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不定愁訴例の長期管理における脈波の応用 : 更年期を含む12年間の経過観察

By  Toshiko TAKEMIYA,  Akemi TANAKA,  Hiromi WATANABE,  Seiko YAMAGUCHI,  Yoko MIURA,  Yuko SUGISHITA and  Mikiko SHIMIZU

Abstract

更年期に発症した精神的要素を含む,多彩な血管運動調節障害性不定愁訴の症例を12年間経過観察し,愁訴の詳細な聴取による内容と3種の脈波所見(指趾先容積脈波・その一次微分即ち速度脈波・その二次微分即ち加速度脈波)を対応させて検討し,下記のような結論を得た.(1)指趾先容積脈波所見:症候と趾先容積脈波パターンの動きはよく一致した.(2)指趾先速度脈波所見:症候と指/趾の波高比の動きはよく一致した.(3)指趾先加速度脈波所見:症候と指先脈波パターン,b/aとd/a均衡度の変化はよく一致した.必ずしも常に3種類の脈波を揃える必要はなく,臨床上の目的に応じて,それぞれ特徴のある脈波の判読法が活用されるよう勧めた.本例の精神的変化の背景因子を検討し,子供の自立期に発症した妻の更年期障害を契機に,夫はそれまで会社の重要な地位で仕事にだけ向いていた目を,主治医の説明と支援要請で改めて妻に向け始め,玉谷らの主張する[心理的再婚]に到達し,このことがなによりの治療効果を上げたことも強調した.A patient with varied equivocal complaints of vasomotor disorders, including psychological components that developed during the climacteric, was followed for 12 years. The detailed content of their complaints obtained during patient interviews, and three types of plethysmography findings (finger-tip and toe-tip plethysmography, and its primary differential, i.e., velocity plethysmography, and its secondary differential, i.e., accelerated plethysmography) were applied and assessed, and the conclusions below were obtained. (1) Finger-tip and toe-tip plethysmography findings: There was good consistency between the changes in the clinical manifestations and the finger-tip and toe-tip plethysmography patterns. (2) Finger-tip and toe-tip velocity plethysmography findings: There was good consistency between the clinical manifestations and the finger/toe wave height ratio. (3) Finger-tip and toe-tip accelerated plethysmography findings: The wave pattern is more closely in tandem with the patient's physical condition, and the patient's physical condition was good when the b/a and d/a values were almost the same. There was developed the climacteric disorder during the period when her child became independent, her husband, who had important position in his company and had been completely engrossed in his work, responded to the physician's explanation and request for support by beginning to devote more attention to his wife, and that had the greatest therapeutic effect, leading to the "psychological remarriage" described by Tamaya et al

Publisher: 東京女子医科大学学会
Year: 1997
OAI identifier: oai:ir.twmu.ac.jp:10470/23743
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