title: Evaluating the effect of Matricaria recutita and Mentha piperita herbal mouthwash on management of oral mucositis in patients undergoing hematopoietic stem cell transplantation: A randomized, double blind, placebo controlled clinical trial.
abstract: OBJECTIVE
  To investigate the effects of Matricaria recutita and Mentha piperita on oral mucositis (OM) in patients undergoing hematopoietic stem cell transplantation (HSCT).
  
  
  METHODS
  Randomized double blind placebo controlled clinical trial.
  
  
  METHODS
  Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, and Bone Marrow Transplantation Center at Taleghani Teaching Hospital, Tehran, Iran.
  
  
  METHODS
  Sixty patients undergoing HSCT were randomly assigned to two groups: placebo (n=33), and herbal mouthwash group (n=27).
  
  
  METHODS
  All patients received the mouthwash one week before HSCT and were instructed to use it three times daily for at least 30s.
  
  
  METHODS
  OM was graded using National Cancer Institute Common Toxicity Criteria (NCI-CTC) scale (grade 0-5). The Numerical Rating Scale (NRS: 0-10 scale) measured the severity of OM symptoms.
  
  
  RESULTS
  The duration, maximum and average daily grade of OM were significantly reduced in the treatment group (P<0.05). The use of herbal mouthwash led to significant improvements in pain intensity (P=0.009), dryness (P=0.04) and dysphagia (P=0.009). Other significant results included: reduced need for complementary medications (P=0.03), narcotic analgesics (P=0.047), total parenteral nutrition (TPN) (P=0.02) and the duration of TPN (P=0.03).
  
  
  CONCLUSIONS
  This study shows that patients receiving the herbal mouthwash experienced less complications and symptoms associated with OM. In summary, it seems that the use of our prepared herbal mouthwash is beneficial for patients undergoing HSCT.
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Pharmaceutical sciences research center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Maria
authors.initials: M
authors.lastname: Tavakoli Ardakani
authors.affiliation: Student Research Committee, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Ghassemi
authors.affiliation: Taleghani Bone Marrow Transplantation Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: mehdizadeh@sbmu.ac.ir.
authors.forename: Mahshid
authors.initials: M
authors.lastname: Mehdizadeh
authors.affiliation: Department of Pharmacognosy, School of Pharmacy and, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Pharmaceutical sciences research center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Faraz
authors.initials: F
authors.lastname: Mojab
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Jamshid
authors.initials: J
authors.lastname: Salamzadeh
authors.affiliation: Student Research Committee, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Samaneh
authors.initials: S
authors.lastname: Ghassemi
authors.affiliation: Taleghani Bone Marrow Transplantation Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Hajifathali
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D031168:Matricaria / Q000737:chemistry*; D036142:Mentha piperita / Q000737:chemistry*; D009067:Mouthwashes / Q000627:therapeutic use*; D013280:Stomatitis / Q000188:drug therapy*
chemical_list: D004365:Drugs, Chinese Herbal; D009067:Mouthwashes
keywords: Hematopoietic stem cell transplantation; Herbal preparation; Matricaria recutita; Mentha piperita; Mouthwash; Oral mucositis