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<title>漢方薬処方テキスト | 株式会社文光堂</title>


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<meta name="description" content="近年，循環器診療における漢方薬の位置づけは大きく変わり，過去にはタブーに近い存在であった漢方薬が，今や標準治療の一翼を担う存在になりつつある．高齢者の心不全や，心不全パンデミックの到来などの大きな課題を抱える今，これからの循環器診療において漢方薬をどのように役立てられるのであろうか．2013年刊行の好評書『循環器医が知っておくべき漢方薬』の著者による，これまでの経験や新たな治験をもとにした“循環器">

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					著：北村　順（神戸海星病院内科部門長・島根大学医学部臨床教授）
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					監修：田邊一明（島根大学医学部内科学第四・教授）
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				<ul class="property"><li class="disc">A5判・136頁・2色刷</li><li class="disc">ISBN&nbsp;978-4-8306-1949-6</li><li class="disc">2020年3月5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">近年，循環器診療における漢方薬の位置づけは大きく変わり，過去にはタブーに近い存在であった漢方薬が，今や標準治療の一翼を担う存在になりつつある．高齢者の心不全や，心不全パンデミックの到来などの大きな課題を抱える今，これからの循環器診療において漢方薬をどのように役立てられるのであろうか．2013年刊行の好評書『循環器医が知っておくべき漢方薬』の著者による，これまでの経験や新たな治験をもとにした“循環器漢方の教科書”，待望の新作．</section><section class="preface">監修のことば<br><br>　北村順先生の著書「循環器医が知っておくべき漢方薬」（2013年2月），「続・循環器医が知っておくべき漢方薬─患者満足度を上げる次の一手」（2017年3月）を手にし，漢方薬に見向きもしなかった循環器医（私自身）が，この症状は漢方で何とかなるかもしれない，と処方する機会が増えました．2017年3月，金沢で開催された第81回日本循環器学会学術集会のファイアーサイドセミナー「循環器領域での漢方薬の可能性─治療満足度を上げる次の一手」が循環器領域の全国学会で初めて漢方にスポットライトを当てたと記憶しています．北村先生が演者の一人として「循環器医療の中でも，定石の治療で取りきれない症状に対して，漢方医学的に何とかなりますか？　と考えることが重要」というメッセージを発せられました．60席ほどの会場が一杯で，座長をさせていただいた私も「患者満足度」というキーワードを求める循環器医がいることに，これからこの領域が大きくなっていく期待を感じました．2018年9月，大阪で開催された第66回日本心臓病学会学術集会では，ケースに学ぶ「循環器診療における漢方処方例」で北村先生がやはり演者の一人として循環器診療における漢方薬の使い方や効果について講演されました．大きな会場を埋め尽くす参加者に，循環器診療において未だ十分なデータが集積されていないものの，漢方によって「患者満足度」を上げたいという循環器医が着実に増えてきているということを実感しました．<br>　2019年2月に地方会ではありますが，私が主催させていただいた日本心臓リハビリテーション学会第4回中国支部地方会で，北村先生にランチョンセミナーの講師をお願いし，「心臓リハビリテーション領域で役に立つ漢方─特にフレイル・サルコペニア・高齢者の心不全について」のタイトルで講演していただきました．この講演でフレイル・サルコペニア・高齢者の心不全という現代の循環器領域の大きなテーマに対し，「消化器フレイル（脾虚）」に六君子湯，人参養栄湯，「呼吸器フレイル（肺虚）」に人参養栄湯，「腎骨格フレイル（腎虚）」に牛車腎気丸という漢方の可能性を示していただきました．腎虚とは老化による諸機能低下のことであり，先天の精気という気「腎気」は生まれついたときの量が最大量で，年齢を重ねるごとに減っていくのだそうです．腎気を補うことがフレイルの進行を遅らせるとすれば，漢方が効くかもしれない多くの患者さんの顔が思い浮かびます．牛車腎気丸が高齢者心不全，浮腫にも効果が期待されると知り，処方する例が増えてきました．日本循環器学会のガイドライン「急性・慢性心不全診療ガイドライン（2017年改訂版）」で高齢者に多い左室駆出率の保たれた心不全（HFpEF）の治療薬として，クラスⅠはうっ血に伴う自覚症状軽減目的での利尿薬投与のみです．したがって，HFpEF の治療は原疾患に対する基本的治療，心不全症状の軽減，併存症に対する治療を個別に行うことになります．北村先生は2013年から西洋医学と漢方の併用という考え方を提案されています．循環器医が管理する中でガイドラインに沿った西洋医学的治療を尽くし，老化による諸機能低下を漢方で補うという考え方は，眼前で悩む患者さんに対して試みてもいいのではないでしょうか．「患者満足度」を上げる新たな一手を北村先生に教えていただきたいと思います．<br><br>2020年1月<br>田邊一明</section><section class="indexes">はじめに<br>漢方エキス製剤の基本<br>心不全<br>心臓リハビリテーションによる包括的疾病・栄養・運動管理における漢方<br>胸痛・虚血性心疾患<br>動悸・不整脈<br>奔豚気病<br>高血圧<br>低血圧・めまい・失神<br>漢方薬の副作用について<br>循環器領域における漢方—今後の展望<br>あとがき<br>索引</section></article>
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