横浜嚥下障害症例検討会

私たちは横浜、湘南、横須賀の医師、歯科医師、コメディカルの有志で作られた会です。嚥下障害の臨床を追求し、より質の高い臨床を患者さんに提供出来ることを目指しています。


テーマ:

嚥下障害に対し、漢方を用いて治療した日本からの報告です。効果判定に嚥下造影検査と嚥下内視鏡検査を行っています。


Functional improvement of deglutitionafter hangekobokuto treatment 

in two cases: Endoscopy and fluoroscopyevaluation 


「嚥下障害における半夏厚朴湯の使用経験」

Yoshinobu Nakada,1* Makoto Arai,2 Masaharu Kokawa,3 Hirohisa Takayanagi,4 Kaori Mochiduki,5Naoki Yamabe6 & Tetsuo Akiba7

1 Department of Internal Medicine, Shonan Hospital, Yokosuka, Kanagawa, Japan
2 Department of Oriental Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan   
3 Department of Rehabilitation, Shin-totsuka Hospital, Yokohama, Kanagawa, Japan                            4 Department of Otorhinolaryngology, Shonan Hospital, Yokosuka, Kanagawa, Japan

5 Department of Pharmacy, Shonan Hospital, Yokosuka, Kanagawa, Japan
6 Department of Rehabilitation, Shonan Hospital, Yokosuka, Kanagawa, Japan
7 Akiba Clinic of Traditional Medicine, Sammu, Chiba, Japan

ABSTRACT

Case: Patients with dysphagia frequently suffer from aspiration pneumonia, are frequently hospitalized, and are often deprived ofthe joys of eating. Although dysphagia is life-threatening, treatment for dysphagia is still limited. Recently, the effectiveness of hang-ekobokuto (Banxia-houpo-tang in Chinese; HKT) for dysphagia has attracted attention. We treated two dysphagic patients with HKTand evaluated deglutition before and after HKT treatment on imaging.

Outcome: The first patient was a 69-year-old alcoholic liver-cirrhosis patient who was diagnosed with dysphagia after hospitaladmission, and the second patient was a 92-year-old aspiration pneumonia patient. After treating the chief complaint, HKT (TJ-16) extract (7.5 g/day) was given and continued indefinitely. Deglutition before and after HKT commencement was evaluatedon video endoscopy and video fluoroscopy, respectively. Deglutition after the treatment was monitored visually.

Conclusion: Deglutition improved after HKT treatment, as judged on endoscopy and fluoroscopy.

 

【要旨】

嚥下機能を改善する薬は選択肢が少なく、経口摂取を希望する患者にとって嚥下障害は苦痛以外のなにものでもない。我々は、半夏厚朴湯を使用して嚥下機能の改善を認めた2例を経験し、それぞれ嚥下内視鏡及び嚥下造影で評価したので論文としてまとめた。半夏厚朴湯は、比較的副作用が少なく安全に使用できる薬剤である。嚥下障害に対し、口腔ケアとともに積極的な半夏厚朴湯の単独使用、及び他薬剤との併用が推奨される。




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