当科における味覚障害321例の臨床的検討 [in Japanese] Treatment Outcome in Patients with Taste Disturbance [in Japanese]
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近年,quality of life(QOL)の要求が高まるにつれ,味覚障害は様々な場で取り上げられるようになった.しかし,味覚障害の各原因において治療転帰を報告したものはほとんどなく,どれ位の期間治療を要するのか疑問である.今回,我々は味覚障害を原因別に追跡して自覚症状や味覚検査の改善率および平均改善期間を検討した.<br>味覚外来を受診し,転帰が確定し得た321例(男性131例,女性190例,平均年齢59.9歳)を対象とした.治療は主に亜鉛製剤,抗うつ剤,鉄剤,漢方薬等を使用した.全例,初診時に問診,電気味覚検査,濾紙ディスク検査を施行し,治療終了まで経過を追った.原因分類では特発性が125例(38.9%),薬剤性が62例(19.3%),感冒後が38例(11.8%),心因性が21例(6.5%),鉄欠乏性が18例(5.6%)であった.<br>自覚症状において特発性では79/103例(76.7%),感冒後では24/33例(72.7%),鉄欠乏性では14/17例(82.4%)に改善がみられたのに対し,薬剤性では32/50例(62.4%),心因性では5/15例(33.3%)と改善しにくい傾向にあった.また平均改善期間も前者3疾患では平均が4ヵ月から6ヵ月であったのに対して,薬剤性では平均1年と長くかかる傾向にあった.また症状出現から受診まで6ヵ月以上経過している症例では改善率が悪く,回復までの期間が有意に長かった.
The importance of taste has been recently evaluated from the standpoint of quality of life, but few reports exist on the clinical status of taste disturbance.<br>We classified taste disturbance by cause and studied the effect of treatment and recovery duration.<br>Subjects were 321 patients with taste disturbance, i. e., 131 men and 190 women (mean age: 59.9 years). Electrogustometry (EGM) and filter paper disks (FPD) were used to assess taste function in all subjects. We also asked them all about the degree of symptoms using visual analog scale (VAS). Statistical analysis was done using the unpaired t-test, with p<0.05 considered significant. Patients were treated with zinc sulfate, ferrotherapy, herbal medicine, and minor tranquilizers.<br>Causes of taste disturbance were classified into idiopathic, post-common-cold, drug-induced, psychogenic, constitutional, and iron deficiency. Idiopathic taste disturbance was the commonest cause (125 cases, 38.9%), followed by druginduced (62 cases, 19.3%), and post-common-cold (38 cases, 11.8%). Drug-induced and psychogenic taste disturbance have increased.<br>Recovery from symptoms was 79/103 (76.7%) in idiopathic taste disturbance, 24/33 (72.7%) in post-common-cold, and 14/17 (82.4%) in iron deficiency. Recovery took 22.2 weeks. Recovery was 32/50 cases (62.4%) in drug-induced, taking 48 weeks. For all causes, EGM and FPD results were not associated with the degree of symptoms. Both tests tended to show delayed improvement compared to symptoms.<br>Cases taking more than 6 months from symptom onset to medical examination showed significantly lower improvement and longer recovery time than those taking 6 months on less (p=0.04).
- Nippon Jibiinkoka Gakkai Kaiho
Nippon Jibiinkoka Gakkai Kaiho 109(5), 440-446, 2006-05-20
The Oto-Rhino-Laryngological Society of Japan, Inc.