研究动态
Articles below are published ahead of final publication in an issue. Please cite articles in the following format: authors, (year), title, journal, DOI.

用低强度激光和氯硝西泮治疗灼口综合症:一项随机、单盲临床试验。

Burning Mouth Syndrome Treated with Low-Level Laser and Clonazepam: A Randomized, Single-Blind Clinical Trial.

发表日期:2024 May 09
作者: Ana Garcia Martinez, Pia Lopez-Jornet, Luis Pardo Marin, Eduardo Pons-Fuster, Asta Tvarijonaviciute
来源: Burns & Trauma

摘要:

灼口综合征 (BMS) 是一种慢性疼痛疾病,其特征是口腔内烧灼感或感觉障碍,但没有任何可识别的病变。人们已经对多种 BMS 治疗方法进行了研究,但还没有得出结论性的结果。分析了低强度二极管激光和氯硝西泮治疗 BMS 患者的疗效,并对治疗前后不同唾液生物标志物的水平进行了研究。一项随机、单盲临床试验该研究涉及 89 名患者,分为以下几组:第 1 组(激光,Helbo® Theralite 激光 3D 袖珍探针​​氯硝西泮)(n = 20),第 2 组(假激光安慰剂)(n = 19),第 3 组(激光) (n = 21) 和第 4 组(氯硝西泮)(n = 18)。根据视觉模拟评分(VAS)对症状强度进行评分。在治疗前后进行唾液测定,并进行口干症调查、口腔健康影响概况 14 (OHIP-14) 和简易营养评估 (MNA) 调查问卷。在唾液样本中测量了以下标记物:白介素(IL2、IL4、IL5、IL6、IL7、IL8、IL1β、IL10、IL12、IL13、IL17、IL21 和 IL23)、蛋白质(MIP-3α、MIP-1α 和 MIP- 1β)、GM-CSF、干扰素 γ (IFNγ)、干扰素诱导 T 细胞 α 趋化剂 (ITAC)、fratalkine 和肿瘤坏死因子 α (TNFα)。第 1 组治疗后观察到 VAS 评分显着下降(激光氯硝西泮)(p = 0.029)和第 3 组(激光)(p = 0.005)。反过来,第 3 组(激光)显示 fractalkine 唾液浓度降低(p = 0.025);白细胞介素 IL12 (p = 0.048)、IL17 (p = 0.020)、IL21 (p = 0.008)、IL7 (p = 0.001) 和 IL8 (p = 0.007);蛋白质 MIP1α (p = 0.048) 和 MIP1β (p = 0.047);和 TNFα (p = 0.047) 与基线相比。治疗后,第 1 组(激光氯硝西泮)与基线相比,IL21 (p = 0.045) 和 IL7 (p = 0.009) 表现出显着差异,而第 4 组(氯硝西泮)在 IL13 (p = 0.036)、IL2 (p = 0.020)和 IL4(p = 0.001)。第 2 组(假激光安慰剂)没有记录到显着差异。低强度二极管激光是 BMS 中的一个很好的治疗选择,可减少患者症状和唾液生物标志物。然而,为了得出更可靠的结论,需要对干预方案和激光强度参数进行标准化。
Burning mouth syndrome (BMS) is a chronic pain disorder characterized by intraoral burning or dysaesthetic sensation, with the absence of any identifiable lesions. Numerous treatments for BMS have been investigated, though without conclusive results. An analysis was conducted of the efficacy of treatment with a low-level diode laser and clonazepam in patients with BMS, and a study was carried out on the levels of different salivary biomarkers before and after treatment.A randomized, single-blind clinical trial was carried out involving 89 patients divided into the following groups: group 1 (laser, The Helbo® Theralite Laser 3D Pocket Probe + clonazepam) (n = 20), group 2 (sham laser placebo) (n = 19), group 3 (laser) (n = 21) and group 4 (clonazepam) (n = 18). Symptom intensity was scored based on a visual analogue scale (VAS). Sialometry was performed before and after treatment, and the Xerostomia Inventory, Oral Health Impact Profile-14 (OHIP-14) and Mini-Nutritional Assessment (MNA) questionnaires were administered. The following markers were measured in saliva samples: interleukins (IL2, IL4, IL5, IL6, IL7, IL8, IL1β, IL10, IL12, IL13, IL17, IL21 and IL23), proteins (MIP-3α, MIP-1α and MIP-1β), GM-CSF, interferon gamma (IFNγ), interferon-inducible T-cell alpha chemoattractant (ITAC), fractalkine and tumor necrosis factor α (TNFα).A significant decrease in the VAS scores was observed after treatment in group 1 (laser + clonazepam) (p = 0.029) and group 3 (laser) (p = 0.005). In turn, group 3 (laser) showed a decrease in the salivary concentration of fractalkine (p = 0.025); interleukins IL12 (p = 0.048), IL17 (p = 0.020), IL21 (p = 0.008), IL7 (p = 0.001) and IL8 (p = 0.007); proteins MIP1α (p = 0.048) and MIP1β (p = 0.047); and TNFα (p = 0.047) versus baseline. Following treatment, group 1 (laser + clonazepam) showed significant differences in IL21 (p = 0.045) and IL7 (p = 0.009) versus baseline, while group 4 (clonazepam) showed significant differences in IL13 (p = 0.036), IL2 (p = 0.020) and IL4 (p = 0.001). No significant differences were recorded in group 2 (sham laser placebo).The low-level diode laser is a good treatment option in BMS, resulting in a decrease in patient symptoms and in salivary biomarkers. However, standardization of the intervention protocols and laser intensity parameters is needed in order to draw more firm conclusions.