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<title>危険な咳・そうでない咳の見分け方（電子版のみ） | 株式会社文光堂</title>


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<meta name="description" content="「咳嗽に関するガイドライン」作成委員の著者による一般内科医のための咳診療のテキスト．咳は臨床現場で遭遇する頻度が極めて高い症候である．その原因疾患は多岐にわたり，肺癌などの重篤な原因疾患を見逃してはならない．本書では重篤な原因疾患を除外するための検査法から，診断前治療における処方の仕方とその評価，薬の止めどき，患者指導，専門医への紹介のタイミングなど，一般内科医が進める実際の診療の流れに沿って解説">

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		<h1 class="catchCopy">「咳嗽に関するガイドライン」作成委員が教える，一般内科医に必要な咳診療のエッセンスが詰まった1冊</h1>
		

		<h1 class="copy">ガイドライン＋αの</h1>
		<h1 class="title">危険な咳・そうでない咳の見分け方（電子版のみ）<span class="version"></span></h1>
		

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					著：松瀬厚人（東邦大学医療センター大橋病院呼吸器内科教授）
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				<ul class="property"><li class="disc">B5判・96頁・2色刷</li><li class="disc">ISBN&nbsp;978-4-8306-1735-5</li><li class="disc">2017年8月8日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">「咳嗽に関するガイドライン」作成委員の著者による一般内科医のための咳診療のテキスト．咳は臨床現場で遭遇する頻度が極めて高い症候である．その原因疾患は多岐にわたり，肺癌などの重篤な原因疾患を見逃してはならない．本書では重篤な原因疾患を除外するための検査法から，診断前治療における処方の仕方とその評価，薬の止めどき，患者指導，専門医への紹介のタイミングなど，一般内科医が進める実際の診療の流れに沿って解説されている．著者自身の治療経験も随所に挿入されており，ガイドラインでは書けない咳診療の実際が詰まった1冊．</section><section class="preface">序<br><br>　私は平成元年に医師となり，当時の研修医制度に則って大学の内科医局に入局しました．その後2年間にわたって内科全般の研修を行った後，平成3年からは呼吸器内科を専門として現在に至っています．気が付くと呼吸器内科医となってから20年以上が過ぎているのですが，その間最も長く勤務したのは大学病院ということになります．大学病院では市中病院に比べるとcommon diseaseが診られないという欠点があるのですが，市中病院ではできないような検査ができるという利点もあります．また，外勤として，いろいろなレベルの病院で患者さんを診ることができたので，その病院でできるベストを尽くして診療を行うという経験を積むことができました．そんな私の医師としての経験のなかで，最も頻度が高く，頭を使うのが“せき”の患者さんであり，臨床医として多くの教訓を与えていただきました．そのうちの何名かには本書にも登場していただいています．<br>　私と“せき”とのもう一つの大きなかかわりは，恩師である長崎大学医学部第二内科の河野 茂先生が教授在任中に作成委員長をされた日本呼吸器学会発行の「咳嗽に関するガイドライン」初版と第2版において事務局を務めさせていただいたことです．大変な作業でしたが，国内の咳の研究と診療の第一人者の先生方の意見をまとめ，ガイドラインを作り上げる作業から，咳嗽診療の重要性を再認識するとともに，現状における多くの問題点を知ることができました．<br>　本書を執筆中だった2016年末に私自身が風邪をひいてしまい，ひどい咳で苦しみました．こういう場合，外来の患者さんには風邪の咳だから心配ないと簡単に言っておきながら，4，5日咳が止まらないと何か他の病気ではないかと心配し，中に何が入っているかもわからない市販の咳止めを飲み，抗菌薬にも手を出そうとしている我が身を振り返って，“せき”を主訴とする多くの患者さんの不安と診療される先生方のご苦労を改めて感じることができました．<br>　本書は「咳嗽に関するガイドライン」を基にしながら，必ずしもエビデンスのない筆者の経験や学術論文の内容も加えて，主に市中で咳嗽の診療を行われる一般開業医の先生方を対象に書かせていただきました．<br>　本書が“せき”で困っておられる患者さんと，その診療で困っておられる先生方の苦痛を少しでも和らげるお役にたてれば幸いです．<br><br>平成29年7月<br>松瀬厚人</section><section class="indexes">第1章　咳とはなにか<br>1　咳の定義・メカニズム・疫学<br>　咳とは？<br>　咳の出るメカニズム<br>　リアルワールドでの咳の実態調査<br>2　咳の分類<br>　乾性咳嗽と湿性咳嗽<br>　咳の持続期間による分類<br>3　危険な咳，そうでない咳<br>　危険な急性咳嗽<br>　危険な遷延性・慢性咳嗽：自験例の紹介<br>　まとめ<br>4　慢性呼吸器疾患に合併する咳嗽<br>　肺癌に伴う咳嗽<br>　特発性間質性肺炎（IPF）に伴う咳嗽<br>　慢性閉塞性肺疾患（COPD）に伴う咳嗽<br>　睡眠時無呼吸症候群（SAS）に伴う咳嗽<br>5　咳嗽の評価法<br>　咳受容体感受性試験<br>　visual analog scale（VAS）<br>　咳嗽のQOL問診票<br>　咳嗽モニター<br>6　専門医へ紹介するタイミング<br>　初期対応で重篤な異常が認められた場合<br>　診断前治療が無効の場合<br>　再発例の場合<br>　紹介を受けた専門医として<br>7　『咳嗽に関するガイドライン』の使い方<br>　世界の咳嗽ガイドライン<br>　咳嗽ガイドラインの使い方<br>第2章　咳の診断・検査<br>1　咳嗽の原因疾患の診断<br>　咳嗽診断の原則<br>2　急性咳嗽の代表的な疾患の臨床像と原因疾患の診断法<br>　感染性咳嗽<br>　急性咳嗽診断の進め方<br>3　遷延性・慢性咳嗽の代表的な疾患の臨床像と原因疾患の診断法<br>　感染後咳嗽<br>　咳喘息（CVA）<br>　副鼻腔気管支症候群（SBS）<br>　胃食道逆流症（GERD）<br>　遷延性・慢性咳嗽の診断の実際<br>　一般診療所における遷延性・慢性咳嗽への対応の実際<br>　専門施設で行う検査<br>第3章　咳の治療<br>1　鎮咳薬による治療<br>　鎮咳薬の分類<br>　非特異的鎮咳薬の使い方<br>　漢方薬とハチミツ<br>2　咳嗽の非薬物療法<br>　慢性咳嗽の理学療法，会話療法<br>　今後の展望<br>3　感染性咳嗽の治療<br>　感染性咳嗽の治療方針<br>　抗菌薬を使うか使わないか<br>4　副鼻腔気管支症候群（SBS）の治療<br>　SBS治療の実際<br>5　咳喘息（CVA）の治療<br>　咳喘息の日常管理<br>　咳喘息の急性増悪時の管理<br>　咳喘息の治療期間<br>　日常生活指導<br>6　胃食道逆流症（GERD）による慢性咳嗽の治療<br>　GERDによる慢性咳嗽の治療<br>7　感染後咳嗽の治療<br>　感染後咳嗽の治療の考え方<br>8　原因不明の慢性咳嗽の治療<br>　cough hypersensitivity syndrome（CHS）について<br>　原因不明の慢性咳嗽に対する治療<br>9　その他の咳嗽の治療<br>　慢性気管支炎による咳嗽<br>　後鼻漏（PND）による咳嗽<br>　薬剤性咳嗽<br>　高齢者の咳嗽<br>　職業性・環境因子による咳嗽<br>　主な略語<br>索引<br><br>【Column】<br>　咳の患者は増えている？<br>　なぜ3週間？<br>　ガイドライン通りにやったのに<br>　アトピー咳嗽とは<br>　治療前診断が正しいかどうかの判断はどうする？<br>　聴診で炎症がわかる？<br>　市販の咳止めには何が入っているのか<br>　咳エチケットについて<br>　まずはエリスロマイシンから始める理由<br>　マクロライドと肺のマイクロバイオーム<br>　吸入指導の重要性<br>　喘息は治らない？<br>　飲酒と喘息<br>　吸入ステロイド単剤か吸入ステロイド＋長時間作用型β<sub>2</sub>刺激薬合剤か？<br>　感染後咳嗽に対する長時間作用型吸入抗コリン薬の効果<br>　感染後咳嗽はどこまで止めるべきなのか<br>　咳の脳科学<br>　餅は餅屋</section></article>
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