著者

篠崎 昌一 森山 雅文 林田 淳之介 田中 昭彦 前原 隆 古川 祥子 太田 美穂 今林 佑美 中村 誠司

出版者

社団法人 日本口腔外科学会

雑誌

日本口腔外科学会雑誌 (ISSN:00215163)

巻号頁・発行日

vol.61, no.3, pp.147-153, 2015-03-20 (Released:2015-09-29)

参考文献数

13

被引用文献数

1

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Objectives: Cevimeline hydrochloride (CH) and pilocarpine hydrochloride (PH) are recognized as salivation-inducers with a high affinity for M3 muscarinic receptors. However, these drugs have a high frequency of side effects, including digestive symptoms and hyperhidrosis. We compared the effectiveness and side effects of these two drugs before and after a medication change.Materials and Methods: Seventy-six patients with Sjögren's syndrome were divided into the following four groups: 1) CH group, CH was administered for 12 months; 2) PH group, PH was administered for 12 months; 3) CH-PH group, CH was administered for 6 months followed by PH for 6 months; 4) PH-CH group, PH was administered for 6 months followed by CH for 6 months. We measured the salivary flow rate and recorded the subjective symptoms in each group.Results: In each group, stimulated whole saliva (SWS) and unstimulated whole saliva (UWS) significantly increased after 3 months and 6 months, respectively, and subjective symptoms improved after 3 months. The incremental changes in both SWS and UWS did not differ significantly between the groups. The CH and PH groups both had digestive symptoms (32.3% and 32.1%, respectively) and hyperhidrosis (29.0% and 39.3%, respectively). We found no significant difference in salivary flow rate or subjective symptoms after the medication change. However, the frequencies of side effects in the CH-PH and PH-CH groups decreased significantly for both digestive symptoms (9.7% and 10.7%, respectively) and hyperhidrosis (25.8% and 14.3%, respectively).Conclusions: After changing the salivation-inducing drug, there was no significant difference in salivary function or subjective symptoms, while the frequency of side effects markedly decreased. These results suggest that changing the salivation-inducing drug effectively reduces side effects.

著者

古川 祥子 藤原 和哉 尾本 美代子 村山 友樹 呉 龍梅 笹木 晋 熊谷 亮 五十野 桃子 秋根 大 小林 浩幸 高屋敷 典生 鈴木 浩明 島野 仁 野牛 宏晃

出版者

THE JAPAN DIABETES SOCIETY

雑誌

糖尿病 (ISSN:0021437X)

巻号頁・発行日

vol.57, no.12, pp.913-920, 2014

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症例は21歳女性.2年前から繰り返す発熱,倦怠感,頭痛,動悸,嘔気が1ヶ月前より増悪し来院.血圧186/133 mmHg,脈拍106/分,体温38.5 ℃,血液検査上HbA1c 8.2 %,血糖356 mg/d<i>l</i>と糖尿病を認め,CRP 40.21 mg/d<i>l</i>, IL-6 100 pg/m<i>l</i>と高値だった.画像上¹²³I-MIBGシンチグラフィーで集積のある7 cm大の左後腹膜腫瘤を認め,カテコラミン・メタネフリン高値であり褐色細胞腫と診断した.ドキサゾシン,プロプラノロールの他,発熱,炎症反応高値に対しナプロキセンを使用した結果,CRP 0.15 mg/d<i>l</i>, IL-6 1.7 pg/m<i>l</i>まで低下した.同時に耐糖能は改善し,インスリン療法を術前に中止し得た.IL-6高値を伴う褐色細胞腫では,ナプロキセンが二次性糖尿病を改善し,高血糖による手術リスクを減少し得ることが示唆された.