アセチル・ジギトキシン,ラナトサイドA,および,プルプレア配糖体Aの臨床的効果の比較研究

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The comparative studies upon the clinical evaluation of Purpurea A "Takeda" (T-211-P), Lanatoside A "Takeda" (T-211-L) and Acetyl-digitoxin-α "Sandoz" were performed in 58 patients suffered from cardiac insufficiency due to various sorts of underlying heart diseases (Tbl. 3, 4). The severity of congestive cardiac failure is above mediocrity and the sensitivity of the patients to digitalis preparates is relatively even except for very few abnormal cases. From the results of the observation upon the effects of three kinds of preparates for the saturation and the maintenance, as shown in Tbl. 6, 7 and 8, there can hardly essential difference of the saturation curves gained by intravenous route among three preparates, especially between Acetyl-digitoxin and Lanatoside A. Consequently the rapid digitalisation can be as easily accomplished by the intravenous use of these three preparates as by that of Lanatoside C etc. However for the saturation by oral route Lanatoside A is quite on a level with Acetyl-digitoxin (Tbl. 9, Fig. 4). Either dissipation or accumulation rate of three preparates clinically estimated shows considerably wide fluctuation. As to the dissipation Acetyl-digitoxin shows 9〜22.%, Lanatoside A 16〜33 %, and Purpurea A 17〜22 %. Regarding the mean values gained by means of the graphics of frequency distribution, Acetyl-digitoxin gives 18.7 %, Lanatoside A 21.7 % and Purpurea A 19.5 % (Tbl. 10, Fig. 7). Three preparates show the similar distribution curves of effectiveness and toxicity (Fig. 8), however, to describe in detail, Acetyl-digitoxin has the tallest efficacy curve with the narrowest skirt and the lowest toxicity curve with the widest skirt, so that it may be safe to say that Acetyl-digitoxin is promised to have the widest therapeutic range and the least toxicity. There exists no significant difference between Purpurea A and Lanatoside A respecting this problem in due consideration of clinical data collectively examined. Clinical effectiveness of Acetyl-digitoxin, Lanatoside A and Purpurea A is summarized in Fig. 9, 10 and 11. Three preparates bear fairly similar fruit, but closely to describe, Acetyl-digitoxin possesses the most powerful cardiotonic action examined with therapeutic dosage (Fig. 12). It is difficult clinically to make the discrimination of the effectiveness of these three preparates for the treatment of congestive heart failure (Tbl. 11, 12). Deeply impressed with Lown's recent work, some of arrhythmia experienced in this observation were analyzed, because also in Japan there develops the necessity of the. inquisition of the arrhythmia implicated in abuse of digitalis preparates. Except for very few cases with abnormal sensitivity to digitalis preparates, so far as the therapeutic dosage of these three drugs is concerned, there can be scarcely found the hazard of the digitalis arrhythmia properly emphasized by Lown if only the general remark of digitalis use is kept. Although these three digitalis preparates tend to be said as "slow-responded", they respond rapidly sufficient for the clinical praxis when injected intravenously. The enteral resorption of these three preparates exceeds that of Lanatoside C, so that the oral administration of them is very suitable for the maintenance, especially of tachycardic decompensation, because the negative chronotropic action of these three is more potent than that of Lanatoside C etc.
千葉大学の論文

アセチル・ジギトキシン,ラナトサイドA,および,プルプレア配糖体Aの臨床的効果の比較研究

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