抗結核剤による胃腸障害.特にCMI型と胃腸症状との関連および1321THと1314THによる胃腸症状の比較

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To clarify the status of gastrointestinal side effects of antituberculosis drugs, Cornel Medical Index (CMI) was investigated in 407 tuberculous patients of our sanatorium. CMI of the other 57 patients in other sanatoria (Hoseien Sanatorium and Shizuoka Prefectural Fujimi Hospital)who were treated with 1321 TH or 1314TH were investigated, too. The results were summarized as follows: 1. The frequency of Types I (normal), II (almost normal), III (neurotic inclination) and N (neurosis) of CMI level after Fukamachis classification was indicated in Table 1. About 8%of the patients were classified as Type IV. 2. Psychologically unstable patients were more in female than in male. The frequency of Type III (neurotic inclination) was 31.9% in female patients, and 23.0% in male (Table 1). 3. Psychologically unstable patients were more in the groups who were treated wi t h secondary drugs than in groups receiving primary drugs. The frequency of Type III in the patients receiving secondary drugs was 44.2%, while the frequency of those receiving primary drugs was 17.6% (Table 2). 4. Out of 407 patients, 286 (70.3%) complained some gastrointestinal disturbances. The average number of complaints was 2.62 (Table 3). 5. The average number of gastrointestinal c omplaints increased more and more from Type I to Type N. The average number of complaints was 1.06 in the patients of Type I, 2.21in Type Ii, 4.09 in Type II and 5.43 in Type IV (Table 3). 6. The number of complaints increased from Type I to Type IV, in all the groups receiving SM-FINH+PAS, KM (CPM) +1321 TH+CS, KM (CPM) +1314 TH+CS or SM+INH+Sulfa-drug. The number of gastrointestinal complaints correlated more definitly with the Types * From Research Institute, Japan Anti-Tuberculosis Association, Kiyose-machi, Kitatamagun, Tokyo 180-04 Japan. of CMI level than the regimens of antituberculosis drugs (Table 4). 7. From the above-mentioned results, the authors consider t hat the stratification of the object by CMI level is necessary for the investigation or the analysis of subjective complaints such as gastrointestinal disturbances. 8. This investigation revealed the gastrointestinal side effects of antituberculosis drugs in the patients continually taking some drugs. There were some patients who changed from combined therapy with 1314TH to that with 1321 TH or EB because of gastrointestinal toxicity. No patients were found who defaulted from 1321 TH therapy. So, the 1321 TH group had disadvantage for the comparison with the 1314TH group. In spite of this disadvantage, the average number of complaints of the patients receiving 1321T11 was a little fewer than that of the patients receiving 1314TH (Table 4). No one complained nausea or vomitting in the group of patients of Type I and Type II treated with 1321 TH, while there were 11% in Type I and 18% in Type II in the patients receiving 1314TH (Table 6). The authors consider that these results shows the lower toxicity of 1321 TH than that of 1314 TH.
日本結核病学会の論文

抗結核剤による胃腸障害.特にCMI型と胃腸症状との関連および1321THと1314THによる胃腸症状の比較

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