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

dysgeusia

北海道歯学会

北海道歯学雑誌

【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.