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行動療法により良好な経過をたどった高齢者味覚障害の１例
近藤, 美弥子;中澤, 誠多朗;岡田, 和隆;松下, 貴惠;山崎, 裕
Permalink : http://hdl.handle.net/2115/71545
KEYWORDS : 高齢者;味覚障害;行動療法;亜鉛;口腔カンジダ症;elderly people;taste disorder;behavior therapy;zinc;oral candidiasis
Abstract
近年高齢者の味覚障害患者は急増しているが，原因が特発性で亜鉛の補充療法で奏功しない場合は，対応に苦慮する症例を少なからず経験する．今回，種々の薬物療法では効果が得られなかった味覚障害に対し，患者自ら自発的に行動療法を実践した結果，味覚の改善が得られた症例を経験したのでその概要を報告する．
症例は 75 歳女性．当科受診４か月前に，突然味覚異常を自覚し，その後舌痛も感じるようになった．そのため耳鼻咽喉科に３か月間通院したが，改善なく当科紹介受診した．当初，カンジダ性の味覚障害が疑われ抗真菌薬が投与されたが，舌痛の軽快のみで味覚の改善は認めなかった．次に，ロフラゼプ酸エチル，亜鉛の補充療法，２種類の漢方薬が長期投与されたが味覚に変化は認めなかった．その頃，テレビで視覚障害患者のドキュメンタリー番組を見て大いに感動し，味覚異常に執着しないで前向きに生活していくことを患者自らが実践するようになった．
この行動療法により初診から２年目頃には，食事が美味しいと思えるほどに味覚の回復が得られ，その状態を維持している．
In recent years the number of elderly people with taste disorders has been increasing. If the disorder is idiopathic and not alleviated by zinc replacement therapy, it is difficult to resolve. Here, we report on an elderly patient with a taste disorder, that was unresolved after several drug therapies. After behavioral therapy her taste sensation improved. A 75-year-old woman was referred to our department 4-months after the sudden onset of a taste disorder and tongue pain. She had been treated at an otorhinolaryngology clinic as an outpatient for 3 months but without improvement. She was then referred to our department. Initially, oral candidiasis was suspected and antifungal drugs were administered which reduced her tongue pain but did not improve her sense of taste. Next, administration of ethyl loflazepate, zinc replacement therapy, and two kinds of traditional Japanese herbal medicines were attempted, but no change in her taste disorder was observed. After watching an emotional documentary about a visually impaired patient, she started to practice living positively without obsessing over her taste abnormality. By continuing this type of behavioral therapy, 2 years after presenting to our department, her taste disorder completely resolved.
In recent years the number of elderly people with taste disorders has been increasing. If the disorder is idiopathic and not alleviated by zinc replacement therapy, it is difficult to resolve. Here, we report on an elderly patient with a taste disorder, that was unresolved after several drug therapies. After behavioral therapy her taste sensation improved. A 75-year-old woman was referred to our department 4-months after the sudden onset of a taste disorder and tongue pain. She had been treated at an otorhinolaryngology clinic as an outpatient for 3 months but without improvement. She was then referred to our department. Initially, oral candidiasis was suspected and antifungal drugs were administered which reduced her tongue pain but did not improve her sense of taste. Next, administration of ethyl loflazepate, zinc replacement therapy, and two kinds of traditional Japanese herbal medicines were attempted, but no change in her taste disorder was observed. After watching an emotional documentary about a visually impaired patient, she started to practice living positively without obsessing over her taste abnormality. By continuing this type of behavioral therapy, 2 years after presenting to our department, her taste disorder completely resolved.
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