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第39巻 第2号 >

味覚障害患者における臨床的特徴と治療成績に関する検討

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Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/73661

Title: 味覚障害患者における臨床的特徴と治療成績に関する検討
Other Titles: The study of the characteristics and treatment outcome in patientswith dysgeusia
Authors: 山下, 映美1 Browse this author
佐藤, 淳2 Browse this author →KAKEN DB
浅香, 卓哉3 Browse this author
坂田, 健一郎4 Browse this author
北川, 善政5 Browse this author →KAKEN DB
Authors(alt): Yamashita, Emi1
Sato, Jun2
Asaka, Takuya3
Sakata, Ken-ichiro4
Kitagawa, Yoshimasa5
Keywords: 味覚障害
自発性異常味覚
ロフラゼプ酸エチル
亜鉛
dysgeusia
phantogeusia
ethyl loflazepate
zinc
Issue Date: Mar-2019
Publisher: 北海道歯学会
Journal Title: 北海道歯学雑誌
Volume: 39
Issue: 2
Start Page: 122
End Page: 130
Abstract: 【緒言】高齢者が健康に生活してQOLを保つために豊かな食生活は不可欠であるが,味覚異常を訴える高齢者は増加傾向にあり,それにより食べる楽しみが失われ,健康状態にまで影響を及ぼす可能性がある.著者らが所属する北海道大学病院歯科診療センター口腔内科に味覚異常を主訴に来院する患者も増加している.今回,当科を受診した味覚障害患者の背景因子,原因,診断と治療効果を明らかにする目的で検討した. 【対象と方法】2010年7月から2017年3月に味覚異常を主訴に当科を受診した271例を自覚症状,背景因子,原因,検査所見,治療法,治療効果について後方視的に検討した. 【結果と考察】対象271名の性別は男性71例,女性200例で,年齢は19歳から94歳(平均65.5歳)であった.主な自覚症状は味覚減退116例(43 %),自発性異常味覚91例(34 %)であった.主な原因は心因性97例(36 %),口腔疾患58例(21 %),特発性54例(20 %)であった.自発性異常味覚では41例(45 %)の原因が心因性で,他と比較して心因性の割合が有意に高かった(P < 0.05 ; χ2 = 4.5).治療法は236例(87 %)に薬物療法が行われ,236例中181例(77 %)で改善を認めた.主な使用薬剤はロフラゼプ酸エチル(110例,41 %),漢方(106例,39 %)であった.改善率はロフラゼプ酸エチル77 %,漢方56 %であった.病悩期間に関しては6か月未満の症例の改善率は80 %である一方で,6か月以上の症例は71 %であり,有意差は認めなかった(P = 0.09,χ2 = 2.2). 【結論】当科を受診した味覚障害患者の原因は心因性,口腔疾患,特発性が全体の77 %を占めていた.治療は多くの症例で薬物療法が行われ,ロフラゼプ酸エチルの改善率が高かった.治療法の選択については慎重な原因鑑別が重要であると考えられた.
【Introduction】Although rich and varied diet is necessary for the elderly person to maintain the healthy life and QOL, the number of elderly person with dysgeusia is increasing. This condition loses fun to eat from the elderly person and may affect the health conditions of them. The number of the patients with dysgeusia who visit our department, Hokkaido University Hospital Oral Medicine, has a tendency to increase who complain dysgeusia. We performed a clinical study to elucidate the background factors, causes, diagnosis, and treatment outcome in patients with dysgeusia who have visited our department. 【Materials and Methods】We included 271 cases in the present study, who have visited to our department from July 2010 to May 2017. We evaluated the symptoms, background factors, causes, examinations and laboratory findings, and treatment outcome of the cases, retrospectively. 【Results and Discussions】The gender of the 271 cases was male: 71 cases and female : 71 cases, respectively. The age of the cases ranged from 19 to 94 years (mean ; 65.5 years). Main two subjective symptoms of the cases were hypogeusia; 116 cases (43 %) and phantogeusia ; 91 cases (34 %). Main causes of the disease were psychogenic ; 97 cases (34 %), oral diseases; 58 cases (21 %), and idiopathic; 54 cases (20 %). The cause of the phantogeusia was psychogenic in the 41/91 cases (45 %). The ratio of the psychogenic cause was significant higher in the patient with phantogeusia than that of other types of dysgeusia (P < 0.05 ; χ2 = 4.5). As for the treatment, 236 cases (87 %) have received some kinds of pharmacological therapy, and 181 of the 236 cases (77 %) revealed improvement of the symptoms. The main two drugs of the treatment were ethyl loflazepate ; 110 cases (41 %) and Kampo ; 106 cases (39 %). The response rate was 77 % in ethyl loflazepate and 56 % in Kampo, respectively. As for duration of the symptoms, there was no significant difference in the response rate of the treatment between the patients with less than six months and more than six months( P = 0.09, χ2 =2.2). 【Conclusions】In the present study, 77 % of the causes of dysgeusia included psychogenic, oral diseases, and idiopathic. Many cases received pharmacological therapy, and treatment with ethyl loflazepate revealed high response rate. We have noticed that we need to distinguish the causes of dysgeusia carefully to select the treatment options.
Type: article
URI: http://hdl.handle.net/2115/73661
Appears in Collections:北海道歯学雑誌 = Hokkaido Journal of Dental Science > 第39巻 第2号

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