柴朴湯が著効を示した呼吸困難の１例

　西洋医学的検査に異常を認めない呼吸困難に，柴朴湯が著効した症例を経験したので報告する．症例は，２年間続く呼吸困難を訴える68歳の男性である．胸部Ｘ線，心電図，肺機能検査に異常なく，吸入ステロイド薬，吸入β2刺激薬の効果はなかった．そこで，柴朴湯を投与したところ，１週後には，呼吸困難が軽減し，２週後には，呼吸困難は完全に消失した．柴朴湯は，気管支喘息に用いる漢方薬として有名であるが，不安神経症にも効果があるとされる．本例のように，西洋医学的に異常がなく，心身症的な要素の強い呼吸困難患者に柴朴湯が有効であると考えられた．　A case in which Saibokuto has been effective for dyspnea without abnormalities in Western medical examination is reported. The case was 68-year-old male who complained of dyspnea lasting 2 years. His chest X-ray, electrocardiogram and pulmonary function test showed no abnormality, and inhaled corticosteroids and inhaled β2 stimulants had no effects on his dyspnea. Therefore, Saibokuto was administered, as a result, dyspnea was alleviated after one week and disappeared completely after two weeks. Saibokuto is famous as herbal medicine to be used for bronchial asthma, and it is said to have an effect on anxiety neurosis. As shown in this case, it is considered that Saibokuto is effective for dyspnea with strong psychosomatic factor showing no abnormality in Western medical examination

院内肺炎重症群（Ｃ群）に対するTazobactam/Piperacillin, Pazufloxacin 併用療法の有効性と安全性に関する検討

　院内肺炎重症群（Ｃ群）に対するTazobactam/Piperacillin（TAZ/PIPC），Pazufloxacin（PZFX）併用療法の有効性と安全性を検討した．院内肺炎重症群（C 群）20例を対象とし，TAZ/PIPC １回4.5g，１日３回， PZFX １回500mg，１日２回の併用投与を行い，その臨床効果，細菌学的効果，副作用などにつき検討した．その結果，臨床効果は，有効率60.0％（20例中12例有効）であった．細菌学的効果は，除菌率69.2％（13株中９株除菌）であり，Escherichia coli ３株中３株，Streptococcus pneumoniae ２株中２株，methicillin-sensitive Staphylococcus aureus ，Serratiamarcescense 各々１株中１株，Enterococcus faealis ，Pseudomonas aeruginosa 各々２株中１株が除菌された．副作用として，注射部位静脈炎が３例（15.0％）にみられ，臨床検査値の異常変動は８例（40.0％：肝機能障害４例，腎機能障害４例）にみられたが，いずれも軽度であった．以上より，TAZ/PIPC, PZFX 併用投与は，院内肺炎重症群（Ｃ群）に対して推奨できる治療法と考えられた．　The clinical effect and safety of Tazobactam/piperacillin and Pazufloxacin combination therapy on hospital-acquired pneumonia severe group (C group) was evaluated. Twenty patients were treated by combination of TAZ/PIPC (4.5g per dose, 3 times daily) and PZFX (500mg per dose, twice daily) .　Clinical effect, bacteriological effect, and adverse events were examined. Clinical efficacy rate was 60.0% (effectiveness in 12 of 20 patients). As for bacteriological effect, 3 of 3 Escherichia coli strais , 2 of 2 Streptococcus pneumoniae strains, 1 of 1 methicillin-sensitive Staphylococcus aureus strain and Serratia marcescense strain respectively, 1 of 2 Enterococcus faealis strains and Pseudomonas aeruginosa strains respectively were eradicated. In total, 9 (69.2%) of 13 strains were eradicated. Adverse events were infection site phlebitis in 3 patients (15.0%), and abnormal laboratory findings were observed including mild liver dysfunction in 4 patients and mild renal dysfunction in 4 patients. Consequently, TAZ/PIPC and PZFX combination therapy is recommended for hospital-acquired pneumonia severe group(C group)