Permalink : http://hdl.handle.net/2115/65509

KEYWORDS : burning mouth syndrome;traditional Japanese medicine;gargling with Rikkosan;dysgeusia;舌痛症;漢方;立効散含嗽;味覚障害

味覚障害を伴った舌痛症に対し，立効散含嗽単独で良好な結果を得た症例を経験したので報告する． 　患者は75歳，女性．主訴は舌前方部のピリピリであった．初診６か月前から口内の苦味を食事時以外に感じるようになり，舌前方のピリピリも自覚したため，その５か月後に当科を受診した．診察と各種検査結果から異常所見を認めず，味覚障害を伴う舌痛症と診断した．立効散含嗽療法を試みたところ，舌痛と味覚異常は徐々に軽快し，初診日から10か月後には両症状ともに完全に消失したため使用を中止した． 　舌痛症の痛みは表在性で夜間帯に強くなるのが特徴である．立効散含嗽は細辛による表面麻酔効果による舌表面の疼痛軽減と即効性があるため，舌痛症に対し疼痛時に試みてみる価値のある治療法と思われる．
In this paper we will report a case of burning mouth syndrome (BMS) concomitant with　dysgeusia improved by gargling with Rikkosan. 　A 75-year-old woman was referred to our department with a 5-month history of a burning sensation in the anterior part of her tongue and a 6-month history of a continual phantom sensation of a bitter taste with no food in her mouth. As no organic abnormality was identified in her mouth or revealed by laboratory tests, she was diagnosed with BMS concomitant with dysgeusia. We treated her with traditional Japanese medicine, gargling with Rikkosan. Her burning sensation and taste disorder gradually subsided, and finally disappeared 10 months after her first visit. Rikkosan gargling was subsequently discontinued. 　The feature of her BMS sensation was superficial but enhanced at nighttime. Because the surface anesthetic action of saishin reduced peripheral stimulation of the tongue surface, inducing an immediate analgesic effect, Rikkosan gargling seems to be a treatment worth trying for BMS.