{"id":1327,"date":"2017-05-24T10:54:30","date_gmt":"2017-05-24T01:54:30","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1327"},"modified":"2017-05-24T10:54:30","modified_gmt":"2017-05-24T01:54:30","slug":"%e4%be%bf%e7%a7%98%e3%80%80%e8%a8%ba%e6%96%ad%e3%81%a8%e6%b2%bb%e7%99%82%e3%81%ae%e9%80%b2%e6%ad%a9","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1327","title":{"rendered":"\u4fbf\u79d8\u3000\u8a3a\u65ad\u3068\u6cbb\u7642\u306e\u9032\u6b69"},"content":{"rendered":"<p>\u2015\u6587\u732e\u540d\u2015<br \/>\nArnold Wald, MD. Constipation Advances in Diagnosis and Treatment JAMA. 2016;315(2):185-191.<\/p>\n<p>\u2015\u8981\u7d04\u2015<br \/>\n<strong>Importance<\/strong><br \/>\n\u3000\u6162\u6027\u7279\u767a\u6027\u4fbf\u79d8\uff08CIC\uff09\u306f\u7c73\u56fd\u3067\u5c11\u306a\u304f\u3068\u3082\u5e74\u9593800\u4e07\u4eba\u306e\u53d7\u8a3a\u304c\u3042\u308a\u3001\u8a3a\u65ad\u306e\u305f\u3081\u306e\u691c\u67fb\u3068\u4e0b\u5264\u306e\u51e6\u65b9\u3001\u975e\u51e6\u65b9\u4e0b\u5264\u306e\u305f\u3081\u306b\u591a\u984d\u306e\u652f\u51fa\u304c\u884c\u308f\u308c\u3066\u3044\u308b\u3002<\/p>\n<p><strong>Observations<\/strong><br \/>\n\u3000\u523a\u6fc0\u6027\u4e0b\u5264\u3068\u6d78\u900f\u5727\u4e0b\u5264\u3001\u65b0\u305f\u306a\u8178\u7ba1\u5206\u6ccc\u4fc3\u9032\u85ac\u3068\u672b\u68a2\u6027\u03bc\u30aa\u30d4\u30aa\u30a4\u30c9\u53d7\u5bb9\u4f53\u62ee\u6297\u85ac\uff08\u5f8c\u8005\u306f\u3001\u30aa\u30d4\u30aa\u30a4\u30c9\u8a98\u767a\u6027\u4fbf\u79d8\uff08OIC\uff09\u3068\u6cbb\u7642\u306b\u5927\u304d\u306a\u9032\u6b69\u3042\u308a\uff09\u306b\u3064\u3044\u3066\u306e\u6709\u52b9\u6027\u306b\u3064\u3044\u3066\u5f37\u529b\u306a\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u78ba\u7acb\u3055\u308c\u305f\u3002<br \/>\n\u3000\u9069\u5207\u306b\u4f7f\u7528\u3055\u308c\u308c\u3070\u3001senna\u3084bisacodyl\u306e\u3088\u3046\u306a\u523a\u6fc0\u6027\u4e0b\u5264\u306f\u3001\u9577\u671f\u9593\u4f7f\u7528\u3057\u3066\u3082\u5b89\u5168\u3067\u52b9\u679c\u7684\u3067\u3042\u308b\u3002<br \/>\n\u3000\u5b89\u4fa1\u306a\u4e0b\u5264\u3068\u4ed6\u306e\u30e1\u30ab\u30cb\u30ba\u30e0\u3067\u50cd\u304f\u65b0\u305f\u306a\u4e0b\u5264\u3068\u306e\u6bd4\u8f03\u7814\u7a76\u306f\u4e0d\u5341\u5206\u3067\u3042\u308a\u3001\u5f37\u304f\u671b\u307e\u308c\u3066\u3044\u308b\u3002<\/p>\n<p><strong>Conclusions and Relevance<\/strong><br \/>\n\u3000CIC\u3068OIC\u306e\u6cbb\u7642\u9078\u629e\u306f\u3001\u8cbb\u7528\u3068\u6709\u52b9\u6027\u306b\u57fa\u3065\u3044\u3066\u884c\u308f\u308c\u308b\u3079\u304d\u3067\u3042\u308b\u3002<br \/>\n\u3000\u73fe\u5728\u5229\u7528\u53ef\u80fd\u306a\u4e0b\u5264\u306b\u53cd\u5fdc\u3057\u306a\u3044\u4fbf\u79d8\u306f\u3001\u6392\u4fbf\u969c\u5bb3\u306e\u691c\u67fb\u304c\u884c\u3048\u308b\u7d4c\u9a13\u8c4a\u5bcc\u306a\u65bd\u8a2d\u3067\u3055\u3089\u306b\u8a55\u4fa1\u3059\u308b\u5fc5\u8981\u304c\u3042\u308b\u3002<br \/>\n\u3000\u8fd1\u5e74CIC\u306e\u8a3a\u65ad\u306b\u306f\u5927\u304d\u306a\u9032\u6b69\u306f\u306a\u304b\u3063\u305f\u304c\u3001\u904e\u53bb5\u5e74\u9593\u3067CIC\u306e\u6cbb\u7642\u306b\u306f\u6b21\u306e\u3088\u3046\u306a\u5927\u304d\u306a\u91cd\u8981\u306a\u9032\u5c55\u304c\u3042\u3063\u305f\u3002<br \/>\n\u3000\u3000\u2460CIC\u306e\u305f\u3081\u306e\u65b0\u305f\u306a\u78ba\u7acb\u3055\u308c\u305f\u4e0b\u5264\u3001\u5206\u6ccc\u4fc3\u9032\u85ac\u306e\u51fa\u73fe<br \/>\n\u3000\u3000\u2461\u30aa\u30d4\u30aa\u30a4\u30c9\u8a98\u767a\u6027\u4fbf\u79d8\u306e\u6cbb\u7642\u306b\u5bfe\u3059\u308b\u65b0\u305f\u306a\u30a2\u30d7\u30ed\u30fc\u30c1<br \/>\n\u3000\u3000\u2462\u5f93\u6765\u306e\u4e0b\u5264\u306b\u53cd\u5fdc\u3057\u306a\u3044\u6392\u4fbf\u5354\u8abf\u969c\u5bb3\u306e\u8a3a\u65ad<\/p>\n<p><strong>Method<\/strong><br \/>\n\u3000MEDLINE\u3001EMBASE\u3001Cochrane Reviews\u3001AGA\u3001ACG\uff08\u7c73\u56fd\u80c3\u8178\u79d1\u5b66\u4f1a\uff09\u3001GRADE\u3067\u691c\u7d22\u3057\u300121\u306epeer-reviewed studies\u306812\u306emeta-analysis\u306ereviews\u304b\u3089\u307e\u3068\u3081\u305f\u3002<br \/>\n\u3000Pathophysiology\u3000\u4fbf\u79d8\u306e\u539f\u56e0\u3068\u3057\u3066Box\u306e\u3088\u3046\u306a\u3082\u306e\u304c\u3042\u308b\u3002<\/p>\n<p><strong>Clinical Presentation and Assessment<\/strong><br \/>\n\u3000\u60a3\u8005\u306e\u591a\u304f\u306f\u3001\u4fbf\u79d8\u306e\u75c7\u72b6\u3068\u3057\u3066\u300c\u6392\u4fbf\u56de\u6570\u306e\u5c11\u306a\u3055\u300d\u3060\u3051\u3067\u306a\u304f\u300c\u6392\u4fbf\u56f0\u96e3\u300d\u3082\u8a34\u3048\u308b\u3002<br \/>\n\u3000CIC\u3067\u306f\u304a\u8179\u306e\u5f35\u308a\u3084\u8179\u90e8\u4e0d\u5feb\u3092\u8a34\u3048\u308b\u304c\u3001\u6392\u4fbf\u3067\u6539\u5584\u3059\u308b\u3002<br \/>\n\u3000\u4ed6\u65b9\u3001IBS\u3067\u306e\u4fbf\u79d8\u306f\u304a\u8179\u306e\u5f35\u308a\u3084\u8179\u90e8\u4e0d\u5feb\u611f\u306f\u3088\u308a\u5f37\u304f\u3001\u6392\u4fbf\u3067\u306f\u3042\u307e\u308a\u6539\u5584\u3055\u308c\u306a\u3044\u3002<br \/>\n\u3000\u7a81\u7136\u306e\u4fbf\u901a\u5909\u5316\u3001\u8840\u4fbf\u3001\u4e88\u671f\u305b\u306c\u4f53\u91cd\u6e1b\u5c11\u3001\u5927\u8178\u764c\u306e\u5bb6\u65cf\u6b74\u306a\u3069\u306e\u5927\u8178\u764c\u3092\u793a\u5506\u3059\u308b\u8b66\u544a\u75c7\u72b6\u306b\u6ce8\u610f\u304c\u5fc5\u8981\u3067\u3042\u308b\u3002<br \/>\n\u3000\u3053\u306e\u5834\u5408\u3001\u5927\u8178\u5185\u8996\u93e1\u691c\u67fb\u304c\u5fc5\u8981\u3067\u3042\u308a\u3001\u8840\u6db2\u691c\u67fb\u3068\u3057\u3066\u306fTSH\u3001Ca\u3001\u8840\u7cd6\u3092\u307f\u308b\u304c\u3001\u6d88\u5316\u5668\u5185\u79d1\u5b66\u4f1a\u306f\u9244\u6b20\u4e4f\u6027\u8ca7\u8840\u306e\u767a\u898b\u306b\u3088\u3063\u3066\u66f4\u306a\u308b\u691c\u67fb\u3092\u4fc3\u3059\u305f\u3081\u306b\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3068\u3057\u3066CBC\u3092\u63a8\u5968\u3057\u3066\u3044\u308b\u3002<\/p>\n<p><strong>Pharmacologic Agents for Constipation<\/strong><br \/>\n<a href=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2017\/05\/\u5c3e\u5d0e\u5148\u751f\u56f3\u2460.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2017\/05\/\u5c3e\u5d0e\u5148\u751f\u56f3\u2460-1024x641.png\" alt=\"\u5c3e\u5d0e\u5148\u751f\u56f3\u2460\" width=\"640\" height=\"401\" class=\"aligncenter size-large wp-image-1328\" srcset=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2017\/05\/\u5c3e\u5d0e\u5148\u751f\u56f3\u2460-1024x641.png 1024w, https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2017\/05\/\u5c3e\u5d0e\u5148\u751f\u56f3\u2460-300x188.png 300w, https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2017\/05\/\u5c3e\u5d0e\u5148\u751f\u56f3\u2460.png 1654w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n<p>\u3000\u73fe\u5728\u7c73\u56fd\u3067\u5229\u7528\u3067\u304d\u308b\u4e0b\u5264\u306b\u306f\u4e0a\u8a18\u306e\uff14\u7a2e\u985e\u304c\u3042\u308b\u3002\uff08Table 1\uff09<br \/>\n\u591a\u304f\u306e\u4e0b\u5264\uff08\u81a8\u5f35\u6027\u3001\u523a\u6fc0\u6027\u3001\u6d78\u900f\u5727\u4e0b\u5264\uff09\u306f\u51e6\u65b9\u306a\u3057\u3067\u624b\u306b\u5165\u308a\u6bd4\u8f03\u7684\u5b89\u4fa1\u3067\u3042\u308b\u304c\u3001\u65b0\u305f\u306a\u5206\u6ccc\u6027\u4e0b\u5264\u306f\u51e6\u65b9\u304c\u5fc5\u8981\u3067\u6bd4\u8f03\u7684\u9ad8\u4fa1\u3067\u3042\u308b\u3002\uff08Table 2\uff09<br \/>\n\u3000Intestinal Secretogogues \uff08\u8178\u7ba1\u5206\u6ccc\u4fc3\u9032\u85ac\uff09<br \/>\n\u3000Lubiprostone \uff08\u30a2\u30df\u30c6\u30a3\u30fc\u30b6\uff09\u3084 linaclotide\uff08\u30ea\u30f3\u30bc\u30b9\uff09\u304c\u3042\u308b\u3002<br \/>\n\u3000\u4e00\u822c\u306e\u4fbf\u79d8\u85ac\u306f\u4fbf\u79d8\u306b\u306f\u6709\u52b9\u3060\u304c\u8179\u75db\u306b\u306f\u52b9\u304b\u306a\u304b\u3063\u305f\u3002linaclotide\uff08\u30ea\u30f3\u30bc\u30b9\uff09\u306f\u8179\u75db\u306b\u3082\u6709\u52b9\u3067\u3042\u308b\u3002<br \/>\n\u3000Lubiprostone\u306fPGE\u306e\u8a98\u5c0e\u4f53\u3067\u5c0f\u8178\u306eapical chloride-2channel \u306b\u50cd\u304f\u3002<br \/>\n\u3000\u7121\u4f5c\u70ba\u5316\u4e8c\u91cd\u76f2\u691c\u30d7\u30e9\u30bb\u30dc\u5bfe\u7167\u7814\u7a76\u3067\u306f\u3001Lubiproston\uff081\u65e52\u56de24\u03bcg\uff09\u3067\u6cbb\u7642\u3055\u308c\u305f\u60a3\u8005\u306f\u3001\u30d7\u30e9\u30bb\u30dc\u6295\u4e0e\u7fa4\u3088\u308a\u3082\u81ea\u767a\u7684\u306a\u6392\u4fbf\u304c\u591a\u304f\u3001\u60a3\u8005\u8a55\u4fa1\u304c\u6709\u610f\u306b\u9ad8\u304b\u3063\u305f\u3002\u307e\u305f\u5614\u6c17\u3001\u982d\u75db\u3001\u4e0b\u75e2\u306a\u3069\u306e\u526f\u4f5c\u7528\u3082\u5c11\u306a\u304b\u3063\u305f\u3002<\/p>\n<p><strong>Stimulant Laxatives<\/strong><br \/>\n\u3000Senna\u3068Bisacodyl\u306e\u3088\u3046\u306a\u523a\u6fc0\u6027\u4e0b\u5264\u306f\u3001\u51e6\u65b9\u7b8b\u304c\u306a\u304f\u4e00\u6642\u7684\u306a\u4fbf\u79d8\u3084\u6162\u6027\u4fbf\u79d8\u306b\u9577\u671f\u9593\u5229\u7528\u3067\u304d\u308b\u3002<br \/>\n\u3000\u523a\u6fc0\u6027\u4e0b\u5264\u306e\u52b9\u679c\u306f\u78ba\u5b9a\u3055\u308c\u3001\u6709\u5bb3\u306e\u6839\u62e0\u3082\u306a\u3044\u3002<br \/>\n\u3000Bisacodyl\u306f\u7d4c\u53e3\u3068\u5ea7\u85ac\u3067\u4f7f\u7528\u3067\u304d\u308b\u304c\u3001\u5185\u670d\u306f\u7720\u524d\u304c\u826f\u304f\u3001\u5750\u85ac\u306f\u671d\u98df\u5f8c\u306b\u5165\u308c\u3066\u80c3\u8178\u53cd\u5c04\u306b\u5408\u308f\u305b\u308b\u3068\u826f\u3044\u3002<\/p>\n<p><strong>Which Laxatives Are Best for Constipation\uff1f\u3000<\/strong>\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000<br \/>\n\u3000\u5f93\u6765\u306e\u4e0b\u5264\uff08Magnesium salts\u3068Senna\uff09\u3068\u65b0\u3057\u3044\u4e0b\u5264\u3068\u306e\u6bd4\u8f03\u8a66\u9a13\u306f\u306a\u304f\u3001\u5229\u7528\u53ef\u80fd\u306a\u4e0b\u5264\u306e\u9593\u306b\u304b\u306a\u308a\u306e\u4fa1\u683c\u5dee\u304c\u3042\u308b\u3002<br \/>\n\uff08\u65e5\u672c\u3000\u30c6\u30ec\u30df\u30f3\u30bd\u30d5\u30c8\uff1a20\u5186\/\u500b\u3001\u30a2\u30df\u30c6\u30a3\u30fc\u30b6\uff1a160\u5186\/C\uff09\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000<br \/>\n\u3000CIC\u3092\u6cbb\u7642\u3059\u308b\u305f\u3081\u306e\u63a8\u5968\u30a2\u30eb\u30b4\u30ea\u30ba\u30e0\u304cFigure\u306b\u793a\u3055\u308c\u3066\u3044\u308b\u3002\u3000\u3000\u3000<br \/>\n\u3000\u3000\u2460\u98df\u7269\u7e4a\u7dad\uff08\u91ce\u83dc\u6442\u53d6\uff09\u3092\u5897\u3084\u3059\u304b\u3001\u81a8\u5f35\u6027\u4e0b\u5264\uff08bulk agents\uff09\u3001\u4f8b\u3048\u3070\u30b5\u30a4\u30ea\u30a6\u30e0\uff08\u30aa\u30aa\u30d0\u30b3\u306e\u7a2e\u5b50\u306e\u76ae\u304b\u3089\u7cbe\u88fd\u3057\u305f\u98df\u7269\u7e4a\u7dad\uff09\u306e\u5185\u670d\u3000\u3000<br \/>\n\u3000\u3000\u2461\u975e\u5438\u53ce\u7269\u8cea\uff08PEG3350\u3001Lactulose\u3001\u30de\u30b0\u30cd\u30b7\u30a6\u30e0\uff09\u304b\u523a\u6fc0\u6027\u4e0b\u5264\uff08Bisacodyl\u3001Senna\uff09\u3067\u6cbb\u7642\u3002\u4e00\u3064\u306e\u523a\u6fc0\u6027\u4e0b\u5264\u3067\u5931\u6557\u3057\u305f\u3089\u3001\u5225\u306e\u523a\u6fc0\u6027\u4e0b\u5264\u3067\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000\u3000<br \/>\n\u3000\u3000\u2462\u8178\u7ba1\u5206\u6ccc\u4fc3\u9032\u85ac\u306elinaclotide\u304blubiprostone\u3002\u4e00\u65b9\u3067\u5931\u6557\u3057\u305f\u3089\u4ed6\u65b9\u3067\u6cbb\u7642\u3002<br \/>\n\u3000\u3000\u2463\u7cbe\u67fb<\/p>\n<p><strong>Opioid-Induced Constipation<\/strong><br \/>\n\u3000\u30aa\u30d4\u30aa\u30a4\u30c9\u4f7f\u7528\u60a3\u8005\u306e40%\u304b\u308990%\u304c\u4fbf\u79d8\u3092\u3059\u308b\u3002\u30aa\u30d4\u30aa\u30a4\u30c9\u306b\u3088\u308b\u8178\u7ba1\u904b\u52d5\u6291\u5236\u3001\u8178\u7ba1\u5206\u7bc0\u5316 (segmentation)\u3001\u901a\u904e\u6642\u9593\u304c\u9077\u5ef6\u3059\u308b\u3053\u3068\u3067\u6c34\u5206\u5438\u53ce\u304c\u5897\u3048\u308b\u3001\u8178\u7ba1\u3078\u306e\u6c34\u5206\u30fb \u96fb\u89e3\u8cea\u5206\u6ccc\u6291\u5236\u306a\u3069\u304c\u539f\u56e0\u3067\u4fbf\u79d8\u304c\u8d77\u3053\u308b\u3002<br \/>\n\u3000\u30aa\u30d4\u30aa\u30a4\u30c9\u306f\u3001\u03bc\u3001\u03ba\u3001\u03b4\u306e3\u3064\u306e\u30aa\u30d4\u30aa\u30a4\u30c9\u53d7\u5bb9\u4f53\u306b\u4f5c\u7528\u3059\u308b\u304c\u8178\u7ba1\u3067\u306f\u7279\u306b\u03bc\u53d7\u5bb9\u4f53\u306b\u4f5c\u7528\u3059\u308b\u3002<br \/>\n\u3000OIC\u6cbb\u7642\u306b3\u3064\u306e\u03bc\u30aa\u30d4\u30aa\u30a4\u30c9\u53d7\u5bb9\u4f53\u62ee\u6297\u85ac\u304c\u6709\u52b9\u3067\u3042\u308b\u3002<br \/>\n\u3000\u3000\u2460\u30e1\u30c1\u30eb\u30ca\u30eb\u30c8\u30ec\u30ad\u30bd\u30f3 \uff086\u8a66\u9a13\u30011610\u4eba\uff09\uff1a\u76ae\u4e0b\u6ce8\u306e\u307f\u3002<br \/>\n\u3000\u3000\u2461\u30ca\u30ed\u30ad\u30bd\u30f3\uff084\u8a66\u9a13\u3001798\u4eba\uff09\uff1a\u30aa\u30d4\u30aa\u30a4\u30c9\u306b\u3088\u308b\u4fbf\u79d8\u306b\u6709\u52b9\u3002\u9577\u671f\u4f7f\u7528\u306f\u8a31\u53ef\u3055\u308c\u3066\u3044\u306a\u3044\u3002<br \/>\n\u3000\u3000\u2462\u30a2\u30eb\u30d3\u30e2\u30d1\u30f3 (4\u8a66\u9a13\u30011693 \u4eba)\uff1a\u8853\u5f8c\u30a4\u30ec\u30a6\u30b9\u306b\u77ed\u671f\u4f7f\u7528\u3002<br \/>\n\u3000\u9ebb\u85ac\u306b\u3088\u308b\u9177\u3044\u4fbf\u79d8\u306f\u30aa\u30d4\u30aa\u30a4\u30c9\u53d7\u5bb9\u4f53\u62ee\u6297\u85ac\u3067\u3042\u308b\u30ca\u30ed\u30ad\u30bd\u30f3\u3092\u4f7f\u7528\u3059\u308b\u3053\u3068\u3067\u3001\u93ae\u75db\u4f5c\u7528\u3092\u6e1b\u305a\u308b\u3053\u3068\u306a\u304f\u4fbf\u79d8\u3060\u3051\u3092\u6291\u3048\u308b\u3053\u3068\u304c\u51fa\u6765\u308b\u3002\u65e5\u672c\u56fd\u5185\u3067\u306f\u30ca\u30ed\u30ad\u30bd\u30f3\u306f\u6ce8\u5c04\u85ac\u3057\u304b\u306a\u3044\u3002<br \/>\n\u3000oxycodone\/naloxone \u3092\u3001\u6700\u521d10mg\/5mg\u30922\u56de\/\u65e5\u304b\u300120mg\/10mg\u30922\u56de\/\u65e5\u3067\u958b\u59cb\u3057\u6700\u592740mg\/20mg\u307e\u3067\u5897\u91cf\u3059\u308b\u3002Lubiprostone\u304c\u975e\u764c\u60a3\u8005\u306e\u9ebb\u85ac\u306b\u3088\u308b\u4fbf\u79d8\u306b\u30d7\u30e9\u30bb\u30dc\u3088\u308a\u6709\u52b9\u3067\u3042\u3063\u305f\u3002<br \/>\n<a href=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2017\/05\/\u5c3e\u5d0e\u5148\u751f\u56f3\u2461.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2017\/05\/\u5c3e\u5d0e\u5148\u751f\u56f3\u2461.png\" alt=\"\u5c3e\u5d0e\u5148\u751f\u56f3\u2461\" width=\"685\" height=\"875\" class=\"aligncenter size-full wp-image-1329\" srcset=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2017\/05\/\u5c3e\u5d0e\u5148\u751f\u56f3\u2461.png 685w, https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2017\/05\/\u5c3e\u5d0e\u5148\u751f\u56f3\u2461-235x300.png 235w\" sizes=\"auto, (max-width: 685px) 100vw, 685px\" \/><\/a><\/p>\n<p><strong>Discussion<\/strong><br \/>\n\u3000\u5f93\u6765\u306e\u4e0b\u5264\uff08Magnesium salts\u3068Senna\uff09\u3068\u65b0\u3057\u3044\u4e0b\u5264\u3068\u306e\u6bd4\u8f03\u8a66\u9a13\u304c\u306a\u304f\u3001Magnesium salts\u3068Senna\u306eRCT\u304c\u306a\u3044\u305f\u3081\u3001\u4e21\u8005\u3068\u3082\u63a8\u5968\u5ea6\u304cNA\u3067\u3042\u308a\u8ffd\u52a0\u306e\u8a66\u9a13\u304c\u671b\u307e\u308c\u308b\u3002<\/p>\n<p>\u3010\u958b\u50ac\u65e5\u3011<br \/>\n\u30002017\u5e745\u670824\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u2015\u6587\u732e\u540d\u2015 Arnold Wald, MD. Constipation Advances in Diagnosis and Treatment JAMA. 2016;315(2):185-191. \u2015\u8981\u7d04\u2015 Import &hellip; <a href=\"https:\/\/www.hcfm.jp\/journal\/?p=1327\" class=\"more-link\">\u7d9a\u304d\u3092\u8aad\u3080 <span class=\"screen-reader-text\">\u4fbf\u79d8\u3000\u8a3a\u65ad\u3068\u6cbb\u7642\u306e\u9032\u6b69<\/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":[17],"tags":[],"class_list":["post-1327","post","type-post","status-publish","format-standard","hentry","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1327","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=1327"}],"version-history":[{"count":2,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1327\/revisions"}],"predecessor-version":[{"id":1331,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1327\/revisions\/1331"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1327"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1327"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1327"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}