胃切除術後の消化器症状に対する半夏瀉心湯,六君子湯の効果(<特集>第44回日消外会総会特別シンポ2 : 漢方と消化器機能および消化器外科)  [in Japanese] The Effect of Hange-shashin-to and Rikkunshi-to Against the Digestive Symptoms after Gastrectomy  [in Japanese]

胃癌胃切除術後の消化器症状の治療目的で半夏瀉心湯または六君子湯を4週間投与し自覚症状累積消失率,症状消失までの期間を検討した.食欲不振累積消失率は半夏瀉心湯群では早期から改善がみられたが,最終的にはほぼ同程度の改善効果を示した.胃のもたれ,胸やけは両群ともほぼ同程度の改善効果を示した.悪心・嘔吐は半夏瀉心湯群の方が早期から改善がみられたが,最終的な改善効果は六君子湯群の方が高かった.症状消失までの期間は半夏瀉心湯群で悪心・嘔吐,食欲不振,胃のもたれ,腹部膨満感,心窩部痛,腹鳴で,六君子湯群で悪心・嘔吐,心窩部痛で早期に消失したが半夏瀉心湯群の方が高い効果が得られた.全般的には半夏瀉心湯群で肥満度が普通,体表面積が中程度,胃癌亜全摘症例に,六君子湯群で,肥満度がやせ,体表面積が小さい,胃癌全摘症例に高い改善効果がみられたことからもそれぞれの処方の「証」がある程度確認される結果が得られた.

Hange-shashin-to or Rikkunshi-to was administered for four weeks to patients who had digestive symptoms following gastrectomy, to evaluate the cumulative rates of disappearance of subjective symptoms and the duration required for symptoms to disappear. In the evaluation of the rate of disappearance of loss of appetite, the group of patients who received Hange-shashin-to showed improvement early in the test. At the end of the test, the two groups of patients had similar rates of improvement. The rates of disappearance of heavy feeling in the stomach were approximately the same for both groups. There was no difference in the rate of disappearance of heartburn between the two groups. In the evaluation of the rate of disappearance of nausea and vomiting, the group given Hange-Shashin-to showed early improvement, while the group given Rikkunshi-to had a higher rate of final improvement than the former. In evaluation of the time it took for subjective symptoms to disappear, the group that received Hange-shashin-to showed early disappearance of symptoms of nausea, vomiting, loss of appetite, heavy feeling in the stomach, abdominal distension, epigastric pain and borborygmus, while the group that received Rikkunshi-to also demonstrated early disappearance of symptoms of nausea, vomiting and epigastric pain, but the former group showed better results than the latter. In overall evaluation, Hange-shashin-to was found to be highly effective in patients who were of average build, of medium body surface area and underwent subtotal gastrectomy for gastric cancer, and Rikkunshi-to was highly effective in patients who were slim, of small body surface area, and underwent total gastrectomy for gastric cancer. The result verified how to original use of each drug.