{"id":1127,"date":"2016-08-24T16:22:27","date_gmt":"2016-08-24T07:22:27","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1127"},"modified":"2016-08-24T16:22:27","modified_gmt":"2016-08-24T07:22:27","slug":"%e3%80%90ebm%e3%81%ae%e5%ad%a6%e3%81%b3%e3%80%91%e4%b8%8d%e5%ae%89%e9%9a%9c%e5%ae%b3%e3%81%ab%e5%af%be%e3%81%99%e3%82%8bssri%e3%81%ae%e5%8a%b9%e6%9e%9c","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1127","title":{"rendered":"\u3010EBM\u306e\u5b66\u3073\u3011\u4e0d\u5b89\u969c\u5bb3\u306b\u5bfe\u3059\u308bSSRI\u306e\u52b9\u679c"},"content":{"rendered":"<p><strong>STEP1\u3000\u81e8\u5e8a\u60a3\u8005\u306b\u5373\u3057\u305fPI(E)CO<\/strong><br \/>\n\u3010\u8a55\u4fa1\u3092\u884c\u3063\u305f\u65e5\u4ed8\u3011<br \/>\n\u30002016\u5e747\u670822\u65e5<br \/>\n\u3010\u81e8\u5e8a\u72b6\u6cc1\u306e\u30b5\u30de\u30ea\u30fc\u3011<br \/>\n\u300026\u6b73\u5973\u6027\u30022\u5e74\u524d\u304b\u3089\u5614\u6c17\u3001\u4e88\u671f\u4e0d\u5b89\u3092\u4f34\u3046\u52d5\u60b8\u306a\u3069\u306e\u75c7\u72b6\u304c\u3042\u308a\u3001\u7f8e\u5bb9\u5e2b\u306e\u4ed5\u4e8b\u3092\u8f9e\u3081\u3066\u90fd\u5e02\u90e8\u304b\u3089\u6e2f\u753a\u306e\u5730\u5143\u306b\u623b\u3063\u3066\u304d\u305f\u304c\u3001\u73fe\u5728\u3082\u7121\u8077\u3067\u5b9f\u5bb6\u306e\u6f01\u306e\u624b\u4f1d\u3044\u3092\u3057\u3066\u66ae\u3089\u3057\u3066\u3044\u308b\u3002\u524d\u5e7410\u6708\u304b\u3089\u4e0d\u5b89\u969c\u5bb3\u3068\u3057\u3066\u5f53\u8a3a\u7642\u6240\u3067\u30d5\u30a9\u30ed\u30fc\u3055\u308c\u3066\u304a\u308a\u300112\u6708\u3088\u308a\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\uff08\u30ec\u30af\u30b5\u30d7\u30ed\u00ae\uff0910 mg\u304c\u958b\u59cb\u3055\u308c\u305f\u3002\u3057\u304b\u3057\u3001\u305d\u306e\u5f8c\u3082\u75c7\u72b6\u306e\u6539\u5584\u306f\u4e4f\u3057\u304f\u3001X\u5e747\u670820\u65e5\u306e\u5916\u6765\u53d7\u8a3a\u6642\u306b\u3001\u5c02\u9580\u533b\u53d7\u8a3a\u3092\u3057\u3066\u307f\u305f\u3044\u3068\u306e\u76f8\u8ac7\u3092\u53d7\u3051\u3001\u7d39\u4ecb\u3057\u305f\u3002\u4e0d\u5b89\u969c\u5bb3\u306b\u5bfe\u3057\u3001\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u3092\u542b\u3081\u305fSSRI\u306f\u3088\u304f\u4f7f\u7528\u3055\u308c\u308b\u304c\u3001\u5b9f\u969b\u3069\u306e\u7a0b\u5ea6\u3001\u4e0d\u5b89\u75c7\u72b6\u306e\u8efd\u6e1b\u3092\u671f\u5f85\u3067\u304d\u308b\u306e\u304b\u77e5\u8b58\u3092\u6301\u3061\u5408\u308f\u305b\u3066\u3044\u306a\u3044\u3053\u3068\u306b\u6c17\u3065\u3044\u305f\u306e\u3067\u3001\u6587\u732e\u691c\u7d22\u3092\u3057\u3066\u307f\u305f\u3002<\/p>\n<p>\u3000P\uff1b\u4e0d\u5b89\u969c\u5bb3\u306e\u60a3\u8005<br \/>\n\u3000I(E)\uff1b\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u6295\u4e0e<br \/>\n\u3000C\uff1b\u30d7\u30e9\u30bb\u30dc\u6295\u4e0e<br \/>\n\u3000O\uff1b\u4e0d\u5b89\u75c7\u72b6\u304c\u8efd\u6e1b\u3059\u308b\u304b<\/p>\n<p><strong>STEP2\u3000\u691c\u7d22\u3057\u3066\u898b\u3064\u3051\u305f\u6587\u732e\u306e\u540d\u524d<\/strong><br \/>\n\u3010\u898b\u3064\u3051\u305f\u8ad6\u6587\u3011<br \/>\n\u691c\u7d22\u3057\u305f\u30a8\u30f3\u30b8\u30f3\uff1bDynamed<br \/>\n\u898b\u3064\u3051\u305f\u8ad6\u6587\uff1bDavid S. Baldwin, et. al, Escitalopram and paroxetine in the treatment of generalised anxiety disorder. Randomised, placebo-controlled, double-blind study; Br J Psychiatry 2006 Sep;189:264.<\/p>\n<p><strong>STEP3\uff1b\u8ad6\u6587\u306e\u8a55\u4fa1<br \/>\nSTEP3-1.\u8ad6\u6587\u306ePECO\u306f\u60a3\u8005\u306ePECO\u3068\u5408\u81f4\u3059\u308b\u304b\uff1f<\/strong><br \/>\n\u3000P\uff1b18-65\u6b73\u306e\u5168\u822c\u6027\u4e0d\u5b89\u969c\u5bb3\u306e\u60a3\u8005<br \/>\n\u3000HAM-A\u226720\uff08\u4e2d\u7b49\u5ea6\u4ee5\u4e0a\u306e\u4e0d\u5b89\u75c7\u72b6\uff09\u3001MADRS\u226616\uff08\u6291\u3046\u3064\u75c7\u72b6\u306f\u8efd\u5ea6\uff09<br \/>\n\u3000I(E)\uff1b\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e05mg\u300110mg\u300120mg\u6295\u4e0e<br \/>\n\u3000C\uff1b\u30d1\u30ed\u30ad\u30bb\u30c1\u30f320mg\u3001\u30d7\u30e9\u30bb\u30dc\u6295\u4e0e<br \/>\n\u3000O\uff1b12\u9031\u306e\u6cbb\u7642\u3067HAM-A\u306e\u6539\u5584\u304c\u307f\u3089\u308c\u308b\u304b<br \/>\n\u3000\u2192\u60a3\u8005\u306ePECO\u3068\u3000(\u5408\u81f4\u3059\u308b\u3000\u30fb\u3000<span style=\"text-decoration: underline;\"><strong>\u591a\u5c11\u7570\u306a\u308b\u304cOK<\/strong><\/span>\u3000\u30fb\u3000\u5927\u304d\u304f\u7570\u306a\u308b\u305f\u3081\u4e0d\u9069\u5207)<\/p>\n<p><strong>STEP3-2\u3000\u8ad6\u6587\u306e\u7814\u7a76\u30c7\u30b6\u30a4\u30f3\u306e\u8a55\u4fa1\uff1b\u5185\u7684\u59a5\u5f53\u6027\u306e\u8a55\u4fa1<\/strong><br \/>\n\u2460\u7814\u7a76\u65b9\u6cd5\u304cRCT\u306b\u306a\u3063\u3066\u3044\u308b\u304b\uff1f\u96a0\u853d\u5316\u3068\u76f2\u691c\u5316\u306f\u3055\u308c\u3066\u3044\u308b\u304b\uff1f<br \/>\n\u3000\u2192\u30e9\u30f3\u30c0\u30e0\u5272\u308a\u4ed8\u3051\u304c\u3000\uff08\u3000<span style=\"text-decoration: underline;\"><strong>\u3055\u308c\u3066\u3044\u308b<\/strong><\/span>\u3000\u30fb\u3000\u3000\u3055\u308c\u3066\u3044\u306a\u3044\u3000\uff09<br \/>\n\u3000\u2192\u96a0\u853d\u5316\u304c\u3000\u3000\u3000\u3000\u3000\u3000\uff08\u3000<span style=\"text-decoration: underline;\"><strong>\u3055\u308c\u3066\u3044\u308b<\/strong><\/span>\u3000\u30fb\u3000\u3000\u3055\u308c\u3066\u3044\u306a\u3044\u3000\u30fb\u3000\u8a18\u8f09\u306a\u3057 \uff09<br \/>\n\u3000\u2192\u76f2\u691c\u5316\u304c\u3000\u3000\u3000\u3000\u3000\u3000\uff08\u3000<span style=\"text-decoration: underline;\"><strong>\u3055\u308c\u3066\u3044\u308b<\/strong><\/span>\u3000\u30fb\u3000\u3000\u3055\u308c\u3066\u3044\u306a\u3044\u3000\uff09<br \/>\n\u5b9f\u969b\u306eTable\u3067\u4ecb\u5165\u7fa4\u3068\u5bfe\u7167\u7fa4\u306f\u540c\u3058\u3088\u3046\u306a\u96c6\u56e3\u306b\u306a\u3063\u3066\u3044\u308b\u304b\uff1f<br \/>\n\u3000\u2192\uff08\u3000<span style=\"text-decoration: underline;\"><strong>\u306a\u3063\u3066\u3044\u308b<\/strong><\/span>\u3000\u30fb\u3000\u306a\u3063\u3066\u3044\u306a\u3044\uff09<br \/>\n\u2461 \u89e3\u6790\u65b9\u6cd5\u306fITT(intention to treat)\u304b\uff1f<br \/>\n\u3000\u2192ITT\u304c\u3000\uff08 \u00a0<span style=\"text-decoration: underline;\"><strong>\u3055\u308c\u3066\u3044\u308b<\/strong><\/span>\u3000\u30fb\u3000\u3055\u308c\u3066\u3044\u306a\u3044\u00a0\uff09<\/p>\n<p><strong>STEP3-3\u3000\u8ad6\u6587\u3067\u898b\u3044\u3060\u3055\u308c\u305f\u7d50\u679c\u306e\u8a55\u4fa1<\/strong><br \/>\nOutcome\u306b\u3064\u3044\u3066\u3001\u4ee5\u4e0b\u306e\u5024\u3092\u78ba\u8a8d\u3059\u308b<br \/>\n\u3010\u2460 \u6cbb\u7642\u52b9\u679c\u306e\u6709\u7121\uff1b P\u5024\u3092\u78ba\u8a8d\u3059\u308b\u3011<br \/>\n<a href=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2016\/08\/\u5f8c\u85e4\u5148\u751f\u56f3.png\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-1128\" src=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2016\/08\/\u5f8c\u85e4\u5148\u751f\u56f3-1024x827.png\" alt=\"\u5f8c\u85e4\u5148\u751f\u56f3\" width=\"640\" height=\"517\" srcset=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2016\/08\/\u5f8c\u85e4\u5148\u751f\u56f3-1024x827.png 1024w, https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2016\/08\/\u5f8c\u85e4\u5148\u751f\u56f3-300x242.png 300w, https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2016\/08\/\u5f8c\u85e4\u5148\u751f\u56f3.png 1800w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n<p>\u3010\u2461\u6cbb\u7642\u52b9\u679c\u306e\u3086\u3089\u304e\uff1b\u4fe1\u983c\u533a\u9593\u3092\u78ba\u8a8d\u3059\u308b\u3011<br \/>\nMean change from baseline to week 12 in HAMA total score (ITT, LOCF)<br \/>\n<a href=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2016\/08\/\u5f8c\u85e4\u5148\u751f\u56f3\u2461.png\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-1129\" src=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2016\/08\/\u5f8c\u85e4\u5148\u751f\u56f3\u2461.png\" alt=\"\u5f8c\u85e4\u5148\u751f\u56f3\u2461\" width=\"875\" height=\"377\" srcset=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2016\/08\/\u5f8c\u85e4\u5148\u751f\u56f3\u2461.png 875w, https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2016\/08\/\u5f8c\u85e4\u5148\u751f\u56f3\u2461-300x129.png 300w\" sizes=\"auto, (max-width: 875px) 100vw, 875px\" \/><\/a><br \/>\nESC, escitalopram; ITT, intention-to-treat; LOCF, last observation carried forward; PAR, paroxetine; PBO, placebo<\/p>\n<p><strong>STEP4\u3000\u60a3\u8005\u3078\u306e\u9069\u7528<\/strong><br \/>\n\u3010\u2460\u8ad6\u6587\u306e\u60a3\u8005\u3068\u3001\u76ee\u306e\u524d\u306e\u60a3\u8005\u304c\u3001\u7d50\u679c\u304c\u9069\u7528\u3067\u304d\u306a\u3044\u307b\u3069\u7570\u306a\u3063\u3066\u3044\u306a\u3044\u304b\uff1f\u3011<br \/>\n\u3000\u672c\u75c7\u4f8b\u306f\u3001\u8ad6\u6587\u306e\u60a3\u8005\u3068\u5e74\u9f62\u306f\u5408\u81f4\u3057\u3066\u304a\u308a\u3001\u4e0d\u5b89\u75c7\u72b6\u306f\u3042\u308b\u304c\u3001\u6291\u3046\u3064\u75c7\u72b6\u306f\u8efd\u5ea6\u306e\u5370\u8c61\u3067\u3042\u3063\u305f\u70b9\u3082\u5408\u81f4\u3057\u3066\u3044\u308b\u3002\u305f\u3060\u3057\u3001HAM-A\u3084MADRS\u3068\u3044\u3063\u305f\u5c3a\u5ea6\u3067\u8a55\u4fa1\u306f\u3057\u3066\u3044\u306a\u3044\u305f\u3081\u3001\u6b63\u78ba\u306b\u8ad6\u6587\u306e\u60a3\u8005\u3068\u5408\u81f4\u3057\u3066\u3044\u308b\u304b\u306f\u78ba\u8a8d\u3067\u304d\u306a\u3044\u3002\u3055\u3089\u306b\u306f\u3001\u4e0d\u5b89\u969c\u5bb3\u306e\u8a3a\u65ad\u3082\u5bb6\u5ead\u533b\u306b\u3088\u308b\u66ab\u5b9a\u7684\u306a\u8a3a\u65ad\u3067\u3042\u308b\u3002\u672c\u75c7\u4f8b\u306f\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e010mg\u30927\u304b\u6708\u9593\u6295\u4e0e\u3055\u308c\u3066\u304a\u308a\u3001\u8ad6\u6587\u306e\u4ecb\u5165\u671f\u9593\u3092\u5341\u5206\u306b\u8d85\u3048\u3066\u3044\u308b\u305f\u3081\u3001\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u306e\u52b9\u679c\u5224\u5b9a\uff08\u4e0d\u5b89\u75c7\u72b6\u306e\u8efd\u6e1b\u304c\u3042\u3063\u305f\u304b\u306e\u5224\u5b9a\uff09\u306f\u53ef\u80fd\u3067\u3042\u308d\u3046\u3002<br \/>\n\u30fb\u5185\u7684\u59a5\u5f53\u6027\u306e\u554f\u984c\u70b9\u306f\uff1f(STEP3\u306e\u7d50\u679c\u306e\u30b5\u30de\u30ea\u30fc)<br \/>\n\u3000\u2192\u30e9\u30f3\u30c0\u30e0\u5272\u4ed8\u3001\u96a0\u853d\u5316\u3001\u76f2\u691c\u5316\u3055\u308c\u3066\u3044\u308b\u3053\u3068\u304c\u306f\u3063\u304d\u308a\u3068\u8ad6\u6587\u5185\u306b\u8a18\u8f09\u3055\u308c\u3066\u304a\u308a\u3001\u4ecb\u5165\u7fa4\u3068\u5bfe\u7167\u7fa4\u306b\u5927\u304d\u306a\u5dee\u7570\u306f\u306a\u3044\u3002\u307e\u305f\u3001ITT\u89e3\u6790\u3055\u308c\u3066\u3044\u308b\u3002\u5185\u7684\u59a5\u5f53\u6027\u306f\u7279\u306b\u554f\u984c\u306a\u3044\u3068\u8003\u3048\u308b\u3002<br \/>\n\u3000\u3057\u304b\u3057\u3001\u672c\u8ad6\u6587\u306b\u304a\u3044\u3066\u3001\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e010mg\u6295\u4e0e\u306e\u6709\u52b9\u6027\u306f\u793a\u3055\u308c\u305f\u304c\u3001\u7740\u76ee\u3059\u3079\u304d\u306f\u30d7\u30e9\u30bb\u30dc\u6295\u4e0e\u3067\u3082HAM-A\u304c\u5e73\u5747\u3057\u306614.20\u4f4e\u4e0b\u3057\u3066\u3044\u308b\u70b9\u3067\u3042\u308b\uff08\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e010mg\u6295\u4e0e\u3067\u306f16.76\u4f4e\u4e0b\uff09\u3002\u4e71\u66b4\u306a\u898b\u65b9\u3092\u3059\u308c\u3070\u3001\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e010mg\u6295\u4e0e\u304c\u5bc4\u4e0e\u3059\u308bHAM-A\u4f4e\u4e0b\u306f\u3001\u308f\u305a\u304b2.56\uff08= 16.76 \u2013 14.20\uff09\u3067\u3042\u308a\u300114.20\u306e\u4f4e\u4e0b\u306b\u5bc4\u4e0e\u3057\u305f\u306e\u306f\u3001\u85ac\u7269\u7642\u6cd5\u4ee5\u5916\u306e\u8981\u56e0\uff08\u6cbb\u7642\u3055\u308c\u3066\u3044\u308b\u3068\u3044\u3046\u5b89\u5fc3\u611f\u3001\u5358\u7d14\u306a\u6642\u9593\u7d4c\u904e\u3001\u30ab\u30a6\u30f3\u30bb\u30ea\u30f3\u30b0\u3001\u68ee\u7530\u7642\u6cd5\u30fb\u8a8d\u77e5\u884c\u52d5\u7642\u6cd5\u7684\u306a\u30a2\u30d7\u30ed\u30fc\u30c1\u3001\u74b0\u5883\u306e\u5909\u5316\u306a\u3069\uff09\u3067\u3042\u308b\u53ef\u80fd\u6027\u304c\u9ad8\u3044\u306e\u3067\u306f\u306a\u3044\u3060\u308d\u3046\u304b\u3002\u672c\u8ad6\u6587\u306b\u304a\u3044\u3066\u306f\u3001\u85ac\u7269\u7642\u6cd5\u4ee5\u5916\u306e\u8981\u7d20\u306b\u95a2\u3057\u3066\u306f\u8003\u5bdf\u3055\u308c\u3066\u3044\u306a\u3044\u3002<\/p>\n<p>\u3010\u2461\u6cbb\u7642\u305d\u306e\u3082\u306e\u306f\u5fe0\u5b9f\u306b\u5b9f\u884c\u53ef\u80fd\u304b\uff1f\u3011<br \/>\n\u3000\u3059\u3067\u306b\u6cbb\u7642\u3092\u884c\u3063\u3066\u3044\u308b\u3002<br \/>\n\u3010\u2462\u91cd\u8981\u306a\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u30b3\u30b9\u30c8\u3084\u5bb3\u3092\u542b\u3081\u3066\u5168\u3066\u8a55\u4fa1\u3055\u308c\u305f\u304b\uff1f\u3011<br \/>\n\u3000\u6709\u5bb3\u4e8b\u8c61\u306e\u8a55\u4fa1\u3082\u3055\u308c\u3066\u3044\u308b\u3002\uff08\u4e0d\u7720\u3001\u3081\u307e\u3044\u306a\u3069\uff09<br \/>\n\u3010\u2463\u60a3\u8005\u306e\u8003\u3048\u30fb\u55dc\u597d\u306f\u3069\u3046\u306a\u306e\u304b\uff1f\u3011<br \/>\n\u3000\u672c\u75c7\u4f8b\u306f\u3001\u60a3\u8005\u306e\u6c42\u3081\u306b\u5fdc\u3058\u3066\u5c02\u9580\u533b\u306b\u7d39\u4ecb\u3057\u305f\u3002\u4eee\u306b\u5bb6\u5ead\u533b\u5916\u6765\u3067\u6cbb\u7642\u3092\u7d99\u7d9a\u3059\u308b\u5834\u5408\u3001\u3069\u306e\u3088\u3046\u306a\u30a2\u30d7\u30ed\u30fc\u30c1\u3092\u7d9a\u3051\u308b\u3079\u304d\u3067\u3042\u3063\u305f\u3060\u308d\u3046\u304b\u3002\u79c1\u81ea\u8eab\u306f\u3001\u3053\u306e\u60a3\u8005\u30921\u56de\u3057\u304b\u8a3a\u305f\u3053\u3068\u304c\u306a\u304b\u3063\u305f\u304c\u3001\u60a3\u8005\u306f\u3001\u85ac\u7269\u6cbb\u7642\u3092\u7d9a\u3051\u3066\u3082\u5909\u308f\u3089\u306a\u3044\u73fe\u72b6\u306b\u4e00\u77f3\u3092\u6295\u3058\u305f\u304c\u3063\u3066\u3044\u305f\u3002\u300c\u518d\u3073\u793e\u4f1a\u306b\u51fa\u3066\u4ed5\u4e8b\u304c\u3067\u304d\u308b\u3088\u3046\u306b\u306a\u308b\u3001\u65b0\u305f\u306a\u51fa\u4f1a\u3044\u3092\u5f97\u308b\u300d\u3053\u3068\u3092\u671b\u3093\u3067\u3044\u305f\u3002\u4e00\u65b9\u3067\u3001\u6cbb\u7642\u306b\u3088\u3063\u3066\u300c\u4e0d\u5b89\u75c7\u72b6\u304c\u5168\u304f\u306a\u304f\u306a\u308b\u300d\u3053\u3068\u3092\u671f\u5f85\u3057\u3066\u3044\u305f\u3088\u3046\u306a\u5370\u8c61\u304c\u3042\u3063\u305f\u3002\u3082\u3057\u60a3\u8005\u304c\u3001\u4e0d\u5b89\u75c7\u72b6\u304c\u5168\u304f\u306a\u304f\u306a\u3063\u3066\u304b\u3089\u518d\u3073\u793e\u4f1a\u53c2\u52a0\u3092\u3001\u3068\u60a3\u8005\u304c\u8003\u3048\u3066\u3044\u305f\u306e\u3067\u3042\u308c\u3070\u3001\u305d\u306e\u6642\u671f\u306f\u6c38\u9060\u306b\u8a2a\u308c\u306a\u3044\u304b\u3082\u3057\u308c\u306a\u3044\u3002\u4e0d\u5b89\u969c\u5bb3\u306b\u5bfe\u3059\u308b\u85ac\u7269\u7642\u6cd5\u3067\u4e0d\u5b89\u75c7\u72b6\u306e\u8efd\u6e1b\u306f\u3067\u304d\u3066\u3082\u3001\u306a\u304f\u3059\u3053\u3068\u306f\u96e3\u3057\u3044\u3002\u307e\u305f\u3001\u4eca\u56de\u306f\u8abf\u3079\u3066\u3044\u306a\u3044\u304c\u3001\u30d1\u30cb\u30c3\u30af\u969c\u5bb3\u306f\u6bd4\u8f03\u7684SSRI\u306b\u3088\u308b\u75c7\u72b6\u8efd\u6e1b\u306e\u52b9\u679c\u3092\u671f\u5f85\u3067\u304d\u308b\u304c\u3001\u793e\u4f1a\u4e0d\u5b89\u969c\u5bb3\u3084\u5f37\u8feb\u6027\u969c\u5bb3\u306a\u3069\u3067\u306f\u671f\u5f85\u3057\u306b\u304f\u3044\u3088\u3046\u3060\u3002\u5bb6\u5ead\u533b\u3068\u3057\u3066\u60a3\u8005\u3068\u5171\u901a\u306e\u7406\u89e3\u57fa\u76e4\u306b\u7acb\u3061\u3001\u30a2\u30d7\u30ed\u30fc\u30c1\u3057\u3066\u3044\u304f\u306b\u306f\u3001\u533b\u5e2b-\u60a3\u8005\u9593\u306e\u554f\u984c\u8a2d\u5b9a\u3001\u30b4\u30fc\u30eb\u8a2d\u5b9a\u306e\u30ba\u30ec\u3092\u4fee\u6b63\u3057\u3066\u3044\u304f\u5fc5\u8981\u304c\u3042\u308a\u305d\u3046\u3060\u3002\u85ac\u7269\u7642\u6cd5\u306f\u3042\u304f\u307e\u3067\u88dc\u52a9\u7684\u3068\u8003\u3048\u3001\u68ee\u7530\u7642\u6cd5\u7684\u306b\u3001\u4e0d\u5b89\u75c7\u72b6\u3092\u6392\u9664\u3057\u3088\u3046\u3068\u52aa\u529b\u3059\u308b\u306e\u3067\u306f\u306a\u304f\u3001\u3042\u308b\u304c\u307e\u307e\u3092\u53d7\u3051\u5165\u308c\u3066\u3001\u3067\u304d\u308b\u3053\u3068\u304b\u3089\u5efa\u8a2d\u7684\u306b\u793e\u4f1a\u5fa9\u5e30\u3092\u9032\u3081\u3066\u884c\u304f\u3002\u305d\u306e\u3088\u3046\u306a\u8a8d\u8b58\u3092\u60a3\u8005\u3068\u5171\u6709\u3057\u3064\u3064\u3001\u30b5\u30dd\u30fc\u30c8\u3057\u3066\u3044\u304f\u3053\u3068\u304c\u809d\u8981\u3068\u8003\u3048\u305f\u3002<\/p>\n<p>\u3010\u958b\u50ac\u65e5\u3011<br \/>\n2016\u5e748\u670810\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"<p>STEP1\u3000\u81e8\u5e8a\u60a3\u8005\u306b\u5373\u3057\u305fPI(E)CO \u3010\u8a55\u4fa1\u3092\u884c\u3063\u305f\u65e5\u4ed8\u3011 \u30002016\u5e747\u670822\u65e5 \u3010\u81e8\u5e8a\u72b6\u6cc1\u306e\u30b5\u30de\u30ea\u30fc\u3011 \u300026\u6b73\u5973\u6027\u30022\u5e74\u524d\u304b\u3089\u5614\u6c17\u3001\u4e88\u671f\u4e0d\u5b89\u3092\u4f34\u3046\u52d5\u60b8\u306a\u3069\u306e\u75c7\u72b6\u304c\u3042\u308a\u3001\u7f8e\u5bb9\u5e2b\u306e\u4ed5\u4e8b\u3092\u8f9e\u3081\u3066\u90fd\u5e02\u90e8\u304b\u3089\u6e2f\u753a\u306e\u5730\u5143 &hellip; <a href=\"https:\/\/www.hcfm.jp\/journal\/?p=1127\" class=\"more-link\">\u7d9a\u304d\u3092\u8aad\u3080 <span class=\"screen-reader-text\">\u3010EBM\u306e\u5b66\u3073\u3011\u4e0d\u5b89\u969c\u5bb3\u306b\u5bfe\u3059\u308bSSRI\u306e\u52b9\u679c<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15],"tags":[],"class_list":["post-1127","post","type-post","status-publish","format-standard","hentry","category-15"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1127","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1127"}],"version-history":[{"count":3,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1127\/revisions"}],"predecessor-version":[{"id":1132,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1127\/revisions\/1132"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1127"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1127"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1127"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}