胃潰瘍の総合医学的治療研究(3) : 向精神薬療法の併用成績について

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In connection with a series of studies on the comprehensive medical treatment of peptic ulcers, the authors have previously reported, (1) results of studies on the basic mechanisms of ulcer healing, and (2) the influence of psychoneurotic factors on the healing process of gastric ulcers. This third report deals with the influence of tranquilizers in the treatment of ulcers, with special reference to a Thienodiazepine derivate Clotiazepam, on the psychoneuroendocrine fucntion and the healing process of ucers in patients with a gastric ulcer.The multiclinical study was undertaken ona total of 29 in -paetients with gastric ulcers, each of whom was afflicted with an active ulcer of more than 10 mm in diameter. They were treated with 30 mgr. of Clotiazepam a day for 8 weeks.Results obtaiend were as follows : 1) The Clotiazepam treatment was found helpful in 93.1% of the cases studied. The therepeutic spectra of the drug covered various anxiety and hypochondrial symptoms, and observation of time required for healing of an ulcer disclosed an acceleration of healing due to the Clotiazepam.2) Patients were classified into two groups, group A with psychosocial stress and group B without psychosocial stress. Of the 11 cases belong to group A, 5 (45.5%) were found to be healed at the end of the 4th week, 7 (63.3%) at the end of the 6th week and 10 (90.9%) at the end of the 8th week. In comparison among the 18 cases of group B, the numbers were 5 (27.8%), 7 (38.9%) and 15 (38.3%) respectively. The differences in manifest anziety scores before and after the treatment were -3.44±1.92 in group A and -0.44±4.92 in group B. There was a significant reduction of anxiety levels in group A.The improvement of clinical symptoms and the ulcer healing achieved by the Clotiazepam treatment satisfactorily paralleled the reduction of MAS scores and the normalization of the circadian rhythms of blood corticosteroid in a case of a patient with psychosocial stress and recurrent multiple ulcers. The above results showed that treatment utilizing tranquilizers for patients with gastric ulcers can be effective in patients with psychosocial stress and suggested that the stabilization of psychoneuroendocrine funciton achieved by the tranquilizer influenced and promoted the early healing process of gastric ulcers.
日本心身医学会の論文
1980-06-01

胃潰瘍の総合医学的治療研究(3) : 向精神薬療法の併用成績について

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