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<meta name="description" content="『治療を行ったのに症状が取りきれない…』，『検査では正常なのに…』．診療現場では，標準治療だけでは取りきれない患者の症状や不満が残ることがある．漢方薬はその「標準治療の隙間」を埋める対症療法の1つである．前作『循環器医が知っておくべき漢方薬』は症状から処方できる手軽さが好評であったが，続編の本書では，より治療効果を高めるための漢方処方のコツを実例と共に解説する．また循環器疾患以外の様々な症状にも対">

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		<h1 class="catchCopy">漢方薬で患者満足度を上げる！ 標準治療で取りきれない症状に次の一手！</h1>
		

		<h1 class="title">続・循環器医が知っておくべき漢方薬<span class="version"></span></h1>
		<h2 class="subTitle">患者満足度を上げる次の一手</h2>

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					著：北村　順（神戸海星病院内科部長・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・128頁・2色刷</li><li class="disc">ISBN&nbsp;978-4-8306-1933-5</li><li class="disc">2017年3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">『治療を行ったのに症状が取りきれない…』，『検査では正常なのに…』．診療現場では，標準治療だけでは取りきれない患者の症状や不満が残ることがある．漢方薬はその「標準治療の隙間」を埋める対症療法の1つである．前作『循環器医が知っておくべき漢方薬』は症状から処方できる手軽さが好評であったが，続編の本書では，より治療効果を高めるための漢方処方のコツを実例と共に解説する．また循環器疾患以外の様々な症状にも対応する処方を紹介．患者満足度を上げる次の一手がここにある．</section><section class="preface">監修のことば<br><br>　北村　順先生の前作「循環器医が知っておくべき漢方薬」が出版されて4年が経ちました．作用機序はよくわからないけど漢方薬が役に立つ症例があることを知り，北村先生に漢方初心者にもわかりやすい処方集を作ってほしいというのが前作を監修させていただく契機になりました．その後，若い女性や高齢者の立ちくらみに苓桂朮甘湯，健常者の期外収縮で動悸が気になるときの炙甘草湯，ニトログリセリンを多用される冠動脈正常の中年女性に半夏厚朴湯，食欲が出ない虚弱な高齢者に補中益気湯，など漢方薬の効果があった症例を経験し，“ 漢方薬で患者満足度を上げる”という北村先生の言葉を実感することとなりました．前作の書評をお願いした神戸大学感染症内科・岩田健太郎教授の「循環器系の治療戦略は堅牢なもので，ここを漢方薬そのものがひっくり返すことはまれだ．しかし，堅牢なシステムには様々な隙間があり，ここをほったらかしておくと患者には不満が残る．その「隙間」を綺麗に埋めてくれるのが，ユーティリティー・プレイヤーとしての漢方薬だ」という言葉が，見事に自分の中にストンと降りてくるものでした．<br>　下肢の太さに左右差がある子宮がん術後の女性が来られました．下肢静脈エコーで深部静脈血栓はなく，Dダイマーも正常範囲であり，リンパ節郭清もされていることからリンパ浮腫を疑いました．弾性ストッキング着用や足を高くして寝る，というような物理的な治療は効果がなく，北村先生の前作にあるように柴苓湯を試してみました．次の外来では左右差が気にならなくなったとうれしそうで，「漢方を試してみましょう」と言えたことは，循環器診療の幅を広げてくれたと思います．一方で，なぜ効くのかわからない，という思いは依然としてあり，処方した薬に責任を持つべき医師としてのジレンマがあったのも事実です．その後，北村先生の講演を何度か拝聴し，漢方はまだまだ奥が深いということを知らされました．前作によって漢方薬など見向きもしなかった循環器医が，漢方薬を堅牢な治療戦略の隙間を埋めるために使う道具にしました．そこで，北村先生に前作では漢方医として本当は書きたかったけれども書けなかったことを教えていただき，漢方の世界のもう少し奥まで連れて行ってもらうことにしました．循環器医が漢方を知っておくと役に立ちます．再び師匠に尋ねるつもりでこの本に頼ってみていただければ幸いです．<br><br>2017年2月<br>田邊 一明</section><section class="indexes">はじめに　前作上梓から４年経って思うこと<br>患者満足度を上げるための漢方薬<br>漢方エキス製剤の基本的な使い方<br>小児・妊婦・CKD患者への漢方処方<br>漢方薬を上手く使うコツ<br>　その１　気血水の概念を取り入れる<br>　その２　漢方エキス製剤を組み合わせて使う<br>　その３　問診・診察所見を活かす<br>処方の実際<br>　冠攣縮性狭心症の漢方治療<br>　当帰湯を投与した胸痛の一例<br>　若い女性の胸部症状<br>　発作性の頻脈・動悸・血圧上昇は奔豚気を疑う<br>　発作性の動悸に柴胡加竜骨牡蛎湯を投与した一例<br>　β遮断薬の副作用に対する漢方治療を行った一例<br>　子宮癌術後のリンパ浮腫に五苓散を処方した一例<br>　高血圧合併CKDに七物降下湯を処方した症例<br>　高齢者の便秘には麻子仁丸を<br>漢方薬を使えば…『もっと色々な治療ができる』<br>続・知っておくと便利な処方<br>様々な症状・病態に使える漢方<br>循環器診療で役に立つ漢方薬のおさらい<br>あとがき <br>索引 <br><br>COLUMN<br>　①漢方薬の副作用について<br>　②エキス製剤レンジでチンはやめておく<br>　③五苓散と真武湯について</section></article>
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