The Journal of Internal Korean Medicine (대한한방내과학회지)

The Society of Internal Korean Medicine (대한한방내과학회)
권호 표지
DOI QR코드

DOI QR Code

A Clinical Study on the Relationship between Pattern Identifications for Patients with Burning Mouth Syndrome and the Ryodoraku Test

구강작열감증후군 환자에서 양도락의 진단적 가치 및 변증과의 상관성 분석

  • Kim, Dong-yoon (Dept. of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Ha, Na-yeon (Dept. of Digestive Diseases, Kyung Hee University Korean Medicine Hospital) ;
  • Kim, Jin-sung (Dept. of Clinical Korean Medicine, Graduate School, Kyung Hee University)
  • 김동윤 (경희대학교 대학원 임상한의학과) ;
  • 하나연 (경희대학교한방병원 위장소화내과) ;
  • 김진성 (경희대학교 대학원 임상한의학과)
  • Received : 2020.08.21
  • Accepted : 2020.09.26
  • Published : 2020.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: The aim of this study was to analyze the correlation between Ryodoraku and two pattern-identification questionnaires in patients with Burning Mouth Syndrome (BMS). Methods: The study participants were 30 patients with BMS who visited the Oral Diseases Clinic of Kyung Hee Oriental Medicine Hospital from June to November, 2019. The Ryodoraku test and two pattern-identification questionnaires were administered to all patients. Measurements included the average Ryodoraku score, which is called the Total Average (TA), and each score on the Ryodoraku point scale. The degree of Yin-deficiency, Qi-stagnation, and pain were assessed with the Yin-deficiency Questionnaire (YDQ), Qi-stagnation Questionnaire (QSQ), and Visual Analogue Scale (VAS), respectively. Results: The average TA score was 29.90. The LF5 (p=0.013) and RF5 (p=0.016) scores were lower than the TA scores, and the RH5 (p=0.020) and RH6 (p=0.006) scores were higher than the TA scores. A negative correlation was detected between the YDQ scores and the LH1 (r=-0.366, p=0.046), LH2 (r=-0.507, p=0.004), LH3 (r=-0.374, p=0.042), RH1 (r=-0.361, p=0.050), RH2 (r=-0.403, p=0.027) points. The LF5 (p=0.050) and RF2 (p=0.048) scores were lower in the patients with Qi-stagnation patients than without Qi-stagnation. Conclusions: Our results suggest that low TA and Ryodoraku scores on LF5 and RF5 and high Ryodoraku scores on RH5 and RH6 could be quantitative indicators for the diagnosis of BMS. The LH1, LH2, LH3, RH1, RH2, LF5, and RF2 scores could also be an indicators for diagnosis of Yin-deficiency and Qi-stagnation in patients with BMS.

Keywords

References

  1. McMillan R, Forsell H, Buchanan JAG, Glenny AM, Weldon JC, Zakrzewska JM. Interventions for treating burning mouth syndrome(Review). Cochrane Database of Systematic Reviews 2016;11(11):CD002779.
  2. Bergdahl M, Bergdahl J. Burning mouth syndrome: prevalence and associated factors. Journal of Oral Pathology & Medicine 1999;28(8):350-4. https://doi.org/10.1111/j.1600-0714.1999.tb02052.x
  3. Woda A, Pionchon P. A unified concept of idiopathic orofacial pain: Clinical features. Journal of Orofacial Pain 1999;13(3):172-84.
  4. Kohorst JJ, Bruce AJ, Torgerson RR, Schenck LA, Davis MD. The prevalence of burning mouth syndrome: a population-based study. British Journal of Dermatology 2015;172(6):1654-6. https://doi.org/10.1111/bjd.13613
  5. Grushka M, Epstein JB, Gorsky M. Burning Mouth Syndrome. American Family Physician 2002 Feb 15;65(4):615-20.
  6. Zur E. Burning mouth syndrome: a discussion of a complex pathology. Int J Pharm Compd 2012;16(3):196-205.
  7. Kohorst JJ, Bruce AJ, Torgerson RR, Schenck LA, Davis MDP. A population-based study of the incidence of burning mouth syndrome. Mayo Clinic Proceedings 2014;89(11):1545-52. https://doi.org/10.1016/j.mayocp.2014.05.018
  8. Ko WH, Nam SU, Ha NY, Hwang MN, Baek SY, Kim DY, et al. Characteristics of digital infrared thermal imaging and quantitative evaluations for patients with burning mouth syndrome: a cross sectional study. J Int Korean Med 2018;39(4):699-707. https://doi.org/10.22246/jikm.2018.39.4.699
  9. Son JY, Kim JY, Kang K, Baek SH, Choi J, Jang SW, et al. Effects of Korean medicine therapies on oral pain in patients with burning mouth syndrome. Korean J Orient Int Med 2013;34(2):122-33.
  10. Heo J. Donguibogam. Seoul: Namsandang; 2004, p. 87-9, 94, 241, 418, 507, 779.
  11. Seon JK, Kim JS, Han GJ, Oh SW, Son JH, Kang K, et al. Clinical characteristics and evaluation of Yin-deficiency syndrome in patinets with burning mouth syndrome. Korean J Orient Int Med 2011;32(4):473-86.
  12. Kang K, Kim JS, Seon JK, Son JH, Kim JY, Jang SW, et al. Correlation between Qi-stagnation and pressure pain threshold on CV17(Danzhong:膻中) in burning mouth syndrome patients - In the perspective of quantification of pressure pain threshold on CV17 by using algometer. Korean J Orient Int Med 2012;33(4):498-510.
  13. Lee JE, Park JW, Kim JS. Correlation between dysgeusia and spleen qi deficiency patterns in patients with burning mouth syndrome. J Int Korean Med 2017;38(4):455-67. https://doi.org/10.22246/jikm.2017.38.4.455
  14. Committee of biofunctional medicine of whole Korean medicine university. Biofunctional medicine. Seoul: Koonja publisher; 2014, p. 132-44.
  15. Song MH, Yang SJ, Lee CW, Lee BR, Kwon JN. A review study on ryodoraku diagnosis and evaluation of low back pain. J Korean Med 2014;35(3):116-24.
  16. Kim MH. Characteristics of autonomic nervous system in atopic dermatitis patients by heart rate variability and ryodoraku. Masters degree, Kyung Hee university 2015.
  17. Kim ES, Lee JM, Lee CH, Cho JH, Jang JB, Lee KS. A study on characters of yangdorak in climacteric women. The journal of oriental obsterics & gynecology 2008;21(4):159-68.
  18. Hwang JH, Jung SY, Jung SK. The diagnostic values of ryodoraku and pulse analysis for respiratory disease patients. Korean J Orient Int Med 2007;28(3):560-9.
  19. Oh SW, Cho NH, Jeon WH, Park JW, Kim JS, Hong JH, et al. Analysis of symptom-complexes of irritable bowel syndrome and its skin resistance check(良導絡) results. J of Oriental Chr Dis 2000;6(1):197-207.
  20. Ko WH, Ha NY, Ko SJ, Park JW, Kim JS. A clinical study on the relationship between pattern and ryodoraku test identifications for patients with functional dyspepsia. J Int Korean Med 2019;40(3):369-89. https://doi.org/10.22246/jikm.2019.40.3.369
  21. Lee SJ, Park JB, Lee SS, Kim KH. Development of Yin-deficiency questionnaire and examine the reliability and validity. Korean J Oriental Physiology & Pathology 2004;18(2):376-80.
  22. Jang SW, Kim JS. Development cut-off value for Yin-deficiency questionnaire and diagnostic ability of Yin-deficiency in xerostomia. J Int Korean Med 2014;35(4):483-97.
  23. Okitsu R, Iwasaki K, Monma Y, Takayama S, Kaneko S, Shen G, et al. Development of a questionnaire for the diagnosis of Qi stagnation. Complementary Therapies in Medicine 2012;20(4):207-17. https://doi.org/10.1016/j.ctim.2011.12.005
  24. Vellappally S. Burning mouth syndrome: A review of the etiopathologic factors and management. The Journal of Contemporary Dental Practice 2016 Feb;17(2):171-6. https://doi.org/10.5005/jp-journals-10024-1822
  25. Vaidya R. Burning mouth syndrome at menopause: elusive etiology. J Midlife Health 2012 Jan;3(1):3-4.
  26. Tarkkila L, Linna M, Tiitinen A, Lindqvist C, Meurman JH. Oral symptoms at menopause-the role of hormone replacement therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92(3):276-80. https://doi.org/10.1067/moe.2001.117452
  27. Forabosco A, Criscuolo M, Coukos G, Uccelli E, Weinstein R, Spinato S, et al. Efficacy of hormone replacement therapy in postmenopausal women with oral discomfort. Oral Surg Oral Med Oral Pathol 1992;73(5):570-4. https://doi.org/10.1016/0030-4220(92)90100-5
  28. Wardrop RW, Hailes J, Burger H, Reade PC. Oral discomfort at menopause. Oral Surg Oral Med Oral Pathol 1989;67(5):535-40. https://doi.org/10.1016/0030-4220(89)90269-7
  29. Lauria G, Majorana A, Borgna M, Lombardi R, Penza P. Padovani A, et al. Trigeminal small-fiber sensory neuropathy causes burning mouth syndrome. Pain 2005;115(3):332-7. https://doi.org/10.1016/j.pain.2005.03.028
  30. Albuquerque RJ, de Leeuw R, Carlson CR, Okeson JP, Miller CS, Andersen AH. Cerebral activation during thermal stimulation of patients who have burning mouth disorder: an fMRI study. Pain 2006;122(3):223-34. https://doi.org/10.1016/j.pain.2006.01.020
  31. Spanemberg JC, Cherubini K, de Figueiredo MA, Yurgel LS, Salum FG. Aetiology and therapeutics of burning mouth syndrome: an update. Gerodontology 2012;29(2):84-9. https://doi.org/10.1111/j.1741-2358.2010.00384.x
  32. Mendak-Ziolko M, Konopka T, Bogucki ZA. Evaluation of select neurophysiological, clinical and psychological tests for burning mouth syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114(3):325-32. https://doi.org/10.1016/j.oooo.2012.04.004
  33. Kenchadze R, Iverieli M, Okribelashvili N, Geladze N, Khachapuridze N. The psychological aspects of burning mouth syndrome. Georgian Med News 2011;194:24-8.
  34. Thoppay JR, De Rossi S. Ciarrocca KN. Burning mouth syndrome. Dent Clin N Am 2013;57(3):497-512. https://doi.org/10.1016/j.cden.2013.04.010
  35. Headache Classification Committe of the International Headache Society(IHS). The international classification of headache disorder, 3rd edition. Cephalalgia 2018;38(1):1-211.
  36. Lamey PJ, Lewis MA. Oral medicine in practice: burning mouth syndrome. Br Dent J 1989;167(6):197-200. https://doi.org/10.1038/sj.bdj.4806969
  37. Muzyka BC, De Rossi SS. A review of burning mouth syndrome. Cutis 1999;64(1):29-35.
  38. Scala A, Checchi L, Montevecchi M, Marini I, Giamberardino MA. Update on burning mouth syndrome: overview and patient management. Crit Rev Oral Biol Med 2003;14(4):275-91. https://doi.org/10.1177/154411130301400405
  39. Fortuna G, Lorenzo MD, Pollio A. Complex oral sensitivity disorder(COSD): a reappraisal of current classification of burning mouth syndrome. Oral Dis 2013 Oct;19(7):730-2. https://doi.org/10.1111/odi.12066
  40. Kim MS, Lee JS, Park SE, Hong SH. A case study of burning mouth syndrome with oro-facial dyskinesia treated with Korean medicine using Se-sim pharmacopuncture. J Int Korean Med 2017;38(5):564-75. https://doi.org/10.22246/jikm.2017.38.5.564
  41. 何园, 林梅, 李秉琦. 灼口综合征的治疗方案. 现代口腔医学杂志2003;17(6):564-6.
  42. 周兵, 周杰. 灼口汤治疗阴虚型灼口综合征观察. 临床口腔医学杂志2012;28(4):217-8. https://doi.org/10.3969/j.issn.1003-1634.2012.04.009
  43. 郭宏奇. 中药辨证治疗灼口综合征临床观察. 疾病监测与控制杂志2009;8:484-5.
  44. Kim YS, Park YB. Interative medicine of Ryodoraku. Seoul: Koonja publisher; 2009, p. 3-25.
  45. Park YB. The principle of Ryodoraku and application for diagnosis. Third line medicine 1996;1(2):83-94.
  46. Kim SJ. A comparative study of ryodoraku in pulmonary disease group and control group diagnosed by X-ray. Masters degree, Kyung Hee university 2017.
  47. Oh SJ. Studies on the characteristics of the Yin-Yang(陰陽), Heat-Cold(寒熱) by the Yangdorak(良導絡) patterns. Masters degree, Kyung Hee university 2004.
  48. Yoon SH. Sympathetic nerve function to electrical response of ryodoraku point and disarrangement of its meridian location on the anatomical viscera exclude the association between ryodoraku theory and meridian principle. Korean J Orient Int Med 2011;32(2):259-77.
  49. Hwang MN, Nam SU, Ha NY, Ko WH, Baek SY, Kim DY, et al. Clinical characteristics of patients showing fissured tongue with burning mouth syndrome: case series. J Int Korean Med 2018;39(3):363-71. https://doi.org/10.22246/jikm.2018.39.3.363
  50. Lee CW, Song MH, Yang SJ, Kwon JN. Review study on ryodoraku diagnosis study methods. J Korean Med 2014;35(3):1-14.
  51. Lim HD, Kang JK, Lee YM. A review of etiopathogenesis of burning mouth syndrome. Journal of Oral Medicine and Pain 2010;35(1):41-7.
  52. Kim YI, Lee WS, Park HN, Chae WS, Jin HC, Lee JS, et al. Analysis of methods for pain measurement used in Journal of the Korean Pain Society. Journal of the Korean Pain Society 2003;16(1):33-6.
  53. Joo BJ, Lim SM, Kim HJ, Lee DN. The clinical study on yangdorak change of menstrual phase, follicular phase and luteal phase with 14 nurses in 20's. J Orient Obstet Gynecol 2003;16(2):242-53.
  54. Refinetti R, Menaker M. The circadian rhythm of body temperature. Physiol Behav 1992;51(3):613-37. https://doi.org/10.1016/0031-9384(92)90188-8
  55. Kafka MS, Wirz-Justice A, Naber D, Moore RY, Benedito MA. Circadian rhythms in rat brain neurotransmitter receptors. Fed Proc 1983;42(11):2796-801.
  56. Kim DS, Park YG, Im SH, Kim DH, Song MH, Kim HK, et al. The effects of circadian rhythm on sympathetic skin response. J Korean EMG Electrodiagn Med 2008;10(2):113-7.
  57. Critchley HD. Electrodermal response: What happens in the brain. Neuroscientist 2002;8(2):132-42. https://doi.org/10.1177/107385840200800209
  58. Vertrugno R, Liguori R, Cortelli P, Montagna P. Sympathetic skin response: basin mechanism and clinical application. Clin Auto Res 2003;13(4):256-70. https://doi.org/10.1007/s10286-003-0107-5
  59. Koss MC, Davison MA. Characteristics of electrodermal response. Naunyn Schmiedebergs Arch Pharmacol 1976;295(2):153-89. https://doi.org/10.1007/BF00499448
  60. Lofstrom JB, Malmqvist LA, Bengtsson M. Can the "sympatho-galvanic reflex"(skin conductance response) be used to evaluate the extent of sympathetic block in spinal analgesia. Acta Anaesthesiol Scand 1984;28(5):578-82. https://doi.org/10.1111/j.1399-6576.1984.tb02123.x
  61. Lim KJ, Choi YJ. Bilateral horner's syndrome after a stellate ganglion block. Korean Journal of Anesthesiology 2002;43(2):241-4. https://doi.org/10.4097/kjae.2002.43.2.241
  62. Ji JY, Chung JH, Jung HS, Kim DH. Case reports on the effect of stellate ganglion block in patient with postherpetic neuralgia accompanied by itching. Soonchunhyang Medical Science 2019;25(2):145-7. https://doi.org/10.15746/sms.19.030
  63. Momota Y, Takano H, Kani K, Matsumoto F, Motegi K, Aota K, et al. Frequency analysis of heart rate variablility: a useful assessment tool of linearly polarized near-infrared irradiation to stellate ganglion area for burning mouth syndrome. Pain Medicine 2013;14(3):351-7. https://doi.org/10.1111/pme.12008
  64. Schmidt J, Sparenberg C, Fraunhofer S, Sirngibl H. Sympathetic nervous system activity during laparoscopic and needlescopic cholecystectomy. Surg Endosc 2002;16(3):476-80. https://doi.org/10.1007/s00464-001-9057-y
  65. Yamazaki K. Tajimi T, Okuda K, Niimi Y. Skin potential activity in rats, cat, and primates (including man): a phylogenetic point of view. J Com Physiol Psychol 1975;30(3):21-5.