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<meta name="description" content="循環器診療において漢方薬はあくまでも脇役に過ぎない．しかし，定石といえる治療に抵抗する症例や現代医学では対応しがたい患者からの訴えなどにおいて，漢方薬はときに有効である．心不全患者の風邪予防，高血圧の随伴症状，降圧剤の副作用，低血圧・ふらつきなど．本書は，循環器医が日常診療でよく遭遇するケースを中心に処方例を取り上げた．漢方の知識がなくても，明日から手軽に漢方薬を処方できる1冊．　☆図版9点，表組">

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		<h1 class="catchCopy">循環器診療における西洋医学と漢方の併用という新しい「考え方」</h1>
		

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					著：北村　順（神戸海星病院内科部長）
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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・112頁・2色刷</li><li class="disc">ISBN&nbsp;978-4-8306-1920-5</li><li class="disc">2013年2月26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">循環器診療において漢方薬はあくまでも脇役に過ぎない．しかし，定石といえる治療に抵抗する症例や現代医学では対応しがたい患者からの訴えなどにおいて，漢方薬はときに有効である．心不全患者の風邪予防，高血圧の随伴症状，降圧剤の副作用，低血圧・ふらつきなど．本書は，循環器医が日常診療でよく遭遇するケースを中心に処方例を取り上げた．漢方の知識がなくても，明日から手軽に漢方薬を処方できる1冊．<br>☆図版9点，表組12点</section><section class="preface">監修のことば<br><br>　2008年5月に私が母校の教授として赴任した際，少ない医局員の中で右腕として助けてくれたのが北村　順先生でした．北村先生は私の大学の7年後輩で，大学から榊原記念病院，天理よろづ相談所病院と勤務され，主に不整脈を中心として循環器内科専門医として活躍されていました．2004年からは出身地である島根県浜田市でお父上・北村健二郎先生と医院を一緒にされていましたが，私が大学に引っ張り出したのです．北村先生は漢方指導医であるお父上を師匠として漢方専門医を取得されており，西洋医学と東洋医学の両方の専門医としてユニークな医師となっておられました．私自身は漢方を学ぶ機会はなく，作用機序とエビデンスを重視する循環器治療の中で，漢方薬が入り込む隙はないと信じていました．ある時，ペースメーカーポケットの感染で入院中の高齢男性患者の血小板数が8.9万/μLと低下しており，再手術に向けて血小板減少が問題となっていました．北村先生から漢方薬（十全大補湯）を試してみましょうと提案があり，半信半疑で経過をみておりましたら血小板数は順調に増加し，21.1万/μLまで達して無事に再手術ができました．機序はよくわからないけど漢方恐るべしです．<br>　先生方は自分で解決できそうにない症状を患者に訴えられることがありませんか．もちろん西洋医学で考えられる原因を探るのですが，中止できそうな内服薬のない虚血性心疾患患者の「最近食事の味がしない」（→小柴胡湯），高齢者の不整脈，慢性気管支炎の「いつものどに何かひっかかったような感じがして咳が出る」（→柴朴湯），高血圧治療中の中年女性から「冬でも汗をかく，火照る」（→白虎加人参湯），Ca拮抗薬を投与しないと血圧のコントロールができない高齢男性の「足が腫れる」（→柴苓湯）．いずれも2008年からの2年間，外来診察室がとなりであった北村先生に「何か漢方薬でいいのないかな？」と尋ねると，「先生，いい漢方薬があります」と教えていただき，患者から名医（私が）の称号を与えていただけた例です．最近は，漢方薬のブームで患者から「先生，漢方薬を出してください」と依頼されることがあります．近年は卒前教育のモデル・コア・カリキュラムの中で漢方に関する教育が実施されており，漢方薬は特別な薬剤ではなくなってきています．しかしながら，臨床の現場で西洋医学と東洋医学を統合した医療を行うためには，北村先生が言われるように師匠が必要のようです．幸い緊急で漢方薬を処方しないといけない患者は循環器内科の外来にはいらっしゃらないと思います．北村先生が神戸に移られた今では，患者さんに「次回の外来までに解決策を考える時間を下さい」とおことわりし，北村先生に「こんな症例で，あんな症状に効きそうな漢方薬をご教示ください」とメールを打つと，候補の漢方薬の名前を挙げていただけます．いっそのこと北村先生に処方集を作っていただき手元に置いておきたいという願いから出来上がったのがこの本です．<br>　循環器医の先生方にとって，定石と言える治療に抵抗する症例や対応しがたい状況において漢方薬はときに有用です．循環器医が漢方薬を知っておくと役に立ちます．師匠に尋ねるような気持ちでこの本に頼ってみていただけると幸いです．<br><br>　2013年2月<br>　田邊 一明</section><section class="indexes">はじめに<br>循環器医として漢方と向き合うコツ<br>漢方エキス製剤の基本的な使い方<br>高血圧<br>低血圧<br>めまい･ふらつき<br>不整脈･動悸<br>浮腫･胸水･心嚢水･腹水<br>心不全<br>虚血性心疾患･胸痛<br>肥満<br>知っておくと便利な処方 侵襲的治療による合併症対策<br>知っておくと便利な処方 様々な症状･病態に使える漢方<br>漢方薬の副作用について<br>甘草による偽アルドステロン症<br>あとがき<br>索引</section></article>
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