激素替代疗法治疗女性灼口综合征的临床观察

目的 :观察尼尔雌醇治疗女性灼口综合征的临床效果。方法 :采用尼尔雌醇辅以孕激素的雌激素替代疗法治疗已停经的女性灼口综合征患者。结果 :激素治疗组与维生素治疗组相比有显著性差异 (P <0 .0 1)。结论 :舌感觉异常多发生在妇女更年期 ,内分泌紊乱起着重要作用 ,激素替代疗法可以明显缓解症状     

Cost-effectiveness analysis of burning mouth syndrome therapy

Hens MJ, Alonso‐Ferreira V, Villaverde‐Hueso A, Abaitua I, Posada de la Paz M. Cost‐effectiveness analysis of burning mouth syndrome therapy. Community Dent Oral Epidemiol 2012; 40: 185–192. © 2011 John Wiley & Sons A/S Abstract – Objective: To study the cost‐effectiveness of four alternative treatments for burning mouth syndrome (BMS). Methods: A cost‐effectiveness analysis was conducted from a healthcare payer perspective of four therapy strategies (amisulpride, paroxetine, sertraline and topical clonazepam), using a decision‐tree model that incorporated direct healthcare costs and probabilities associated with the possible events and outcomes. Average cost‐effectiveness and incremental cost‐effectiveness ratios were calculated. Sensitivity analyses included the costs of brand name and generic drugs in five European countries (France, Italy, the Netherlands, Spain and UK), as well as two scenarios with different treatment length. Results: Of the drugs analysed, topical clonazepam proved to be the most cost‐effective therapy. Although generic proved more efficient than brand name drugs, they displayed no advantage over brand name topical clonazepam. The Netherlands was the country with the highest overall drug efficiency. Sensitivity analyses highlighted the robustness of the model, because topical clonazepam proved to be the most efficient therapy under all the different scenarios. Conclusions: Topical clonazepam, which previous analyses of clinical evidence have shown to be the drug of choice for BMS, also proved to be the most cost‐effective of the drugs analysed for this condition.     

Psychological aspects of patients with burning mouth syndrome

This article reports the results of a psychological questionnaire survey of 184 patients who have burning mouth syndrome. The results are compared with normative data obtained in the Netherlands. In general, it may be concluded that in a large number of patients with glossodynia, psychological aspects such as anxiety, depression, and neurotic tendencies are of great importance. However, it must be emphasized that this conclusion may not be interpreted as support for a psychogenic cause of the syndrome or for a strong psychological factor in the etiology of glossodynia.     

Analysis of 33 patients with burning mouth syndrome

Thirty-three patients complaining of a burning mouth were investigated for deficiencies which might cause the symptoms. No deficiencies could be demonstrated. They were also questioned on their state of mind in the preceding period and their daily intake of medicine. More than half described their state of mind as normal. Benzodiazepines was the drug group used most. A treatment protocol for these patients is described.     

Quality of life in patients with burning mouth syndrome

Objective:  To study the quality of life in patients with burning mouth syndrome (BMS), our primary aim was to compare BMS patients with healthy controls and the secondary aim was to compare subgroups of BMS patients on the type of therapy received; using the Medical Outcome Short Form Health Survey Questionnaire (SF-36) and the Oral Health Impact Profile (OHIP-49) as measurement instruments.
Method:  Sixty consecutive patients (10 males and 50 females) with BMS were studied in the Department of Oral Medicine (Faculty of Medicine and Dentistry, University of Murcia, Spain), while 60 healthy patients were used as controls. The Spanish version of the SF-36 was used to evaluate general quality of life, together with the OHIP-49 in its Spanish version.
Results:  Regarding general quality of life as assessed with the SF-36, and on comparing the BMS vs. the control groups, lower scores were obtained in the former in all domains ( P  < 0.001). The OHIP-49 in turn yielded significant differences in each of the domains vs. the controls. No significant differences were found between the patients with BMS in any domain regarding parafunctional habits and the presence of dentures. In relation to the different treatments, significant differences were recorded in functional limitation ( P  = 0.02) and physical pain ( P  = 0.033).
Conclusion:  Patients with BMS yield poorer scores on all scales vs. the healthy controls when applying the SF-36 and OHIP-49.     

毫米波治疗灼口综合征疗效观察

目的 评价毫米波治疗灼口综合征的疗效，探求灼口综合征信息治疗新途径。方法 采用随机对照研究，对4组各20例灼口综合征患者分别进行如下治疗：1组：毫米波治疗 常规治疗；2组：毫米波治疗；3组：毫米波安慰性照射 常规治疗；4组：常规治疗。比较各组治疗前后及4组间疼痛程度、淤血程度及自主神经功能的改善情况。结果各组治疗前后疼痛程度、1组及2组治疗前后淤血程度和自主神经功能明显改善，差异均有显著性。4组间两两比较，1组与4组、2组与4组之间疼痛改善差异具有显著性。1组与3组及4组，2组与3组及4组之间淤血程度的改善差异有显著性。结论 毫米波照射手第二掌骨侧全息穴位能促进灼口综合征患者疼痛、淤血程度和自主神经功能的改善，是具有前景的信息治疗新途径。     

Serum zinc levels in patients with burning mouth syndrome

The serum zinc levels were measured by atomic absorption spectrophotometry in 30 patients with burning mouth syndrome, (BMS) and in 30 control subjects with clinically healthy oral mucosa. The mean value of serum zinc levels in the patient group was found to be significantly lower (mean +/- SD = 12.13 +/- 1.40 mumol/L) than the mean value of serum zinc levels in the control group (mean +/- SD = 12.89 +/- 1.62 mumol/L; p less than 0.05). The number of subjects with serum zinc levels less than the minimum normal value (less than 11 mumol/L) was higher in the patients with BMS (30%) than in the control subjects (10%). These results suggest that in some patients low serum zinc levels may be associated with BMS. However, the number of patients with BMS was too small to allow definite conclusions.     

灼口综合征患者唾液谷胱甘肽过氧化物酶活性的变化

有关灼口综合征(BMS)的发病机理目前尚未确定。本文拟通过测定唾液谷胱甘肽过氧化物酶(GPx)的活性,来了解BMS患者口腔粘膜氧自由基(OFR)代谢状况的变化,从而探讨BMS的发病机理。结果显示:BMS组和正常组唾液GPx活性分别为9.30×0.39u/L和8.96±0.29u/L,两者差异无显著性(P>0.05)。     

Evaluation of the response to treatment and clinical evolution in patients with burning mouth syndrome

Objective: the aim of this study is to investigate the clinical evolution, the spontaneous remission of the symptomatology and the response to different treatments in a group of burning mouth syndrome patients.Study Design: the sample was formed by a group of patients that were visited in the Unit of Oral Medicine of the Dentistry Clinic of the University of Barcelona, from the year 2000 to 2011. After revising the clinical records of all the patients that had been under control for a period of time of 18 months or longer, they were contacted by telephone. In the telephone interview, they were questioned about the symptomatology evolution and the response to the treatments received, noting down the data in a questionnaire previously performed. Results: the average duration of the symptoms was 6.5 years (+/-2.5 years). The most frequent treatments were: chlorhexidine mouthrinses, oral benzodiazepines, topical clonazepam, antiinflamatory drugs, antidepressants, antifungicals, vitamins, psycotherapy, salivary substitutes and topical corticoids. The specialists that were consulted with a higher frequency were: dermatologists (30%), othorrynolaringologists (10%) and psychiatrists (3%). In 41 patients the oral symptoms did not improve, 35 reported partial improvements, 12 patients worsened, and only in 3 patients the symptoms remitted. Conclusions: In three of the 91 patients studied the symptoms remitted spontaneously within the five years of treatment. Only 42% of the study population had improved the symptomatology significantly, and this improvement would reach 60% if clonazepam were associated to psychotherapy. Key words:Burning mouth syndrome, stomatodynia, oral pain, clonazepam.     

Mechanical sensitivity and psychological factors in patients with burning mouth syndrome

Clinical Oral Investigations - The aim of this study was to compare mechanical sensitivity on the tongue using quantitative sensory testing (QST) and psychological factors using the General Health...     

Fungiform papillae density in patients with burning mouth syndrome and xerostomia

Objective: The aim of this study was to analyze fungiform papillae density in patients with burning mouth syndrome (BMS) and xerostomia. Study design: In this cross-sectional clinical study, sixty patients were included (20 with BMS, 20 with xerostomia and 20 healthy controls). The fungiform papillae density was analyzed over a small region on the anterior tip of the tongue with the aid of a digital camera. The number of papillae was measured in an area of 19 mm2. Results: The patients with BMS showed significantly higher fungiform papillae density than the patients with xerostomia; though no statistically significant differences were recorded versus the control group. In the BMS group, 65% of all cases presented a density of 71-90 papillae (within an area of 19 mm2), while 10% had more than 90 papillae. On the contrary, 70% of the patients with xerostomia had fewer than 70 papillae in the studied area. Conclusions: The digital camera offers a rapid, noninvasive and relatively simple way to study fungiform papillae density. The patients with BMS have higher fungiform papillae density than the patients with xerostomia. Key words:Tongue, fungiform papillae, burning mouth syndrome, xerostomia.     

Perception of stimulus size in patients with burning mouth syndrome

Twenty subjects with burning mouth syndrome (BMS) and 20 control subjects were tested for oral size perception. Blindfolded subjects assessed the size of holes (2.38–12.70 mm diameter) presented to the tongue, using their fingers to select a matching hole from a comparator series of 31 holes (0.76–15.87 mm diameter) using first static then phasic touch. Both groups overestimated the size of the holes less than 10 mm in diameter but no systematic disparity was evident with holes greater than 10 mm in diameter. The relationship between the stimulus size and the illusion (expressed as the ratio of apparent size to real size) was hyperbolic with the illusion tending towards unity for holes greater than 10 mm. No differences were found in object size perception amongst patients with BMS or control subjects. It is therefore unlikely that altered oral size perception is a precipitating factor or accompanying feature in patients with BMS.     

Hypersensitivity reactions to dental materials in patients with lichenoid oral mucosal lesions and in patients with burning mouth syndrome.

Epicutaneous patch testing of a battery of 35 dental test substances was carried out in 24 patients with visible lichenoid oral mucosal lesions and in 24 patients with burning mouth syndrome (BMS) without any visible lesions. Reactions to mercury ammonium chloride were found in 33% (8/24) of the patients with visible lesions compared to 0% (0/24) of the patients with BMS. The difference was statistically significant. In 7 of the 8 patients who reacted to mercury, total or partial regression of the lesions was observed after removal of dental amalgam. Reactions to nickel sulfate were found in 21% (5/24) of the patients with BMS compared to 3% (1/24) of the patients with lichenoid lesions. This difference was also statistically significant. Nickel is a rare component in dental restorations, but the oral mucosa is daily exposed to nickel through food and water intake. Removal of nickel from the environment of the patient can therefore be hard to accomplish.     

Comparison between burning mouth syndrome patients with and without psychological problems

The purpose of this study was to compare clinical and socio-demographic characteristics between burning mouth syndrome (BMS) patients with and without psychological problems. Of 644 patients with symptoms of oral burning, 224 with primary BMS were selected on the basis of laboratory testing, medical history, and psychometric tests: 39 with psychological problems (age 62.5 ± 11.5 years) and 185 without psychological problems (age 58.4 ± 11.4 years). Comprehensive clinical and socio-demographic characteristics, including psychological profiles and salivary flow rates, were compared between the two groups. No significant difference in sex ratio, duration and diurnal pattern of symptoms, unstimulated whole saliva flow rate, or marital status was found between the groups. The patients with psychological problems had a significantly higher mean age, reduced stimulated whole saliva flow rate, and lower level of education than those without psychological problems. The patients with psychological problems also displayed higher rates and greater severity of various types of BMS-related symptom in most parts of the oral mucosa, higher rates of stress-related symptoms, and greater difficulties in daily activities. The severity of taste disturbance was the factor most significantly correlated with the level of psychometry. In conclusion, psychological problems in BMS patients are associated with an aggravation of BMS symptoms.     

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。     

灼口综合征患者口腔念珠菌生物类型初探

目的：了解灼口综合征（burning mouth syndrome,BMS)患者口腔念珠菌的生物类型。方法：采取漱口法对BMS患者和对照进行了口腔念珠菌的检测和API念珠菌生物类型鉴定。结果：BMS组的念珠菌检出率与对照组相比无统计学差异；第一型BMS的念株菌检出率为28．1％，经危险度估计念珠菌检出阳性有发生第一型BMS的危险；两组受试者所分离的念珠菌均以白色念珠菌为主。结论：BMS组和对照组所分离的念珠菌均以白色念珠菌为主。念株菌在第一型BMS的发生中，可能具有一定的作用。