D-フェニルアラニンによる鍼鎮痛および鍼麻酔の増強効果に関する研究(第2報)

腰下肢痛,抜歯術に対する臨床効果および効果的投与方法

抄録

D-phenylalanine (DPA) is known to block the activity of carboxipeptidase, an enzyme which degrades enkephalines, endogenous morphine-like substances. Therefore, it is considered that, DPA administered as an inhibiting drug of this degrading enzyme, might prolong analgesia induced by acupuncture.
1) Thirty patients suffering from chronic low back pain were treated with acupuncture 30minutes after the oral administration of 4.0 gram of DPA. The results were: excellent in 7 cases, good in 11, fair in 6 and poor in 6. Cases graded excellent and good were then compared with a placebo group. The effect was increased 26% in DPA-acupuncture group, which shows no statistically significant difference (P<0.1).
2) In 56 patients tooth e xtraction was performed under acupuncture anesthesia; 18 had received 4.0 gram of DPA (P.O. ) 30 minutes earlier. The results were excellent in 8, good in 6, f air in 3, and poor in 1. The excellent and good cases were compared with the 38 placebo gr oup cases. The effect in the DPA-acupuncture anesthesia group was significantly increased by 35%(P<0.01).
3) I n order to determine the optimum time for the administration of DPA, two schedules of administration were compared,
[1] DPA was given on the previous day in three 0.5 gram doses (26 cases).
[2] A single 4 gram dose was administered minutes before treatment 30cases).
The results from the excellent, good, and “fair” cases showed a 16% increa se in effectiveness when DPA was administered the day before, not a statistically significant difference (P<0.1), but a clear increase tendency was observed, The above findings show that DPA has an enhancing effect on acupuncture analgesia and anesthesia in clinical practice.