漢方医学的な湯液(漢方薬)治療経験における心身医学療法としての効果(シンポジウム : 東洋における心身医学療法,2007年,第48回日本心身医学会総会(福岡))  [in Japanese] Kampo Therapy Based on the Diagnostic System is Effective for Psychosomatic Disease(Symposium/Asian Psychosomatic Therapies)  [in Japanese]

漢方診療を専門とする飯塚病院漢方診療科において,心療内科領域の受診者は少なくない.健康関連QOL質問票であるSF-36を用いて調査した結果,外来受診者の精神的健康度は4因子を含む健康度8因子すべてが国民標準値より低値だったが,漢方治療開始後3カ月でいずれも改善あるいは改善傾向となった.漢方医学では,病人全体の漢方医学的な病態(証)を把握し,治療は健康体からのバランスの崩れを補正して,生体反応を援助する.分析的に病原を突き止め,排除するという,西洋医学的発想とは異なる.証の基本的な尺度は陰陽であり,やや個別的な要素として虚実・寒熱,あるいは気血水の異常などの要素がある.証に基づいて治療薬を決定するため,治療効果が確認されれぼ診断確定となる.五感を中心とした漢方医学的な診察法・四診を用い,陰陽・虚実を中心として証を判定し治療した結果,茯苓四逆湯が有効であった心身症の3例を提示した.

Kampo, Japanese traditional medicine, was transmitted from China since about 1, 500 years ago and adapted to Japanese people, and with confidence on clinical usefullness of ancient Chinese formulations. We frequently have the opportunity of treating patients suffering from psychosomatic diseases with Kampo medicine. Therefore, we evaluated an index of the health-related quality of life (HQOL) on the out-patients before and three months after treatment with Kampo medicine. HQOL was assessed with the Short Form 36 (SF-36) item health survey, Japanese version. On all eight scales (physical functioning, role physical, body pain, social functioning, general health perceptions, vitality, role emotional and mental health) of the SF-36, the patients' score before treatment were significantly lower than the Japanese national norm scores. Particularly, 5 scales such as the physical functioning, role physical, general health perceptions, social functioning and mental health significantly improved after treatment with Kampo medicine. The results indicate that the patients excepted of Kampo medicine display various physical, emotional and social dysfunctions, and Kampo medicine could improve the HQOL of patients. We usually diagnose the patient's condition by his or her symptoms and signs, and prescribe the Kampo formulation which can rectify the shift from the healthy condition and can assist the patient's biological reaction against the disease. The most basic scale in Kampo diagnosis is Yin and Yan ; Yin disease is negative or inactive state of the patient's biological reaction with coldness, and Yan disease is positive or active, with fever or without coldness. We presented the clinical courses of three cases with psychosomatic diseases. All of them were diagnosed as Yin pattern and treated with Kampo formula containing medicinal plants after taking which the body was warmed up. Then the treatments were effective and their SDS score decreased. We believe Kampo therapy due to Yin or Yan diagnosis is important and useful to treat psychosomatic diseases.