| 摘要: | 背景：口腔黏膜炎是癌症患者接受治療時最常見的副作用之一。在接受化學藥物和放射線治療的頭頸癌患者約有89%會發生口腔黏膜炎，只接受放射線治療的頭頸癌患者幾乎100%會發生口腔黏膜炎。口腔黏膜炎會引起許多不良反應，例如疼痛、體重減輕 ≥ 5%、感染風險增加、住院時間增加，並降低生活質量。
目的：探討使用蜂蜜、蜂膠和常規照護之頭頸癌患者的口腔黏膜炎、疼痛、口腔乾燥症、體重、生活質量和疲勞情形。
研究方法：本研究從放射線治療開始追蹤12週，介入措施分為蜂蜜組、蜂膠組及常規照護組，評估頭頸癌患者口腔黏膜炎、疼痛、口乾、體重、生活品質、疲勞情形。
結果：本研究共收納75位病患。以NCI-CTCAE v5.0，蜂蜜組在第二週、第四週、第八週和第十週減輕口腔黏膜炎，蜂膠組在第二週、第四週和第八週減輕口腔黏膜炎（p<0.05）；以WHO oral toxicity scales，蜂蜜組在第四週、第六週、第八週和第十週的口腔黏膜炎，蜂膠組在第四週、第六週、第八週和第十週的口腔黏膜炎（p<0.05）。
以病人自訴口腔黏膜炎症狀方面，蜂蜜組在第四週、第六週、第八週、第十週和第十二週減輕病人自訴口腔黏膜炎症狀；蜂膠組在第二週減輕、第八週和第十週減輕病人自訴口腔黏膜炎症狀（p<0.05）。
以口腔疼痛方面，蜂蜜組的口腔疼痛在第四週、第六週、第八週減輕、第十週和第十二週減輕口腔疼痛，蜂膠組的口腔疼痛在第四週、第六週、第八週、第十週減輕口腔疼痛（p<0.05）。
以口乾方面，蜂蜜組的口乾程度在第十週減少和第十二週減少口乾（p<0.05）。
以體重方面，蜂蜜組和蜂膠組無顯著差異。
以生活品質方面，蜂蜜組在第四週、第八週和第十週顯著增加生理健全狀況，蜂膠組在第二週、第四週、第八週、第十週和第十二週增加生理健全狀況（p<0.05），且蜂膠組在第四週顯著增加情緒健全狀況在一般生活品質中，蜂蜜組在第四週和第八週增加一般生活品質分數，蜂膠組在第四週、第八週和第十週增加一般生活品質分數；在整體生活品質中，蜂膠組在第四週、第八週和第十週增加整體生活品質分數（p<0.05），而在社交/家庭健全狀況、功能健全狀況、頭頸癌附加關注事項皆無顯著差異。
結論：我們研究結果表明使用蜂蜜和蜂膠在頭頸癌患者接受放射線治療是安全可行的，可提供臨床醫護人員照護之參考。
Background: Oral mucositis is one of the most common adverse reactions of cancer patients undergoing cancer treatment. There is 89% incidence of mucositis in patients treated with radiation and chemotherapy. Patients receiving radiation, in particular to head and neck cancers, have a 100% chance. Oral mucositis cause many adverse effects such as pain, weight loss ≥ 5%, increased risk of infection, increased length of hospital stay, and decreased quality of life.
Purpose: To explore of using honey, propolis and usual care for oral mucositis, pain, xerostomia, body weight, quality of life and fatigue in head and neck cancer patients.
Methods: This study was followed up for 12 weeks from radiation therapy. Intervention measures were divided into honey group, propolis group and usual care group to assess the degree of oral mucositis, pain, xerostomia, weight, quality of life, and fatigue.
Result: A total of 75 patients were included in this study. With NCI-CTCAE v5.0, honey group reduced oral mucositis in the second, fourth, eighth and tenth weeks, and propolis group reduced oral mucositis in the second, fourth and eighth weeks ( p<0.05); according to WHO oral toxicity scales, oral mucositis in honey group at the fourth, sixth, eighth and tenth weeks, and propolis group at the fourth, sixth, eighth and tenth weeks Oral mucositis at ten weeks (p<0.05).
In terms of patient-reported oral mucositis symptom, honey group relieved the patient-reported oral mucositis symptom in the fourth, sixth, eighth, tenth and twelfth weeks; patient-reported oral mucositis symptom, in propolis group were relieved at week and tenth week (p<0.05).
In terms of oral pain, the oral pain in honey group was reduced in the fourth, sixth, eighth, tenth and twelfth weeks, and the oral pain in propolis group was reduced in the fourth, sixth, and twelfth weeks. The oral pain was relieved in the eighth and tenth weeks (p<0.05).
In terms of dry mouth, the degree of dry mouth in the honey group decreased at the tenth week and at the twelfth week (p<0.05).
In terms of quality of life, the honey group significantly increased physical well-being in the fourth, eighth and tenth weeks, and the propolis group increased the physical well-being in the second, fourth, eighth, tenth and twelfth weeks (p<0.05), and the propolis group significantly increased emotional well-being in the fourth week. In the general quality of life, the honey group increased the general quality of life score in the fourth and eighth weeks, and the propolis group in the fourth week and the eighth week. Eighth week and tenth week increased general quality of life scores; in overall quality of life, the propolis group increased overall quality of life scores at weeks four, eight and ten (p<0.05). There were no significant differences in body weight, social/family functional well-being, functional well-being, and head and neck cancer subscale.
Conclusion: Our research results show that it is safe and feasible to use honey and propolis to receive radiation therapy in patients with head and neck cancer. Clinical care workers could use this study as a reference for patient care. |
