Assessment of systemic effects of ginger on salivation in patients with post-radiotherapy xerostomia

Goli Chamani, Mohammad Reza Zarei, Mitra Mehrabani, Nozar Nakhaee, Bita Kalaghchi, Mahdi Aghili, Arezoo Alaee

Abstract


BACKGROUND AND AIM: Our aim was to assess the clinical efficacy of ginger capsule (Zintoma herbal capsule) in the relief of symptoms in patients with post-radiotherapy xerostomia.

METHODS: This study was a randomized double-blind, parallel clinical trial of ginger usage in patients with post-radiotherapy xerostomia. Sixty-one subjects were selected from patients with xerostomia of Imam Khomeini Cancer Institute, Tehran, Iran. Subject-based dry mouth scores derived from 100 mm visual analogue scales (VAS) were recorded at baseline. Patients also completed a questionnaire on the first visit regarding the symptoms of xerostomia. The patients received ginger capsule (30 persons) or placebo (31 persons) three times daily over a 2-weeks period. At the end of day 14, dry mouth scores derived from VAS were recorded again and patients responded to the additional variables regarding dry mouth symptoms and quality of life issues. P < 0.05 was considered significant. Data were analyzed using SPSS.

RESULTS: The mean treatment effect on day 14 was 33.7 ± 20.9 mm in the ginger group and 23.6 ± 17.3 mm in the placebo group. The analysis indicated marginally significant improvement of xerostomia with ginger prescription
(P = 0.057). At the end of intervention there was no significant difference between the two groups regarding improvement of quality of life or dry mouth symptoms.

CONCLUSION: It seems that ginger could be helpful in the treatment of xerostomia. Since ginger is considered a safe herbal medicine with only few and insignificant adverse/side effects further studies in larger group of patients are recommended to provide the effect of ginger on different complaints of xerostomia.


Keywords


Ginger; Radiation; Xerostomia

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References


Glick M. Burket's oral medicine. 12th ed. Shelton, CT: People's Medical Publishing House; 2014. p. 219-21.

Guggenheimer J, Moore PA. Xerostomia: etiology, recognition and treatment. J Am Dent Assoc 2003; 134(1): 61-9.

Koukourakis MI, Danielidis V. Preventing radiation induced xerostomia. Cancer Treat Rev 2005; 31(7): 546-54.

Eisbruch A, Kim HM, Terrell JE, Marsh LH, Dawson LA, Ship JA. Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer. Int J Radiat Oncol Biol Phys 2001; 50(3): 695-704.

Sciubba JJ, Goldenberg D. Oral complications of radiotherapy. Lancet Oncol 2006; 7(2): 175-83.

Brennan MT, Shariff G, Lockhart PB, Fox PC. Treatment of xerostomia: a systematic review of therapeutic trials. Dent Clin North Am 2002; 46(4): 847-56.

Dalodom S, Lam-Ubol A, Jeanmaneechotechai S, Takamfoo L, Intachai W, Duangchada K, et al. Influence of oral moisturizing jelly as a saliva substitute for the relief of xerostomia in elderly patients with hypertension and diabetes mellitus. Geriatr Nurs 2016; 37(2): 101-9.

Davies AN. A comparison of artificial saliva and chewing gum in the management of xerostomia in patients with advanced cancer. Palliat Med 2000; 14(3): 197-203.

Makinen KK, Isotupa KP, Kivilompolo T, Makinen PL, Murtomaa S, Petaja J, et al. The effect of polyol-combinant saliva stimulants on S. mutans levels in plaque and saliva of patients with mental retardation. Spec Care Dentist 2002; 22(5): 187-93.

Rhodus NL, Bereuter J. Clinical evaluation of a commercially available oral moisturizer in relieving signs and symptoms of xerostomia in postirradiation head and neck cancer patients and patients with Sjogren's syndrome. J Otolaryngol 2000; 29(1): 28-34.

McMillan AS, Tsang CS, Wong MC, Kam AY. Efficacy of a novel lubricating system in the management of radiotherapy-related xerostomia. Oral Oncol 2006; 42(8): 842-8.

Regelink G, Vissink A, Reintsema H, Nauta JM. Efficacy of a synthetic polymer saliva substitute in reducing oral complaints of patients suffering from irradiation-induced xerostomia. Quintessence Int 1998; 29(6): 383-8.

Chamani G, Zarei MR, Mehrabani M, Taghiabadi Y. Evaluation of effects of Zingiber officinale on salivation in rats. Acta Med Iran 2011; 49(6): 336-40.

Meng Z, Garcia MK, Hu C, Chiang J, Chambers M, Rosenthal DI, et al. Randomized controlled trial of acupuncture for prevention of radiation-induced xerostomia among patients with nasopharyngeal carcinoma. Cancer 2012; 118(13): 3337-44.

Kilian-Kita A, Puskulluoglu M, Konopka K, Krzemieniecki K. Acupuncture: could it become everyday practice in oncology? Contemp Oncol (Pozn) 2016; 20(2): 119-23.

Ship JA, Pillemer SR, Baum BJ. Xerostomia and the geriatric patient. J Am Geriatr Soc 2002; 50(3): 535-43.

Ghayur MN, Khan AH, Gilani AH. Ginger facilitates cholinergic activity possibly due to blockade of muscarinic autoreceptors in rat stomach fundus. Pak J Pharm Sci 2007; 20(3): 231-5.

Giriraju A, Yunus GY. Assessment of antimicrobial potential of 10% ginger extract against Streptococcus mutans, Candida albicans, and Enterococcus faecalis: an in vitro study. Indian J Dent Res 2013; 24(4): 397-400.

White B. Ginger: an overview. Am Fam Physician 2007; 75(11): 1689-91.

Yemitan OK, Izegbu MC. Protective effects of Zingiber officinale (Zingiberaceae) against carbon tetrachloride and acetaminophen-induced hepatotoxicity in rats. Phytother Res 2006; 20(11): 997-1002.

Jagetia GC, Baliga MS, Venkatesh P, Ulloor JN. Influence of ginger rhizome (Zingiber officinale Rosc) on survival, glutathione and lipid peroxidation in mice after whole-body exposure to gamma radiation. Radiat Res 2003; 160(5): 584-92.

Jagetia G, Baliga M, Venkatesh P. Ginger (Zingiber officinale Rosc), a dietary supplement, protects mice against radiation-induced lethality: mechanism of action. Cancer Biother Radiopharm 2004; 19(4): 422-35.

Haksar A, Sharma A, Chawla R, Kumar R, Arora R, Singh S, et al. Zingiber officinale exhibits behavioral radioprotection against radiation-induced CTA in a gender-specific manner. Pharmacol Biochem Behav 2006; 84(2): 179-88.

Li Y, Tran VH, Duke CC, Roufogalis BD. Preventive and protective properties of Zingiber officinale (ginger) in Diabetes mellitus, diabetic complications, and associated lipid and other metabolic disorders: A brief review. Evid Based Complement Alternat Med 2012; 2012: 516870.

Shahdad SA, Taylor C, Barclay SC, Steen IN, Preshaw PM. A double-blind, crossover study of Biotene Oralbalance and BioXtra systems as salivary substitutes in patients with post-radiotherapy xerostomia. Eur J Cancer Care (Engl) 2005; 14(4): 319-26.

Fox PC, Busch KA, Baum BJ. Subjective reports of xerostomia and objective measures of salivary gland performance. J Am Dent Assoc 1987; 115(4): 581-4.

Ghayur MN, Gilani AH. Ginger lowers blood pressure through blockade of voltage-dependent calcium channels. J Cardiovasc Pharmacol 2005; 45(1): 74-80.

Brizel DM, Wasserman TH, Henke M, Strnad V, Rudat V, Monnier A, et al. Phase III randomized trial of amifostine as a radioprotector in head and neck cancer. J Clin Oncol 2000; 18(19): 3339-45.

Wong HM. Oral complications and management strategies for patients undergoing cancer therapy. Scientific World Journal 2014; 2014: 581795.

Kaluzny J, Wierzbicka M, Nogala H, Milecki P, Kopec T. Radiotherapy induced xerostomia: mechanisms, diagnostics, prevention and treatment--evidence based up to 2013. Otolaryngol Pol 2014; 68(1): 1-14.


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