Application of montmorillonite powder combined vitamin B complex tablets on oral ulcer after high-dose methotrexate chemotherapy

doi:10.3969/j.issn.1009-976X.2020.06.027

Abstract

Abstract: Objective To investigate the clinical effect of montmorillonite powder combined with vitamin B complex tablets（Vit.Bco） for oral ulcer after high dose methotrexate chemotherapy in patients with acute lymphoblastic leukemia. Methods 102 patients with acute lymphoblastic leukemia who were hospitalized in hematology department from January 2018 to December 2019 with high dose methotrexate chemotherapy were divided into control group and observation group. The control group was gargle with conventional mouthwash,the montmorillonite powder combined with Vit.Bco was applied to montmorillonite powder combined with Vit.Bco ulcer on the basis of the control group. Comparative analysis of the oral ulcer cure rate and pain scores between the two groups were performed. Results The cure rate of oral ulcer was 94.33%,77.55% in the observation group and the control group,respectively. The pain scores in the observation group and the control group were 2.29± 1.09,2.97± 1.12, respectively. The difference was statistically significant（P< 0.05）. Conclusion In our study, montmorillonite powder combined with Vit.Bco can effectively cure oral ulcers caused by high dose methotrexate chemotherapy. However, the exact effect needs to be verified by multicenter randomized controlled trial.

Key words: vitamin B complex tablets, montmorillonite powder, oral ulcer, methotrexate

摘要： 目的探讨蒙脱石散联合Vit.Bco在治疗急性淋巴细胞白血病（ALL）患者使用甲氨蝶呤化疗致口腔溃疡的临床效果。方法将2018年1月~2019年12月在本院血液内科住院行大剂量甲氨蝶呤化疗继发口腔溃疡的102例ALL患者作为研究对象,对照组采用常规漱口水漱口,观察组在对照组的基础上加用蒙脱石散联合Vit.Bco糊状物涂抹在溃疡处,对比两组患者口腔溃疡恢复及疼痛评分情况。结果观察组口腔溃疡治愈率为94.33%,对照组口腔溃疡治愈率为77.55%;观察组疼痛评分为2.29±1.09分,对照组疼痛评分为2.97±1.12分,两组指标对比差异均具有统计学意义（P<0.05）。结论本研究中,蒙脱石散联合Vit.Bco能有效治疗大剂量甲氨蝶呤化疗引起的口腔溃疡,但确切疗效尚需多中心进一步随机对照研究验证。

关键词: Vit.Bco, 口腔溃疡, 蒙脱石散, 甲氨蝶呤

CLC Number:

R659

HUANG Wan-yun, QIU Yi-hong, YAN Jie, DONG Ying. Application of montmorillonite powder combined vitamin B complex tablets on oral ulcer after high-dose methotrexate chemotherapy[J]. Lingnan Modern Clinics in Surgery, 2020, 20(06): 814-817.

黄婉芸, 邱逸紅, 颜洁, 董颖. 蒙脱石散联合Vit.Bco治疗对大剂量甲氨蝶呤化疗致口腔溃疡的效果观察[J]. 岭南现代临床外科, 2020, 20(06): 814-817.

References

[1] Heil SG.Genetics of high-dose methotrexate-induced oral mucositis: current perspectives[J]. Pharmacogenomics, 2019, 20(9):621-623.
[2] Costa SF, Miceli MH, Anaissie EJ.Mucosa or skin as source of coagulasenegativestaphylococcal bacteraemia?[J]. Lancet Infect Dis, 2004, 4(5): 278-286.
[3] Campbell JM, Bateman E, Stephenson MD, et al.Methotrexate-induced toxicity pharmacogenetics: an umbrella review of systematic reviews and meta-analyses[J]. Cancer Chemother Pharmacol, 2016, 78(1):27-39.
[4] Sonis ST, Oster G, Fuchs H et al. Oral mucositis and the clinical and economicoutcomes of hematopoietic stem-cell transplantation[J]. J Clin Oncol, 2001, 19(8):2201-2205.
[5] Elting LS, Shih YT, Stiff PJ et al. Economic impact of palifermin on the costs ofhospitalization for autologous hematopoetic stem-cell transplant: analysis ofphase 3 trial results[J]. Biol Blood Marrow Transplant, 2007, 13(7): 806-813.
[6] Fanning SR, Rybicki L, Kalaycio M et al. Severe mucositis is associated withreduced survival after autologous stem cell transplantation for lymphoidmalignancies[J]. Br J Haematol, 2006, 135(3): 374-381.
[7] Al Ibraheemi AA, Shamoun S.Incidence and Risk Factors of Oral Mucositis in Patients with Breast Cancer Who Receiving Chemotherapy in Al-Bashir Hospital[J]. Int J Hematol Oncol Stem Cell Res, 2016, 10(4):217-223.
[8] Keefe DM, Schubert MM, Elting LS et al. Updated clinical practice guidelines forthe prevention and treatment of mucositis[J]. Cancer, 2007, 109(5): 820-831.
[9] Gori E, Arpinati M, Bonifazi F, et al.Cryotherapy in the prevention of oral mucositis in patients receiving low-dose methotrexate following myeloablative allogeneic stem cell transplantation: a prospective randomized study of the Gruppo Italiano Trapianto di Midollo Osseo nurses group[J]. Bone Marrow Transplant, 2007, 39(6):347-352.
[10] Edelman MJ, Gandara D, Perez EA et al. Phase I trial of edatrexate pluscarboplatin in advanced solid tumors: amelioration of dose-limiting mucositis byice chip cryotherapy[J]. Invest New Drugs 1998; 16(1): 69-75.
[11] Kono T, Kaneko A, Matsumoto C, et al.Multitargeted effects of hangeshashinto for treatment of chemotherapy-induced oral mucositis on inducible prostaglandin E2 production in human oral keratinocytes[J]. Integr Cancer Ther, 2014, 13(5): 435-445.
[12] Jiang YS, Ma YY, Wang ZQ, et al.Therapeutic effects of smecta or smectite powder on rats with paraquat toxication[J]. World J Emerg Med, 2013, 4(2): 144-150.
[13] Buccigrossi V, Russo C, Guarino A, et al.Mechanisms of antidiarrhoeal effects by diosmectite in human intestinal cells[J]. Gut Pathog, 2017, 9: 23.
[14] 李晓. 蒙脱石散治疗口腔溃疡的临床疗效观察[J]. 中国处方药, 2018, 16(2): 79-80.
[15] Forster VJ, McDonnell A, Theobald R, McKay JA. Effect of methotrexate/vitamin B12on DNA methylation as a potential factor in leukemia treatment-related neurotoxicity[J].Epigenomics, 2017, 9(9):1205-1218.