著者
山際 幹和 原田 輝彦 坂倉 康夫
出版者
耳鼻咽喉科臨床学会
雑誌
耳鼻咽喉科臨床 (ISSN:00326313)
巻号頁・発行日
vol.84, no.6, pp.837-851, 1991-06-01 (Released:2011-11-04)
参考文献数
36

Without following the traditional diagnostic procedure based on oriental medicine, we administered an oral Kampo (traditional Chinese herbal) medicine, Tsumura Saiboku-to (7.5g/day), daily for 2 weeks to 108 patients with abnormal sensation in the throat, such as a lump or choking.After excluding 8 patients, 4 with unpleasant side effects and 4 who discontinued the medication, we evaluated the efficacy at the end of the first and second week of administration and one week after the termination of treatment in 38 males and 62 females. The medicine was considered to be very effective when the abnormal sensation improved subjectively by 80% or more, moderately effective if improvement was 50% to 80%, slightly effective if it was 30% to 50% and not effective if less than 300.The respective effectiveness rates were 22%, 32%, 11% and 35% at the end of the first week; and 35%, 33%, 12% and 20% at the end of the second weed; and 43%, 30%, 7% and 20% at the end of the third week. Further analysis of the data suggests that this medicine is more effective for females than males, for younger patients and those over 50, for non-drinking than habitually drinking patients, for those not previously treated, for those without cancer phobia, for those treated within one month after the start of abnormal sensation, for those with the sensation higher in the pharynx, and for those with lower neurotic scores on psychological tests.Side effects were reported by 6 (6%), 4 of whom stopped the medication: 4 had gastrointestinal symptoms and 2 had dry mouth and/or throat.From the point of view of western medicine, the effectiveness of Saiboku-to on abnormal sensation in the throat is good enough. It would probably be even better if administered after a selection based on diagnosis according to the concepts of oriental medicine.
著者
山際 幹和 福生 治城 坂倉 康夫 三吉 康郎
出版者
耳鼻咽喉科臨床学会
雑誌
耳鼻咽喉科臨床 (ISSN:00326313)
巻号頁・発行日
vol.76, no.4, pp.1307-1319, 1983-04-01 (Released:2011-11-04)
参考文献数
18
被引用文献数
1

咽喉頭異常感症女性例50例を東洋医学的診断を行うことなく, 西洋医薬と同様の概念でツムラ半夏厚朴湯 (7.5g/日, 14日間連日経口投与) を用いて治療した. 自覚症状の改善率が80%以上を著効, 50%以上を有効, 30%以上をやや有効, それ未満を不変として効果を判定した. その結果, 著効, 有効およびやや有効率は, 1週目で各々26%, 26%, 8%, 2週目で各々42%, 16%, 12%, 又, 3週目 (休薬後1週目) で各48%, 18%, 6%であった. 1例に副作用らしき症状 (嘔気) がみられた. 種々の点から治療成績の分析を行ったところ, 発症より本剤による治療開始までの期間が短い例ほど有効率が有意に高いことが判明したが, 本剤の作用機序を類推するには至らなかった. 西洋医学的診療に加え, 東洋医学的診療を行うことにより, 本症の治療成績は明らかに向上するものと考えた.
著者
山際 幹和
出版者
日本鼻科学会
雑誌
日本鼻科学会会誌 (ISSN:09109153)
巻号頁・発行日
vol.47, no.1, pp.86-87, 2008 (Released:2009-06-05)
参考文献数
8
著者
大山 勝 山際 幹和 荘司 邦夫 橋本 真実 古田 茂 小幡 悦朗 三吉 康郎
出版者
耳鼻咽喉科臨床学会
雑誌
耳鼻咽喉科臨床 (ISSN:00326313)
巻号頁・発行日
vol.75, no.8, pp.1681-1689, 1982-08-01 (Released:2011-11-04)
参考文献数
18
被引用文献数
1

By means of laryngofiberscopy, pneumatography and photoelectric glottography, the closure reflex activity of the larynx which was evoked by trasnasal stimulation with various concentrations of isovaleric acid and ammonia during inspiration was determined in 24 normal subjects and 53 patients with chronic sinusitis, anosmia, nasal allergy and chronic obstructive pulmonary diseases (COPD).The reflex activity was characterized by a remarkable tendency to decrease in the majority of normal older subjects and most of the patients with conditions other than nasal allergy.It was assumed that this reflex might be of great importance in preventing hazardous materials from going into the lung and that depression or absence of the reflex sensitivity in the upper respiratory tract might lead to a higher incidence of pulmonary diseases.The results which were obtained here will help clarify the laryngeal clossure reflex. This methodology may be employed practically to serve as objective olfactometry.
著者
山際 幹和
出版者
耳鼻と臨床会
雑誌
耳鼻と臨床 (ISSN:04477227)
巻号頁・発行日
vol.52, no.2, pp.128-131, 2006

胃食道逆流症 (GERD) の定型的症状である胸やけ・呑酸症状が全くなかったにもかかわらずプロトンポンプ阻害薬 (PPI) であるlansoprazole (タケプロン®) が奏効した挿管後の喉頭肉芽腫症患者 (女性、24歳、Marfan症候群があり、急性大動脈剥離の全身麻酔下手術と術後管理のため22.5時間の気管内挿管を受けた後に右披裂軟骨声帯突起部に肉芽腫が発生) を経験した。本例の治療経験から、挿管による組織傷害は肉芽腫の発症のきっかけにはなるが、肉芽腫の形成に大きく関与する要因として、不顕性に食道や咽喉頭へ逆流する胃内容物の反復的な物理的・化学的刺激が重要であると推察した。筆者は、本例や類似症例の治療経験から、難治性の挿管性肉芽腫症患者に対しては、明白なGERDや咽喉頭逆流症の自覚症状がなくても、PPIを試用する価値があると考えている。