著者

浅香 卓哉 坂田 健一郎 竹川 英輝 羽藤 裕之 鎌口 真由美 大賀 則孝 佐藤 淳 山崎 裕 北川 善政

出版者

社団法人 日本口腔外科学会

雑誌

日本口腔外科学会雑誌 (ISSN:00215163)

巻号頁・発行日

vol.65, no.8, pp.500-506, 2019-08-20 (Released:2019-10-21)

参考文献数

28

---

Glossodynia is defined as a burning sensation on the tongue without any systemic or local cause. Although its pathophysiology remains unclear, it has been associated with neuropathic, nociceptive, and psychogenic pains. In Japan, difficulties are encountered in the treatment of glossodynia as prescribed medications are not covered by health insurance. Recently, a traditional Chinese medicine treatment (kampo), rikko-san (TJ-110), has been suggested to be useful for glossodynia. The objective of this retrospective study was to evaluate the efficacy of rikko-san gargling in patients with glossodynia. In total, 221 patients with glossodynia who were treated by rikko-san gargling between 2012 and 2018 were examined. Of these, 90 patients (seven men, 83 women; mean age, 67 years) who were treated by gargling with rikko-san dissolved in water for >1 month and no other medications were included. Tongue pain was assessed using a visual analog scale (VAS). Improvement was defined as at least a 50% reduction in the VAS score after treatment compared with that before treatment. The associations between the efficacy of rikko-san gargling and factors such as age, disease duration, pain area, and psychiatric disorders were evaluated. Improvement was noted in 60% of the patients (54/90) ; the mean administration period to the end of treatment in the improvement group was approximately 5 months. There was no significant correlation between the aforementioned factors and the efficacy of rikko-san gargling. Treatment in 41 patients was completed with rikko-san gargling alone, whereas 40 patients required additional treatment such as another kampo medicine or ethyl loflazepate. No side effect was observed in any patient, although stomatitis was noted in one excluded case. The mechanism underlying rikko-san’s delivery pathway is distinct from that of selective serotonin reuptake inhibitors, benzodiazepines, and nonsteroidal anti-inflammatory drugs. We speculated that saishin (Asiasarum root), one of the major components of rikko-san, may reduce peripheral stimulation to the tongue surface through its anesthetic effect. In addition, the transmucosal actions of other components in rikko-san may influence various receptor-related neuropathic pains. In conclusion, rikko-san gargling is efficacious and safe for the treatment of glossodynia.

著者

森本 真弘 浅香 卓哉 鎌口 真由美 山下 映美 坂田 健一郎 大内 学 大賀 則孝 佐藤 淳 佐藤 千晴 北川 善政

出版者

公益社団法人 日本口腔外科学会

雑誌

日本口腔外科学会雑誌 (ISSN:00215163)

巻号頁・発行日

vol.65, no.7, pp.447-454, 2019-07-20 (Released:2019-09-20)

参考文献数

22

被引用文献数

2

---

Palmoplantar pustulosis (PPP) is a refractory skin disorder exhibiting numerous sterile pustules on the palms and soles of the patients. PPP is related to dental focal infection and metal allergy, and the experts in dermatology and dentistry have worked together to arrive at a consensus regarding the diagnosis and treatment of PPP. However, the obvious cause of PPP remains unknown, and a standard treatment has yet to be established. In this study, we aimed to clarify the relation of PPP to dental focal infection and dental metal allergy. We evaluated 29 patients with PPP who underwent oral examination and patch testing in the Department of Oral Medicine at Hokkaido University Hospital from July 2010 through May 2014. In total, 22 of the 29 patients had positive patch test results, and flare-up was observed in one patient. Metallic component analysis revealed that the oral cavity was metal-positive in 14 of 22 patch test-positive patients. In contrast, odontogenic foci were found in 25 of 29 patients. Among 14 patients who had positive patch-test results for metal in the oral cavity, the course after metal removal could be confirmed in nine patients, and skin symptoms improved in all patients. Among 15 patients who did not have patch-test results for metal in the oral cavity, the course after treatment of odontogenic foci could be confirmed in eight patients, and symptoms improved in only one patient. This study resulted in a higher rate of improvement after removal of dental metals versus treatment of odontogenic foci, suggesting that PPP strongly correlates with dental metal allergy. However, because odontogenic foci may be treated concurrently with metal removal, an association between PPP and dental focal infection cannot be denied. In addition to the time and cost burden of metal removal, symptoms may improve naturally in some cases. Therefore, we suggest that it is necessary to consider the suitability of metal removal on a case-by-case basis.