舌痛などの舌症状を主訴とする患者の臨床統計学的検討<br>-舌痛症の特異性について-  [in Japanese] Clinical Statistics of Patients with Lingual Abnormalities Including Glossalgia -Clinical Characteristics of Glossodynia-  [in Japanese]

Access this Article

Author(s)

    • 桃田 幸弘 Momota Yukihiro
    • 徳島大学大学院ヘルスバイオサイエンス研究部口腔内科学分野 Department of Oral Medicine, Institute of Health Biosciences, the University of Tokushima Graduate Faculty of Dentistry
    • 高野 栄之 Takano Hideyuki
    • 徳島大学大学院ヘルスバイオサイエンス研究部口腔内科学分野 Department of Oral Medicine, Institute of Health Biosciences, the University of Tokushima Graduate Faculty of Dentistry
    • 可児 耕一 Kani Koichi
    • 徳島大学大学院ヘルスバイオサイエンス研究部口腔内科学分野 Department of Oral Medicine, Institute of Health Biosciences, the University of Tokushima Graduate Faculty of Dentistry
    • 松本 文博 Matsumoto Fumihiro
    • 徳島大学大学院ヘルスバイオサイエンス研究部口腔内科学分野 Department of Oral Medicine, Institute of Health Biosciences, the University of Tokushima Graduate Faculty of Dentistry
    • 茂木 勝美 Motegi Katsumi
    • 徳島大学大学院ヘルスバイオサイエンス研究部口腔内科学分野 Department of Oral Medicine, Institute of Health Biosciences, the University of Tokushima Graduate Faculty of Dentistry
    • 青田 桂子 Aota Keiko
    • 徳島大学大学院ヘルスバイオサイエンス研究部口腔内科学分野 Department of Oral Medicine, Institute of Health Biosciences, the University of Tokushima Graduate Faculty of Dentistry
    • 山村 佳子 Yamamura Yoshiko
    • 徳島大学大学院ヘルスバイオサイエンス研究部口腔内科学分野 Department of Oral Medicine, Institute of Health Biosciences, the University of Tokushima Graduate Faculty of Dentistry
    • 大守 真由子 Omori Mayuko
    • 徳島大学大学院ヘルスバイオサイエンス研究部口腔内科学分野 Department of Oral Medicine, Institute of Health Biosciences, the University of Tokushima Graduate Faculty of Dentistry
    • 東 雅之 Azuma Masayuki
    • 徳島大学大学院ヘルスバイオサイエンス研究部口腔内科学分野 Department of Oral Medicine, Institute of Health Biosciences, the University of Tokushima Graduate Faculty of Dentistry

Abstract

目的:舌痛の器質的要因をスクリーニングする系統的診断システムを提案し,本法によって診断された舌痛関連疾患を検討する.<br>方法:2007年1月から2009年12月までに舌痛などの舌症状を主訴としてで徳島大学病院歯科口腔外科を受診した患者104名(男性12名,女性92名,平均68歳2か月)を臨床統計学的に検討した.病歴聴取,口腔内・外診査,パノラマエックス線検査,血液検査,培養検査および唾液分泌検査を行った.局所麻酔薬と非ステロイド性抗炎症薬の効果も確認した.<br>結果:原因疾患は口腔カンジダ症,口腔乾燥症,舌炎,舌痛症などであった.器質的変化や自覚症状の乏しい口腔カンジダ症や口腔乾燥症が認められた.舌痛症の多くは舌尖に発現し,食餌性刺激による誘発痛や圧痛が認められないものが多く,局所麻酔薬や非ステロイド系抗炎症薬の効果も乏しかった.舌痛症における味覚異常や低亜鉛血症の発現頻度は低く,手掌部発汗が高頻度に認められた.<br>結論:培養検査や唾液分泌検査が不可欠であり,器質的変化や自覚症状の乏しい口腔カンジダ症や口腔乾燥症は舌痛症と診断される可能性があった.舌尖部疼痛を有し,食餌性刺激による誘発痛や圧痛がないことが舌痛症特異的な所見と考えられ,その病態に舌粘膜障害の関与は否定的であった.味覚障害や低亜鉛血症は舌痛症特異的な所見ではなかった.手掌部発汗は舌痛症特異的な所見と考えられ,その病態に自律神経異常の関与が示唆された.

Purpose: There are many kinds of diseases that can cause glossalgia, and it is not always easy to determine the differential diagnosis. Therefore, establishment of screening procedures for organic factors of glossalgia is important to obtain the correct diagnosis. We statistically analyzed the findings in patients with various lingual abnormalities. <br>Methods: Patients were 104 persons consisted of 12 males and 92 females. Medical history taking, intraoral and extraoral examinarion, panoramic x-ray radiography, blood examination, culture, and salivation test were performed. It was also determined whether local analgesic or nonsteroidal anti-inflammatory drug relieved the pain or not. <br>Results: Glossalgia-related diseases consisted of oral candidiasis, xerostomia, glossitis, glossodynia and other diseases. The major part of oral candidiasis lacked a change in organic appearance. Concerning xerostomia, a sense of thirst was also lacking. Local analgesic or nonsteroidal anti-inflammatory drug showed a limited effect on glossodynia. The prevalence of taste disorder or hypozincemia in glossodynia was less than that in other diseases. On the other hand the prevalence of palm sweating in glossodynia was greater than that in other diseases. <br>Conclusions: Culture and salivation test were necessary for the diagnosis of either oral candidiasis without a change in organic appearance or xerostomia without a sense of thirst. If these examinations were not performed, these cases might be diagnosed as glossodynia. The presence of pain on tongue tip and the absence of food-induced pain or oppressive pain were specific findings of glossodynia. Lingual mucous damage could not be directly correlated with pathology of glossodynia judging from the nature of glossalgia and the result of analgesic effects. Taste disorder and hypozincemia were found to be nonspecific findings of glossodynia. It was suggested that glossodynia is related to dysautonomia, and palm sweating is a specific finding of glossodynia.

Journal

  • Japanese Journal of Orofacial Pain

    Japanese Journal of Orofacial Pain 5(1), 27-35, 2012

    Japanese Society of Orofacial Pain

Codes

  • NII Article ID (NAID)
    130004540647
  • Text Lang
    JPN
  • ISSN
    1883-308X
  • Data Source
    J-STAGE 
Page Top