最近の降圧薬,とくに,Chlorothiazide, Hydrochlorothiazideの臨床的薬効分析と,重症高血圧症の治療について

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概要

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• 1. By the use of recent depressant drugs the average life expectancy of malignant or severe (Schroeder) hypertensive patient increased fairly in its amount, so that some of them were possible even to be engaged in their work. However in order to augment the number of such favourable cases, both early diagnosis and early initiation of the treatment must be more promoted. Despite of the excellency of recent depressant drugs, the therapeutic results of the benign hypertensive cases, mostly used to be treated as outpatients, especially those of the long termed observation left much to be desired. Notice must be furthermore paid upon the influence of the present biological and social environment of the benign hypertensive patients in Japan. 2. In the light of Prof. Smirk the optimal state was researched during the course of the controlling of the hypertension, not only from standpoint of the pressure level but also from that of the hemodynamical factors, i. e., output, peripheral and elastic vascular resistance. The hemodynamical optimal state is meant by the blood pressure level under which the hemodynamical factors of the patients show the most approximate values to the normal. The blood pressure level of the optimal state which is defined by Prof. Smirk did not always agree with that of the optimal state which is defined by hemodynamical analysis. There were some cases of which the still high blood pressure against the remedy must be considered to be so-ealled "Erfordernisdruck" in the sense of Volhard et al. 3. The some supplementary observations were made with respect to the depressant actions and the side effects of mecamylamine, pempidine and camphidonium salts, 4. The circulatory analysis showed, as a rule, the hypotension of "Anspannungstypus" (Duesberg & Schroeder) resulted by the administration of chlorothiazide or hydrochlorothiazide, however the characteristics of the mode of the depression was more marked by the use of the former. Besides the salt-deprivating action of these two drugs which was repeatedly assured by many authors, there took place also the actions of the reduction of both extracellular fluid volume and circulating blood volume, frequently accompanied with the decrease in output. The extent of the diuresis of these two drugs, mainly due to the inhibition of the tubular resorption of Na, Cl and K was not always parallel with that of the depression.

• 千葉大学の論文

著者

• 木川田 隆一

  千葉大学

• 木川田 隆一

  千葉大学医学部第二内科学教室

関連論文

• 30. 高血圧症の重症度と腎動脈病変の関係(第423回千葉医学会例会)
• 最近の降圧薬,とくに,Chlorothiazide, Hydrochlorothiazideの臨床的薬効分析と,重症高血圧症の治療について

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