薬剤による結核復職者の再燃防止に関する研究
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The recurrence of pulmonary tuberculosis in persons recovered from the disease and rehabilitated has growingly attracted the attention of health officers in industry. This series of study were undertaken to prevent the recurrence by means of a continuing administration of an antitubercular chemotherapeutic over a long period of time. Sodium isonicotinic acid hydrazide methanesul-fonate (IHMS) was used throughout the study. I. The Influence of Administration of IHMS on the Tuberculin Sensitivity Induced by BCG Vaccination. Sixty-two persons presenting no positive reaction to a tuberculin of usual concentration were divided into 2 groups of same in number. Persons of the one were administered orally an amount of 0.3g of IHMS twice a week for 4 months. At the end of beginning month of administration, all persons of the both group were inoculated with 0.05mg of dried BCG vaccine, they were then tested a tuberculin reaction monthly until the 9th month from the beginning of vaccination. Following results were obtained: 1) The administration of IHMS inhibited definitely the advent of tuberculin sensitivity induced by BCG vaccination. 2) The inhibitory effect of the drug was shown more distinctly in the formation of in-duration than redness of the reaction. 3) The number of tuberculin positive reactors in the each group increased at the period of beginning 1 to 2 months after vaccination, reduced then with the lapse of time thereafter, however, the reduction began much earlier in time and more significant in the group received the drug. II. The Effect of a Continuing Administration of IHMS on the Recurrence of Pulmonary Tuberculosis. One hundred and forty persons who had recovered from pulmonary tuberculosis and are working were subjected to the study. They were divided at random into 2 groups and persons of the one were administered IHMS for 6 and 3 months continuously with an interval of 6 months. The amount of drug and the method of administration were the same as described in the pervious paper. The persons of the other group who did not received the drug were designated as control. All persons of the both group received then roentgenological chest examinations every 3 months for 2 years and the change of their tuberculous foci were followed. The results are as follows: 1) The administration of IHMS reduced the recurrence of disease to one thirds in rate in the group of persons who had shown foci of exudative type at the beginning of experiment, and to one fifths in those of cirrhotic type. In contrast, the improvement of disease rised about 3 times in rate in the persons showing tuberculous foci of the both type initially. 2) No relationship was found between the use of INH in the past and the preventive effect of IHMS on the recurrence of the disease. 3) The reduction of recurrence rate resulted by the administration of IHMS was much greater in the persons of younger age, whereas the rise of improvment rate was more greater in those of older age. III. The Influence of Past History of Pulmonary Tuberculosis on the Chemoprophy-lactic Effect of IHMS. The persons of 140 in number who were subjected to the previous study were investigated their past histories of tuberculosis, namely, the nature of tuberculous foci, the method of treatment for the disease and the time interval from rehabilitation to the beginning of experiment. Then, the relationships between the histories and results of chemoprophylaxis on the recurrence of disease were observed as groups. 1) In the control group, the recurrence rate was higher in persons who belonged to the roentgenological status 1 at the beginning of experiment than those to the status 2, however, the administration of IHNS was equally effective for the persons of both status of disease. 2) The recurrence rate was the highest in persons who had received solely a chemotherapy in the past and the lowest in those who had received both chemotherapy and pneumothorax, however, the reduction of recurrenc
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