{"id":1202,"date":"2016-11-14T16:32:46","date_gmt":"2016-11-14T07:32:46","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1202"},"modified":"2016-11-14T16:33:00","modified_gmt":"2016-11-14T07:33:00","slug":"%e3%80%90ebm%e3%81%ae%e5%ad%a6%e3%81%b3%e3%80%91%e6%85%a2%e6%80%a7%e5%bf%83%e4%b8%8d%e5%85%a8%e3%81%a8%e5%88%a9%e5%b0%bf%e8%96%ac","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1202","title":{"rendered":"\u3010EBM\u306e\u5b66\u3073\u3011\u6162\u6027\u5fc3\u4e0d\u5168\u3068\u5229\u5c3f\u85ac"},"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\u5e7411\u67089\u65e5<br \/>\n\u3010\u81e8\u5e8a\u72b6\u6cc1\u306e\u30b5\u30de\u30ea\u30fc\u3011<br \/>\n\u300078\u6b73\u7537\u6027\u3001\u6162\u6027\u5fc3\u4e0d\u5168\u3001\u6162\u6027\u5fc3\u623f\u7d30\u52d5\u3042\u308a\u3001\u30a4\u30b0\u30b6\u30ec\u30eb\u30c810mg\uff0c\u30d5\u30ed\u30bb\u30df\u30c920mg\uff0c\u30a2\u30e0\u30ed\u30b8\u30d4\u30f35mg\u3092\u5185\u670d\u3057\u3066\u3044\u308b\u3002\u5f53\u9662\u3078\u5b9a\u671f\u901a\u9662\u3092\u5207\u308a\u66ff\u3048\u305f\u3044\u3068\u3044\u3046\u4e3b\u8a34\u3067\u53d7\u8a3a\u3057\u305f\u3002\u521d\u56de\u5916\u6765\u3067\u30012\u9031\u524d\u304b\u3089\u4f53\u91cd\u304c3kg\u5897\u3048\u3001\u8db3\u306e\u3080\u304f\u307f\u304c\u5897\u5f37\u3057\u3001\u5026\u6020\u611f\u3084\u8d77\u5ea7\u547c\u5438\u304c\u3042\u308b\u3068\u8a34\u3048\u3042\u308a\u3002\u80f8\u90e8\u30ec\u30f3\u30c8\u30b2\u30f3\u3067\u306f\u4e21\u5074\u80f8\u6c34\u8caf\u7559\u304c\u307f\u3089\u308c\u3001\u5fc3\u30a8\u30b3\u30fc\u3067\u306f\u53ce\u7e2e\u80fd\u4f4e\u4e0b\uff08EF38\uff05\uff09\u3001\u4e2d\u7b49\u5ea6MR\u3001\u4e2d\u7b49\u5ea6AR\u304c\u307f\u3089\u308c\u305f\u3002\u3046\u3063\u8840\u6027\u5fc3\u4e0d\u5168\u3068\u8a3a\u65ad\u3057\u3001\u30d5\u30ed\u30bb\u30df\u30c940mg\u3078\u5897\u91cf\u3057\u305f\u304c\u6539\u5584\u306a\u304f\u3001\u4e88\u5b9a\u5165\u9662\u3068\u3057\u305f\u3002\u5165\u9662\u65e5\u307e\u3067\u30d5\u30ed\u30bb\u30df\u30c9\u309260mg\u3078\u5897\u91cf\u3057\u3066\u51e6\u65b9\u3057\u305f\u3002\u5165\u9662\u5f8c\u306f\u3082\u3068\u306e\u30d5\u30ed\u30bb\u30df\u30c960mg\u5185\u670d\u306b\u30e9\u30b7\u30c3\u30af\u30b920mg\u9759\u6ce8\u3092\u8ffd\u52a0\u3057\u305f\u30021\u9031\u9593\u3067\u8457\u660e\u306b\u4e0b\u817f\u6d6e\u816b\u8efd\u6e1b\u3057\u3001\u4f53\u91cd\u6e1b\u5c11\u304c\u307f\u3089\u308c\u3001\u8d77\u5ea7\u547c\u5438\u3084\u5026\u6020\u611f\u3082\u6d88\u5931\u3057\u305f\u3002\u8131\u6c34\u50be\u5411\u3082\u8a8d\u3081\u305a\u3001\u9759\u6ce8\u3092\u4e2d\u6b62\u3057\u3059\u3079\u3066\u5185\u670d\u3078\u5207\u308a\u66ff\u3048\u3088\u3046\u3068\u3057\u305f\u3002\u30d5\u30ed\u30bb\u30df\u30c980mg\u5185\u670d\u3092\u691c\u8a0e\u3057\u3066\u3044\u305f\u304c\u3001\u4e0a\u7d1a\u533b\u306e\u3059\u3059\u3081\u3067\u9577\u6642\u9593\u4f5c\u7528\u578b\u306e\u30eb\u30fc\u30d7\u5229\u5c3f\u85ac\u30a2\u30be\u30bb\u30df\u30c9\uff08\u5546\u54c1\u540d\u30c0\u30a4\u30a2\u30fc\u30c8\uff09\u306e\u5b58\u5728\u3092\u77e5\u3063\u305f\u3002\u30a2\u30be\u30bb\u30df\u30c9\u306f\u7de9\u5f90\u306a\u5229\u5c3f\u52b9\u679c\u3092\u793a\u3059\u305f\u3081\u3001\u5185\u670d\u76f4\u5f8c\u306e\u983b\u5c3f\u3092\u89e3\u6d88\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3042\u3063\u305f\u3002\u904e\u53bb\u306e\u81e8\u5e8a\u8a66\u9a13\u3067\u3001\u30d5\u30ed\u30bb\u30df\u30c920mg\u306b\u5bfe\u3057\u3066\u30a2\u30be\u30bb\u30df\u30c930mg\u304c\u540c\u3058\u5c3f\u91cf\u6392\u6cc4\u3092\u4fc3\u3059\u3068\u3044\u3046\u3053\u3068\u3067\u3042\u3063\u305f\u306e\u3067\u3001\u4e88\u5b9a\u3057\u3066\u3044\u308b\u30d5\u30ed\u30bb\u30df\u30c980mg\u5185\u670d\u3092\u5358\u7d14\u63db\u7b97\u3059\u308b\u3068\u30a2\u30be\u30bb\u30df\u30c9120mg\u3068\u306a\u308b\u4e88\u5b9a\u3067\u3042\u3063\u305f\u3002\u679c\u305f\u3057\u3066\u60a3\u8005\u306e\u4e88\u5f8c\u3084QOL\u6539\u5584\u306b\u826f\u3044\u5f71\u97ff\u3092\u3082\u305f\u3089\u3059\u306e\u304b\u7591\u554f\u306b\u601d\u3063\u305f\u3002<\/p>\n<p>\u3000P\uff1b70\u53f0\u306e\u5fc3\u623f\u7d30\u52d5\u3092\u6301\u3064\u6162\u6027\u5fc3\u4e0d\u5168\u60a3\u8005\uff0eNYHA2\u5ea6\uff0e<br \/>\n\u3000I(E)\uff1b\u30c0\u30a4\u30a2\u30fc\u30c8120mg\u6295\u4e0e<br \/>\n\u3000C\uff1b\u30d5\u30ed\u30bb\u30df\u30c980mg\u6295\u4e0e<br \/>\n\u3000O\uff1aQOL\u6539\u5584<\/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 \/>\nSuperiority of Long-Acting to Short-Acting Loop Diuretics in the\u3000Treatment of Congestive Heart Failure\u2013 The J-MELODIC Study \u2013. Masuyama T, Tsujino T, Origasa H, Yamamoto K, Akasaka T, Hirano Y, Ohte N, Daimon T, Nakatani S, Ito H. Circ J. 2012;76(4):833-42.<\/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\uff1b\u5e74\u9f62\u4e2d\u9593\u502471\u6b73\u3067\uff0cNYHA2\u301c3\u5ea6\u306e\u6162\u6027\u5fc3\u4e0d\u5168\u306e\u3042\u308b\u60a3\u8005320\u540d<br \/>\n\u3000I(E)\uff1b\u30a2\u30be\u30bb\u30df\u30c930\u301c60mg\/day<br \/>\n\u3000C\uff1b\u30d5\u30ed\u30bb\u30df\u30c920\u301c40mg\/day<br \/>\n\u3000O\uff1b2\u5e74\u9593\u306e\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u306b\u3088\u308b\u6b7b\u4ea1\u307e\u305f\u306f\u3046\u3063\u8840\u6027\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u7dca\u6025\u5165\u9662\u306e\u7387\u3092\u4e0b\u3052\u308b<br \/>\n\u2192\u60a3\u8005\u306ePECO\u3068\u3000(\u5408\u81f4\u3059\u308b\u3000\u30fb\u3000<strong>\u591a\u5c11\u7570\u306a\u308b\u304cOK<\/strong>\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\uff08\u3000\u3055\u308c\u3066\u3044\u308b\u3000\u30fb\u3000\u3000\u3055\u308c\u3066\u3044\u306a\u3044\u3000\u30fb\u3000<span style=\"text-decoration: underline;\"><strong>\u4e0d\u660e<\/strong><\/span> \uff09<br \/>\n\u3000\u2192\u76f2\u691c\u5316\u304c\uff08\u3000\u3055\u308c\u3066\u3044\u308b\u3000\u30fb\u3000\u4e00\u90e8\u3055\u308c\u3066\u3044\u308b\u3000\u30fb\u3000\u3000<span style=\"text-decoration: underline;\"><strong>\u3055\u308c\u3066\u3044\u306a\u3044<\/strong><\/span>\u3000\u30fb\u8a18\u8f09\u306a\u3057\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\u3000\u30fb\u3000\u8a18\u8f09\u306a\u3057\u3000\uff09<br \/>\n\u3000PROBE\u6cd5\u304c\u63a1\u7528\u3055\u308c\u3066\u3044\u308b\u3002<br \/>\n\u3000\u203bPROBE\u6cd5\u3068\u306fProspective, Randomized, Open-labeled Blinded Endpoints\uff08\u524d\u5411\u304d\u30e9\u30f3\u30c0\u30e0\u5316\u30aa\u30fc\u30d7\u30f3\u30e9\u30d9\u30eb\u8a66\u9a13\uff09\u306e\u7565\u3002\u53c2\u52a0\u8005\uff08\u60a3\u8005\uff09\u3068\u4ecb\u5165\u5b9f\u65bd\u8005\uff08\u533b\u5e2b\uff09\u306e\u4e8c\u8005\u306f\u3001\u7d4c\u904e\u4e2d\u3001\u6cbb\u7642\u7fa4\u3068\u5bfe\u7167\u7fa4\u306e\u3069\u3061\u3089\u306b\u5272\u308a\u4ed8\u3051\u3089\u308c\u305f\u304b\u3092\u77e5\u3063\u3066\u3044\u308b\u304c\u3001Outcome\u8a55\u4fa1\u8005\u306f\u305d\u308c\u3092\u77e5\u3089\u305a\u306bOutcome\u3092\u8a55\u4fa1\u3059\u308b\u65b9\u6cd5\u3067\u3042\u308b\u3002\uff08\u306f\u3058\u3081\u3066\u30c8\u30e9\u30a4\u30a2\u30eb\u30b7\u30fc\u30c8\u3088\u308a\uff08\u5357\u90f7\u533b\u5e2b\u306eHP\u3088\u308a\uff09\uff09<br \/>\n\u2461 \u89e3\u6790\u65b9\u6cd5\u306fITT(intention to treat)\u304b\uff1f<br \/>\n\u3000\u2192ITT\u304c\uff08 <span style=\"text-decoration: underline;\"><strong>\u3055\u308c\u3066\u3044\u308b<\/strong><\/span>\u3000\u30fb\u3000\u3055\u308c\u3066\u3044\u306a\u3044 \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 \/>\n1\uff09Primary outcome<br \/>\n\u3000\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u306b\u3088\u308b\u6b7b\u4ea1\u307e\u305f\u306f\u3046\u3063\u8840\u6027\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u518d\u5165\u9662<br \/>\n\u3000\u4ecb\u5165\u7fa423\/160\uff0c\u5bfe\u7167\u7fa434\/160\uff0e<span style=\"color: #ff0000;\">p\uff1d0.03<\/span><br \/>\n2\uff09Secondary outcome<br \/>\n\u3000\u3046\u3063\u8840\u6027\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u518d\u5165\u9662\u307e\u305f\u306f\u5fc3\u4e0d\u5168\u306e\u6cbb\u7642\u85ac\u5909\u66f4\u304c\u5fc5\u8981\u306b\u306a\u3063\u305f<br \/>\n\u3000\u4ecb\u5165\u7fa426\/160\uff0c\u5bfe\u7167\u7fa436\/160\uff0e<span style=\"color: #ff0000;\">p\uff1d0.048<\/span><br \/>\n\u3059\u3079\u3066\u306e\u6b7b\u4ea1\u7387<br \/>\n\u3000\u4ecb\u5165\u7fa417\/160\uff0c\u5bfe\u7167\u7fa417\/160\uff0ep\uff1d0.99<br \/>\n3) Component events<br \/>\n\u3000\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u306b\u3088\u308b\u6b7b\u4ea1<br \/>\n\u3000\u4ecb\u5165\u7fa47\/160\uff0c\u5bfe\u7167\u7fa411\/160\uff0ep\uff1d0.36<br \/>\n\u3000\u3046\u3063\u8840\u6027\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u7dca\u6025\u5165\u9662<br \/>\n\u3000\u4ecb\u5165\u7fa419\/160\uff0c\u5bfe\u7167\u7fa429\/160\uff0e<span style=\"color: #ff0000;\">p\uff1d0.04<\/span><br \/>\n\u3000\u5fc3\u4e0d\u5168\u306e\u6cbb\u7642\u85ac\u5909\u66f4\u304c\u5fc5\u8981\u306b\u306a\u3063\u305f\u30b1\u30fc\u30b9<br \/>\n\u3000\u4ecb\u5165\u7fa47\/160\uff0c\u5bfe\u7167\u7fa410\/160\uff0ep\uff1d0.44<\/p>\n<p>\u3010\u2461\u6cbb\u7642\u52b9\u679c\u306e\u5927\u304d\u3055\uff1b\u6bd4\u306e\u6307\u6a19\u3068\u5dee\u306e\u6307\u6a19\u3092\u78ba\u8a8d\u3059\u308b\u3011<br \/>\n\u25cfRR(\u3042\u308b\u3044\u306fHR\u30fbOR)\u3092\u78ba\u8a8d\u3059\u308b<br \/>\n\u25cfARR\u3068NNT\u3092\u8a08\u7b97\u3059\u308b<br \/>\n\u3000\u203bP\u5024\u3067\u6709\u610f\u5dee\u304c\u51fa\u305f\u3082\u306e\u306b\u3064\u3044\u3066\u8a08\u7b97<br \/>\n1\uff09Primary outcome<br \/>\n\u3000\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u306b\u3088\u308b\u6b7b\u4ea1\u307e\u305f\u306f\u3046\u3063\u8840\u6027\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u518d\u5165\u9662<br \/>\n\u3000HR\uff1d0.55(95% CI, 0.32 to 0.95)<br \/>\n\u3000ARR=CER\u2014EER\uff1d34\/160-23\/160=11\/160=0.069<br \/>\n\u3000NNT=1\/ARR=1\/0.069=15<br \/>\n2\uff09Secondary outcome<br \/>\n\u3000\u3046\u3063\u8840\u6027\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u518d\u5165\u9662\u307e\u305f\u306f\u5fc3\u4e0d\u5168\u306e\u6cbb\u7642\u85ac\u5909\u66f4\u304c\u5fc5\u8981\u306b\u306a\u3063\u305f<br \/>\n\u3000HR\uff1d0.60(95% CI, 0.36 to 0.997)<br \/>\n\u3000ARR=CER\u2014EER\uff1d36\/160-26\/160=10\/160=0.063<br \/>\n\u3000NNT=1\/ARR=1\/0.063=16<br \/>\n3) Component events<br \/>\n\u3000\u3046\u3063\u8840\u6027\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u7dca\u6025\u5165\u9662<br \/>\n\u3000HR\uff1d0.53(95% CI, 0.30 to 0.96)<br \/>\n\u3000ARR=CER\u2014EER\uff1d29\/160-19\/160=10\/160=0.063<br \/>\n\u3000NNT=1\/ARR=1\/0.063=16<\/p>\n<p>\u3010\u2462\u6cbb\u7642\u52b9\u679c\u306e\u3086\u3089\u304e\uff1b\u4fe1\u983c\u533a\u9593\u3092\u78ba\u8a8d\u3059\u308b\u3011<br \/>\n\u3000\u2461\u53c2\u7167<\/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\u5e74\u9f62\u3001\u5fc3\u4e0d\u5168\u306e\u91cd\u75c7\u5ea6\u306f\u540c\u7b49\u3002<br \/>\n\u3000\u7b2c\u4e00\u306b\u30a2\u30be\u30bb\u30df\u30c9\u306e\u521d\u671f\u6295\u4e0e\u91cf\u306b\u3064\u3044\u3066\u3002\u672c\u7814\u7a76\u3067\u306f30\u301c60mg\/day\u3067\u3042\u308b\u304c\u672c\u75c7\u4f8b\u3067\u306f120mg\/day\u3068\u7570\u306a\u308b\u3002\u3057\u304b\u3057\u3001Methods\u306e\u6b04\u306b\u306f\u5fc3\u4e0d\u5168\u306e\u75c7\u72b6\u304c\u5b89\u5b9a\u3057\u306a\u3044\u3068\u304d\u306b\u30a2\u30be\u30bb\u30df\u30c9\u3092120mg\/day\u307e\u3067\u5897\u91cf\u3057\u305f\u3068\u3042\u308a\u3001\u7d50\u679c\u304c\u9069\u5fdc\u3067\u304d\u306a\u3044\u307b\u3069\u306e\u5dee\u306f\u306a\u3044\u3068\u8003\u3048\u308b\u3002<br \/>\n\u3000\u7b2c\u4e8c\u306b\u4ed6\u306e\u5185\u670d\u85ac\u5909\u66f4\u6b74\u306b\u3064\u3044\u3066\u3002\u672c\u7814\u7a76\u306e\u9664\u5916\u57fa\u6e96\u306b\u306f\u300c\u30e9\u30f3\u30c0\u30e0\u5272\u4ed8\u3059\u308b\u524d1\u30f6\u6708\u4ee5\u5185\u306e\u5fc3\u8840\u7ba1\u7cfb\u5185\u670d\u85ac\u5909\u66f4\u6b74\u300d\u304c\u7d44\u307f\u8fbc\u307e\u308c\u3066\u3044\u308b\u3002\u672c\u75c7\u4f8b\u306f\u3001\u30eb\u30fc\u30d7\u5229\u5c3f\u85ac\u5909\u66f4\u524d\u306bACE\u963b\u5bb3\u85ac\u3092\u5c0e\u5165\u3057\u305f\u308a\u3001Ca\u62ee\u6297\u85ac\u3092\u4e2d\u6b62\u3057\u305f\u308a\u3057\u3066\u3044\u308b\u70b9\u3067\u9664\u5916\u57fa\u6e96\u306b\u5f53\u3066\u306f\u307e\u308b\u3002\u3057\u304b\u3057\u3001\u3053\u306e\u9664\u5916\u57fa\u6e96\u306f\u30eb\u30fc\u30d7\u5229\u5c3f\u85ac\u306e\u5dee\u3092\u6b63\u78ba\u306b\u8abf\u3079\u308b\u305f\u3081\u306e\u57fa\u6e96\u3067\u3042\u308b\u3053\u3068\u304c\u4e88\u60f3\u3055\u308c\u3001\u672c\u75c7\u4f8b\u3078\u306e\u9069\u5fdc\u306b\u95a2\u3057\u3066\u5927\u304d\u306a\u554f\u984c\u306f\u306a\u3044\u3068\u8003\u3048\u308b\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\uff1c\u6700\u5b89\u4fa1\u3092\u63a1\u7528\u3057\u305f\u5834\u5408\uff1e<br \/>\n\u3000\u30a2\u30be\u30bb\u30df\u30c9\uff08\u30a2\u30be\u30bb\u30df\u30c9\u9320\uff0960mg\u00d72T\uff1d34.8\u5186<br \/>\n\u3000\u30d5\u30ed\u30bb\u30df\u30c9\uff08\u30d5\u30ed\u30bb\u30df\u30c9\u9320\uff0940mg\u00d72T\uff1d12.6\u5186<br \/>\n\uff1c\u5f53\u9662\u306e\u5834\u5408\uff1e<br \/>\n\u3000\u30a2\u30be\u30bb\u30df\u30c9\uff08\u30c0\u30a4\u30a2\u30fc\u30c8\u9320\uff0930mg\u00d74T\uff1d83.6\u5186<br \/>\n\u3000\u30d5\u30ed\u30bb\u30df\u30c9\uff08\u30d5\u30ed\u30bb\u30df\u30c9\u9320\uff0940mg\u00d72T\uff1d12.6\u5186<br \/>\n\u3000\u30a2\u30be\u30bb\u30df\u30c9\u3092\u4f7f\u7528\u3059\u308b\u3053\u3068\u3067\u85ac\u4fa1\u304c3\u301c7\u500d\u3068\u306a\u308b\u3002\u307e\u305f\u6dfb\u4ed8\u6587\u66f8\u4e0a\u3001\u30c0\u30a4\u30a2\u30fc\u30c8\u306e\u6700\u5927\u6295\u4e0e\u91cf\u306f60mg\/day\u3067\u3042\u308a\u3001120mg\/day\u306e\u4f7f\u7528\u306f\u4fdd\u967a\u3092\u304d\u3089\u308c\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002<\/p>\n<p>\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 \u30b3\u30b9\u30c8\u306f\u4e0a\u8a18\u306e\u901a\u308a\u3002\u526f\u4f5c\u7528\u306f\u4e0b\u8a18\u3002<br \/>\n<a href=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2016\/11\/\u9ed2\u5ca9\u5148\u751f\u56f3\u2460.png\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-1204\" src=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2016\/11\/\u9ed2\u5ca9\u5148\u751f\u56f3\u2460.png\" alt=\"\u9ed2\u5ca9\u5148\u751f\u56f3\u2460\" width=\"777\" height=\"173\" srcset=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2016\/11\/\u9ed2\u5ca9\u5148\u751f\u56f3\u2460.png 777w, https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2016\/11\/\u9ed2\u5ca9\u5148\u751f\u56f3\u2460-300x67.png 300w\" sizes=\"auto, (max-width: 777px) 100vw, 777px\" \/><\/a><\/p>\n<p>\u30001\u5e74\u4ee5\u5185\u306e\u4f4eK\u8840\u75c7\u304c\u30a2\u30be\u30bb\u30df\u30c9\u7fa4\u3067\u591a\u3044\u3088\u3046\u306b\u898b\u3048\u308b\u304c\u3001P\u5024\u306f\u8a08\u7b97\u3055\u308c\u3066\u3044\u306a\u3044\u3002\u526f\u4f5c\u7528\u306e\u767a\u751f\u7387\u306b\u3064\u3044\u3066\u306f\u5dee\u304c\u306a\u3044\u306e\u304b\u3069\u3046\u304b\u308f\u304b\u3089\u306a\u3044\u3002<br \/>\n\u30a2\u30a6\u30c8\u30ab\u30e0\u306b\u3064\u3044\u3066\u3002\u672c\u7814\u7a76\u306b\u3088\u3063\u3066\u3001\u300c2\u5e74\u4ee5\u5185\u306e\u3046\u3063\u8840\u6027\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u7dca\u6025\u5165\u9662or\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u306b\u3088\u308b\u6b7b\u4ea1\u300d\u304c\u30a2\u30be\u30bb\u30df\u30c9\u7fa4\u3067\u4f4e\u304f\u306a\u308b\u3053\u3068\u304c\u793a\u3055\u308c\u305f\u3002\u3057\u304b\u3057\u3001\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u671f\u9593\u306f\u6700\u4f4e2\u5e74\u9593\u3068\u77ed\u304f\u9577\u671f\u7684\u306a\u4e88\u5f8c\u306b\u3064\u3044\u3066\u306f\u4e0d\u660e\u3067\u3042\u308b\u3002\u307e\u305f\u3001\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u306b\u3088\u308b\\\\\\\\\u6b7b\u4ea1\u7387\u306e\u307f\u3067\u306e\u6bd4\u8f03\u3084\u7dcf\u6b7b\u4ea1\u7387\u306e\u307f\u3067\u306e\u6bd4\u8f03\u3067\u306f\u6709\u610f\u5dee\u306f\u51fa\u3066\u304a\u3089\u305a\u3001\u751f\u547d\u4e88\u5f8c\u306b\u95a2\u3059\u308b\u7d50\u679c\u3082\u4e0d\u660e\u3067\u3042\u308b\u3002<br \/>\n\u307e\u305f\u3001\u672c\u7814\u7a76\u306f\u53c2\u52a0\u8005\uff08\u60a3\u8005\uff09\u3068\u4ecb\u5165\u5b9f\u65bd\u8005\uff08\u533b\u5e2b\uff09\u306e\u76f2\u691c\u5316\u306e\u306a\u3055\u308c\u3066\u3044\u306a\u3044PROBE\u6cd5\u306b\u3088\u308bRCT\u3067\u3042\u308b\u3002Primary endpoint\u306b\u3082\u542b\u307e\u308c\u308b\u300c\u3046\u3063\u8840\u6027\u5fc3\u4e0d\u5168\u306b\u3088\u308b\u7dca\u6025\u5165\u9662\u300d\u3084Secondary endpoint\u306b\u3042\u308b\u300c\u5fc3\u4e0d\u5168\u6cbb\u7642\u85ac\u306e\u5909\u66f4\u300d\u306b\u3064\u3044\u3066\u306f\u3001\u4ecb\u5165\u5b9f\u65bd\u8005\u304c\u6063\u610f\u7684\u306b\u64cd\u4f5c\u3059\u308b\u3053\u3068\u3082\u53ef\u80fd\u3067\u3042\u308b\u3002\u3057\u305f\u304c\u3063\u3066\u4eca\u56de\u306e\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u4f4e\u3081\u306b\u898b\u7a4d\u3082\u3063\u305f\u65b9\u304c\u826f\u3044\u3002<br \/>\n\u30c7\u30e1\u30ea\u30c3\u30c8\u306b\u3064\u3044\u3066\u3002\u526f\u4f5c\u7528\u306b\u95a2\u3059\u308b\u4e21\u7fa4\u306e\u6bd4\u8f03\u306f\u5341\u5206\u306b\u306a\u3055\u308c\u3066\u304a\u3089\u305a\u3001\u30a2\u30be\u30bb\u30df\u30c9\u3092\u4f7f\u7528\u3059\u308b\u3053\u3068\u3067\u85ac\u4fa1\u306f3\u301c7\u500d\u3068\u306a\u308b\u3002\u307e\u305f\u4fdd\u967a\u4e0a\u3001\u4f7f\u7528\u3067\u304d\u308b\u5bb9\u91cf\u306b\u3082\u4e0a\u9650\u304c\u3042\u308a\u305d\u3046\u3067\u3042\u308b\u3002<br \/>\n\u4ee5\u4e0a\u306e\u8003\u5bdf\u3088\u308a\u3001\u30a2\u30be\u30bb\u30df\u30c9\u6295\u4e0e\u306e\u30e1\u30ea\u30c3\u30c8\u306f\u672c\u7814\u7a76\u3067\u8457\u8005\u304c\u4e3b\u5f35\u3059\u308b\u307b\u3069\u5927\u304d\u304f\u306a\u3044\u304c\u3001\u30c7\u30e1\u30ea\u30c3\u30c8\u3067\u3042\u308b\u85ac\u4fa1\u304c\u60a3\u8005\u306b\u3068\u3063\u3066\u4e9b\u7d30\u306a\u554f\u984c\u3067\u3001\u304b\u3064\u4fdd\u967a\u4e0a\u4f7f\u7528\u53ef\u80fd\u306a\u5bb9\u91cf\u3067\u3042\u308c\u3070\u3001\u30a2\u30be\u30bb\u30df\u30c9\u3092\u4f7f\u7528\u3059\u308b\u4fa1\u5024\u306f\u3042\u308b\u3068\u8003\u3048\u308b\u3002<\/p>\n<p>\u3010\u2463\u60a3\u8005\u306e\u8003\u3048\u30fb\u55dc\u597d\u306f\u3069\u3046\u306a\u306e\u304b\uff1f\u3011<br \/>\n\u7406\u60f3\u7684\u306b\u306f\u85ac\u4fa1\u306e\u554f\u984c\u3092\u8b70\u8ad6\u3057\u306a\u304c\u3089\u3001\u60a3\u8005\u304a\u3088\u3073\u3054\u5bb6\u65cf\u3068\u5c0e\u5165\u306b\u3064\u3044\u3066\u691c\u8a0e\u3059\u308b\u5fc5\u8981\u304c\u3042\u308b\u3002\u3057\u304b\u3057\u3001\u9ad8\u9f62\u306e\u975e\u533b\u7642\u5f93\u4e8b\u8005\u306b\u4ee5\u4e0a\u306e\u8003\u5bdf\u3092\u5171\u6709\u3059\u308b\u3053\u3068\u306f\u96e3\u3057\u3044\u3002<br \/>\n\u305d\u3053\u3067\u3001\u60a3\u8005\u306e\u7d4c\u6e08\u72b6\u6cc1\u306b\u3064\u3044\u3066\u63a8\u6e2c\u3059\u308b\u3002\u60a3\u8005\u306f\u3059\u3067\u306b\u5f15\u9000\u3057\u305f\u304c\u3001\u540c\u6577\u5730\u5185\u306b\u5c45\u4f4f\u3057\u3066\u3044\u308b\u9577\u7537\u304c\u60a3\u8005\u306e\u59bb\u3068\u3068\u3082\u306b\u8fb2\u5bb6\u3068\u916a\u8fb2\u3092\u55b6\u3093\u3067\u3044\u308b\u3002\u533b\u7642\u8cbb\u306f\u9577\u7537\u304b\u3089\u306e\u652f\u51fa\u3068\u306a\u308b\u3053\u3068\u304c\u4e88\u60f3\u3055\u308c\u308b\u3002\u66f4\u5225\u6751\u306e\u8fb2\u5bb6\u306f\u4f5c\u4ed8\u9762\u7a4d\u304c\u5e83\u304f\u6bd4\u8f03\u7684\u88d5\u798f\u306a\u5bb6\u5ead\u304c\u591a\u304f\u3001\u7d4c\u6e08\u7684\u306a\u554f\u984c\u306f\u5c11\u306a\u3044\u3053\u3068\u304c\u4e88\u60f3\u3055\u308c\u308b\u3002<br 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\/>\n2016\u5e7411\u67089\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\u5e7411\u67089\u65e5 \u3010\u81e8\u5e8a\u72b6\u6cc1\u306e\u30b5\u30de\u30ea\u30fc\u3011 \u300078\u6b73\u7537\u6027\u3001\u6162\u6027\u5fc3\u4e0d\u5168\u3001\u6162\u6027\u5fc3\u623f\u7d30\u52d5\u3042\u308a\u3001\u30a4\u30b0\u30b6\u30ec\u30eb\u30c810mg\uff0c\u30d5\u30ed\u30bb\u30df\u30c920mg\uff0c\u30a2\u30e0\u30ed\u30b8\u30d4\u30f35mg\u3092 &hellip; <a href=\"https:\/\/www.hcfm.jp\/journal\/?p=1202\" class=\"more-link\">\u7d9a\u304d\u3092\u8aad\u3080 <span class=\"screen-reader-text\">\u3010EBM\u306e\u5b66\u3073\u3011\u6162\u6027\u5fc3\u4e0d\u5168\u3068\u5229\u5c3f\u85ac<\/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":[1,17],"tags":[],"class_list":["post-1202","post","type-post","status-publish","format-standard","hentry","category-1","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1202","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=1202"}],"version-history":[{"count":2,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1202\/revisions"}],"predecessor-version":[{"id":1205,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1202\/revisions\/1205"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1202"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1202"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1202"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}