A Case Report of Glossodynia and Xerostomia Successfully Treated with Kampo Medicines

• Published in: Japanese Journal of Orofacial Pain Vol. 11; no. 1; pp. 43 - 47
• Main Authors: Sendo, Ryozo, Yamaguchi, Kojiro, Yamashita, Kaoru, Tohya, Akina, Yamagata, Kazuaki, Manabe, Yozo, Sugimura, Mitsutaka
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Orofacial Pain 2018
• Subjects: glossodynia; hochuekkito; kamishoyosan; tokishakuyakusan; xerostomia
• ISSN: 1883-308X; 1882-9333
• DOI: 10.11264/jjop.11.43

Patient: We report a case of xerostomia and glossodynia that was treated with traditional Japanese kampo medicines.Case: A 31-year-old female complained of dry mouth and tongue pain for two months after extraction of four wisdom teeth. Three months later, she was treated with Goreisan, but with no improvement in her symptoms. General condition: She complained of headache, coldness of limbs, general malaise and severe menstrual pain. Clinical test results: VAS 43, Anti-SS-A and anti SS-B antibody negative, Saxon test for xerostomia : 1.2g/2min, CMI area Ⅱ＋angry type, SDS 47, State-trait anxiety inventory（STAI）scores : state-anxiety 48（Ⅳ）, trait anxiety 47（Ⅳ）. Clinical diagnosis: Xerostomia and psychogenic glossodynia. Treatment and subsequent course: Since the Saxon test was 1.2g/2 min, assuming dry mouth as being the cause of the tongue pain, we started administration of 5 g/day of Hochuekkito and 5 g/day of Tokishakuyakusan. After 35 days, her Saxon test result improved to 1.9g/2 min. However, since tongue pain severity on a visual analogue scale（VAS）was 43 and she had a neurotic tendency, therapy was changed to 5 g/day of Kamishoyosan, which was discontined after 56 days when tongue pain scores on the VAS were zero. Discussion: In this case, the patient had a combination of basal metabolic decline, body fluid loss, peripheral circulatory failure and anxiety symptoms. Therefore, her symptoms improved with a two-stage treatment consisting of supplementing vital energy and blood, controlling fluid balance and treatment of anxiety symptoms using kampo medicines. Conclusions: In cases where xerostomia and glossodynia coexist, it may be difficult to decide the treatment policy. However, there are cases in which the treatment efficacy of xerostomia and glossodynia can be improved by using psychological tests, oriental medicine examination methods and administration of Hozai and Qi medicine.