灼口综合征病因研究新进展

灼口综合征(burning mouth syndrome,BMS)以口腔黏膜疼痛、烧灼感或感觉异常为特征。其病因多样,尚缺乏统一观点。近年来,有关于灼口综合征的病因研究增多,许多学者对灼口综合征的病因提出了新的观点。该文诣在对灼口综合征的病因及其发病机制的最新研究进展进行综述,从而为灼口综合征的临床诊断及治疗手段的发展提供一定的帮助。     

灼口综合征患者心理学相关因素的临床分析

的　对 98例灼口综合征 (BMS)患者进行心理学相关因素研究 ,以了解BMS与心理障碍关系 ,为进一步心理行为治疗提供理论依据。方法　对 98例非病理性BMS患者进行心理学病因、心因性躯体症状观察 ,并对BMS患者组和相配对的正常组进行SAS、SDS和SCL90量表的分析。结果　 98例BMS患者中 ,有 95 %有各种心理学病因 ,所有患者存在各种心因性躯体症状 ,最常见的为睡眠障碍 ( 90 .8% ) ;有 96 %患者存在中重度的抑郁 ,75 %患者存在中重度的焦虑 ;SCL90量表主要以躯体化、强迫症状、抑郁、焦虑、精神病性为主。结论　BMS是一类以抑郁为主的心理障碍症状群 ;心理学病史、心因性躯体症状具有临床诊断的参考价值 ,心理量表分析则可进一步明确心理障碍的类型和程度 ,心理行为治疗可能是治疗精神性BMS的有效方法。     

神经病理性疼痛灼口综合征的诊断与治疗进展

灼口综合征（Burningmouthsyndrome，BMS）是一种以口腔黏膜烧灼样疼痛为特征的慢性疼痛，常不伴有器质性损害。BMS的病因和发病机制不明确，亦缺乏公认的诊断标准，因此对BMS的治疗仍是一个难题。神经病理性疼痛（Neuropathicpain，NP）被认为是疾病影响外周或中枢神经系统的躯体感觉传导途径的结果，发生在各种神经源性疾病当中，人群发病率达到6％-8％，对人的生活、情绪和睡眠质量有很大影响。目前一些研究认为BMS是一种NP，应用NP的诊断标准和治疗方法将可能成为解决BMS治疗难题的突破点之一。本文将从BMS是NP的证据、应用NP的诊断标准诊断BMS、应用NP的治疗方法治疗BMS三个方面进行综述。     

老年人灼口综合征临床报告

灼口综合征(Burning Mouth Syndrome,BMS)又称舌痛症,是指发生于舌部及其口腔黏膜部位以烧灼样疼痛为主要表现的一组症候群,临床病变体征不明显[1].其发病与多种因素有关,多发于更年期妇女,特别是更年期综合征患者.本文对1995年以来诊治的15例60岁以上老年人灼口综合症患者的病因及治疗方法进行分析报告.     

灼口综合征的心理因素分析及心理治疗

灼口综合征(burning mouth syndrome，BMS)是以舌部为主要发病部位，以烧灼样疼痛为主要表现、常不伴有粘膜病损及其他临床体征的一组综合征。又称舌痛症(glossdynia)、舌感觉异常、口腔粘膜感觉异常等。BMS的病因不明，多数学者倾向于多因素发病，并将之归纳为3个方面：局部因素、系统因素和心理因素。     

灼口综合征疼痛机制研究

灼口综合征(BMS)主要表现为口腔颌面部慢性疼痛,其病因尚不清楚,目前多数学者认为灼口综合征是一种神经源性疾病.本文主要就神经系统、味觉、细胞因子和唾液4个方面的改变在BMS患者疼痛中的作用作一综述.     

灼口综合征患者情绪障碍与血清白介素-2和白介素-6浓度的关系

目的　探讨灼口综合征(BMS)患者血清IL-2和IL-6浓度与情绪障碍间的相关性。方法　采用酶联免疫吸附测定法(ELISA)检测48例BMS患者血清IL-2、IL-6的浓度,并采用汉密顿抑郁量表评定患者的抑郁症状。结果　伴有或不伴有抑郁的BMS患者血清IL-2、IL-6浓度无显著差异,但汉密顿抑郁量表与疼痛程度呈正相关。结论　本研究支持BMS患者与情绪障碍有关,汉密顿抑郁量表可用作临床评定BMS患者的抑郁状态,并为临床治疗提供参考;BMS患者血清IL-2、IL-6的浓度与患者抑郁症状无相关性。     

灼口综合征的治疗方案

灼口综合征 (BurningMouthSyndrome ,BMS)是以舌部为主要发病部位 ,以烧灼样疼痛为主要表现的一组综合征 ,又称舌痛症 (glossodynia)。该病具有症状与体征不协调、症状变化有特殊的规律和节律、病程呈慢性迁延状态及无特征的组织病理变化等特征。目前 ,对BMS的治疗是从其可能发病因素入手的。有学者指出 ,BMS治疗失败的主要原因是未能找到其发病因素[1] ,因此 ,BMS治疗方案的第一步就是寻找可能的发病因素。一、通过认真详细的问诊与检查 ,查明其可能发病因素。参照国内外同行有关资料 ,根据我国情 ,作者拟出BMS问诊体检表 ,以期比…     

下丘脑-交感-肾上腺髓质系统功能与灼口综合征

运用中西医的系统，还原相结合的认识方法剖析灼口综合征（BMS）可能病因以及临床特点。发现下丘脑－交感－肾上腺髓质系统活动增强在BMS的发病机制中起了关键作用或信息传递作用。从局部和整体结合观点，以人的生物心理社会模式的观点来简述下丘脑－交感－肾上腺髓质;轴功能与BMS的关系，发现下丘脑－交感－肾上腺髓质活动增强在心理因素导致BMS的发病机制中可能起中介作用；BMS的烧灼样疼痛可能是由交感神经维持的慢性痛；BMS可能是胃肠道伤害性刺激通过交感末梢传入信息经延髓的整合机制传递儿茶酚胺，表现为口面部疼痛及全身的一组症侯群。对BMS的治疗提出控制下丘脑－交感－肾上腺髓质轴活动的设想。     

佳蓉片治疗更年期妇女灼口综合征的疗效观察及其对血清性激素水平的影响

目的：观察佳蓉片治疗更年期妇女灼口综合征（burning mouth syndrome,BMS）的临床疗效及其对患者血清性激素水平的影响。方法：将60例更年期妇女BMS患者按编码随机抽取方法分为佳蓉片组30例、空白对照组30例,空白对照组予以安慰剂,采用空心胶囊,应用视觉模拟定级法（visual analogous scale,VAS）评定两组治疗前后疼痛强度,应用疼痛指数法比较其临床疗效,并检测两组患者治疗前后血清性激素水平。结果：治疗前两组BMS患者VAS疼痛指数无显著性差异;1疗程后各组疼痛指数均较治疗前减少（P〈0.01）,佳蓉片组与空白对照组之间有统计学意义（P〈0.01）;2疗程后佳蓉片组疼痛指数均较治疗前和1疗程后明显减少（P〈0.01）,与空白对照组之间有统计学意义（P〈0.01）,空白对照组疼痛指数与治疗前比较有统计学意义,但与1疗程后比较无统计学意义。佳蓉片组的总有效率明显优于空白对照组（P〈0.01）。治疗前两组BMS患者雄激素水平无统计学意义;2疗程后与治疗前相比：佳蓉片组显著降低（P〈0.01）,空白对照组无差异,其差值比较两组之间有统计学意义（P〈0.01）。结论：佳蓉片治疗更年期妇女BMS具有良好的临床疗效,降低更年期妇女雄激素水平,可能是其治疗更年期妇女BMS的作用机制之一。     

Burning mouth syndrome: a guide for the general practitioner

A commonly misdiagnosed condition, burning mouth syndrome (BMS) is characterized by burning sensations of the oral cavity in the absence of physical abnormalities of the oral mucosa. BMS affects middle-aged women predominantly. This condition has a multifactorial etiology, although several conditions have been associated with BMS, including depression/anxiety, hematinic deficiencies (iron, folate, and vitamin B complex), oral habits such as tongue thrusting and bruxism, and idiopathic BMS. Multiple approaches to treatment have been described in the literature, although few controlled clinical trials have been designed to determine their efficacy. This article examines BMS, its related factors, and treatment options available to the general dentist.     

Burning mouth syndrome. A retrospective analysis of clinical characteristics and treatment outcomes

Burning mouth syndrome is a condition characterized by burning sensations of the oral cavity in the absence of physical abnormalities of the mucosa or a detectable underlying medical disorder. It is a multifactorial disorder with unclear etiology, affecting predominatly middle-aged women. Multiple approaches to treatment have been described in the literature, with few controlled clinical trials regarding their efficacy. The objectives of this retrospective study were to: 1. determine the epidemiologic characteristics of BMS patients referred to an oral medicine practice; 2. determine if BMS classification correlates with response to treatment; 3. determine the efficacy of a variety of known therapies for BMS. A database was constructed from the charts of 150 consecutive patients diagnosed with BMS; and these charts were reviewed. Patients were classified according to previously published criteria for BMS. Presumed etiologies were grouped into depression/anxiety-associated; hematinic deficiencies, including iron, folate and vitamin B complex; oral habits: and idiopathic BMS. Treatment approaches were divided into seven categories: soft desensitizing appliance; tricyclic antidepressants (TCA); benzodiazepines (BZD); topical analgesics; hematinic supplements; habit awareness counseling; and multi-modal therapy (combining two or more of the above). Improvement was recorded using a zero to 100% VAS scale and classified as no relief (0%); mild (0-40%); meaningful/moderate (41-80%); and profound relief (81-100%). Burning mouth syndrome without any identifiable cause (idiopathic) was diagnosed in 33 patients (46.6%). Patients were followed up at one month (4 weeks) after the initial visit. Nine patients (12.7%) reported profound relief; 17 patients (23.9%) reported meaningful relief; 39 patients (54.9%) reported mild relief. This retrospective review showed no significant correlation between classification of BMS and response to therapy. The most effective treatment modalities were habit awareness, followed by TCAs.     

Burning mouth syndrome: prevalence and associated factors

Burning mouth syndrome (BMS) is characterized by a burning sensation in the oral cavity although the oral mucosa is clinically normal. The syndrome mostly affects middle-aged women. Various local, systemic and psychological factors have been found to be associated with BMS, but its etiology is not fully understood. Oral complaints and salivary flow were surveyed in 669 men and 758 women randomly selected from 48,500 individuals between the ages 20 and 69 years. Fifty-three individuals (3.7%), 11 men (1.6%) and 42 women (5.5%), were classified as having BMS. In men, no BMS was found before the age group 40 to 49 years where the prevalence was 0.7%, which increased to 3.6% in the oldest age group. In women, no BMS was found in the youngest age group, but in the age group 30 to 39 years the prevalence was 0.6% and increased to 12.2% in the oldest age group. Subjective oral dryness, age, medication, taste disturbances, intake of L-thyroxines, illness, stimulated salivary flow rate, depression and anxiety were factors associated with BMS. In individuals with BMS, the most prevalent site with burning sensations was the tongue (67.9%). The intensity of the burning sensation was estimated to be 4.6 on a visual analogue scale. There were no increased levels of depression, anxiety or stress among individuals with more pain compared to those with less pain. It was concluded that BMS should be seen as a marker of illness and/or distress, and the complex etiology of BMS demands specialist treatment.     

The diagnosis of burning mouth syndrome represents a challenge for clinicians

AIMS: To evaluate the occurrence of professional delay in the diagnosis, referral, and treatment of patients with burning mouth syndrome (BMS). METHODS: Fifty-nine patients (51 women and 8 men; average age, 60.5 years; age range, 32 to 88 years) diagnosed with BMS at our institution were retrospectively studied. Data were collected about the onset of oral symptoms, consultations with medical and dental practitioners, and misdiagnosis before definitive BMS diagnosis and treatment. RESULTS: The average delay from the onset of the symptoms to definitive diagnosis was 34 months (range, 1 to 348 months; median, 13 months). The average number of medical and dental practitioners consulted by each patient over this period and who initially misdiagnosed BMS was 3.1 (range, 0 to 12; median, 3). Candidiasis and aspecific stomatitis were the most frequent misinterpretations of the symptoms before appropriate referral. In about 30% of cases, no diagnosis of the oral symptoms was made or explanation given. CONCLUSION: Professional delay in diagnosing, referring, and appropriately. managing BMS patients occurred frequently in the group studied. No significant differences were found in the number of medical and dental practitioners who were consulted. Emphasis must therefore be placed upon educational efforts to improve health care providers' awareness of BMS. This should increase the rate of recognition and appropriate referral or treatment of patients with chronic orofacial pain due to BMS.     

US6Burning mouth syndrome

Burning mouth syndrome (BMS) is an idiopathic burning discomfort or pain affecting people with clinically normal oral mucosa in whom a medical or dental cause has been excluded. Associated symptoms include altered taste and a sensation of oral dryness. Terms previously used to describe BMS include glossodynia, glossopyrosis, stomatodynia, stomatopyrosis, sore tongue, and oral dysaesthesia. BMS mainly affects women particularly after the menopause, when its prevalence may be 18–33%. Suggested causal factors include hormonal disturbances associated with the menopause and psychogenic factors (including anxiety, depression, stress, life events, personality disorders, and cancer phobia). There is increasing evidence that a sensory neuropathy underlies BMS symptoms. Management of the symptoms of BMS can be challenging. It has been hampered by a relative lack of high quality evidence and randomised controlled trials into BMS treatment. Many studies have not differentiated between those with burning mouth syndrome (i.e. idiopathic disease) from those with other conditions (such as haematinic deficiencies) causing symptoms of a burning mouth, making results unreliable. Local and systemic factors (such as mucosal disorders, allergies, ill fitting dentures, hypersensitivity reactions and vitamin deficiencies) may cause the symptom of burning mouth and should be excluded before reaching the diagnosis of BMS. Various interventions have been proposed to be beneficial in managing BMS ranging from cognitive behaviour therapy, antidepressants, dietary supplements, hormone replacement in postmenopausal women, topical benzydamine hydrochloride, capsaician and clonazepam. This presentation will critically review BMS diagnosis, the evidence concerning the efficacy of potential interventions and propose a management protocol.     

灼口综合征病因及发病机制

灼口综合征（burning mouth syndrome，BMS）是一种发生在口腔黏膜的慢性疼痛性疾病，临床症状多样，包括舌部、唇或其他口腔黏膜表面的灼烧感或刺痛感，可伴有口腔干燥或唾液过少、味觉改变或感觉麻痹。多年来，学者们对BMS病因的研究众多，但关于BMS确切的病因及发病机制仍不明确。文章就多年来学者们对BMS病因及发病机制的研究做一综述。     

Burning mouth syndrome: literature review and model for research and management

The literature on burning mouth syndrome (BMS) is reviewed with particular reference to its prevalence, local and systemic etiologic factors, psychogenic background and treatment. Research requirements are discussed, which focus on different clinical and psychological parameters and the necessity to evaluate BMS. Finally, a treatment protocol including oral, medical and psychological investigations is presented.     

国内灼口综合征疗效的循证医学研究及Meta分析

目的 对目前国内有关灼口综合征治疗的临床研究进行循证医学分析，为治疗灼口综合征提供指导。方法 检索2003年7月前发表在国内中文期刊上所有相关文献，对其进行循证医学分析，并对符合要求的文献进行。Meta分析。结果 共检索到32篇有关BMS临床治疗的研究。无大样本随机对照研究报道，B级文献18篇、C级文献14篇，各研究均报道对灼口综合征治疗有效；其中5篇有关雌激素替代疗法文献的Meta分析表明，雌激素替代疗法治疗更年期女性灼口综合征的疗效明显优于维生素类。结论 雌激素替代疗法可作为治疗更年期前后女性灼口综合征的首选方法之一；局部神经封闭、毫米波理疗、穴位注射、中西医结合疗法治疗灼口综合征治疗的确切疗效，尚有待于进一步研究证实。     

Cognitive therapy in the treatment of patients with resistant burning mouth syndrome: a controlled study

The effect of cognitive therapy (CT) on resistant burning mouth syndrome (BMS) was studied. Thirty patients with resistant BMS after odontological and medical treatment were randomly divided into two equal groups; a therapy group (TG) was treated with CT and an attention/placebo group (APG) served as a control group. The intensity of BMS, which was estimated by the use of a visual analogue scale, was significantly reduced in the TG directly after CT was completed and was further reduced in a 6–month follow-up. The APG did not show any decrease in intensity of BMS. The results of this study indicate that, in some cases, resistant BMS probably is of psychological origin.     

Damage to taste system and oral pain: burning mouth syndrome

The burning mouth syndrome (BMS) is an oral pain disorder. Central or peripheral pain mechanisms may play a role in the oral burning of BMS. Various local, systemic and psychological factors have been found to be associated with BMS, but its etiology is not fully understood. This syndrome mostly affects middle-aged women and is frequently accompanied by taste complaints. This association of symptoms suggests an interaction between the mechanisms of nociception and gustation, 2 senses with strong hedonic components. There are connections between taste and oral pain in the central nervous system and it is possible that BMS and other oral pain phantoms result from damage to the taste system. This suggests that individuals who suffer from BMS are likely to be supertasters.