(incidence,occurrence time,duration and severity),other symptoms(dry mouth,ulcer bleeding,taste disorders,swallowing disorders),the degree of pain and the use of analgesic drugs,the days of fever and the number of infections,nutritional status(weight change,number of users of intravenous hypernutrition therapy),and time of granulocyte and megakaryocyte implantation were recorded.Results:1.A total of 33 patients participated in this study(one patient died and two patients were removed from the group because they could not tolerate Qingshuyin gargle),and 30 patients were finally included in the statistical analysis,15 in the experimental group and 15 in the control group.There was no statistical difference between the experimental group and the control group in gender,age,BMI,primary disease before transplantation and Pretreatment scheme(P > 0.05).2.There was no significant difference between the experimental group and the control group in the overall incidence of OM(80.00% vs 86.67%,P= 0.624),the incidence of mild OM(66.67% vs 53.33%,P = 0.456),and the incidence of severe OM(13.33% vs 33.33%,P = 0.195).The onset time of OM in the experimental group was 14.54 ± 2.57 days after the start of pretreatment,which was later than that in the control group(16.92 ± 6.39days),but the difference was not statistically significant(P = 0.096).The duration of OM in the experimental group was lower than that in the control group(14.00 ± 5.01 days vs 22.62 ± 8.07 days),and the difference was statistically significant(P = 0.004).The number of people with dry mouth in the experimental group was less than that in the control group(2 vs 9),and the difference was statistically significant(P = 0.023).3.The pain score of the experimental group was lower than that of the control group(3.67 ± 0.78 vs 5.62 ± 1.39),and the difference was statistically significant(P < 0.001).The number of people using analgesic drugs in the experimental group and the control group were 4 and 8respectively,and the difference was not statistically significant(P >0.313).The time of using analgesic drugs in the experimental group was less than that in the control group [1.5(1,2)vs 4.75(1,23),P = 0.039],especially in patients with severe OM(1.50 ± 0.71 days vs 13.60 ± 9.32days),and the difference was statistically significant(P = 0.043).4.The time of fever in the experimental group and the control group was 6.93 ± 4.01 days and 8.13 ± 4.21 days respectively,and the difference was not statistically significant(P = 0.431).The number of infected people in the experimental group and the control group was 6 and7,respectively,and there was no significant difference(P = 0.713).5.The degree of weight loss in the experimental group was lower than that in the control group(5.33±2.96 kg vs 9.30±2.87 kg),and the difference was statistically significant(P = 0.001).There were 5 and 6patients in the experimental group and the control group using intravenous hypernutrient therapy,respectively,and the difference was not statistically significant(P = 0.705).6.There was no statistical significance between the experimental group and the control group in the engraftment time of granulocytes and megakaryocytes(P > 0.05).Conclusions:1.Compared with Recombinant human interleukin-11 mouthwash alone,Qingshuyin combined with Recombinant human interleukin-11 mouthwash cannot reduce the incidence and severity of OM,nor can it shorten the duration of fever and reduce the frequency of infection in patients with OM.2.Qingshuyin combined with Recombinant human interleukin-11 mouthwash can effectively shorten the duration of OM in allo-HSCT patients,reduce pain,reduce the frequency of analgesic use in patients with severe OM,reduce the degree of weight loss,and reduce the frequency of dry mouth.3.Qingshuyin combined with Recombinant human interleukin-11 mouthwash has no effect on the engraftment time of granulocytes and megakaryocytes in patients with allogeneic hematopoietic stem cell transplantation. |
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