The examination of endoscopic findings in 221 cases of rheumatoid arthritis treated with Japanese Oriental (Kampo) medicine

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概要

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• 和漢薬治療中の関節リウマチ(RA)患者の胃十二指腸病変を検討した。【方法】当科で和漢薬治療中のRA患者のうち,1980年1月から2000年10月までに上部消化管内視鏡検査を施行した221例について内視鏡所見とRAの活動度,治療内容との関連を検討した。【結果】対象221例中,活動性の消化性潰瘍は10例(4.5%)。内訳は胃潰瘍9例,十二指腸潰瘍3例であった。潰瘍瘢痕は21例(9.5%)。内訳は胃潰瘍瘢痕16例,十二指腸瘢痕5例であった。その他,びらん性変化が12例(5.4%),早期胃癌が4例(1.8%)に認められた。非ステロイド性消炎鎮痛剤(NSAIDs)またはステロイド剤(ス剤)併用治療群(107例)と和漢薬単独治療群(96例)で比較検討すると,前者の活動性胃十二指腸潰瘍合併例が10例(9.3%)であるのに対し,後者では2例(2.1%)とNSAIDsまたはス剤併用群に有意に多く活動性潰瘍が合併していた。【考察】1999年CheatumらはNSAIDs服用中のRA患者の胃十二指腸病変を内視鏡検査で検討し,1009例中239例(23.6%)に胃または十二指腸潰瘍があったことを報告している。RA患者の胃十二指腸潰瘍の合併頻度については,Farahらの185例中67例(1988年),塩川らの1008例中175例(1991年)などがあり,いずれもNSAIDs投与との関連性が指摘されている。今回の検討では,221例中10例とこれらの報告と比較して少ない傾向にあった。和漢薬を中心とした治療で,NSAIDs使用を最小限にとどめることにより,消化性潰瘍の合併を減らしうる可能性が示唆された。

• 和漢医薬学会の論文

著者

• TERASAWA Katsutoshi

  Department of Japanese Oriental Medicine, Faculty of Medicine, Toyama Medical and Pharmaceutical Uni

• KOGURE TOSHIAKI

  Department of Integrated Japanese Oriental Medicine, School of Medicine, Gunma University

• Terasawa Katsutoshi

  群馬大学 医学部医学科統合和漢診療学講座

• SHIMADA Yutaka

  Department of Japanese Oriental Medicine, Faculty of Medicine, Toyama Medical and Pharmaceutical Uni

• Terasawa K

  Dept. Of Japanese Oriental Medicine Graduate School Of Medicine Chiba University

• SAKAI Shinya

  Department of Japanese Oriental Medicine, Faculty of Medicine, Toyama Medical and Pharmaceutical Uni

• NIIZAWA Atsushi

  Department of Japanese-Oriental Medicine, Kanebo Memorial Hospital

• Shimada Y

  Dept. Of Japanese Oriental Medicine Faculty Of Medicine University Of Toyama

• NIIZAWA Atsushi

  Dept. of Japanese Oriental Medicine, Kanebo Memorial Hospital

• MANTANI NAOKI

  Department of Integrated Japanese Oriental Medicine, Faculty of Medicine

• Shimada Y

  Tokyo Inst. Technol. Yokohama Jpn

• Sakai Shinya

  Department Of Japanese Oriental Medicine Faculty Of Medicine

• Sakai Shinya

  Department Of Health Science Hokkaido University

• Mantani N

  Department Of Integrated Japanese Oriental Medicine Faculty Of Medicine Gunma University

• Mantani Naoki

  Departments Of Oriental Medicine Faculty Of Medicine Toyama Medical And Pharmaceutical University

• Mantani Naoki

  Department Of General Medicine Gunma University School Of Medicine

• Shimada Yuji

  Microsystem Research Center Precision And Intelligence Laboratory Tokyo Institute Of Technology

• Shimada Y

  Tohoku Univ. Sendai Jpn

• 島田 洋蔵

  産業技術総合研究所

• NIIZAWA Atsushi

  富山医科薬科大学医学部和漢診療学教室

• Niizawa Atsushi

  Dept. Of Japanese Oriental Medicine Kanebo Memorial Hospital

• Niizawa Atsushi

  Department Of Japanese-oriental Medicine Kanebo Memorial Hospital

• 嶋田 豊

  富山医科薬科大学医学部和漢診療学

• Kogure Toshiaki

  Department Of Integrated Japanese Oriental Medicine Faculty Of Medicine Gunma University School Of M

• KOBAYASHI Yutaka

  Yukiguni Yamato Sou-gou Hospital

• Terasawa Katsutoshi

  21st Century Coe Program University Of Toyama:department Of Japanese Oriental Medicine Graduate Scho

• Kobayashi Y

  Department Of Orthodontics Graduate School Of Biomedical Sciences Nagasaki University

• 島田 洋蔵

  Dept. Of Japanese Oriental Medicine Faculty Of Medicine University Of Toyama

• Shimada Yutaka

  Department Of Anatomy And Cell Biology School Of Medicine Chiba Unversity

• Terasawa Katsutoshi

  Department Of Japanese Oriental Medicine Faculty Of Medicine Toyama Medical And Pharmaceutical Unive

• Shimada Yutaka

  21^<st> Century Coe Program Toyama Medical And Pharmaceutical University

• Terasawa Katsutoshi

  Department Of Japanese Oriental (kampo) Medicine Faculty Of Medicine Toyama Medical And Pharmaceutic

• Shimada Yutaka

  Department Of Anatomy And Cell Biology School Of Medicine Chiba University

• Terasawa Katsutoshi

  Department Of Integrated Japanese Oriental Medicine School Of Medicine Gunma University

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