{"id":2252,"date":"2023-03-23T10:52:42","date_gmt":"2023-03-23T01:52:42","guid":{"rendered":"https:\/\/www.hcfm.jp\/journal\/?p=2252"},"modified":"2023-03-23T15:19:24","modified_gmt":"2023-03-23T06:19:24","slug":"%e7%b5%82%e6%9c%ab%e6%9c%9f%e3%81%ae%e6%82%a3%e8%80%85%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e6%ad%bb%e3%81%ae%e5%96%98%e9%b3%b4%e3%81%ab%e5%af%be%e3%81%99%e3%82%8b%e4%ba%88%e9%98%b2%e7%9a%84%e7%9a%ae","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=2252","title":{"rendered":"\u7d42\u672b\u671f\u306e\u60a3\u8005\u306b\u304a\u3051\u308b\u6b7b\u306e\u5598\u9cf4\u306b\u5bfe\u3059\u308b\u4e88\u9632\u7684\u76ae\u4e0b\u81ed\u5316\u30d6\u30c1\u30eb\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u306e\u52b9\u679c"},"content":{"rendered":"

\u2015\u6587\u732e\u540d\u2015
\nvan Esch HJ, van Zuylen L, Geijteman ECT, et al. Effect of Prophylactic Subcutaneous Scopolamine Butylbromide on Death Rattle in Patients at the End of Life: The SILENCE Randomized Clinical Trial. JAMA. 2021;326(13):1268-1276. doi:10.1001\/jama.2021.14785<\/p>\n

\u2015\u8981\u7d04\u2015
\nIntroduction\uff1a
\n\u6b7b\u524d\u5598\u9cf4\u306f\u4e0a\u6c17\u9053\u306b\u305f\u307e\u3063\u305f\u5206\u6ccc\u7269\u306b\u3088\u308a\u8d77\u3053\u308b\u3046\u308b\u3055\u3044\u547c\u5438\u3068\u3057\u3066\u5b9a\u7fa9\u3055\u308c\u3001\u6bd4\u8f03\u7684\u6b7b\u6226\u671f\u306e\u60a3\u8005\u3067\u3088\u304f\u307f\u3089\u308c\u308b\u30022014\u5e74\u306e\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u3067\u306f\u6b7b\u524d\u5598\u9cf4\u306e\u6709\u75c5\u7387\u306f12~92%\u3068\u3055\u308c\u308b\u3002\u6b7b\u524d\u5598\u9cf4\u306e\u7ba1\u7406\u306f\u3001\u4e00\u822c\u7684\u306b\u60a3\u8005\u306e\u8ca0\u62c5\u3092\u8efd\u6e1b\u3059\u308b\u305f\u3081\u306b\u60a3\u8005\u306e\u4f53\u4f4d\u3092\u5909\u3048\u305f\u308a\u3001\u89aa\u65cf\u3084\u4ed6\u306e\u89b3\u5bdf\u8005\u306b\u60c5\u5831\u63d0\u4f9b\u3092\u3057\u3066\u5b89\u5fc3\u3055\u305b\u308b\u3053\u3068\u3067\u3042\u308b\u3002\u3057\u304b\u3057\u3001\u60c5\u5831\u63d0\u4f9b\u3059\u308b\u3060\u3051\u3067\u306f\u3001\u89aa\u65cf\u3084\u89b3\u5bdf\u8005\u306e\u4f53\u9a13\u3092\u6539\u5584\u3059\u308b\u306b\u306f\u5341\u5206\u3067\u306a\u3044\u5834\u5408\u3082\u3042\u308b\u3002\u3044\u304f\u3064\u304b\u306e\u81e8\u5e8a\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u306f\u975e\u85ac\u7269\u7642\u6cd5\u304c\u594f\u529f\u3057\u306a\u304b\u3063\u305f\u5834\u5408\u306b\u6b7b\u524d\u5598\u9cf4\u3092\u6291\u3048\u308b\u305f\u3081\u306b\u6297\u30b3\u30ea\u30f3\u85ac\u3092\u63a8\u5968\u3057\u3066\u3044\u308b\u304c\u3001\u305d\u306e\u6709\u52b9\u6027\u306b\u95a2\u3059\u308b\u30a8\u30d3\u30c7\u30f3\u30b9\u306f\u4e0d\u8db3\u3057\u3066\u3044\u308b\u3002\u6297\u30b3\u30ea\u30f3\u85ac\u304c\u7c98\u6db2\u3092\u6e1b\u5c11\u3055\u305b\u308b\u52b9\u679c\u304c\u3042\u308b\u3053\u3068\u3092\u8003\u3048\u308b\u3068\u3001\u4e88\u9632\u7684\u306b\u6295\u4e0e\u3059\u308b\u3053\u3068\u304c\u3088\u308a\u9069\u5207\u3067\u3042\u308b\u304b\u3069\u3046\u304b\u4e0d\u660e\u3067\u3042\u308b\u30022018\u5e74\u306b\u6b7b\u6226\u671f\u306e\u60a3\u8005\u306b\u81ed\u5316\u30d6\u30c1\u30eb\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u3092\u4e88\u9632\u7684\u306b\u6295\u4e0e\u3059\u308b\u3053\u3068\u3068\u3001\u6b7b\u524d\u5598\u9cf4\u304c\u8d77\u304d\u305f\u6642\u306b\u81ed\u5316\u30d6\u30c1\u30eb\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u3092\u6295\u4e0e\u3059\u308b\u3053\u3068\u3092\u6bd4\u8f03\u3057\u305fRCT\u3067\u306f\u81ed\u5316\u30d6\u30c1\u30eb\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u3092\u4e88\u9632\u7684\u306b\u6295\u4e0e\u3055\u308c\u305f\u60a3\u8005\u306f\u826f\u3044\u7d50\u679c\u3092\u793a\u3057\u305f\u3002\u305d\u3053\u3067\u81ed\u5316\u30d6\u30c1\u30eb\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u306e\u4e88\u9632\u6295\u4e0e\u304c\u6b7b\u524d\u5598\u9cf4\u3092\u6e1b\u5c11\u3055\u305b\u308b\u304b\u3069\u3046\u304b\u3092\u3055\u3089\u306b\u691c\u8a0e\u3059\u308b\u305f\u3081\u306bSILENCE\u8a66\u9a13\u304c\u5b9f\u65bd\u3055\u308c\u305f\u3002<\/p>\n

Objective\uff1a\u81ed\u5316\u30d6\u30c1\u30eb\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u3092\u4e88\u9632\u7684\u306b\u6295\u4e0e\u3059\u308b\u3053\u3068\u3067\u6b7b\u524d\u5598\u9cf4\u3092\u6e1b\u3089\u3059\u304b\u3069\u3046\u304b\u3092\u691c\u8a0e\u3059\u308b
\nDesign,Setting,and Participants\uff1a
\n\u30aa\u30e9\u30f3\u30c0\u306e\uff16\u3064\u306e\u30db\u30b9\u30d4\u30b9\u306b\u304a\u3044\u3066\u591a\u65bd\u8a2d\u30e9\u30f3\u30c0\u30e0\u5316\u4e8c\u91cd\u76f2\u691c\u30d7\u30e9\u30bb\u30dc\u5bfe\u7167\u8a66\u9a13\u3092\u5b9f\u65bd\u3057\u305f\u3002\u30db\u30b9\u30d4\u30b9\u306b\u5165\u9662\u5f8c\u3001\u4e88\u5f8c\u304c\uff13\u65e5\u4ee5\u4e0a\u306e\u60a3\u8005\u306b\u5bfe\u3057\u3066\u30012017\u5e744\u670810\u65e5\u304b\u30892019\u5e7412\u670831\u65e5\u307e\u3067\u306b\u4e8b\u524d\u306b\u30a4\u30f3\u30d5\u30a9\u30fc\u30e0\u30c9\u30b3\u30f3\u30bb\u30f3\u30c8\u3092\u6c42\u3081\u305f\u3002\u60a3\u8005\u306f\u30db\u30b9\u30d4\u30b9\u3078\u306e\u5165\u9662\u304c\u6b7b\u4ea1\u3059\u308b\u307e\u3067\u7d9a\u304f\u3053\u3068\u3092\u8a8d\u8b58\u3057\u3066\u304a\u308a\u3001\u7814\u7a76\u306b\u95a2\u3059\u308b\u60c5\u5831\u3092\u7406\u89e3\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u308b\u60a3\u8005\u3067\u3001\u6c17\u7ba1\u5207\u958b\u3084\u6c17\u7ba1\u30ab\u30cb\u30e5\u30fc\u30ec\u3092\u88c5\u7740\u3057\u3066\u3044\u305f\u5834\u5408\u3001\u6297\u30b3\u30ea\u30f3\u85ac\u306e\u5168\u8eab\u6295\u4e0e\u3001\u30aa\u30af\u30ec\u30aa\u30c1\u30c9\u3092\u4f7f\u7528\u3057\u3066\u3044\u305f\u5834\u5408\u3001\u6d3b\u52d5\u6027\u306e\u547c\u5438\u5668\u611f\u67d3\u75c7\u306b\u7f79\u60a3\u3057\u3066\u3044\u305f\u5834\u5408\u306f\u9664\u5916\u3057\u305f\u3002
\n\u6b7b\u6226\u671f\u3068\u8a8d\u8b58\u3055\u308c\u305f\u6642\u70b9\u3067\u3001\u9069\u683c\u57fa\u6e96\u3092\u6e80\u305f\u3057\u305f\u60a3\u8005\u3092\u7121\u4f5c\u70ba\u5316\u3057\u305f\u3002229\u4eba\u306e\u30a4\u30f3\u30d5\u30a9\u30fc\u30e0\u30c9\u30b3\u30f3\u30bb\u30f3\u30c8\u3092\u5f97\u305f\u60a3\u8005\u306e\u3046\u3061\u3001\u6700\u7d42\u7684\u306b162\u4eba\u304c\u7121\u4f5c\u70ba\u5316\u3057\u305f\u3002<\/p>\n

Interventions\uff1a\u81ed\u5316\u30d6\u30c1\u30eb\u30b9\u30b3\u30dd\u30e9\u30df\u30f320mg\uff11\u65e54\u56de\u3092\u76ae\u4e0b\u6ce8\u5c04(N=79) \u3082\u3057\u304f\u306f \u30d7\u30e9\u30bb\u30dc(n=78)\u3067\u5b9f\u65bd\u3002
\n \u7015\u6b7b\u306e\u6bb5\u968e\u306f\u60a3\u8005\u304c\u5bdd\u305f\u304d\u308a\u3067\u3042\u308b\u3053\u3068\u3001\u6c34\u5206\u3092\u4e00\u53e3\u3057\u304b\u98df\u3079\u3089\u308c\u306a\u3044\u3053\u3068\u3001\u98f2\u307f\u8fbc\u3080\u3053\u3068\u3084\u7d4c\u53e3\u85ac\u3092\u98f2\u3080\u3053\u3068\u304c\u3067\u304d\u306a\u3044\u3053\u3068\u3001\u534a\u660f\u7761\u72b6\u614b\u3067\u3042\u308b\u3053\u3068\u306a\u3069\u3044\u304f\u3064\u304b\u306e\u5146\u5019\u3092\u8003\u616e\u3057\u3066\u3001\u591a\u8077\u7a2e\u30c1\u30fc\u30e0\u306e\u81e8\u5e8a\u5224\u65ad\u306b\u3088\u308a\u6b7b\u304c\u5dee\u3057\u8feb\u3063\u305f\u3068\u304d\u306b\u6b7b\u6226\u671f\u306e\u6bb5\u968e\u304c\u59cb\u307e\u308b\u3002\u6cbb\u7642\u306f\u6b7b\u306c\u307e\u3067\u304b\u30014\u6642\u9593\u9593\u9694\u30672\u56de\u9023\u7d9a\u3057\u3066grade2\u304b\u305d\u308c\u4ee5\u4e0a\u306e\u6b7b\u524d\u5598\u9cf4\u304c\u751f\u3058\u308b\u307e\u3067\u7d9a\u3051\u305f\u3002
\nMain outcomes and measures
\nPrimary outcomes\u306f\uff14\u6642\u9593\u306e\u9593\u9694\u3067\uff12\u56de\u6e2c\u5b9a\u3055\u308c\u305f\u3001Back\u3089\u306e\u8ad6\u6587\u3067\u5b9a\u7fa9\u3055\u308c\u305f\u30b0\u30ec\u30fc\u30c9\uff12\u4ee5\u4e0a\u306e\u6b7b\u524d\u5598\u9cf4\u3068\u3057\u305f(\u7bc4\u56f20-3\u3001Back\u3089\u306e4\u6bb5\u968e\u8a55\u4fa1[0\uff1d\u97f3\u304c\u805e\u3053\u3048\u306a\u3044 1=\u60a3\u8005\u306b\u8fd1\u3065\u304f\u3068\u805e\u3053\u3048\u308b 2\u9759\u304b\u306a\u90e8\u5c4b\u3067\u30d9\u30c3\u30c9\u30b5\u30a4\u30c9\u306b\u7acb\u3064\u72b6\u614b\u3067\u805e\u3053\u3048\u308b\u30004\u9759\u304b\u306a\u90e8\u5c4b\u3067\u60a3\u8005\u304b\u308920\u30d5\u30a3\u30fc\u30c8(\u7d046m)\u306e\u8ddd\u96e2\u3067\u805e\u3053\u3048\u308b])\u3002Secondary outcomes\u306f\u6b7b\u6226\u671f\u3060\u3068\u8a8d\u8b58\u3057\u3066\u304b\u3089\u6b7b\u524d\u5598\u9cf4\u304c\u767a\u751f\u3059\u308b\u307e\u3067\u306e\u6642\u9593\u3068\u6297\u30b3\u30ea\u30f3\u85ac\u306b\u3088\u308b\u6709\u5bb3\u4e8b\u8c61(e.g\u843d\u3061\u7740\u304b\u306a\u3055\u3001\u53e3\u6e07\u3001\u5c3f\u9589\u306a\u3069)\u306e\u767a\u751f\u72b6\u6cc1\u3067\u3042\u3063\u305f\u3002
\nResults
\n\u30e9\u30f3\u30c0\u30e0\u5316\u3055\u308c\u305f162\u4eba\u306e\u60a3\u8005\u306e\u3046\u3061157\u540d\uff0897%\u3001\u5e74\u9f62\u4e2d\u592e\u502476\u6b73[IQR,66-84\u6b73];\u5973\u602756%,\u764c\u60a3\u800586%\uff09\u304c\u4e3b\u8981\u5206\u6790\u306b\u542b\u307e\u308c\u305f(base line=table1)\u3002
\nPrimary outcomes
\n\u6b7b\u524d\u5598\u9cf4\u306f\u81ed\u5316\u30d6\u30c1\u30eb\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u7fa4\u3067\u306f10\u4eba\uff0813%\uff09\u767a\u751f\u3057\u305f\u306e\u306b\u5bfe\u3057\u3066\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u306f21\u4eba\uff0827%\uff09\u306b\u767a\u751f\u3057\u305f(Table2\u5dee14%,95%CI,2%~27%,P=0.02)\u3002\u6700\u7d42\u7684\u306b\u6b7b\u4ea1\u3057\u306a\u304b\u3063\u305f5\u540d\u306e\u60a3\u8005\u3092\u6cbb\u7642\u5931\u6557\u8005\u3068\u3057\u3066\u542b\u3080post hoc \u611f\u5ea6\u5206\u6790\u3067\u306f\u3001\u81ed\u5316\u30d6\u30c1\u30eb\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u7fa4\u3067\u6b7b\u524d\u5598\u9cf4\u3092\u767a\u75c7\u3057\u305f\u60a3\u8005\u306e\u5272\u5408\u306f\u30d7\u30e9\u30bb\u30dc\u7fa4\u306b\u6bd4\u3079\u3066\u512a\u4f4d\u306b\u4f4e\u304b\u3063\u305f\u3002
\nSecondary outcomes
\nsecondary outcomes\u306b\u3064\u3044\u3066\u306f\u6b7b\u524d\u5598\u9cf4\u304c\u51fa\u308b\u307e\u3067\u306e\u6642\u9593\u3092\u5206\u6790\u3057\u305f\u7d50\u679c(Figure2)\u3001\u90e8\u5206\u5206\u5e03\u30cf\u30b6\u30fc\u30c9\u6bd4\uff08HR\uff09\u306f0.44\uff0895\uff05CI\uff0c0.20-0.92\uff0cP\uff1d0.03\uff0c48\u6642\u9593\u5f8c\u306e\u7d2f\u7a4d\u767a\u751f\u7387\uff1a\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u7fa48\uff05\uff0c\u30d7\u30e9\u30bb\u30dc\u7fa417\uff05\uff09\u30021\u70b9\u306e\u6b7b\u524d\u5598\u9cf4\u3067\u305d\u306e\u5f8c\u6539\u5584\u3057\u306a\u304b\u3063\u305f\u5834\u5408\u3067\u89e3\u6790\u3057\u305f\u611f\u5ea6\u5206\u6790\u3067\u306f\u90e8\u5206\u5206\u5e03\u30cf\u30b6\u30fc\u30c9\u6bd40.41(95%CI,0.22-0.78 P=0.006)
\n\u81ed\u5316\u30d6\u30c1\u30eb\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u7fa4\u5bfe\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u306f\u3001\u305d\u308c\u305e\u308c\u843d\u3061\u7740\u304d\u306e\u306a\u3055\u304c22\/79\u4eba(28%)\u5bfe18\/78\u4eba\uff0823%\uff09\u3001\u53e3\u6e07\u304c8\/79(10%)\u5bfe12\/78(15%),\u5c3f\u95896\/25(23%)\u5bfe3\/18(17%)\u8a8d\u3081\u3089\u308c\u305f\u3002\u3044\u305a\u308c\u3082\u6709\u610f\u5dee\u306a\u3057\u3002(table 2)
\nExploratory outcomes \u6b7b\u6226\u671f\u306f\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u7fa4(median 42.8hours IQR20.9-80.1 hours;95%CI 32.8-55.2)\u306f\u30d7\u30e9\u30bb\u30dc\u7fa4(median,29.5hours;IQR,21.1-41.7hours;95%CI 21.1-41.7 P=0.04)\u306b\u6bd4\u3079HR0.71\u3067\u512a\u4f4d\u306b\u9577\u304b\u3063\u305f(95%CI,0.52-0.98;P=0.04)\u3002<\/p>\n

Discussion\uff1a
\n\u3053\u306e\u591a\u65bd\u8a2d\u5171\u540cRCT\u306f\u4e88\u9632\u7684\u306a\u81ed\u5316\u30d6\u30c1\u30eb\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u306e\u76ae\u4e0b\u6295\u4e0e\u304c\u512a\u4f4d\u306b\u6b7b\u524d\u5598\u9cf4\u306e\u767a\u751f\u7387\u3092\u6e1b\u5c11\u3055\u305b\u308b\u3053\u3068\u304c\u308f\u304b\u3063\u305f\u3002\u6709\u5bb3\u4e8b\u8c61\u306f\uff12\u30b0\u30eb\u30fc\u30d7\u9593\u3067\u5b9f\u8cea\u7684\u306b\u5dee\u304c\u306a\u304b\u3063\u305f\u3002
\n\u4eca\u56de\u306e\u7814\u7a76\u3067\u306f\u6297\u30b3\u30ea\u30f3\u85ac\u3092\u6b7b\u6226\u671f\u306b\u5229\u7528\u3059\u308b\u3053\u3068\u3067\u751f\u3058\u308b\u6709\u5bb3\u4e8b\u8c61\u306e\u5272\u5408\u304c\u5897\u3048\u308b\u3068\u3044\u3046\u660e\u78ba\u306a\u30a8\u30d3\u30c7\u30f3\u30b9\u306f\u660e\u3089\u304b\u306b\u306a\u3089\u306a\u304b\u3063\u305f\u3002\u81ed\u5316\u30d6\u30c1\u30eb\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u7fa4\u3068\u30d7\u30e9\u30bb\u30dc\u7fa4\u306b\u9593\u306b\u3001\u75db\u307f\u3001\u547c\u5438\u82e6\u3001\u5614\u6c17\u3001\u5614\u5410\u306e\u75c7\u72b6\u306b\u304a\u3044\u3066\u6709\u610f\u5dee\u306f\u306a\u304b\u3063\u305f\u3002\u4e00\u3064\u306e\u4f8b\u5916\u3068\u3057\u3066\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u3092\u4f7f\u7528\u3057\u305f\u30d7\u30e9\u30bb\u30dc\u5bfe\u7167\u8a66\u9a13\u304c\u3042\u308a\u3001\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u306f\u6709\u610f\u306b\u75db\u307f\u3092\u5897\u3084\u3059\u3068\u3044\u3046\u7d50\u679c\u304c\u3042\u308b\u3002\u305d\u306e\u7814\u7a76\u3067\u306f\u3001\u610f\u8b58\u306e\u306a\u3044\u60a3\u8005\u3067\u306f\u75bc\u75db\u306e\u8a55\u4fa1\u304c\u96e3\u3057\u304f\u3001\u305d\u306e\u7814\u7a76\u306e\u8457\u8005\u3089\u306f\u843d\u3061\u7740\u304d\u306e\u306a\u3055\u3084\u7126\u71e5\u611f\u3092\u75bc\u75db\u306e\u5146\u5019\u3068\u89e3\u91c8\u3057\u305f\u306e\u304b\u3082\u3057\u308c\u306a\u3044\u3002\u4e00\u65b9\u3067\u672c\u7814\u7a76\u3067\u306f\u6cbb\u7642\u7fa4\u9593\u3067\u75db\u307f\u3084\u843d\u3061\u7740\u304d\u306e\u306a\u3055\u306b\u5927\u304d\u306a\u9055\u3044\u306f\u898b\u3089\u308c\u306a\u304b\u3063\u305f\u3002
\n \u3053\u306e\u7814\u7a76\u3067\u306f\u30d7\u30e9\u30bb\u30dc\u7fa4\u306b\u80ba\u764c\u60a3\u8005\u3001\u4f75\u5b58\u75c7\u3068\u3057\u3066COPD\u306e\u60a3\u8005\u304c\u591a\u304f\u542b\u307e\u308c\u3001\u55ab\u7159\u6b74\u3082\u9577\u304b\u3063\u305f\u3002\u3053\u306e\u60a3\u8005\u7fa4\u306e\u504f\u308a\u304c\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u306e\u6b7b\u524d\u5598\u9cf4\u306e\u767a\u751f\u7387\u3092\u9ad8\u3081\u308b\u8981\u56e0\u3068\u306a\u3063\u305f\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002\u3057\u304b\u3057\u3001\u4e8b\u5f8c\u89e3\u6790\u306e\u7d50\u679c\u3067\u306f\u3001\u3053\u308c\u3089\u306e\u75c7\u72b6\u3092\u6301\u3064\u30d7\u30e9\u30bb\u30dc\u6cbb\u7642\u3092\u53d7\u3051\u305f\u60a3\u8005\u306e\u30b5\u30d6\u30b0\u30eb\u30fc\u30d7\u306b\u304a\u3051\u308b\u6b7b\u524d\u5598\u9cf4\u306e\u767a\u751f\u7387\u306f\u30d7\u30e9\u30bb\u30dc\u30b0\u30eb\u30fc\u30d7\u5168\u4f53\u306e\u767a\u751f\u7387\u3088\u308a\u4f4e\u3044\u3053\u3068\u304c\u308f\u304b\u3063\u305f\u3002
\n\u3000\u3053\u306e\u7814\u7a76\u3067\u306f\u4e88\u9632\u7684\u306b\u81ed\u5316\u30d6\u30c1\u30eb\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u306e\u6295\u4e0e\u3092\u53d7\u3051\u305f\u60a3\u8005\u306e\u65b9\u304c\u3001\u30d7\u30e9\u30bb\u30dc\u3092\u6295\u4e0e\u3055\u308c\u305f\u60a3\u8005\u3088\u308a\u6b7b\u671f\u304c\u9577\u304b\u3063\u305f\u3053\u3068\u304c\u308f\u304b\u308a\u307e\u3057\u305f\u3002\u3053\u308c\u306f\u63a2\u7d22\u7684\u306a\u7d50\u679c\u3067\u306f\u3042\u308b\u304c\u3001\u3053\u306e\u77e5\u898b\u306f\u904e\u53bb\u306b\u5831\u544a\u3055\u308c\u305f\u30e9\u30f3\u30c0\u30e0\u5316\u8a66\u9a13\u306b\u304a\u3044\u3066\u3001\u6b7b\u6226\u671f\u306e\u5e73\u5747\u6642\u9593\u304c\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u306e\u4e88\u9632\u6295\u4e0e\u3092\u53d7\u3051\u305f\u60a3\u8005\u306745.2\u6642\u9593\u3067\u3042\u3063\u305f\u306e\u306b\u5bfe\u3057\u3066\u3001\u7d42\u672b\u671f\u306b\u306a\u3063\u3066\u304b\u3089\u6cbb\u7642\u3092\u53d7\u3051\u305f\u60a3\u8005\u3067\u306f41.1\u6642\u9593\u3067\u3042\u3063\u305f\u3068\u3044\u3046\u7d50\u679c\u3068\u4e00\u81f4\u3059\u308b\u3002<\/p>\n

Limitation
\n\u3000\u2460\u6700\u7d42\u7684\u306a\u5206\u6790\u5bfe\u8c61\u8005\u304c\u3001\u8abf\u67fb\u671f\u9593\u4e2d\u306b\u30db\u30b9\u30d4\u30b9\u306b\u5165\u9662\u3057\u305f\u5168\u60a3\u8005\u306e10\uff05\u3067\u3042\u3063\u305f\u3053\u3068\u3002\u3053\u306e\u53c2\u52a0\u7387\u306e\u4f4e\u3055\u306f\u30db\u30b9\u30d4\u30b9\u306b\u5165\u9662\u3057\u305f\u60a3\u8005\u306e\u534a\u6570\u8fd1\u304f\u304c\u60c5\u5831\u3092\u7406\u89e3\u3067\u304d\u306a\u3044\u3053\u3068\u3084\u6b7b\u304c\u9593\u8fd1\u306b\u8feb\u3063\u3066\u3044\u305f\u3081\u57fa\u6e96\u306b\u8a72\u5f53\u3057\u306a\u304b\u3063\u305f\u3053\u3068\u3001\u610f\u601d\u6c7a\u5b9a\u524d\u306b\u75c7\u72b6\u304c\u60aa\u5316\u3057\u305f\u3053\u3068\u304c\u6319\u3052\u3089\u308c\u308b\u3002
\n\u3000\u2461\u3053\u308c\u3089\u306e\u7d50\u679c\u306f\u5fc5\u305a\u3057\u3082\u547c\u5438\u5668\u611f\u67d3\u75c7\u306e\u60a3\u8005\u306b\u306f\u5f53\u3066\u306f\u307e\u3089\u306a\u3044\u304b\u3082\u3057\u308c\u306a\u3044\u304c\u3001\u4eca\u56de\u306f\u9664\u5916\u57fa\u6e96\u3060\u3063\u305f\u3002
\n\u3000\u2462\u533b\u7642\u5f93\u4e8b\u8005\u304c\u6b7b\u671f\u3092\u8fce\u3048\u305f\u3068\u8a8d\u8b58\u3057\u305f\u6642\u70b9\u3067\u3059\u3067\u306b\u6b7b\u524d\u5598\u9cf4\u3092\u767a\u75c7\u3057\u305f\u3044\u305f\u60a3\u8005\u3082\u3057\u305f\u3002\u672c\u7814\u7a76\u3067\u306f\u533b\u7642\u5f93\u4e8b\u8005\u304c\u6c7a\u5b9a\u6a29\u3092\u6301\u3064\u300c\u81e8\u7d42\u671f\u306e\u30b1\u30a2\u306b\u95a2\u3059\u308b\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u300d\u306b\u57fa\u3065\u3044\u3066\u7d42\u672b\u671f\u3092\u8a8d\u8b58\u3057\u305f\u3002\u3057\u304b\u3057\u3001\u73fe\u5728\u306e\u3068\u3053\u308d\u3001\u6b7b\u6226\u671f\u306e\u59cb\u307e\u308a\u3092\u8a55\u4fa1\u3059\u308b\u305f\u3081\u306e\u6709\u52b9\u306a\u30c4\u30fc\u30eb\u304c\u5b58\u5728\u3057\u306a\u3044\u305f\u3081\u5168\u3066\u306e\u6b7b\u671f\u304c\u8fd1\u3044\u60a3\u8005\u306b\u6b7b\u524d\u5598\u9cf4\u3092\u304a\u3053\u3089\u306a\u3044\u3088\u3046\u306b\u3059\u308b\u3053\u3068\u306f\u3067\u304d\u306a\u3044\u3002
\n\u3000\u2463\u85ac\u7269\u306e\u76ae\u4e0b\u6295\u4e0e\u306f\u5168\u3066\u306e\u30bb\u30c3\u30c6\u30a3\u30f3\u30b0\u306b\u304a\u3044\u3066\u5fc5\u305a\u3057\u3082\u671b\u307e\u3057\u3044\u307e\u305f\u306f\u53ef\u80fd\u3068\u306f\u9650\u3089\u306a\u3044\u3002
\n\u3000\u2464114\/157\u4eba\u306e\u60a3\u8005(\u7d0473%)\u304c\u4e00\u3064\u306e\u30db\u30b9\u30d4\u30b9\u304b\u3089\u53c2\u52a0\u3057\u305f\u3002\u30d9\u30c3\u30c9\u6570\u304c\u3082\u3063\u3068\u3082\u591a\u3044\u30db\u30b9\u30d4\u30b9\u3067\u3001\u7814\u7a76\u671f\u9593\u4e2d\u305a\u3063\u3068\u53c2\u52a0\u3092\u3057\u3066\u3044\u305f\u305f\u3081\u3001\u4e88\u60f3\u5916\u306a\u3053\u3068\u3067\u306f\u306a\u304b\u3063\u305f\u3002
\nConclusions
\n \u6b7b\u6226\u671f\u306b\u8fd1\u3044\u60a3\u8005\u306b\u304a\u3044\u3066\u4e88\u9632\u7684\u306a\u81ed\u5316\u30d6\u30c1\u30eb\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\u306e\u76ae\u4e0b\u6295\u4e0e\u306f\u30d7\u30e9\u30bb\u30dc\u3068\u6bd4\u8f03\u3057\u3066\u3001\u6709\u610f\u306b\u6b7b\u524d\u5598\u9cf4\u306e\u767a\u751f\u3092\u6e1b\u5c11\u3055\u305b\u305f\u3002<\/p>\n

\"\"<\/a><\/p>\n

\"\"<\/a><\/p>\n

\"\"<\/a><\/p>\n

\"\"<\/a><\/p>\n

\u3010\u958b\u50ac\u65e5\u3011
\n2021\u5e7411\u670810\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\u2015\u6587\u732e\u540d\u2015 van Esch HJ, van Zuylen L, Geijteman ECT, et al. Effect of Prophylactic Subcutaneous Scopolamine Butylbr … \u7d9a\u304d\u3092\u8aad\u3080 \u7d42\u672b\u671f\u306e\u60a3\u8005\u306b\u304a\u3051\u308b\u6b7b\u306e\u5598\u9cf4\u306b\u5bfe\u3059\u308b\u4e88\u9632\u7684\u76ae\u4e0b\u81ed\u5316\u30d6\u30c1\u30eb\u30b9\u30b3\u30dd\u30e9\u30df\u30f3\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":[12],"tags":[],"class_list":["post-2252","post","type-post","status-publish","format-standard","hentry","category-12"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2252","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=2252"}],"version-history":[{"count":4,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2252\/revisions"}],"predecessor-version":[{"id":2286,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2252\/revisions\/2286"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2252"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2252"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2252"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}