The influence of formula Ma-Huang-Fu-Zi-Xi-Xin-Tang (Mao-bushi-saishin-to ;Mbst) on the results of urodynamic studies
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概要
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目的:エフェドリン含有漢方薬が,若年者のみならず高齢者においても,その交感神経刺激作用にもかかわらず,排尿に多大な影響を及ぼさないことを尿流量試験を用いて示す。方法:麻黄附子細辛湯エキスカプセル(Mbst)とプラセポ(P)による尿流量に対する効果のクロスオーバー試験を13名の若年ボランティア(平均38.0±6.0歳,31〜47歳)に行った。対象の前立腺の推定平均重量は15.6±6.9g。エフェドリン含有製剤の一例として麻黄附子細辛湯を用いた。なお,コタロー麻黄附子細辛湯カプセルは,味覚や外見上プラセポが作成しやすかったため対象に採用した。尿流量試験は,MbstやPの投与前に一回,投与3時間後に一回それぞれ施行した。最大尿流量率(Qmax),平均尿流量率(Qave)及びvoiding efficiency ε=Qave/Qmaxを指標とした。我々は,無症状の被験者に対して以上の実験を施行することで実験の安全性を確認した後,高齢者に対して麻黄附子細辛湯投与前後の尿流量試験の比較実験を施行した。結果:MbstとPの投与後のvoiding efficiency ε=Qave/Qmaxは0.66±0.08と0.65±0.09。最大尿流量率は各々20.7±6.1と19.7±7.3ml/sec,平均尿流量率は13.3±3.3と12.4±3.9ml/secであった。それゆえ,どのエンドポイントにおいても薬剤による影響は認められなかった。各エンドポイントの中でもε=Qave/Qmaxが排尿困難の最も良い指標と考えられた。また,高齢者での尿流量試験でも薬剤投与前後において排尿に影響は認められず,若年者と同じ傾向を示した。結論:エフェドリンを含有する麻黄附子細辛湯は,若年者のみならず高齢者に対してもそれほど多大な悪影響を来さないことが統計学的に示された。加えて,voiding efficiency(ε=Qave/Qmax)は,尿道狭窄の有用な指標であることが示された。
- 2001-10-31
著者
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Kohri Kenjiro
Department Of Urology Nagoya City University Medical School
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TSUTANI Kiichiro
Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, The University
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青木 良純
青木診療所
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Tsutani Kiichiro
Department Of Drug Policy And Management Graduate School Of Pharmaceutical Sciences The University O
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Tsutani Kiichiro
Department Of Pharmacoeconomics Graduate School Of Pharmaceutical Sciences The University Of Tokyo
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Ueda Kosuke
Department Of Uroloty Nagoya City University Medical School
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Kohri Kenjiro
Department Of Nephro-urology Nagoya City University Graduate School Of Medical Science
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Ueda Kosuke
Department Of Urology Nagoya City University Medical School
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Ueda Kosuke
Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine
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