臨牀消化器内科 Vol.28 No.2(3-7-2)


特集名 消化管疾患に対する漢方医学からのアプローチ ― 現状と展望
題名 消化管疾患に対する漢方医療の実際 (7) 消化器癌に対する補助療法 b.全身状態改善とがん化学療法副作用軽減
発刊年月 2013年 02月
著者 元雄 良治 金沢医科大学腫瘍内科学・集学的がん治療センター
【 要旨 】 消化管癌患者の全身状態改善には補中益気湯・十全大補湯が用いられ,腫瘍熱を呈する患者には抗炎症作用をもつ漢方製剤の投与が勧められる.化学療法の副作用軽減では,食欲不振に対する六君子湯の基礎的・臨床的報告が増えている.オキサリプラチンの末梢神経障害には牛車腎気丸の効果が検討されているが,まだ確固たる成績は得られていない.血液毒性には十全大補湯・加味帰脾湯・人参養栄湯など,口内炎に半夏瀉心湯の効果が報告されている.標準治療を完遂するために,まだエビデンスレベルの高い臨床研究は少ないが,化学療法の支持療法としての漢方は実地診療に定着しつつある.
Theme Treatment of Gastrointestinal Disorders Using Traditional Japanese Herbal Medicine : Present Status and Future Prospects
Title Improvement of General Conditions and Attenuation of Side Effects of Chemotherapy by Kampo in Patients with Gastrointestinal Cancers
Author Yoshiharu Motoo Department of Medical Oncology, Kanazawa Medical University
[ Summary ] In order to improve general conditions for cancer patients, hochuekkito and juzentaihoto are often used, and anti-inflammatory formulas are recommended for patients with tumor fevers. Attenuation of side effects from chemotherapy, is being evaluated in terms of basic and clinical evidence concerning the effects of rikkunshito on chemotherapy-induced anorexia. Oxaliplatin-induced peripheral neuropathy is difficult to prevent. Although the effects of goshajinkigan have been examined in several clinical trials, there is no concrete evidence of its efficacy. For hematotoxicity, juzentaihoto, kamikihito, and ninjinyoeito have been tested, and hangeshashinto seems to be useful for treatment of irinotecan-induced diarrhea and chemotherapy-induced oral mucositis. In order to complete a standard treatment, Kampo has been widely introduced to clinical practice, although there are few clinical trials of high quality concerning its efficacy.
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