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  • 學位論文

修格蘭氏症候群患者的口乾症對口腔健康生活品質的影響

The impact of xerostomia on oral-health-related quality of life in patients with Sjögren's syndrome

指導教授 : 嚴雅音
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摘要


研究背景: 修格蘭氏症候群(Sjögren's syndrome, SS)是一種常見的慢性自體免疫性疾病,特徵為口腔及眼部的持續性乾燥,進而衍生出全身性相關疾病。對於唾液減少引起口乾進而影響到口腔問題,如容易發生齲齒和缺牙、配戴假牙不適等口腔狀況,往後對日常生活及社交活動也會受到影響。而口腔健康相關生活品質量表(Oral Health Impact Profile, OHIP)主要測量受試者自覺在生理、心理及社會層面之健康狀態受到口腔健康問題影響的程度。 目的: 本研究探討修格蘭氏症候群患者之口乾情況對口腔健康相關生活品質的影響因素。 方法: 研究樣本為患有過敏免疫風濕科之門診病人,此次調查共收集51位原發性修格蘭氏症候群及61位次發性修格蘭氏症候群(含19位紅斑性狼瘡、42位類風濕關節)炎完成問卷。藉由OHIP-14量表評估口腔健康相關生活品質之影響程度,以探討口腔狀況、疾病與口腔健康相關品質之相關。 結果: 本研究共有112人完成口腔檢查及問卷訪談。研究結果顯示,修格蘭氏症患者之口腔健康狀況方面:80.4%自覺有口乾情形是在其他時間所發生,平均口腔缺牙顆數為6顆,42%修格蘭氏症候群患者,其存留齒數少於20顆、而配戴活動式假牙佔16.1%。修格蘭氏症患者之口腔健康生活品質(OHIP-14)分數差異性分析,各3組中(未用藥組、一般健保用藥組、健保專案用藥組),在不同口乾程度中最普遍受到影響為『您是否覺得口乾是在其他的時間』、『口中唾液是否太多太少或沒注意』等情形為口腔健康相關生活品質之重要影響因素。不使用口乾相關藥物為未用藥組,一般健保用藥組為使用Bromhexine和Ambroxol,健保專案用藥組為使用Pilocarpine 和Cevimmeline。此外,本研究發現口腔相關健康生活品質(OHIP-14)可預測到每一種OHIP層面至少有一個項目與口乾症有關。 結論: 口乾症狀確實會直接關係到修格蘭氏症候群患者的日常生活與不同層面功能所影響的負面衝擊。再者,自覺口腔健康狀況對口腔健康生活品質的影響相較於臨床口腔疾病明顯。因此,應加強修格蘭氏症候群患者之口腔健康生活品質。 關鍵詞:修格蘭氏症候群、口乾、生活品質、OHIP-14

並列摘要


Background: Sjögren's syndrome (SS) is a common chronic autoimmune disease characterized by persistently dry mouth and eyes. It is usually set of clinical manifestations present in systemic diseases. Oral problems caused by reduction in saliva production, such as increased risk of dental caries, missing teeth, and difficulty in wearing dentures, significantly impact social and daily activity in life. The oral health-related quality of life scales (Oral Health Impact Profile, OHIP) measures how the subjects feel about the impact oral hygiene problems have on major physical, psychological and social dimensions of health. Study Objective: This study investigates the impact of Sjögren's syndrome patients’ dry mouth condition on oral health-related quality of life factors. Methods: Study sample was collected from outpatients suffering allergies and rheumatism. A total of 51 primary Sjögren's syndrome patients and the 61 secondary Sjögren's syndrome (including 19 lupus erythematosus, 42 rheumatoid joint) patients completed the questionnaire. By OHIP-14 scale assessment of oral health related quality of life impact, to explore the oral health, disease and oral health-related quality-related. Results: In this study, 112 people completed the oral examination and questionnaire interviews. The results showed that patients with Sjögren's syndrome of the oral health status. 80.4% feel that dry mouth episodes have occurred in other times. The average number of missing teeth and oral cavity was 6. 42% of Sjögren's syndrome patients retained less than 20 teeth and those equipped with removable dentures accounted for 16.1%. In Sjögren's disease of the oral health quality of life (OHIP-14) score difference analysis, for all three groups (untreated, the general health care treatment group, treatment group health project) with different levels of dryness, the most common factors for oral health related quality of life were "Do you think the dry mouth at other times”, "saliva is too little or too much", and other similar situations. Untreated group was not administered xerostomia-related medication. General health care treatment group used Bromhexine and Ambroxol. Treatment group was treated with Pilocarpine and Cevimmeline. In addition, the study found that oral health-related quality of life (OHIP-14) can predict the level of each OHIP with at least one project related xerostomia. Conclusions: Oral dryness would definitely impact the daily lives and different functions of patients with Sjögren's syndrome directly. Moreover, condition of oral health had more influence to oral health related quality of life than that of clinical oral diseases. In conclusion, the oral health related quality of life for patients with Sjögren's syndrome should be improved. Keywords:dry mouth, OHIP-14, quality of life, Sjögren's syndrome

並列關鍵字

dry mouth OHIP-14 quality of life Sj&ouml gren's syndrome

參考文獻


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