A clinical study of Hange-shashin-to (Ban-Xia-Xie-Xin-Tang) administered through a naso-esophageal feeding tube for the treatment of diarrhea related to tube feeding

食餌の経口摂取が困難な患者に対して用いられる経管栄養療法により下痢を発症することがあるが,止痢剤の投与による便秘が問題となり,内服薬も経管による投与のため,薬剤の溶解法などに工夫も必要である。この経管栄養療法中の下痢に対してとうもろこし澱粉を賦形剤に用いてフローコーティング法で製造された半夏瀉心湯エキス剤を経鼻胃管から投与する治療に対する効果の検討を行った。経管栄養療法により下痢を発症した8例を対象に,ジュンコウ半夏瀉心湯エキス剤(AB-14)(2.0g)を温水 40ml に溶解して経鼻経管栄養用よリ3回/日の投与を連続3日間行い,下痢の改善効果を検討した。AB-14は温水に容易に溶解することができ,経鼻経管栄養用のチュープを通じて投与することが可能であった。これにより下痢の改善の臨床効果は著効:37.5%,有効:50.0%であった。症状の悪化したものはみられず,便秘などの副作用の出現もなく,本方剤による治療は臨床上有用と考えられた。

Some patients with difficultly orally consuming food develop diarrhea during tube feeding. In addition, such problems as constipation induced by the administration of anti-diarrheal agents also sometime occur. We treated such patients by the administration of Hange-shashin-to (Ban-Xia-Xie-Xin-Tang, 半夏瀉心湯) extract granules (manufactured with corn starch filler) through a naso-eso-phageal feeding tube. We examined its effectiveness in the treatment of diarrhea in 8 patients who received a three consecutive day administration of Hange-shashin-to extract granules (AB-14) (2.0 g, 3 times a day) dissolved in 40 ml of hot water. AB-14 showed good solubility and it was easily administered through a feeding tube. Its effectiveness in the treatment of diarrhea was as follows: 37.5 % of the patients showed a remarkable improvement, while 50.0 % had some improvement. No deterioration and no adverse effects such as constipation or ileus were observed. As a result, the treatment with the Hange-shashin-to was thus considered to be effective for the treatment of diarrhea during tube feeding.