“Coffee plus Honey” versus “topical steroid” in the treatment of Chemotherapy-induced Oral Mucositis: a randomised controlled trial

BMC Complementary and Alternative Medicine

Hamidreza Jalalian¹  Seyyed Mostafa Ahmadi⁶  Fereshteh Raeessi⁵  Ali Akbar Karimi Zarchi³  Alireza Saadat¹  Seyyed Masoud Davoudi⁸  Homa Gharaie⁷  Yunes Panahi²  Neda Raeessi²  Mohammad Ali Raeessi⁴ 

[1]Department of Hematology and Oncology, Baqiyatallah University of Medical Sciences, Tehran, Iran

[2]Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

[3]Department of Epidemiology and Biostatics, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran

[4]Department of Otolaryngology, Baqiyatallah University of Medical Sciences, Tehran, Iran

[5]Research Branch, Islamic Azad University of Pharmaceutical Science, Tehran, Iran

[6]Research Center of Baqiyatallah University of Medical Sciences, Tehran, Iran

[7]Natural Medicines Office in Deputy of Food and Drug, Ministry of Health and Medical Educations, Tehran, Iran

[8]Department of Dermatology, Baqiyatallah University of Medical Sciences, Tehran, Iran

关键词: Topical steroid;    Coffee;    Honey;    Cancer chemotherapy;    Oral mucositis;   

Others  :  1087009
DOI  :  10.1186/1472-6882-14-293

 received in 2014-04-02, accepted in 2014-07-17,  发布年份 2014

【 摘 要 】

Background

Oral mucositis is one of the common complications of cancer chemotherapy and about 40% of the patients who take chemotherapy protocols, experience this irritating problem. The purpose of this study was to draw comparison between the therapeutic effects of our treatment modalities (topical steroid, honey, honey plus coffee) in patients suffering from oral mucositis.

Methods

This was a double blinded randomised clinical trial of a total of 75 eligible adult participants which they randomly fell into three treatment groups. For all the participants a syrup-like solution was prepared. Each 600 grams of the product consisted of “20 eight-mg Betamethasone solution ampoules” in the Steroid (S) group, “300 grams of honey plus 20 grams of instant coffee” in the Honey plus Coffee (HC) group, and “300 grams of honey” for the Honey (H) group. The participants were told to sip 10 ml of the prescribed product, and then swallow it every three hours for one week. Severity of lesions was clinically evaluated before the treatment and also one week after the initiation of the intervention. This study adhered to the principles of the Declaration of Helsinki and guidelines of Good Clinical Practice.

Results

This study showed that all three treatment regimens reduce the severity of lesions. The best reduction in severity was achieved in HC group. H group and S group took the second and third places. In other words, honey plus coffee regimen was the most effective modality for the treatment of oral mucositis.

Conclusion

Oral mucositis can be successfully treated by a combination of honey and coffee as an alternative medicine in a short time. Further investigations are warranted in this field.

Trial registration

Iranian Registry of Clinical Trials IRCT: 201104074737N3, (9 May 2011).

【 授权许可】

   
2014 Raeessi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D: Global cancer statistics. CA Cancer J Clin 2011, 61(2):69-90.
• [2]Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM: Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010, 127(12):2893-2917.
• [3]Karimi Zarchi AA, Gahangiri M: Pre hypertension and hypertension in Iranian military personnel: prevalence according to some related factors. World Appl Sci J 2010, 11(5):541-547.
• [4]Doll R, Peto R: The Causes of Cancer: Quantitative Estimates of Avoidable Risks of Cancer in the United States Today. J Natl Cancer Inst 1981, 66(6):1192-1308.
• [5]Lind M: Principles of cytotoxic chemotherapy. Medicine 2011, 39(12):711-716.
• [6]Lalla RV, Brennan M, Schubert M: Oral complications of cancer therapy. In Pharmacology and Therapeutics for Dentistry. 6th edition. Edited by Yagiela JA, Dowd FJ, Johnson BS. St. Louis: Mosby Elsevier; 2011:782-798.
• [7]Hawley P, Hovan A, McGahan C, Saunders D: A randomized placebo-controlled trial of manuka honey for radiation-induced oral mucositis. Support Care Cancer 2014, 22(3):751-761.
• [8]Worthington HV, Clarkson JE, Bryan G, Furness S, Glenny A-M, Littlewood A, McCabe MG, Meyer S, Khalid T: Interventions for preventing oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev 2011, 4:5-6.
• [9]Yarom N, Ariyawardana A, Hovan A, Barasch A, Jarvis V, Jensen SB, Zadik Y, Elad S, Bowen J, Lalla RV: Systematic review of natural agents for the management of oral mucositis in cancer patients. Support Care Cancer 2013, 21(11):3209-3221.
• [10]Keefe DM, Schubert MM, Elting LS, Sonis ST, Epstein JB, Raber‒Durlacher JE, Migliorati CA, McGuire DB, Hutchins RD, Peterson DE: Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer 2007, 109(5):820-831.
• [11]Bensinger W, Schubert M, Ang K, Brizel D, Brown E, Eilers J, Elting L, Mittal B, Schattner M, Spielberger R: NCCN Task Force Report. prevention and management of mucositis in cancer care. J Natl Compr Canc Netw 2008, 6:S1.
• [12]Clarkson JE, Worthington HV, Furness S, McCabe M, Khalid T, Meyer S: Interventions for treating oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev 2010, 8:12-14.
• [13]Peterson D, Bensadoun R-J, Roila F: Management of oral and gastrointestinal mucositis: ESMO Clinical Practice Guidelines. Ann Oncol 2011, 22(suppl 6):vi78-vi84.
• [14]Drugs & Medications - betamethasone oral http://www.webmd.com/drugs/drug-8457-betamethasone+oral.aspx webcite
• [15]Jull AB, Walker N, Deshpande S: Honey as a topical treatment for wounds. Cochrane Database Syst Rev 2013, 2:2.
• [16]Shadkam MN, Mozaffari-Khosravi H, Mozayan MR: A comparison of the effect of honey, dextromethorphan, and diphenhydramine on nightly cough and sleep quality in children and their parents. J Altern Complement Med 2010, 16(7):787-793.
• [17]Paul IM, Beiler J, McMonagle A, Shaffer ML, Duda L, Berlin CM Jr: Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Arch Pediatr Adolesc Med 2007, 161(12):1140.
• [18]Pfeiffer WF: A multicultural approach to the patient who has a common cold. Pediatr Rev 2005, 26(5):170-175.
• [19]Haq F, Ahmad H, Alam M: Traditional uses of medicinal plants of Nandiar Khuwarr catchment (District Battagram) Pakistan. J Med Plant Res 2011, 5:39-48.
• [20]Al-Waili NS: Topical application of natural honey, beeswax and olive oil mixture for atopic dermatitis or psoriasis: partially controlled, single-blinded study. Complement Ther Med 2003, 11(4):226-234.
• [21]Tushar T, Vinod T, Rajan S, Shashindran C, Adithan C: Effect of honey on CYP3A4, CYP2D6 and CYP2C19 enzyme activity in healthy human volunteers. Basic Clin Pharmacol Toxicol 2007, 100(4):269-272.
• [22]Yao LK, Razak SLA, Ismail N, Fai NC, Asgar M, Sharif N, Aan G, Jubri Z: Malaysian gelam honey reduces oxidative damage and modulates antioxidant enzyme activities in young and middle aged rats. J Med Plant Res 2011, 5(23):5618-5625.
• [23]Khanal B, Baliga M, Uppal N: Effect of topical honey on limitation of radiation-induced oral mucositis: an intervention study. Int J Oral Maxillofac Surg 2010, 39(12):1181-1185.
• [24]Zaid SS, Sulaiman SA, Sirajudeen KN, Othman NH: The effects of Tualang honey on female reproductive organs, tibia bone and hormonal profile in ovariectomised rats-animal model for menopause. BMC Complement Altern Med 2010, 10(1):82. BioMed Central Full Text
• [25]Makpol S, Ahmad T, Jubri Z, Rejab N, Yusof N, Yusof YAM: Gelam honey acting as a radioprotectant agent in gamma-irradiated human diploid fibroblasts. J Med Plant Res 2012, 6:129-138.
• [26]Sezer M, Sahin O, Solak O, Fidan F, Kara Z, Unlu M: Effects of Caffeic Acid Phenethyl Ester on the Histopathological Changes in the Lungs of Cigarette Smoke‒Exposed Rabbits. Basic Clin Pharmacol Toxicol 2007, 101(3):187-191.
• [27]Tan H, Rahman R, Gan S, Halim A, Hassan S, Sulaiman S, Kirnpal-Kaur B: The antibacterial properties of Malaysian tualang honey against wound and enteric microorganisms in comparison to manuka honey. BMC Complement Altern Med 2009, 9(1):34. BioMed Central Full Text
• [28]Basson NJ, Grobler SR: Antimicrobial activity of two South African honeys produced from indigenous Leucospermum cordifolium and Erica species on selected micro-organisms. BMC Complement Altern Med 2008, 8(1):41. BioMed Central Full Text
• [29]Al-Waili N: An alternative treatment for pityriasis versicolor, tinea cruris, tinea corporis and tinea faciei with topical application of honey, olive oil and beeswax mixture: an open pilot study. Complement Ther Med 2004, 12(1):45-47.
• [30]Bogdanov S, Jurendic T, Sieber R, Gallmann P: Honey for nutrition and health: a review. J Am Coll Nutr 2008, 27(6):677-689.
• [31]Al Ameen NM, Altubaigy F, Jahangir T, Mahday IA, Mohammed EA, Musa OA: Effect of Nigella sativa and bee honey on pulmonary, hepatic and renal function in Sudanese in Khartoum state. J Med Plant Res 2011, 5:6857-6863.
• [32]Nilforoushzadeh MA, Jaffary F, Moradi S, Derakhshan R, Haftbaradaran E: Effect of topical honey application along with intralesional injection of glucantime in the treatment of cutaneous leishmaniasis. BMC Complement Altern Med 2007, 7(1):13. BioMed Central Full Text
• [33]Khoo Y-T, Halim A, Singh K-K, Mohamad N-A: Wound contraction effects and antibacterial properties of Tualang honey on full-thickness burn wounds in rats in comparison to hydrofibre. BMC Complement Altern Med 2010, 10(1):48. BioMed Central Full Text
• [34]Molan PC: Potential of honey in the treatment of wounds and burns. Am J Clin Dermatol 2001, 2(1):13-19.
• [35]Sherlock O, Dolan A, Athman R, Power A, Gethin G, Cowman S, Humphreys H: Comparison of the antimicrobial activity of Ulmo honey from Chile and Manuka honey against methicillin-resistant Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa. BMC Complement Altern Med 2010, 10(1):47. BioMed Central Full Text
• [36]Nasir N-AM, Halim AS, Singh K-KB, Dorai AA, Haneef M-NM: Antibacterial properties of tualang honey and its effect in burn wound management: a comparative study. BMC Complement Altern Med 2010, 10(1):31. BioMed Central Full Text
• [37]Pipicelli G, Tatti P: Therapeutic properties of honey. Health 2009, 1(2):281-283.
• [38]English H, Pack A, Molan P: The effects of manuka honey on plaque and gingivitis: a pilot study. J Int Acad Periodontol 2004, 6(2):63-67.
• [39]Eccles R: Mechanisms of the placebo effect of sweet cough syrups. Respir Physiol Neurobiol 2006, 152(3):340-348.
• [40]Song JJ, Twumasi-Ankrah P, Salcido R: Systematic review and meta-analysis on the use of honey to protect from the effects of radiation-induced oral mucositis. Adv Skin Wound Care 2012, 25(1):23-28.
• [41]Rashad U, Al-Gezawy S, El-Gezawy E, Azzaz A: Honey as topical prophylaxis against radiochemotherapy-induced mucositis in head and neck cancer. J Laryngol Otol 2009, 123(02):223-228.
• [42]Motallebnejad M, Akram S, Moghadamnia A, Moulana Z, Omidi S: The effect of topical application of pure honey on radiation-induced mucositis: a randomized clinical trial. J Contemp Dent Pract 2008, 9(3):40-47.
• [43]Welsh EJ, Bara A, Barley E, Cates CJ: Caffeine for asthma. Cochrane Database Syst Rev 2010, 1:2-3.
• [44]Henderson-Smart DJ, Steer PA: Caffeine versus theophylline for apnea in preterm infants. Cochrane Database Syst Rev 2010, 1:4-5.
• [45]Pereira P, De Oliveira PA, Ardenghi P, Rotta L, Henriques JAP, Picada JN: Neuropharmacological analysis of caffeic acid in rats. Basic Clin Pharmacol Toxicol 2006, 99(5):374-378.
• [46]Davis JK, Green JM: Caffeine and anaerobic performance. Sports Med 2009, 39(10):813-832.
• [47]Furtado KS, Prado MG, Silva MA e, Dias MC, Rivelli DP, Rodrigues MA, Barbisan LF: Coffee and caffeine protect against liver injury induced by thioacetamide in male Wistar rats. Basic Clin Pharmacol Toxicol 2012, 111(5):339-347.
• [48]Lecoultre V, Carrel G, Egli L, Binnert C, Boss A, MacMillan EL, Kreis R, Boesch C, Darimont C, Tappy L: Coffee consumption attenuates short-term fructose-induced liver insulin resistance in healthy men. Am J Clin Nutr 2014, 99(2):069526.
• [49]Raeessi MA, Aslani J, Gharaie H, Karimi Zarchi AA, Raeessi N, Assari S: Honey with Coffee: a new finding in the treatment of Persistent Postinfectious Cough. Iran J Otorhinolaryngol 2011, 23(2):1-8.
• [50]Raeessi MA, Aslani J, Raeessi N, Gharaie H, Karimi Zarchi AA, Raeessi F: Honey plus coffee versus systemic steroid in the treatment of persistent post-infectious cough: a randomised controlled trial. Prim Care Respir J 2013, 22(3):325-330.
• [51]Raeessi MA, Aslani J, Raeessi N, Gharaie H, Karimi Zarchi AA, Raeessi F, Ahmadi SM: “Persistent post-infectious cough” is better treated by which one? Prednisolone, Honey, Coffee, or Honey plus coffee: a meta-analysis. Indian J Traditional Knowledge 2014, 13(3):453-460.
• [52]Hsiao G, Sonis S: Oral Mucositis, mucositis assessment scales. In Interactive Textbook on Clinical Symptom Research. Edited by Max MB, Lynn J. Bethesda: National Institutes of Health; 2003.
• [53]Ghashm AA, Othman NH, Khattak MN, Ismail NM, Saini R: Antiproliferative effect of Tualang honey on oral squamous cell carcinoma and osteosarcoma cell lines. BMC Complement Altern Med 2010, 10(1):49.
• [54]Abdulrhman M, Samir Elbarbary N, Ahmed Amin D, Saeid Ebrahim R: Honey and a mixture of honey, beeswax, and olive oil-propolis extract in treatment of chemotherapy-induced oral mucositis: a randomized controlled pilot study. Pediatr Hematol Oncol 2012, 29(3):285-292.
• [55]Moore OA, Smith LA, Campbell F, Seers K, McQuay HJ, Moore RA: Systematic review of the use of honey as a wound dressing. BMC Complement Altern Med 2001, 1(1):2. BioMed Central Full Text