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抄録
早期胃癌に対する幽門側胃切除術後の食欲不振に香蘇散合六君子湯が奏効した一例を経験したので報告する。症例は71歳の男性。早期胃癌(0-IIa+IIc)と診断され幽門側胃切除術を施行された。術後に, 嘔吐, 食欲不振が出現し経口摂取が不能となった。内視鏡的バルーン拡張術, 種々の西洋薬による薬物治療を試みられたが, 術後46日を経過しても経口摂取が不能なままであった。そこで漢方治療の適応と判断され当科転科となった。中心静脈栄養を併用しながら漢方治療を開始した。香蘇散投与後から急速に経口摂取量が増加し, 香蘇散合六君子湯に転方することで常食を摂取可能となり, 術後90日で退院となった。胃切除後の食欲不振は心理的原因, 器質的原因の双方で生じる可能性があり, 心身の異常に対し, これを調和して治療可能な漢方治療の有効性が示唆された。
We report a case of an anorectic 71-year-old male post-gastrectomy patient who was successfully treated with Koso-san and Rikkunshi-to. The patient underwent resection for early gastric cancer (0-IIa+IIc). After partial gastrectomy, he suffered from nausea and vomiting. He was treated with endoscopic balloon dilatation at the anastomotic site, and was simultaneously treated with some western drugs. However, he was completely unable to eat because of nausea and vomiting. Oriental medicine was then recommended. We treated him with Kampo medicines in combination with parenteral nutrition. After the administration of Koso-san, his nausea and vomiting disappeared immediately and he could ingest a fluid diet. Further, after the administration of Koso-san and Rikkunshi-to, his food intake increased. Finally, he could eat ordinary meals and his food intake reached an adequate level. This suggests that Koso-san and Rikkunshi-to are useful in the treatment of anorectic patients after gastrectomy.
