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重度の咽喉頭異常感症に半夏厚朴湯が著効した１例
中澤, 誠多朗;新井, 絵理;前, 壮功仁;岡田, 和隆;松下, 貴恵;濱田, 浩美;山崎, 裕
Permalink : http://hdl.handle.net/2115/73684
KEYWORDS : 咽喉頭異常感症;漢方;半夏厚朴湯;摂食嚥下障害;globus hystericus;kampo medicine;hangekobokuto;dysphagia
Abstract
重度の咽喉頭異常感症に対し，漢方薬である半夏厚朴湯単剤で良好な結果を得た症例を経験したので報告する．
78歳，女性．20年以上前からのどの違和感を自覚し，夫との死別を契機に食物の嚥下困難感が増悪し，週に１回以上の頻度で食事中に食塊が詰まりのどに指を差し入れて嘔吐することで解除していた．近医耳鼻科および内科を受診したが異常なしとされ，摂食嚥下障害の精査目的で当科紹介受診となった．当科での診察および各種検査では局所に明らかな異常を認めず，咽喉頭異常感症と診断した．半夏厚朴湯（TJ-16）7.5 g，分3／日を処方したところ，服用１週目で効果を実感し，２か月後には支障なく食事ができるようになった．また，初診時，明らかに減弱していた咽頭反射も回復が認められた．
We report a case of successful treatment with hangekobokuto of a 78-year-old woman suffering from globus hystericus for several decades. She self-regurgitated food by induced vomiting with her fingers about once per week. Two otolaryngologists and one physician diagnosed no physical abnormality and she was referred to our department for examination of dysphagia. No organic abnormality was found by clinical examination except decrease of globus reflection, so she was diagnosed with globus hystericus and started on kampo medicine. Hangekobokuto (TH-16) 7.5 g/day orally in 3 divided doses before meals for 7 days improved her throat discomfort such that she didn’t induce vomiting. Additionally, her globus reflection was recovered. Therefore it was suggested that hangekobokuto is effective to treat globus hystericus.
We report a case of successful treatment with hangekobokuto of a 78-year-old woman suffering from globus hystericus for several decades. She self-regurgitated food by induced vomiting with her fingers about once per week. Two otolaryngologists and one physician diagnosed no physical abnormality and she was referred to our department for examination of dysphagia. No organic abnormality was found by clinical examination except decrease of globus reflection, so she was diagnosed with globus hystericus and started on kampo medicine. Hangekobokuto (TH-16) 7.5 g/day orally in 3 divided doses before meals for 7 days improved her throat discomfort such that she didn’t induce vomiting. Additionally, her globus reflection was recovered. Therefore it was suggested that hangekobokuto is effective to treat globus hystericus.
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