がん化学療法を受けた患者の味覚変化に関する研究—第1報 がん化学療法剤と味覚変化との関係

Taste Disturbance in Patients Treated with Cancer Chemotherapy : -First Report- Relationship between Chemotherapeutic Agents and Changes in Taste Sensation

要約

　がん化学療法を受けた患者の味覚（塩味，甘味，酸味，苦味）変化の出現頻度を明らかにし，食事援助のあり方を検討する目的で，血液・造血器腫瘍疾患で化学療法を受けた患者110例を対象とし自己記述法による質問紙調査を行い，以下のような結果を得た．

　1．がん化学療法に伴う味覚変化の出現頻度は，治療中において塩味49名（44.5％），甘味45名（40.9％），治療後では塩味・甘味39名（35.5％），酸味・苦味29名（26.4％）であり，治療中の方が治療後よりも変化の割合が高かったが有意差は認められなかった．

　2．治療中においてアルカロイド剤の使用者は未使用者に比べて塩味に変化を有する割合が有意に高く，また，副腎皮質ステロイド剤の使用者は未使用者に比べて甘味の変化を有する割合が有意に高くなっていた．

　3．治療中は四味覚ともに変化の有無と食事摂取量との間に差は認められず，治療後は，苦味の味覚に変化がある者はない者に比べ有意に食事摂取量が少なくなっていた．

　以上のことより，アルカロイド剤，副腎皮質ステロイド剤の使用者に対しては，味覚変化の訴えを丁重に聴取することが不可欠である．また，化学療法後は苦味を招く食事中の尿素含有量を減らすなど献立を工夫することが食事摂取量増加につながると考える．

Abstract

　A questionnaire survey was conducted in 110 patients treated with chemotherapy for hematological malignancies to investigate changes in taste sensation(salty, sweet, sour and bitter)and to develop better dietary support.

The patients were instructed to fill out the questionnaire by themselves.

The following results were obtained.

　1. Taste disturbance was noted during chemotherapy in 44.5% of patients for salty taste and 40.9% for sweet taste. It was also noted after chemotherapy in 33.5% of patients for salty/sweet taste and 26.4% for sour/bitter taste. Changes in taste sensation were greater during chemotherapy than after chemotherapy.

　2. Changes in salty taste sensation were more frequently noted in patients given alkaloids agents than those who were not given these drugs. Changes in sweet taste sensation were more frequently noted in patients given adrenocorticosteroid than those who were not given drugs.

　3. There were no relationship between taste disturbance and food intake during chemotherapy. After chemotherapy, however, in food intake many patients with bitter taste disturbance was significantly lower than those without bitter taste disturbance.

　The above results suggest that it is very important to carefully examine patients undergoing chemotherapy with alkaloids agents or adrenocorticosteroid with respect to changes in taste sensation. It is also suggested that the reduction of urea in food, which is attributable to bitter taste, will result in an increase in food intake in patients after chemotherapy.