半夏瀉心湯, 小柴胡湯により薬剤性肝障害ならびに間質性肺炎を来した一例  [in Japanese] A Case of Hepatitis and Interstitial Pneumonitis Induced by Hangeshashin-to and Shosaiko-to  [in Japanese]

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Abstract

症例は60歳男性で●●●●●●●●腹部不快感を主訴に北里研究所東洋医学総合研究所を受診した。半夏潟心湯の投与により腹部症状は軽減したが, 半夏潟心湯の服用は6月より8月まで継続した。同年●●●●より悪寒, 発熱, 倦怠感が出現した。肝機能障害を指摘されたため, 半夏潟心湯を中止し小柴胡湯を投与した。●●当院漢方科入院となり, 抗生剤, 強力ミノファーゲンCにて経過観察した。入院時の胸部レントゲンにて左上肺野にスリガラス状陰影を認めたため, 小柴胡湯を中止した。肝機能障害は改善したが, 呼吸困難が顕著となり, 捻髪音を聴取するようになった。胸部レントゲン, 胸部CTにて間質性変化を確認し, ●●●●●よりPSLの投与を開始した。経過は良好で症状, 画像所見, 検査所見とも改善を認めた。DLSTは小柴胡湯, 柴胡, 黄苓で陽性だった。当初小柴胡湯による間質性肺炎を疑ったが, 小柴胡湯投与前の他院での胸部レントゲン写真でも左上肺野のスリガラス上陰影を認めたため, 本例は半夏潟心湯が主でさらに小柴胡湯の投与により薬剤性の肝障害ならびに間質性肺炎を発症したものと考えられた。

A 60-year-old male patient visited the Oriental Medicine Research Institute of the Kitasato on ***** because of abdominal discomfort. Hangeshashin-to was administered to him and the abdominal discomfort was relieved. He continued to take Hangeshashin-to from June to August 1997. He had chills, high fever, and fatigue from ********. He stopped Hangeshashin-to and took Shosaiko-to for five days because of liver dysfunction. He was admitted to our hospital on ********. Antibiotics and stronger neo-minophagen C were administered to him. A chest roentgenogram revealed a ground-glass shadow on the left upper lung, and Shosaiko-to was discontinued. The patient began to complain of dyspnea and had fine crackles on the chest. A chest roentgenogram and chest CT showed interstitial pneumonitis. Oral predonisolone therapy was started for hypoxemia and the patient improved. A drug lymphocytes stimulation test revealed that lymphocytes were stimulated by Shosaiko-to and its components, Saiko and Ogon. A chest roentgenogram just before ingesting Hangeshashin-to revealed the interstitial change of the lung. Taken all together, this patient suffered from druginduced hepatitis and pneumonitis as a result of ingesting Hangeshashin-to and Shosaiko-to.

Journal

  • Kampo Medicine

    Kampo Medicine 50(1), 57-65, 1999-07-20

    The Japan Society for Oriental Medicine

References:  19

Cited by:  5

Codes

  • NII Article ID (NAID)
    110004001295
  • NII NACSIS-CAT ID (NCID)
    AN00015774
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    02874857
  • Data Source
    CJP  CJPref  NII-ELS  J-STAGE 
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