耳鼻咽喉科臨床
Online ISSN : 1884-4545
Print ISSN : 0032-6313
咽喉頭異常感症女性例の心身医学評価と薬効
山際 幹和坂倉 康夫福生 治城
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83 巻 (1990) 12 号 p. 1885-1890

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Hange-koboku-to is a Kampo medicine which is supposed to be effective for abnormal sensations, such as a lump or choking, in the throat. Some authors, including the present authors, have investigated clinically the relationship of its efficacy and the severity of the patients' neurotic condition. No complete agreement, however, has been reached. Some have reported that non-neurotic patients respond better to this medication, but others do not agree. No study has been done yet on the relationship between the efficacy of Hangekoboku-to and autonomic nerve dysfunction. The purpose of this study is to determine whether there is any relationship between the effect of Hange-koboku-to and psychosomatic conditions classified with a newly developed method (modification of Abe's method) using the Cornell Medical Index-Health Questionnaire Analysis which places patients into four categories: normal, autonomic nerve dysfunctioning, neurotic and psychosomatic (autonomic nerve dysfunctioning+neurotic).
Ninety-six female patients with abnormal sensation in the throat were classified by a modification of Abe's method into the 4 groups mentioned above and treated with Tsumura Hange-koboku-to (7.5g/day) for 2 weeks. The clinical effectiveness was evaluated 1, 2 and 3 weeks after the start of medication. A reduction of the abnormal sensation, evaluated subjectively, of more than 80% was considered to show excellent effectiveness. The number of patients reporting excellent effectiveness increased gradually to a peak at the end of the 3rd week, indicating that in some patients further improvement occurred after the termination of medication. The percentages of patients reporting an excellent effect in the 3rd week were 49%, 29%, 45% and 37%, respectively, in the normal, autonomic dysfunctioning, neurotic and psychosomatic groups.
The diagnostic procedures of the oriental medicine are quite different from those of western medicine because of the difference in basic concepts. Our results indicate that psychosomatic evaluation of patients by a modification of Abe's method is helpful for physicians trained in western medicine, who do have little knowledge of oriental diagnostic procedures, for determining whether Hange-koboku-to might be useful in the treatment of individual patients.

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