{"id":1432,"date":"2017-11-01T11:36:19","date_gmt":"2017-11-01T02:36:19","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1432"},"modified":"2017-11-01T11:36:19","modified_gmt":"2017-11-01T02:36:19","slug":"%e6%88%90%e4%ba%ba%e3%81%ae%e9%9d%9e%e5%96%98%e6%81%af%e6%80%a7%e6%80%a5%e6%80%a7%e4%b8%8b%e6%b0%97%e9%81%93%e6%84%9f%e6%9f%93%e3%81%ab%e5%af%be%e3%81%99%e3%82%8b%e7%b5%8c%e5%8f%a3%e3%82%b9%e3%83%86","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1432","title":{"rendered":"\u6210\u4eba\u306e\u975e\u5598\u606f\u6027\u6025\u6027\u4e0b\u6c17\u9053\u611f\u67d3\u306b\u5bfe\u3059\u308b\u7d4c\u53e3\u30b9\u30c6\u30ed\u30a4\u30c9\u306e\u52b9\u679c"},"content":{"rendered":"

\u30fc\u6587\u732e\u540d\u30fc
\nEffect of Oral Prednisolone on Symptom Duration and Severity in Nonasthmatic Adults With Acute Lower Respiratory Tract Infection: A Randomized Clinical Trial.
\nJAMA. 2017 Aug 22;318(8):721-730. doi: 10.1001\/jama.2017.10572.<\/p>\n

\u30fc\u8981\u7d04\u30fc
\nIntroduction\uff1a<\/strong>
\n\u30d7\u30e9\u30a4\u30de\u30ea\u30b1\u30a2\u306b\u304a\u3051\u308b\u6025\u6027\u4e0b\u6c17\u9053\u611f\u67d3\u3092\u6271\u3046\u3053\u3068\u306f\u975e\u5e38\u306b\u4e00\u822c\u7684\u3067\u3042\u308a\u3001\u6025\u6027\u4e0b\u6c17\u9053\u611f\u67d3\u75c7\u306e\u75c7\u72b6\u306f\u5897\u60aa\u3057\u305f\u5598\u606f\u306b\u985e\u4f3c\u3057\u3066\u3044\u308b\u3002\u7d4c\u53e3\u304a\u3088\u3073\u5438\u5165\u30b3\u30eb\u30c1\u30b3\u30b9\u30c6\u30ed\u30a4\u30c9\u306f\u6025\u6027\u5598\u606f\u306b\u5bfe\u3057\u3066\u975e\u5e38\u306b\u6709\u52b9\u3067\u3042\u308b\u304c\u3001\u7c73\u56fd\u3001\u82f1\u56fd\u3001\u304a\u3088\u3073\u6b27\u5dde\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u306f\u3001\u30b3\u30eb\u30c1\u30b3\u30b9\u30c6\u30ed\u30a4\u30c9\u3092\u6025\u6027\u4e0b\u6c17\u9053\u611f\u67d3\u75c7\u306b\u4f7f\u7528\u3059\u3079\u304d\u304b\u3069\u3046\u304b\u306b\u3064\u3044\u3066\u306f\u6307\u91dd\u304c\u793a\u3055\u308c\u3066\u3044\u306a\u3044\u3002\u3053\u308c\u306b\u3082\u95a2\u308f\u3089\u305a\u5438\u5165\u3001\u7d4c\u53e3\u30b9\u30c6\u30ed\u30a4\u30c9\u304c\u4f7f\u7528\u3055\u308c\u3066\u3044\u308b\u3053\u3068\u304c\u591a\u3044\u3002\u4eca\u7814\u7a76\u306e\u76ee\u7684\u306f\u3001\u5598\u606f\u306e\u306a\u3044\u6210\u4eba\u306e\u6025\u6027\u4e0b\u6c17\u9053\u611f\u67d3\u75c7\u306b\u5bfe\u3059\u308b\u7d4c\u53e3\u30b3\u30eb\u30c1\u30b3\u30b9\u30c6\u30ed\u30a4\u30c9\u306e\u52b9\u679c\u3092\u7121\u4f5c\u70ba\u306b\u8abf\u3079\u308b\u3053\u3068\u3067\u3042\u308b\u3002<\/p>\n

Method\uff1a<\/strong>
\nThe Oral Steroids for Acute Cough(OSAC) trial\u306f2013\u5e74\uff16\u6708\uff5e2014\u5e7410\u6708\u306e\u671f\u9593\u3067\u884c\u308f\u308c\u305f\u3001\u7121\u4f5c\u70ba\u30013\u91cd\u76f2\u691c\u5316\u306e\u30d7\u30e9\u30bb\u30dc\u7fa4\u3092\u5bfe\u7167\u3068\u3057\u305f\u7814\u7a76\u3067\u3042\u308b\u3002\u591a\u65bd\u8a2d\u3067\u884c\u308f\u308c\u3001\u30aa\u30c3\u30af\u30b9\u30d5\u30a9\u30fc\u30c9\u7b49\u306e4\u3064\u306e\u5927\u5b66\u3067\u7814\u7a76\u306e\u624b\u6cd5\u3092\u5b66\u3093\u3060\u5bb6\u5ead\u533b\u3068\u770b\u8b77\u5e2b\u304c\u60a3\u8005\u306e\u9069\u6b63(4\u9031\u9593\u4ee5\u5185\u306e\u767a\u75c7\u3067\u3001\u54b3\u55fd\u306b\u52a0\u3048\u306624\u6642\u9593\u4ee5\u5185\u306b\u5c11\u306a\u304f\u3066\u30821\u3064\u306e\u4e0b\u6c17\u9053\u75c7\u72b6(\u75f0\u3001\u5598\u9cf4\u3001\u606f\u5207\u308c\u3001\u80f8\u75db)\u3092\u6301\u3061\u3001\u5373\u65e5\u6297\u751f\u7269\u8cea\u306e\u6295\u4e0e\u304c\u5fc5\u8981\u3067\u306a\u304f\u304b\u30645\u5e74\u9593\u5598\u606f\u306e\u6cbb\u7642\u3092\u53d7\u3051\u3066\u3044\u306a\u3044\u6210\u4eba\u60a3\u8005)\u3092\u8a55\u4fa1\u3057\u53c2\u52a0\u8005\u3068\u3057\u305f\u3002\u4ecb\u5165\u306f\u30d7\u30ec\u30c9\u30cb\u30f3\u30be\u30ed\u30f320mg\/\u65e5\u3068\u30d7\u30e9\u30bb\u30dc\u30925\u65e5\u9593\u6295\u4e0e\u3067\u3042\u308a\u3001\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u306f\u30a6\u30a7\u30d6\u53c8\u306f\u7528\u7d19\u3092\u7528\u3044\u30660\uff5e6\u306e\u75c7\u72b6\u309228\u65e5\u9593\u6bce\u65e5\u8a18\u8f09\u3057\u3001\u54b3\u306f\u3055\u3089\u306b28\u65e5\u9593\u8a18\u8f09\u3057\u305f\u3002
\n\u4e3b\u8981\u306a\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u2780\u5f90\u3005\u306b\u5897\u60aa\u3057\u3066\u3044\u305f\u4e2d\u7b49\u5ea6\u54b3\u55fd\u306e\u6301\u7d9a\u6642\u9593\u2461\u6295\u85ac\u5f8c\u306e\u75c7\u72b6\u91cd\u75c7\u5ea6(\u54b3\u55fd\u3001\u75f0\u3001\u606f\u5207\u308c\u3001\u4e0d\u5b89\u3001\u4e0d\u7720\u3001\u6d3b\u52d5\u969c\u5bb3)\u306e2\uff5e4\u65e5\u9593\u3067\u306e\u5e73\u5747\u30b9\u30b3\u30a2(0\uff5e6\u70b9)\u3067\u3042\u3063\u305f\u3002<\/p>\n

Results\uff1a<\/strong>
\n58\u4eba\u306e\u5bb6\u5ead\u533b\u306850\u4eba\u306e\u770b\u8b77\u5e2b\u304c\u8a55\u4fa1\u3057\u3001525\u4eba\u306e\u53c2\u52a0\u8005\u304c\u9078\u3070\u308c\u305f\u3002\u305d\u306e\u4e2d\u3067124\u4eba\u304c\u9664\u5916\u3055\u308c\u3001401\u4eba\u304c\u53c2\u52a0\u3068\u306a\u3063\u305f\u3002\u3053\u306e\u3046\u3061\u54b3\u55fd\u306e\u30c7\u30fc\u30bf\u306f334\u4eba\u3001\u75c7\u72b6\u306e\u91cd\u75c7\u5ea6\u306b\u95a2\u3057\u3066\u306f370\u4eba\u304c\u5229\u7528\u53ef\u80fd\u3067\u3042\u3063\u305f\u3002\u53cc\u65b9\u306e\u60a3\u8005\u306e\u6027\u8cea\u306b\u95a2\u3057\u3066\u306f\u30d7\u30ec\u30c9\u30cb\u30be\u30ed\u30f3\u7fa4\u304c\u308f\u305a\u304b\u306b\u7537\u6027\u304c\u591a\u304f\u5e74\u9f62(\u5e73\u574750\u6b73)\u304c\u9ad8\u304b\u3063\u305f(table1)\u3002
\n\u4e3b\u8981\u306a\u30a2\u30a6\u30c8\u30ab\u30e0\u306b\u3064\u3044\u3066\u3001\u2460\u4e2d\u7b49\u5ea6\u306b\u60aa\u3044\u54b3\u306e\u671f\u9593\u306e\u4e2d\u592e\u5024\u306f\u30d7\u30ec\u30c9\u30cb\u30be\u30ed\u30f3\u3001\u30d7\u30e9\u30bb\u30dc\u3068\u3082\u306b5\u65e5\u9593\u3067\u3042\u308a(table2)\u3001\u54b3\u306e\u6301\u7d9a\u6642\u9593\u306e\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u306e\u4e2d\u592e\u5024\u3092Cox\u30e2\u30c7\u30eb\u306b\u5f53\u3066\u306f\u3081\u3066\u8a08\u7b97\u3059\u308b\u30680.91(95%Cl 0.76\uff5e1.10P=36) \u5bfe1.11(95%Cl 0.89-1.39)\u3067\u3042\u308a(9\uff05\uff1c20\uff05)\u6709\u610f\u5dee\u306f\u8a8d\u3081\u306a\u304b\u3063\u305f\u3002
\n\u24612\uff5e4\u65e5\u76ee\u306e\u75c7\u72b6\u306e\u91cd\u75c7\u5ea6\u306b\u95a2\u3057\u3066\u306f\u30d7\u30ec\u30c9\u30cb\u30be\u30ed\u30f3\u7fa4\u3068\u30d7\u30e9\u30bb\u30dc\u30671.99\u5bfe2.16(95\uff05Cl-0.4\uff5e0.00,P=0.5)\u30680.2\u30dd\u30a4\u30f3\u30c8(9.3%<20%)\u3067\u3042\u308a\u6709\u610f\u5dee\u306f\u8a8d\u3081\u306a\u304b\u3063\u305f(table2)\u3002<\/p>\n

Discussion\uff1a<\/strong>
\n\u3053\u306e\u7814\u7a76\u3067\u306f\u3044\u304f\u3064\u304b\u306e\u9650\u754c\u304c\u3042\u308a\u30011\u3064\u76ee\u306f\u60a3\u8005\u304c\u9078\u629e\u7684\u306b\u96c6\u3081\u3089\u308c\u3066\u3044\u308b\u305f\u3081\u52df\u96c6\u7387\u304c\u4f4e\u304f\u306a\u308a\u4e00\u822c\u5316\u306b\u5f71\u97ff\u304c\u51fa\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3053\u3068\u30022\u3064\u76ee\u306f\u4e2d\u7b49\u5ea6\u306b\u60aa\u3044\u54b3\u306e\u671f\u9593\u304c\u57fa\u6e96\u3092\u6e80\u305f\u3055\u306a\u304b\u3063\u305f\u52df\u96c6\u8005\u304c\u4e88\u60f3\u4ee5\u4e0a\u306b\u591a\u304b\u3063\u305f\u3053\u3068\u3002
\n3\u3064\u76ee\u306f\u4ed6\u306e\u30d0\u30a4\u30aa\u30de\u30fc\u30ab\u30fc(\u30ec\u30f3\u30c8\u30b2\u30f3\u3001\u708e\u75c7\u53cd\u5fdc\u3001\u5fae\u751f\u7269\u5b66\u7684\u691c\u67fb\u3001\u30ec\u30f3\u30c8\u30b2\u30f3)\u304c\u6e2c\u5b9a\u3055\u308c\u3066\u3044\u306a\u304b\u3063\u305f\u306e\u3067
\n\u91cd\u75c7\u5ea6\u306b\u5dee\u304c\u51fa\u3066\u3044\u305f\u53ef\u80fd\u6027\u304c\u3042\u308b\u3053\u3068\u3002\uff14\u3064\u76ee\u306b\u8a66\u9a13\u306e\u9069\u683c\u57fa\u6e96\u306b\u306f\u3001\u6025\u6027\u4e0b\u6c17\u9053\u611f\u67d3\u3067\u306f\u306a\u304f\u6162\u6027\u307e\u305f\u306f\u611f\u67d3\u5f8c\u306e\u54b3\u3092\u4f34\u3046\u60a3\u8005\u304c\u542b\u307e\u308c\u3066\u3044\u305f\u53ef\u80fd\u6027\u304c\u3042\u308b\u3053\u3068\u30025\u3064\u76ee\u306b\u3053\u306e\u7814\u7a76\u3067\u306f\u3001\u60a3\u8005\u5831\u544a\u306e\u7d50\u679c\u3092\u7528\u3044\u305f\u306e\u3067\u5ba2\u89b3\u7684\u3067\u306f\u306a\u3044\u3053\u3068\u30026\u3064\u76ee\u306b\u30b0\u30eb\u30fc\u30d7\u9593\u3067\u670d\u85ac\u30b3\u30f3\u30d7\u30e9\u30a4\u30a2\u30f3\u30b9\u4e0d\u826f\u306b\u3088\u308b\u6709\u5bb3\u4e8b\u8c61\u306e\u52b9\u679c\u306b\u3064\u3044\u3066\u6b20\u5982\u3057\u3066\u3044\u308b\u3053\u3068\u304c\u9650\u754c\u3068\u3057\u3066\u6319\u3052\u3089\u308c\u305f\u3002
\n\u6700\u5f8c\u306b\u3001\u4eca\u5f8c\u306fCRP\u306e\u4e0a\u6607\u3084\u5373\u6642\u306b\u6297\u83cc\u85ac\u304c\u5fc5\u8981\u306a\u7a0b\u5ea6\u306e\u91cd\u75c7\u5ea6\u306e\u9ad8\u3044\u5834\u9762\u3067\u306e\u30b9\u30c6\u30ed\u30a4\u30c9\u306e\u6709\u52b9\u6027\u306b\u3064\u3044\u3066\u3082\u7814\u7a76\u304c\u5fc5\u8981\u3067\u3042\u308b\u3002<\/p>\n

\u3010\u958b\u50ac\u65e5\u3011
\n2017\u5e7411\u67081\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\u30fc\u6587\u732e\u540d\u30fc Effect of Oral Prednisolone on Symptom Duration and Severity in Nonasthmatic Adults With Acute Lower Res … \u7d9a\u304d\u3092\u8aad\u3080 \u6210\u4eba\u306e\u975e\u5598\u606f\u6027\u6025\u6027\u4e0b\u6c17\u9053\u611f\u67d3\u306b\u5bfe\u3059\u308b\u7d4c\u53e3\u30b9\u30c6\u30ed\u30a4\u30c9\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":[17],"tags":[],"class_list":["post-1432","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\/1432","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=1432"}],"version-history":[{"count":1,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1432\/revisions"}],"predecessor-version":[{"id":1433,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1432\/revisions\/1433"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1432"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1432"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1432"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}