The Study Of Gargle With Dark Plum To Relieve Xerostomia In Hemodialysis Patients

Part 1 Systematic ReviewObjectiveTo observe the efficacy and safety of Chinese medicine for xerostomia in hemodialysis patients.MethodsWe searched CMCI,CNKI,VIP,WANFANG,The Cochrane Library,PUBMED,OVID,CINAHL,EMBASE and Google Scholar for all relevant RCTS.Date of searching limited in April,2016.Risk of bias of the included studies was using the Cochrane criteria.Also Revman5.3 was used.ResultsSeven RCTs with 383 participants were included.All studies were Chinese literature,including four studies used Auricular,three for the treatment of Chinese medicine.Incidence of heart failure events were not reported.There were obviously decline in Chines Medicine Group on change of the thirsty degree of hemodialysis patients compared with the Control Group.Also Chines Medicine Group could significant raise Saliva flow rate and reduce IDWG.But there wasn' t any difference between two groups in reducing the serum sodium concentration.The Chinese medicine group reported acid regurgitation,stick tooth after taking Chinese medicine and anaphylactic reaction after Auricular application.ConclusionChinese medicine showed beneficial effects for xerostomia in hemodialysis patients.However,there is no strong evidence to support the using of Chinese medicine for xerostomia in hemodialysis patients,because the low quality of RCTs and small sample.More large and high quality RCTs are needed.Part 2 Clinical studyObjectiveTo explore the associated factors of salivary flow rate in hemodialysis patients with xerostomia.MethodsThe study selected 47 patients with Yin fluid deficiency in hemodialysis patients with xerostomia.Detected the saliva levels of potassium,sodium,phosphorus,phosphate,calcium,urea,creatinine,monocyte chemotactic protein 1(MCP-1),fibroblast growth factor-23(FGF23),total protein,salivary flow rate,salivary PH,SXI,DTI and VAS.ResultsSingle factor analysis of this research found that and salivary protein(r=0.413,P=0.413)and VAS(r=0.303,P=0.303)had significantly negative correlation with salivary flow rate,but age,dialysis age,salivary FGF-23,salivary MCP-1,salivary potassium,salivary sodium,salivary phosphorus,salivary calcium,SXI and DIT had no significant relationship with salivary flow rate.Multiple linear regression analysis demonstrated that salivary protein as the independent fator affected salivary flow rate in hemodialysis patients with xerostomia.ConclusionSalivary protein as the independent fator affected salivary flow rate in hemodialysis patients with xerostomia.More samples or continue to look for other relevant factors are needed.Part 3 Clinical studyObjectiveTo study gargle with dark plum to relieve xerostomia in hemodialysis patients through clinical randomized controlled study.MethodsThe study selected 68 patients with Yin fluid deficiency in hemodialysis patients with xerostomia.All patients were randomly divided into Chinese medicine group and control group.Two groups were treated with the routine western medicine as basic treatment.The Chinese medicine group was treated with dark plum gargle and the control group was treated by gargling with cold water.Two groups received 4 weeks treatment.Using SXI,DTI,VAS as quantitative indicators for xerostomia,using salivary flow rate,salivary PH,salivar biochemical indices as saliva indicators,IDWG,PIWG,average IDWG,average PIWG as intradialytic weight gain indicators,and blood pressure change,to evaluate the dark plum gargle if it can influence the xerostomia in hemodialysis patients.ResultsThere were obviously decline in Chines Medicine Group on change of the thirsty degree of hemodialysis patients in chewing,swallowing dry food and before dialysis compared with the Control Group(P<0.05).Also Chines Medicine Group could significant raise salivary flow rate(P<0.05).And a trend of decrease could observed in IDWG and PIWG.But there wasn' t any difference between two groups in salivary biochemical indices and blood pressure change.Both groups could observed incidence of heart failure events.ConclusionGargle with dark plum can relieve xerostomia in hemodialysis patients.But this study failed to prove dark plum gargle can reduce IDWG and PIWG.Further research is needed to extend the research cycle.