口腔不定疼痛症の特性に関する研究 (1)

抄録

To clarify the characteristics of atypical pain diseases of the oral cavity, a study was conducted on 229 cases diagnosed as glossodynia in OPD at the Oralsurgical Department of the Tokyo Medical College during the period from October, 1978 to February, 1984. This study was carried out by symptom analyses using pain cards, various psychological tests, autonomic nervous function examinations, pain sense threshold and tolerance examinations with electric stimulation apparatus, pain sense abnormality examinations by laughing gas absorption, psychosomatic medical evaluations and prognoses of pain during treatment, and prognosis analyses. The following results were obtained.
1) Physical and psychosomatic investigations showed climacteric and near old-age female patients (40-60 years of age) to be prone to these diseases, whose pain was characteristically mild, persistent, superficial, localized and spontaneous, and centered in the region of the tongue tip and its lingual border. The patients frequently felt anxiety over the pain. Of the patients examined, 50.5% showed signs of worry and anxiety, 32.8% were restless, 44.5% had tendencies toward depression, and 59% showed restless autonomic nervousness.
2) The pain sense threshold and tolerance examinations using electric stimulation apparatus, showed the restless autonomic nervous patients to have significantly lower pain thresholds and tolerance values than the psychologically stable patients.
3) The administration of laughing gas at the initial medical examination resulted in the temporary alleviation of pain in numerous cases but was without effect in others. Following this, treatment of disease in the former was frequently found effective but not so in the latter. Thus, the results of disease treatment can be predicted to some extent on the basis of the results from laughing gas administration.
4) In the psychosomatic medical evaluations, correlation between disease symptoms and treatment and values obtained for various psychosomatic examinations was noted to be in direct proportion to symptom severity. This indicates that our systematic treatment was effective in bringing about a cure for the pain.
5) In 77.4% of the patients, the prognosis was found to be good. In 24.4% of the female patients, a recurrence of pain was noted but in all such cases it was less than that formerly experienced. In 60% of the patients, improvements were noted in their daily lives as well as a reduction of pain.