Rhodus Nelson L, Fricton James, Carlson Patricia, Messner Ronald
Division of Oral Medicine, University of Minnesota, Minneapolis, Minnesota 55455, USA.
J Rheumatol. 2003 Aug;30(8):1841-5.
Studies have described oral problems associated with fibromyalgia syndrome (FM), including sicca, oral ulcerations, and orofacial pain. We evaluated the prevalence and profile of various oral symptoms in a population of patients diagnosed with FM.
Subjects diagnosed with FM by American College of Rheumatology criteria (n = 67; all women, mean age +/- SEM 47.6 +/- 2.3 yrs) were enrolled in the study after meeting strict exclusion criteria (i.e., oral mucosal conditions, Sjögren's syndrome, anemia, inflammatory bowel syndrome or other gastrointestinal disturbances, and other disorders that may manifest oral symptoms). Subjective oral evaluations were carried out for each subject, including oral pain (Melzack scale) for glossodynia, throbbing, aching, etc.; temporomandibular joint dysfunction (TMD); xerostomia (including intake of fluids, functional problems, etc.); dysphagia; dysgeusia; and information about frequent oral ulcerations or lesions. Psychological tests included Beck Depression Scale (BDS) and Spielberger Anxiety Scale (SAS) were administered.
The results indicated a significant prevalence in some subjects' oral symptoms, compared to age and sex matched control data (mean +/- SEM) for xerostomia 70.9% vs 5.7% (p < 0.001); glossodynia 32.8% vs 1.1% (p < 0.001); TMD 67.6% vs 20% (p < 0.01); dysphagia 37.3% vs 0.4% (p < 0.001); dysgeusia 34.2% vs 1.0% (p < 0.001). Other findings were not significantly different from controls: oral ulcerations/lesions 5.1% vs 4.4% (NS); BDS 34% vs 30% (NS); SAS 21% vs 19% (NS). The average visual analog scale (100 mm) for burning pain was 53.0 +/- 5.6 (p < 0.001). Anxiety and depression scores were no different in the FM subjects compared to controls with chronic pain conditions.
These data indicate that patients with FM have significantly increased prevalence of xerostomia, glossodynia, dysphagia, dysgeusia, and TMD compared to controls, with no significant difference in clinical oral lesions or psychological status.
已有研究描述了与纤维肌痛综合征（FM）相关的口腔问题，包括口干、口腔溃疡和口面部疼痛。我们评估了被诊断为FM的患者群体中各种口腔症状的患病率和特征。
根据美国风湿病学会标准被诊断为FM的受试者（n = 67；均为女性，平均年龄±标准误47.6±2.3岁）在符合严格的排除标准（即口腔黏膜疾病、干燥综合征、贫血、炎症性肠综合征或其他胃肠道疾病，以及可能表现出口腔症状的其他疾病）后纳入研究。对每位受试者进行主观口腔评估，包括口腔疼痛（用于诊断味觉异常、搏动性疼痛、酸痛等的梅尔扎克量表）；颞下颌关节功能障碍（TMD）；口干（包括液体摄入量、功能问题等）；吞咽困难；味觉障碍；以及关于频繁口腔溃疡或病变的信息。还进行了心理测试，包括贝克抑郁量表（BDS）和斯皮尔伯格焦虑量表（SAS）。
结果表明，与年龄和性别匹配的对照数据相比，一些受试者的口腔症状患病率显著升高（平均±标准误），口干为70.9%对5.7%（p < 0.001）；味觉异常为32.8%对1.1%（p < 0.001）；TMD为67.6%对20%（p < 0.01）；吞咽困难为37.3%对0.4%（p < 0.001）；味觉障碍为34.2%对1.0%（p < 0.001）。其他结果与对照组无显著差异：口腔溃疡/病变为5.1%对4.4%（无显著性差异）；BDS为34%对30%（无显著性差异）；SAS为21%对19%（无显著性差异）。灼痛的平均视觉模拟量表（100毫米）为53.0±5.6（p < 0.001）。与患有慢性疼痛疾病的对照组相比，FM受试者的焦虑和抑郁评分无差异。
这些数据表明，与对照组相比，FM患者的口干、味觉异常、吞咽困难、味觉障碍和TMD患病率显著增加，临床口腔病变或心理状态无显著差异。
